Sample records for adverse resource impacts

  1. Stress and resource pathways connecting early socioeconomic adversity to young adults' physical health risk.

    PubMed

    Wickrama, Kandauda K A S; Lee, Tae Kyoung; O'Neal, Catherine Walker; Kwon, Josephine A

    2015-05-01

    Although research has established the impact of early stress, including stressful life contexts, and early resources, such as educational attainment, on various adolescent health outcomes, previous research has not adequately investigated "integrative models" incorporating both stress and resource mediational pathways to explain how early socioeconomic adversity impacts physical health outcomes, particularly in early life stages. Data on early childhood/adolescent stress and socioeconomic resources as well as biomarkers indicating physical health status in young adulthood were collected from 11,798 respondents (54 % female) over a 13-year period from youth participating in the National Study of Adolescent Health (Add Health). Physical health risk in young adulthood was measured using a composite index of nine regulatory biomarkers of cardiovascular and metabolic systems. Heterogeneity in stress and socioeconomic resource pathways was assessed using latent class analysis to identify clusters, or classes, of stress and socioeconomic resource trajectories. The influence of early socioeconomic adversity on young adults' physical health risk, as measured by biomarkers, was estimated, and the role of stress and socioeconomic resource trajectory classes as linking mechanisms was assessed. There was evidence for the influence of early socioeconomic adversity on young adults' physical health risk directly and indirectly through stress and socioeconomic resource trajectory classes over the early life course. These findings suggest that health models should be broadened to incorporate both stress and resource experiences simultaneously. Furthermore, these findings have prevention and intervention implications, including the importance of early socioeconomic adversity and key intervention points for "turning" the trajectories of at-risk youth.

  2. Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use.

    PubMed

    Al-Hashar, Amna; Al-Zakwani, Ibrahim; Eriksson, Tommy; Sarakbi, Alaa; Al-Zadjali, Badriya; Al Mubaihsi, Saif; Al Zaabi, Mohammed

    2018-05-12

    Background Adverse drug events from preventable medication errors can result in patient morbidity and mortality, and in cost to the healthcare system. Medication reconciliation can improve communication and reduce medication errors at transitions in care. Objective Evaluate the impact of medication reconciliation and counselling intervention delivered by a pharmacist for medical patients on clinical outcomes 30 days after discharge. Setting Sultan Qaboos University Hospital, Muscat, Oman. Methods A randomized controlled study comparing standard care with an intervention delivered by a pharmacist and comprising medication reconciliation on admission and discharge, a medication review, a bedside medication counselling, and a take-home medication list. Medication discrepancies during hospitalization were identified and reconciled. Clinical outcomes were evaluated by reviewing electronic health records and telephone interviews. Main outcome measures Rates of preventable adverse drug events as primary outcome and healthcare resource utilization as secondary outcome at 30 days post discharge. Results A total of 587 patients were recruited (56 ± 17 years, 57% female); 286 randomized to intervention; 301 in the standard care group. In intervention arm, 74 (26%) patients had at least one discrepancy on admission and 100 (35%) on discharge. Rates of preventable adverse drug events were significantly lower in intervention arm compared to standard care arm (9.1 vs. 16%, p = 0.009). No significant difference was found in healthcare resource use. Conclusion The implementation of an intervention comprising medication reconciliation and counselling by a pharmacist has significantly reduced the rate of preventable ADEs 30 days post discharge, compared to the standard care. The effect of the intervention on healthcare resource use was insignificant. Pharmacists should be included in decentralized, patient-centred roles. The findings should be interpreted in the context

  3. Prevention of adverse climate change impacts on water resources

    NASA Astrophysics Data System (ADS)

    Fosumpaur, P.

    2003-04-01

    The water resources design is generally based on the assumption of the stationary hydrological process and the reservoir storage is obviously evaluated in simulated flow series derived by the synthetic hydrology methods. Recently, results of numerous studies and major flood events have clearly proved that the variation of meteorological and hydrological parameters are beyond the bounds of the stationary process. These changes are related to the global climate change, which has been emphasised by the IPCC (International Panel of Climate Change) since the beginning of the 80s. Regional scenarios of the climate change are downscaled from the GCM and they are characterised by considerable variance. This uncertainty enters hydrological models of a catchment runoff which quantify impacts of the global climate change on the river flow regime. A number of studies have dealt with impacts of hydrological regime changes on water resources planning. They have shown that the variability of the reservoir storage-yield curve is seriously high. This study is aimed at the design of preventive actions based on the adaptation principle which is known from cybernetics. These prevention measures should be designed with respect to the proper identification of risks. Thus, the risk analysis should be considered. The main goals of the study are as follows: 1) Proposition of the strategic preventive actions which will be aimed to reassess particular reservoir functions with respect to actual and predicted conditions of the environment. This topic includes a potential reassessment of the capacity of particular reservoir storages. 2) Design of the system of real-time adaptive actions in the real reservoir operation to optimize the measure of the risk related to the extreme hydrological events as floods and hydrological droughts. This research has been supported by the grants No. 103/02/D049, No. 103/01/0201 and No. 103/02/0606 of the Grant Agency of the Czech Republic.

  4. Reducing Adverse Impact: One City's Efforts.

    ERIC Educational Resources Information Center

    Prewitt, Jeff

    Following a workshop on "Innovations in Employment Testing that Improve Validity and Reduce Adverse Impact," the City of Louisville (Kentucky) implemented a strategy to develop a comprehensive testing and recruiting program for police recruits. To improve candidate expectations and preparation, the following activities were undertaken:…

  5. Impact of High-Reliability Education on Adverse Event Reporting by Registered Nurses.

    PubMed

    McFarland, Diane M; Doucette, Jeffrey N

    Adverse event reporting is one strategy to identify risks and improve patient safety, but, historically, adverse events are underreported by registered nurses (RNs) because of fear of retribution and blame. A program was provided on high reliability to examine whether education would impact RNs' willingness to report adverse events. Although the findings were not statistically significant, they demonstrated a positive impact on adverse event reporting and support the need to create a culture of high reliability.

  6. SSAIS: A Program to Assess Adverse Impact in Multistage Selection Decisions

    ERIC Educational Resources Information Center

    De Corte, Wilfried

    2004-01-01

    The article describes a Windows program to estimate the expected value and sampling distribution function of the adverse impact ratio for general multistage selections. The results of the program can also be used to predict the risk that a future selection decision will result in an outcome that reflects the presence of adverse impact. The method…

  7. Parental personality as an inner resource that moderates the impact of ecological adversity on parenting.

    PubMed

    Kochanska, Grazyna; Aksan, Nazan; Penney, Sara J; Boldt, Lea J

    2007-01-01

    Parents' personality was examined as a moderator of the impact of demographic risk on parenting in a longitudinal study (N=102 families). Parents' personality and demographic risk (i.e., education level, age, family income, and family size) were assessed when children were infants, and parents' power assertion, warmth, and positive affect were observed in naturalistic interactions 2.5 years later. Parents' personality moderated the adverse impact of demographic risk on parenting. For parents who had memories of unstable and unhappy childhood experiences and who reported low conventionality, higher risk was linked to more power assertion, but there was no such link for those parents who recalled happy childhood experiences and who embraced conventions. For both parents who lacked a sense of optimism and social trust, and for fathers who reported low conventionality, higher risk was linked to less affectively positive parenting, but there was no such link for parents who were optimistic and trusting or for fathers who were conventional. Higher risk was linked to more power assertion, but only for mothers low in Extraversion and for fathers high in Neuroticism. 2007 APA, all rights reserved

  8. Childhood adversity impacts on brain subcortical structures relevant to depression.

    PubMed

    Frodl, Thomas; Janowitz, Deborah; Schmaal, Lianne; Tozzi, Leonardo; Dobrowolny, Henrik; Stein, Dan J; Veltman, Dick J; Wittfeld, Katharina; van Erp, Theo G M; Jahanshad, Neda; Block, Andrea; Hegenscheid, Katrin; Völzke, Henry; Lagopoulos, Jim; Hatton, Sean N; Hickie, Ian B; Frey, Eva Maria; Carballedo, Angela; Brooks, Samantha J; Vuletic, Daniella; Uhlmann, Anne; Veer, Ilya M; Walter, Henrik; Schnell, Knut; Grotegerd, Dominik; Arolt, Volker; Kugel, Harald; Schramm, Elisabeth; Konrad, Carsten; Zurowski, Bartosz; Baune, Bernhard T; van der Wee, Nic J A; van Tol, Marie-Jose; Penninx, Brenda W J H; Thompson, Paul M; Hibar, Derrek P; Dannlowski, Udo; Grabe, Hans J

    2017-03-01

    Childhood adversity plays an important role for development of major depressive disorder (MDD). There are differences in subcortical brain structures between patients with MDD and healthy controls, but the specific impact of childhood adversity on such structures in MDD remains unclear. Thus, aim of the present study was to investigate whether childhood adversity is associated with subcortical volumes and how it interacts with a diagnosis of MDD and sex. Within the ENIGMA-MDD network, nine university partner sites, which assessed childhood adversity and magnetic resonance imaging in patients with MDD and controls, took part in the current joint mega-analysis. In this largest effort world-wide to identify subcortical brain structure differences related to childhood adversity, 3036 participants were analyzed for subcortical brain volumes using FreeSurfer. A significant interaction was evident between childhood adversity, MDD diagnosis, sex, and region. Increased exposure to childhood adversity was associated with smaller caudate volumes in females independent of MDD. All subcategories of childhood adversity were negatively associated with caudate volumes in females - in particular emotional neglect and physical neglect (independently from age, ICV, imaging site and MDD diagnosis). There was no interaction effect between childhood adversity and MDD diagnosis on subcortical brain volumes. Childhood adversity is one of the contributors to brain structural abnormalities. It is associated with subcortical brain abnormalities that are relevant to psychiatric disorders such as depression. Copyright © 2016. Published by Elsevier Ltd.

  9. Recreation impacts to cliff resources in the Potomac Gorge: Final report, June 2011

    USGS Publications Warehouse

    Marion, Jeffrey L.; Carr, C.; Davis, C.A.

    2011-01-01

    Managers of the National Park Service (NPS) are directed by law to accommodate appropriate types and amounts of visitation while ensuring that: any adverse impacts are the minimum necessary, unavoidable, cannot be further mitigated, and do not constitute impairment or derogation of park resources and values. (NPS 2006). The increasing popularity of the national park system presents substantial management challenges. High visitatation may cause unacceptable impacts to fragile natural and cultural resources, and may also cause crowding and other social impacts, which can also degrade the quality of visitor experiences. Responding to these concerns, NPS managers at Chesapeake & Ohio Canal National Historical Park (CHOH) and George Washington Memorial Parkway (GWMP) sponsored this research within the upper Potomac Gorge portions of these parks to investigate visitation-related impacts to the park?s cliff resources. The cliffs and rocky areas within the Great Falls and Mather Gorge areas provide important habitats for numerous sensitive rare plants and plant communities. A recent General Management Planning process for Great Falls Park (GFP), a portion of GWMP, highlighted the potential impacts of cliff-associated recreational activities, including hiking, climbing, and fishing, on sensitive cliff resources. The planning process identified the need for development of a Climbing Management Plan and a Trail Plan to more specifically address site and visitor management actions needed to protect rare and sensitive natural and cultural resources. Good science to assess cliff-associated rare plants and communities and to determine the existing and potential effects of cliff-related recreational activities is required for these new planning efforts. This research is designed to specifically address these informational needs and to assist park managers on both sides of the river with current and future cliff and recreation management decisions.

  10. Adverse weather impacts on arable cropping systems

    NASA Astrophysics Data System (ADS)

    Gobin, Anne

    2016-04-01

    Damages due to extreme or adverse weather strongly depend on crop type, crop stage, soil conditions and management. The impact is largest during the sensitive periods of the farming calendar, and requires a modelling approach to capture the interactions between the crop, its environment and the occurrence of the meteorological event. The hypothesis is that extreme and adverse weather events can be quantified and subsequently incorporated in current crop models. Since crop development is driven by thermal time and photoperiod, a regional crop model was used to examine the likely frequency, magnitude and impacts of frost, drought, heat stress and waterlogging in relation to the cropping season and crop sensitive stages. Risk profiles and associated return levels were obtained by fitting generalized extreme value distributions to block maxima for air humidity, water balance and temperature variables. The risk profiles were subsequently confronted with yields and yield losses for the major arable crops in Belgium, notably winter wheat, winter barley, winter oilseed rape, sugar beet, potato and maize at the field (farm records) to regional scale (statistics). The average daily vapour pressure deficit (VPD) and reference evapotranspiration (ET0) during the growing season is significantly lower (p < 0.001) and has a higher variability before 1988 than after 1988. Distribution patterns of VPD and ET0 have relevant impacts on crop yields. The response to rising temperatures depends on the crop's capability to condition its microenvironment. Crops short of water close their stomata, lose their evaporative cooling potential and ultimately become susceptible to heat stress. Effects of heat stress therefore have to be combined with moisture availability such as the precipitation deficit or the soil water balance. Risks of combined heat and moisture deficit stress appear during the summer. These risks are subsequently related to crop damage. The methodology of defining

  11. On the impact of adverse pressure gradient on the supersonic turbulent boundary layer

    NASA Astrophysics Data System (ADS)

    Wang, Qian-Cheng; Wang, Zhen-Guo; Zhao, Yu-Xin

    2016-11-01

    By employing the particle image velocimetry, the mean and turbulent characteristics of a Mach 2.95 turbulent boundary layer are experimentally investigated without the impact of curvature. The physical mechanism with which the streamwise adverse pressure gradient affects the supersonic boundary layer is revealed. The data are compared to that of the concave boundary layer with similar streamwise distributions of wall static pressure to clarify the separate impacts of the adverse pressure gradient and the concave curvature. The logarithmic law is observed to be well preserved for both of the cases. The dip below the logarithmic law is not observed in present investigation. Theoretical analysis indicates that it could be the result of compromise between the opposite impacts of the compression wave and the increased turbulent intensity. Compared to the zero pressure gradient boundary layer, the principal strain rate and the turbulent intensities are increased by the adverse pressure gradient. The shear layer formed due the hairpin packets could be sharpened by the compression wave, which leads to higher principal strain rate and the associated turbulent level. Due to the additional impact of the centrifugal instability brought by the concave wall, even higher turbulent intensities than that of the adverse pressure gradient case are introduced. The existence of velocity modes within the zero pressure gradient boundary layer suggests that the large scale motions are statistically well organized. The generation of new velocity modes due to the adverse pressure gradient indicates that the turbulent structure is changed by the adverse pressure gradient, through which more turbulence production that cannot be effectively predicted by the Reynolds-stress transport equations could be brought.

  12. Defining "adverse environmental impact" and making paragraph 316(b) decisions: a fisheries management approach.

    PubMed

    Bailey, David E; Bulleit, Kristy A N

    2002-05-17

    The electric utility industry has developed an approach for decisionmaking that includes a definition of Adverse Environmental Impact (AEI) and an implementation process. The definition of AEI is based on lessons from fishery management science and analysis of the statutory term "adverse environmental impact" and is consistent with current natural resource management policy. The industry has proposed a definition focusing on "unacceptable risk to the population"s ability to sustain itself, to support reasonably anticipated commercial or recreational harvests, or to perform its normal ecological function." This definition focuses not on counting individual fish or eggs cropped by the various uses of a water body, but on preserving populations of aquatic organisms and their functions in the aquatic community. The definition recognizes that assessment of AEI should be site-specific and requires both a biological decision and a balancing of diverse societal values. The industry believes that the definition of AEI should be implemented in a process that will maximize the overall societal benefit of the paragraph 316(b) decision by considering the facility"s physical location, design, and operation, as well as the local biology. The approach considers effects on affected fish and shellfish populations and the benefits of any necessary best technology available (BTA) alternatives. This is accomplished through consideration of population impacts, which conversely allows consideration of the benefits of any necessary BTA modifications. This in turn allows selection of BTAs that will protect potentially affected populations in a cost-effective manner. The process also employs risk assessment with stakeholder participation, in accordance with EPA's Guidelines for Ecological Risk Assessment. The information and tools are now available to make informed decisions about site-specific impacts that will ensure protection of aquatic ecosystems and best serve the public interest.

  13. Ameliorating the biological impacts of childhood adversity: A review of intervention programs.

    PubMed

    Purewal Boparai, Sukhdip K; Au, Vanessa; Koita, Kadiatou; Oh, Debora Lee; Briner, Susan; Burke Harris, Nadine; Bucci, Monica

    2018-05-01

    Childhood adversity negatively impacts the biological development of children and has been linked to poor health outcomes across the life course. The purpose of this literature review is to explore and evaluate the effectiveness of interventions that have addressed an array of biological markers and physical health outcomes in children and adolescents affected by adversity. PubMed, CINAHL, PsychInfo, Sociological Abstracts databases and additional sources (Cochrane, WHO, NIH trial registries) were searched for English language studies published between January 2007 and September 2017. Articles with a childhood adversity exposure, biological health outcome, and evaluation of intervention using a randomized controlled trial study design were selected. The resulting 40 intervention studies addressed cortisol outcomes (n = 20) and a range of neurological, epigenetic, immune, and other outcomes (n = 22). Across institutional, foster care, and community settings, intervention programs demonstrated success overall for improving or normalizing morning and diurnal cortisol levels, and ameliorating the impacts of adversity on brain development, epigenetic regulation, and additional outcomes in children. Factors such as earlier timing of intervention, high quality and nurturant parenting traits, and greater intervention engagement played a role in intervention success. This study underlines progress and promise in addressing the health impacts of adversity in children. Ongoing research efforts should collect baseline data, improve retention, replicate studies in additional samples and settings, and evaluate additional variables, resilience factors, mediators, and long-term implications of results. Clinicians should integrate lessons from the intervention sciences for preventing and treating the health effects of adversity in children and adolescents. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Financial impact of inaccurate Adverse Event recording post Hip Fracture surgery: Addendum to 'Adverse event recording post hip fracture surgery'.

    PubMed

    Lee, Matthew J; Doody, Kevin; Mohamed, Khalid M S; Butler, Audrey; Street, John; Lenehan, Brian

    2018-02-15

    A study in 2011 by (Doody et al. Ir Med J 106(10):300-302, 2013) looked at comparing inpatient adverse events recorded prospectively at the point of care, with adverse events recorded by the national Hospital In-Patient Enquiry (HIPE) System. In the study, a single-centre University Hospital in Ireland treating acute hip fractures in an orthopaedic unit recorded 39 patients over a 2-month (August-September 2011) period, with 55 adverse events recorded prospectively in contrast to the HIPE record of 13 (23.6%) adverse events. With the recent change in the Irish hospital funding model from block grant to an 'activity-based funding' on the basis of case load and case complexity, the hospital financial allocation is dependent on accurate case complexity coding. A retrospective assessment of the financial implications of the two methods of adverse incident recording was carried out. A total of €39,899 in 'missed funding' for 2 months was calculated when the ward-based, prospectively collected data was compared to the national HIPE data. Accurate data collection is paramount in facilitating activity-based funding, to improve patient care and ensure the appropriate allocation of resources.

  15. Evaluation of hypothesized adverse outcome pathway linking thyroid peroxidase inhibition to fish early life stage toxicity

    EPA Science Inventory

    There is an interest in developing alternatives to the fish early-life stage (FELS) test (OECD test guideline 210), for predicting adverse outcomes (e.g., impacts on growth and survival) using less resource-intensive methods. Development and characterization of adverse outcome pa...

  16. Ci4SeR--curation interface for semantic resources--evaluation with adverse drug reactions.

    PubMed

    Souvignet, Julien; Asfari, Hadyl; Declerck, Gunnar; Lardon, Jérémy; Trombert-Paviot, Béatrice; Jaulent, Marie-Christine; Bousquet, Cédric

    2014-01-01

    Evaluation and validation have become a crucial problem for the development of semantic resources. We developed Ci4SeR, a Graphical User Interface to optimize the curation work (not taking into account structural aspects), suitable for any type of resource with lightweight description logic. We tested it on OntoADR, an ontology of adverse drug reactions. A single curator has reviewed 326 terms (1020 axioms) in an estimated time of 120 hours (2.71 concepts and 8.5 axioms reviewed per hour) and added 1874 new axioms (15.6 axioms per hour). Compared with previous manual endeavours, the interface allows increasing the speed-rate of reviewed concepts by 68% and axiom addition by 486%. A wider use of Ci4SeR would help semantic resources curation and improve completeness of knowledge modelling.

  17. Relationship between adverse early experiences, stressors, psychosocial resources and wellbeing.

    PubMed

    Mc Elroy, Sharon; Hevey, David

    2014-01-01

    The study examined a diathesis stress model of the relationship between adverse child experiences (ACEs), stressors and psychosocial resources to explore their relationship with wellbeing. A cross sectional study was conducted across two mental health and addiction treatment centers. 176 individuals were interviewed using a demographics form, SCID-DSM-IV(First, Spitzer, Gibbon, &Williams, 2002), Child Trauma Questionnaire (Bernstein & Fink, 1998), NEO-Five Factor Inventory (Costa & McCrae, 1992), Trait Emotional Intelligence Questionnaire (Petrides, 2009), The Coping, Inventory for Stressful Situations (CISS) (Endler & Parker, 1990), Recent Life Events Questionnaire (Department of Health, 1985) and perceived social support from family, friends and religion. Multiple, regressions and correlations were used to analyze the data. All early experiences, except physical, abuse and death of a parent in childhood, were significantly correlated with increased number of, stressors and lower wellbeing scores. This is possibly because of sample specific issues. Number of stressors partially mediated the relationship between ACEs and wellbeing. Increased number of ACEs was related to higher neuroticism and emotion-focused coping and lower conscientiousness, agreeableness, trait emotional intelligence and task coping scores. These resources were significantly related to increased stressors and lower wellbeing. Distraction and emotion coping significantly moderated the relationship between number of stressors and wellbeing. These findings support the diathesis stress model and indicate that there are significant relationships between ACEs, psychosocial, resources, stressors and wellbeing. Recommendations to improve wellbeing are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. The psychological impact of chronic environmental adversity: Responding to prolonged drought.

    PubMed

    Stain, Helen J; Kelly, Brian; Carr, Vaughan J; Lewin, Terry J; Fitzgerald, Michael; Fragar, Lyn

    2011-12-01

    The health effects of chronic environmental adversity have received insufficient attention, particularly those associated with the psychological impact of drought. Resilience or adaptive response to drought has received even less attention than vulnerability factors. This research examined factors associated with drought impact in rural and remote Australian communities. In 2008 postal surveys were completed by 302 adults (mean age 53 years; 57% female, 77% married) living in rural areas of prolonged drought exposure. Outcome measures were: (i) psychological distress (Kessler 10) and (ii) an index of concern or worry about drought. A range of predictor variables were assessed: adaptability (hopefulness, neuroticism), other adverse events, personal support and community connectedness, and sense of place, as a measure of connection to the local environment. Predictors of drought related worry differed from those associated with psychological distress levels. The former included socio-economic factors (living on a farm [Odds Ratio, OR 3.09], current employment [OR 3.64]), personal psychological characteristics (neuroticism [OR 1.29]), and greater connection with the environment (sense of place [OR 1.05]). On the other hand, psychological distress was associated chiefly with personal factors, such as higher neuroticism [OR 1.92], lower levels of hopefulness [OR 0.28], and lower perceived social support and community connectedness [OR 0.39]. Practical financial, employment and family factors were identified as important elements of drought impact, as to a lesser extent was sense of place, reflecting a confrontation with the consequences of chronic environmental degradation, while personal hopefulness may help mitigate the psychological impact of such adversity. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  19. Annual Research Review: Positive adjustment to adversity -Trajectories of minimal-impact resilience and emergent resilience

    PubMed Central

    Bonanno, George A.; Diminich, Erica D.

    2012-01-01

    Background Research on resilience in the aftermath of potentially traumatic life events is still evolving. For decades researchers have documented resilience in children exposed to corrosive early environments, such as poverty or chronic maltreatment. Relatively more recently the study of resilience has migrated to the investigation of isolated and potentially traumatic life events (PTE) in adults. Methods In this article we first consider some of the key differences in the conceptualization of resilience following chronic adversity versus resilience following single-incident traumas, and then describe some of the misunderstandings that have developed about these constructs. To organize our discussion we introduce the terms emergent resilience and minimal-impact resilience to represent trajectories positive adjustment in these two domains, respectively. Results We focused in particular on minimal-impact resilience, and reviewed recent advances in statistical modeling of latent trajectories that have informed the most recent research on minimal-impact resilience in both children and adults and the variables that predict it, including demographic variables, exposure, past and current stressors, resources, personality, positive emotion, coping and appraisal, and flexibility in coping and emotion regulation. Conclusions The research on minimal impact resilience is nascent. Further research is warranted with implications for a multiple levels of analysis approach to elucidate the processes that may mitigate or modify the impact of a PTE at different developmental stages. PMID:23215790

  20. The moderating impact of childhood adversity profiles and conflict on psychological health and suicidal behaviour in the Northern Ireland population.

    PubMed

    McLafferty, Margaret; O'Neill, Siobhan; Murphy, Sam; Armour, Cherie; Ferry, Finola; Bunting, Brendan

    2018-04-01

    Childhood adversities are key etiological factors in the onset and persistence of psychopathology. In Northern Ireland the Troubles also impacted on the population's psychological health. This study used data from the Northern Ireland Study of Health and Stress a collaborative epidemiological study which used the WMH-CIDI to assess mental health disorders in a nationally representative sample (Part 2, n = 1986). The aims of the study were to assess co-occurrences of childhood adversities and investigate the impact of adversity profiles and conflict experience on psychopathology and suicidal behaviour. Latent Class Analysis uncovered 3 discrete childhood adversity profiles, a low, medium, and high risk class. Individuals from higher risk adversity profiles displayed significantly increased odds of having psychological problems, with conflict exposure also impacting on psychopathology. However, the study revealed that the impact of conflict exposure on suicidal behaviour was moderated by latent class membership and that some adversity may actually be protective. The findings highlight the need to consider that, while adversity can have a negative impact on psychopathology, a lack of adversity early in life may hinder some people from developing adequate coping strategies. Further research is required to identify adversity patterns and other interacting factors that are protective. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders.

    PubMed

    Schalinski, Inga; Fischer, Yolanda; Rockstroh, Brigitte

    2015-08-30

    Accumulating evidence indicates an impact of childhood adversities on the severity and course of mental disorders, whereas this impact on psychotic disorders remains to be specified. Effects of childhood adversities on comorbidity, on symptom severity of the Positive and Negative Syndrome Scale and global functioning across four months (upon admission, 1 and 4 months after initial assessment), as well as the course of illness (measured by the remission rate, number of re-hospitalizations and dropout rate) were evaluated in 62 inpatients with psychotic spectrum disorders. Adverse experiences (of at least 1 type) were reported by 73% of patients. Patients with higher overall level of childhood adversities (n=33) exhibited more co-morbid disorders, especially alcohol/substance abuse and dependency, and higher dropout rates than patients with a lower levels of adverse experiences (n=29), together with higher levels of positive symptoms and symptoms of excitement and disorganization. Emotional and physical neglect were particularly related to symptom severity. Results suggest that psychological stress in childhood affects the symptom severity and, additionally, a more unfavorable course of disorder in patients diagnosed with psychoses. This impact calls for its consideration in diagnostic assessment and psychiatric care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  2. Rates of minor adverse events and health resource utilization postcolonoscopy

    PubMed Central

    Azalgara, Vladimir Marquez; Sewitch, Maida J; Joseph, Lawrence; Barkun, Alan N

    2014-01-01

    BACKGROUND: Little is known about minor adverse events (MAEs) following outpatient colonoscopies and associated health care resource utilization. OBJECTIVE: To estimate the rates of incident MAE at two, 14 and 30 days postcolonoscopy, and associated health care resource utilization. A secondary aim was to identify factors associated with cumulative 30-day MAE incidence. METHODS: A longitudinal cohort study was conducted among individuals undergoing an outpatient colonoscopy at the Montreal General Hospital (Montreal, Quebec). Before colonoscopy, consecutive individuals were enrolled and interviewed to obtain data regarding age, sex, comorbidities, use of antiplatelets/anticoagulants and previous symptoms. Endoscopy reports were reviewed for intracolonoscopy procedures (biopsy, polypectomy). Telephone or Internet follow-up was used to obtain data regarding MAEs (abdominal pain, bloating, diarrhea, constipation, nausea, vomiting, blood in the stools, rectal or anal pain, headaches, other) and health resource use (visits to emergency department, primary care doctor, gastroenterologist; consults with nurse, pharmacist or telephone hotline). Rates of incident MAEs and health resources utilization were estimated using Bayesian hierarchical modelling to account for patient clustering within physician practices. RESULTS: Of the 705 individuals approached, 420 (59.6%) were enrolled. Incident MAE rates at the two-, 14- and 30-day follow-ups were 17.3% (95% credible interval [CrI] 8.1% to 30%), 10.5% (95% CrI 2.9% to 23.7%) and 3.2% (95% CrI 0.01% to 19.8%), respectively. The 30-day rate of health resources utilization was 1.7%, with 0.95% of participants seeking the services of a physician. No predictors of the cumulative 30-day incidence of MAEs were identified. DISCUSSION: The incidence of MAEs was highest in the 48 h following colonoscopy and uncommon after two weeks, supporting the Canadian Association of Gastroenterology’s recommendation for assessment of late

  3. Rates of minor adverse events and health resource utilization postcolonoscopy.

    PubMed

    Marquez Azalgara, Vladimir; Sewitch, Maida J; Joseph, Lawrence; Barkun, Alan N

    2014-12-01

    Little is known about minor adverse events (MAEs) following outpatient colonoscopies and associated health care resource utilization. To estimate the rates of incident MAE at two, 14 and 30 days postcolonoscopy, and associated health care resource utilization. A secondary aim was to identify factors associated with cumulative 30-day MAE incidence. A longitudinal cohort study was conducted among individuals undergoing an outpatient colonoscopy at the Montreal General Hospital (Montreal, Quebec). Before colonoscopy, consecutive individuals were enrolled and interviewed to obtain data regarding age, sex, comorbidities, use of antiplatelets/anticoagulants and previous symptoms. Endoscopy reports were reviewed for intracolonoscopy procedures (biopsy, polypectomy). Telephone or Internet follow-up was used to obtain data regarding MAEs (abdominal pain, bloating, diarrhea, constipation, nausea, vomiting, blood in the stools, rectal or anal pain, headaches, other) and health resource use (visits to emergency department, primary care doctor, gastroenterologist; consults with nurse, pharmacist or telephone hotline). Rates of incident MAEs and health resources utilization were estimated using Bayesian hierarchical modelling to account for patient clustering within physician practices. Of the 705 individuals approached, 420 (59.6%) were enrolled. Incident MAE rates at the two-, 14- and 30-day follow-ups were 17.3% (95% credible interval [CrI] 8.1% to 30%), 10.5% (95% CrI 2.9% to 23.7%) and 3.2% (95% CrI 0.01% to 19.8%), respectively. The 30-day rate of health resources utilization was 1.7%, with 0.95% of participants seeking the services of a physician. No predictors of the cumulative 30-day incidence of MAEs were identified. The incidence of MAEs was highest in the 48 h following colonoscopy and uncommon after two weeks, supporting the Canadian Association of Gastroenterology's recommendation for assessment of late complications at 14 days. Predictors of new onset of MAEs were

  4. Idaho National Laboratory Cultural Resource Monitoring Report for 2013

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williams, Julie B.

    2013-10-01

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during 2013. Throughout the year, thirty-eight cultural resource localities were revisited including: two locations with Native American human remains, one of which is also a cave; fourteen additional caves; seven prehistoric archaeological sites ; four historic archaeological sites; one historic trail; one nuclear resource (Experimental Breeder Reactor-I, a designated National Historic Landmark); and nine historic structures located at the Central Facilities Area. Of the monitored resources, thirty-three were routinely monitored, and five were monitored to assess project compliance with cultural resourcemore » recommendations along with the effects of ongoing project activities. On six occasions, ground disturbing activities within the boundaries of the Power Burst Facility/Critical Infrastructure Test Range Complex (PBF/CITRC) were observed by INL CRM staff prepared to respond to any additional finds of Native American human remains. In addition, two resources were visited more than once as part of the routine monitoring schedule or to monitor for additional damage. Throughout the year, most of the cultural resources monitored had no visual adverse changes resulting in Type 1determinations. However, Type 2 impacts were noted at eight sites, indicating that although impacts were noted or that a project was operating outside of culturally cleared limitations, cultural resources retained integrity and noted impacts did not threaten National Register eligibility. No new Type 3 or any Type 4 impacts that adversely impacted cultural resources and threatened National Register eligibility were observed at cultural resources monitored in 2013.« less

  5. Health Effects of Energy Resources

    USGS Publications Warehouse

    Orem, William; Tatu, Calin; Pavlovic, Nikola; Bunnell, Joseph; Kolker, Allan; Engle, Mark; Stout, Ben

    2010-01-01

    Energy resources (coal, oil, and natural gas) are among the cornerstones of modern industrial society. The exploitation of these resources, however, is not without costs. Energy materials may contain harmful chemical substances that, if mobilized into air, water, or soil, can adversely impact human health and environmental quality. In order to address the issue of human exposure to toxic substances derived from energy resources, the U.S. Geological Survey (USGS) Energy Resources Program developed a project entitled 'Impacts of Energy Resources on Human Health and Environmental Quality.' The project is intended to provide policymakers and the public with the scientific information needed to weigh the human health and environmental consequences of meeting our energy needs. This fact sheet discusses several areas where the USGS Energy Resources Program is making scientific advances in this endeavor.

  6. 76 FR 22724 - Draft Program Environmental Impact Statement/Environmental Impact Report (PEIS/R) and Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... (Restoration Goal); and (2) to reduce or avoid adverse water supply impacts to all of the Friant Division long... populations of salmon and other fish. Water Management Goal--To reduce or avoid adverse water supply impacts... Bureau of Reclamation and the California Department of Water Resources (DWR) have prepared a joint Draft...

  7. Resource impact factor (RIF) approach to optimal use of energy resources

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jones, R.R.

    1976-10-01

    A concept called the Resource Impact Factor (RIF) is presented as a means to quantify the social value of energy resources for buildings. The flow of various raw resources from the point of extraction to the building project boundary is shown, and a flow chart indicating the decision making process is given. (PMA)

  8. The impact of childhood adversities on anxiety and depressive disorders in adulthood.

    PubMed

    Marackova, Marketa; Prasko, Jan; Matousek, Stanislav; Latalova, Klara; Hruby, Radovan; Holubova, Michaela; Slepecky, Milos; Vrbova, Kristyna; Grambal, Ales

    2016-12-01

    The childhood adversities model is generally accepted as a predictor of adult psychopathology vulnerability. It stems from child development theories, but the question remains as of how well solid research supports it. The aim of this article is to give a review of the studies concerning childhood adversities and their impact on the development of anxiety disorders and major depressive disorder in adulthood. A computerized search of the MEDLINE database of publications up to 31 March 2016 was done, using the keywords "childhood adversities, abuse, maltreatment, bullying" and "anxiety disorders, depressive disorder". No backward time constraints were used. Non-original studies, conference abstracts, books and book chapters, commentaries, and dissertations were excluded. The influence of childhood adversities on later age psychopathology is examined in five categories: the negative family atmosphere, abuse, loss of a close person, the social difficulties, and problems at school (including, most importantly bullying). The majority of studies confirmed the connection between childhood adversities and anxiety and depression disorders in adulthood. The character of the adversities is not, apparently, a specific predictor for a concrete psychopathology. Multiple adversities are more frequently connected with depressive and anxiety disorders in adulthood, cumulating together in broader adverse context. Childhood adversities were found to increase vulnerability to the distress, depression, fear and anxiety later in the life. However, specific correlations between a given childhood adversity and a specific form of depression or anxiety disorder were either not found or weak. This is in line with the generally accepted view considering each of these factors a non-specific stressor increasing vulnerability to mood and affect disorders later in life.

  9. Cognitive predictors and age-based adverse impact among business executives.

    PubMed

    Klein, Rachael M; Dilchert, Stephan; Ones, Deniz S; Dages, Kelly D

    2015-09-01

    Age differences on measures of general mental ability and specific cognitive abilities were examined in 2 samples of job applicants to executive positions as well as a mix of executive/nonexecutive positions to determine which predictors might lead to age-based adverse impact in making selection and advancement decisions. Generalizability of the pattern of findings was also investigated in 2 samples from the general adult population. Age was negatively related to general mental ability, with older executives scoring lower than younger executives. For specific ability components, the direction and magnitude of age differences depended on the specific ability in question. Older executives scored higher on verbal ability, a measure most often associated with crystallized intelligence. This finding generalized across samples examined in this study. Also, consistent with findings that fluid abilities decline with age, older executives scored somewhat lower on figural reasoning than younger executives, and much lower on a letter series test of inductive reasoning. Other measures of inductive reasoning, such as Raven's Advanced Progressive Matrices, also showed similar age group mean differences across settings. Implications for employee selection and adverse impact on older job candidates are discussed. (c) 2015 APA, all rights reserved).

  10. Adverse Impact of Electromagnetic Radiation on Urban Environment and Natural Resources using Optical Sensors

    NASA Astrophysics Data System (ADS)

    Kumar, Pawan; Katiyar, Swati; Rani, Meenu

    2016-07-01

    We are living in the age of a rapidly growing population and changing environmental conditions with an advance technical capacity.This has resulted in wide spread land cover change. One of the main causes for increasing urban heat is that more than half of the world's population lives in a rapidly growing urbanized environment. Satellite data can be highly useful to map change in land cover and other environmental phenomena with the passage of time. Among several human-induced environmental and urban thermal problems are reported to be negatively affecting urban residents in many ways. The built-up structures in urbanized areas considerably alter land cover thereby affecting thermal energy flow which leads to development of elevated surface and air temperature. The phenomenon Urban Heat Island implies 'island' of high temperature in cities, surrounded by relatively lower temperature in rural areas. The UHI for the temporal period is estimated using geospatial techniques which are then utilized for the impact assessment on climate of the surrounding regions and how it reduce the sustainability of the natural resources like air, vegetation. The present paper describes the methodology and resolution dynamic urban heat island change on climate using the geospatial approach. NDVI were generated using day time LANDSAT ETM+ image of 1990, 2000 and 2013. Temperature of various land use and land cover categories was estimated. Keywords: NDVI, Surface temperature, Dynamic changes.

  11. Impact of a labor and delivery safety bundle on a modified adverse outcomes index.

    PubMed

    Tolcher, Mary Catherine; Torbenson, Vanessa E; Weaver, Amy L; McGree, Michaela E; El-Nashar, Sherif A; Nesbitt, Katharine M; Gostout, Bobbie S; Famuyide, Abimbola O

    2016-03-01

    The Obstetrics Adverse Outcomes Index was designed to measure the quality of perinatal care and includes 10 adverse events that may occur at or around the time of delivery. We hypothesized that adverse outcomes in the labor and delivery suite, including hypoxic ischemic encephalopathy, could be decreased with a combination of interventions, even among high-risk pregnancies. The objective of the study was to evaluate the impact of a labor and delivery care bundle on adverse obstetrics outcomes as measured by a modified Obstetrics Adverse Outcomes Index, Weighted Adverse Outcomes Index, and Severity Index. This is a retrospective cohort study including all women who delivered at our academic, tertiary care institution over a 3 year period of time, before and after the implementation of an intervention to decrease adverse outcomes. Outcome measures consisted of previously reported indices that were modified including the addition of hypoxic ischemic encephalopathy. The adverse outcomes index is a percentage of deliveries with 1 or more adverse events, the weighted adverse outcomes index is the sum of the points assigned to cases with adverse outcomes divided by the number of deliveries, and the severity index is the sum of the adverse outcome scores divided by the number of deliveries with an identified adverse outcome. A segmented regression analysis was utilized to evaluate the differences in the level and trend of each index before and after our intervention using calendar month as the unit of analysis. During the study period, 5826 deliveries met inclusion criteria. Comparing the pre- and postintervention periods, high-risk pregnancy was more common in the postintervention period (73.5% vs 79.4%, P < .001). Overall, there was a decrease in both the Modified Weighted Adverse Outcomes Index (P = .0497) and the Modified Severity Index (P = 0.01) comparing the pre- and postintervention periods; there was no difference in the Modified Adverse Outcomes Index (P = .43

  12. Impact of early life adversity on EMG stress reactivity of the trapezius muscle.

    PubMed

    Luijcks, Rosan; Vossen, Catherine J; Roggeveen, Suzanne; van Os, Jim; Hermens, Hermie J; Lousberg, Richel

    2016-09-01

    Human and animal research indicates that exposure to early life adversity increases stress sensitivity later in life. While behavioral markers of adversity-induced stress sensitivity have been suggested, physiological markers remain to be elucidated. It is known that trapezius muscle activity increases during stressful situations. The present study examined to what degree early life adverse events experienced during early childhood (0-11 years) and adolescence (12-17 years) moderate experimentally induced electromyographic (EMG) stress activity of the trapezius muscles, in an experimental setting. In a general population sample (n = 115), an anticipatory stress effect was generated by presenting a single unpredictable and uncontrollable electrical painful stimulus at t = 3 minutes. Subjects were unaware of the precise moment of stimulus delivery and its intensity level. Linear and nonlinear time courses in EMG activity were modeled using multilevel analysis. The study protocol included 2 experimental sessions (t = 0 and t = 6 months) allowing for examination of reliability.Results show that EMG stress reactivity during the stress paradigm was consistently stronger in people with higher levels of early life adverse events; early childhood adversity had a stronger moderating effect than adolescent adversity. The impact of early life adversity on EMG stress reactivity may represent a reliable facet that can be used in both clinical and nonclinical studies.

  13. The Health Impact Assessment (HIA) Resource and Tool ...

    EPA Pesticide Factsheets

    Health Impact Assessment (HIA) is a relatively new and rapidly emerging field in the U.S. An inventory of available HIA resources and tools was conducted, with a primary focus on resources developed in the U.S. The resources and tools available to HIA practitioners in the conduct of their work were identified through multiple methods and compiled into a comprehensive list. The compilation includes tools and resources related to the HIA process itself and those that can be used to collect and analyze data, establish a baseline profile, assess potential health impacts, and establish benchmarks and indicators for monitoring and evaluation. These resources include literature and evidence bases, data and statistics, guidelines, benchmarks, decision and economic analysis tools, scientific models, methods, frameworks, indices, mapping, and various data collection tools. Understanding the data, tools, models, methods, and other resources available to perform HIAs will help to advance the HIA community of practice in the U.S., improve the quality and rigor of assessments upon which stakeholder and policy decisions are based, and potentially improve the overall effectiveness of HIA to promote healthy and sustainable communities. The Health Impact Assessment (HIA) Resource and Tool Compilation is a comprehensive list of resources and tools that can be utilized by HIA practitioners with all levels of HIA experience to guide them throughout the HIA process. The HIA Resource

  14. Impact of health care adversity on providers: Lessons learned from a staff support program.

    PubMed

    Trent, Maxine; Waldo, Kimberly; Wehbe-Janek, Hania; Williams, Daniel; Hegefeld, Wendy; Havens, Lisa

    2016-08-01

    Health care providers often experience traumatic events and adversity that can have negative emotional impacts on the profession and on patients. These impacts are typically multifaceted and can result from many different events, such as unanticipated outcomes, licensing board complaints, claims, and litigation. Because health care providers are exposed to diverse situations, they require adequate and timely support, imperative for provider resilience and patient safety. This study evaluated the success of an institution's second victim health care support program and best practices in responding to these traumatic experiences effectively. Twenty faculty and medical residents who utilized the support program at a large hospital system located in Central Texas from 2001 to 2012 participated in 1 of 6 focus groups. Qualitative data were collected from these groups to describe program requirements for the adequate delivery of health care adversity support and necessary program improvements. Responses were first transcribed verbatim. Each research team member analyzed data using a thematic framework approach. This approach helped to characterize traumatic experiences and to design a support system. The results revealed that (1) provider experiences are traumatic, (2) it is necessary to communicate an adverse event in a confidential and timely manner, preferably with a peer, (3) preemptive education regarding risk management and the legal process is helpful, and (4) there is a need for further support of the specific experience of a board complaint. Focus group data indicated the complexity of the emotional impact of traumatic experiences. Specific program components are needed to create best practices for providers affected by health care adversity, including support when providers face board complaints. The program's unique combination of support and education allowed us to expand upon leading national health care adversity programs. © 2016 American Society for

  15. Impact of early life adversity on EMG stress reactivity of the trapezius muscle

    PubMed Central

    Luijcks, Rosan; Vossen, Catherine J.; Roggeveen, Suzanne; van Os, Jim; Hermens, Hermie J.; Lousberg, Richel

    2016-01-01

    Abstract Human and animal research indicates that exposure to early life adversity increases stress sensitivity later in life. While behavioral markers of adversity-induced stress sensitivity have been suggested, physiological markers remain to be elucidated. It is known that trapezius muscle activity increases during stressful situations. The present study examined to what degree early life adverse events experienced during early childhood (0–11 years) and adolescence (12–17 years) moderate experimentally induced electromyographic (EMG) stress activity of the trapezius muscles, in an experimental setting. In a general population sample (n = 115), an anticipatory stress effect was generated by presenting a single unpredictable and uncontrollable electrical painful stimulus at t = 3 minutes. Subjects were unaware of the precise moment of stimulus delivery and its intensity level. Linear and nonlinear time courses in EMG activity were modeled using multilevel analysis. The study protocol included 2 experimental sessions (t = 0 and t = 6 months) allowing for examination of reliability. Results show that EMG stress reactivity during the stress paradigm was consistently stronger in people with higher levels of early life adverse events; early childhood adversity had a stronger moderating effect than adolescent adversity. The impact of early life adversity on EMG stress reactivity may represent a reliable facet that can be used in both clinical and nonclinical studies. PMID:27684800

  16. 18 CFR 701.309 - Appeal of initial adverse determination.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Appeal of initial adverse determination. 701.309 Section 701.309 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Protection of Privacy § 701.309 Appeal of initial adverse determination. (a...

  17. 18 CFR 701.309 - Appeal of initial adverse determination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Appeal of initial adverse determination. 701.309 Section 701.309 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Protection of Privacy § 701.309 Appeal of initial adverse determination. (a...

  18. 18 CFR 701.309 - Appeal of initial adverse determination.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Appeal of initial adverse determination. 701.309 Section 701.309 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Protection of Privacy § 701.309 Appeal of initial adverse determination. (a...

  19. 18 CFR 701.309 - Appeal of initial adverse determination.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Appeal of initial adverse determination. 701.309 Section 701.309 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Protection of Privacy § 701.309 Appeal of initial adverse determination. (a...

  20. 18 CFR 701.309 - Appeal of initial adverse determination.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Appeal of initial adverse determination. 701.309 Section 701.309 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Protection of Privacy § 701.309 Appeal of initial adverse determination. (a...

  1. The impact of adverse events on health care costs for older adults undergoing nonelective abdominal surgery.

    PubMed

    Bailey, Jonathan G; Davis, Philip J B; Levy, Adrian R; Molinari, Michele; Johnson, Paul M

    2016-06-01

    Postoperative complications have been identified as an important and potentially preventable cause of increased hospital costs. While older adults are at increased risk of experiencing complications and other adverse events, very little research has specifically examined how these events impact inpatient costs. We sought to examine the association between postoperative complications, hospital mortality and loss of independence and direct inpatient health care costs in patients 70 years or older who underwent nonelective abdominal surgery. We prospectively enrolled consecutive patients 70 years or older who underwent nonelective abdominal surgery between July 1, 2011, and Sept. 30, 2012. Detailed patient-level data were collected regarding demographics, diagnosis, treatment and outcomes. Patient-level resource tracking was used to calculate direct hospital costs (2012 $CDN). We examined the association between complications, hospital mortality and loss of independence cost using multiple linear regression. During the study period 212 patients underwent surgery. Overall, 51.9% of patients experienced a nonfatal complication (32.5% minor and 19.4% major), 6.6% died in hospital and 22.6% experienced a loss of independence. On multivariate analysis nonfatal complications (p < 0.001), hospital mortality (p = 0.021) and loss of independence at discharge (p < 0.001) were independently associated with health care costs. These adverse events respectively accounted for 30%, 4% and 10% of the total costs of hospital care. Adverse events were common after abdominal surgery in older adults and accounted for 44% of overall costs. This represents a substantial opportunity for better patient outcomes and cost savings with quality improvement strategies tailored to the needs of this high-risk surgical population.

  2. Resource Programs : Draft Environmental Impact Statement, Volume 2, Appendices.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    United States. Bonneville Power Administration.

    1992-03-01

    Every two years, Bonneville Power Administration (BPA) prepares a Resource Program which identifies the resource actions BPA will take to meet its obligation to serve the forecasted power requirements of its customers. The Resource Program`s Environmental Impact Statement (RPEIS) is a programmatic environmental document which will support decisions made in several future Resource Programs. Environmental documents tiered to the EIS may be prepared on a site-specific basis. The RPEIS includes a description of the environmental effects and mitigation for the various resource types available in order to evaluate the trade-offs among them. It also assesses the environmental impacts of addingmore » thirteen alternative combinations of resources to the existing power system. This report contains the appendices to the RPEIS.« less

  3. Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health.

    PubMed

    Logan-Greene, Patricia; Green, Sara; Nurius, Paula S; Longhi, Dario

    2014-01-01

    Although evidence is rapidly amassing as to the damaging potential of early life adversities on physical and mental health, as yet few investigations provide comparative snapshots of these patterns across adulthood. This population-based study addresses this gap, examining the relationship of adverse childhood experiences (ACEs) to physical and mental health within a representative sample (n = 19,333) of adults, comparing the prevalence and explanatory strength of ACEs among four birth cohorts spanning ages 18-79. This assessment accounts for demographic and socioeconomic factors, as well as both direct and moderating effects of resilience resources (social/emotional support, life satisfaction, and sleep quality). Findings demonstrate (1) increasing trends of reported ACEs across younger cohorts, including time period shifts such as more prevalent family incarceration, substance abuse, and divorce, (2) significant bivariate as well as independent associations of ACEs with poor health within every cohort, controlling for multiple covariates (increasing trends in older age for physical health), and (3) robust patterns wherein resilience resources moderated ACEs, indicating buffering pathways that sustained into old age. Theoretical and practice implications for health professionals are discussed.

  4. Did intense adverse media publicity impact on prescribing of paroxetine and the notification of suspected adverse drug reactions? Analysis of routine databases, 2001-2004.

    PubMed

    Martin, Richard M; May, Margaret; Gunnell, David

    2006-02-01

    To document the impact on clinical practice in England of media attention around possible adverse effects of paroxetine. Analysis of national selective serotonin reuptake inhibitor (SSRI) prescribing trends and yellow-card adverse drug reaction reports, 2001-2004. From a steady state in 2001, paroxetine prescribing declined sharply from April 2002, coinciding with a USA regulatory action; the subsequent decline in paroxetine prescribing was 1.87% per month (95% confidence interval - 2.06, -1.68). Other SSRI prescribing increased by 1% per month until a major UK review of SSRIs in children in December 2003, after which prescribing plateaued. Media publicity was associated with short-term peaks in yellow-card reports related to paroxetine. Falls in paroxetine and other SSRI prescribing in the UK coincided, respectively, with regulatory communications from the USA and the UK, but associations may have noncausal or other explanations. Reports of adverse reactions to paroxetine appeared to increase after adverse media publicity about the drug.

  5. [Assessing the economic impact of adverse events in Spanish hospitals by using administrative data].

    PubMed

    Allué, Natalia; Chiarello, Pietro; Bernal Delgado, Enrique; Castells, Xavier; Giraldo, Priscila; Martínez, Natalia; Sarsanedas, Eugenia; Cots, Francesc

    2014-01-01

    To evaluate the incidence and costs of adverse events registered in an administrative dataset in Spanish hospitals from 2008 to 2010. A retrospective study was carried out that estimated the incremental cost per episode, depending on the presence of adverse events. Costs were obtained from the database of the Spanish Network of Hospital Costs. This database contains data from 12 hospitals that have costs per patient records based on activities and clinical records. Adverse events were identified through the Patient Safety Indicators (validated in the Spanish Health System) created by the Agency for Healthcare Research and Quality together with indicators of the EuroDRG European project. This study included 245,320 episodes with a total cost of 1,308,791,871€. Approximately 17,000 patients (6.8%) experienced an adverse event, representing 16.2% of the total cost. Adverse events, adjusted by diagnosis-related groups, added a mean incremental cost of between €5,260 and €11,905. Six of the 10 adverse events with the highest incremental cost were related to surgical interventions. The total incremental cost of adverse events was € 88,268,906, amounting to an additional 6.7% of total health expenditure. Assessment of the impact of adverse events revealed that these episodes represent significant costs that could be reduced by improving the quality and safety of the Spanish Health System. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. A structural model of racial discrimination, acculturative stress, and cultural resources among Arab American adolescents.

    PubMed

    Ahmed, Sawssan R; Kia-Keating, Maryam; Tsai, Katherine H

    2011-12-01

    Despite evidence towards the risk for discrimination and acculturative stress that Arab American adolescents may face, the link between socio-cultural adversities and psychological well-being in this population has not been established. This study examined the role of socio-cultural adversities (discrimination and acculturative stress) and cultural resources (ethnic identity, religious support and religious coping) in terms of their direct impact on psychological distress. Using structural equation modeling, the proposed model was tested with 240 Arab American adolescents. The results indicated a strong positive relationship between socio-cultural adversities and psychological distress. Furthermore, this study supported a promotive model of cultural resources, where a negative association between cultural resources and psychological distress was found. Understanding the manner in which socio-cultural adversities and resources are linked to psychological distress can inform the development of culturally appropriate interventions that can effectively mitigate mental health concerns for understudied and vulnerable populations.

  7. Criteria-Based Resource Allocation: A Tool to Improve Public Health Impact.

    PubMed

    Graham, J Ross; Mackie, Christopher

    2016-01-01

    Resource allocation in local public health (LPH) has been reported as a significant challenge for practitioners and a Public Health Services and Systems Research priority. Ensuring available resources have maximum impact on community health and maintaining public confidence in the resource allocation process are key challenges. A popular strategy in health care settings to address these challenges is Program Budgeting and Marginal Analysis (PBMA). This case study used PBMA in an LPH setting to examine its appropriateness and utility. The criteria-based resource allocation process PBMA was implemented to guide the development of annual organizational budget in an attempt to maximize the impact of agency resources. Senior leaders and managers were surveyed postimplementation regarding process facilitators, challenges, and successes. Canada's largest autonomous LPH agency. PBMA was used to shift 3.4% of the agency budget from lower-impact areas (through 34 specific disinvestments) to higher-impact areas (26 specific reinvestments). Senior leaders and managers validated the process as a useful approach for improving the public health impact of agency resources. However, they also reported the process may have decreased frontline staff confidence in senior leadership. In this case study, PBMA was used successfully to reallocate a sizable portion of an LPH agency's budget toward higher-impact activities. PBMA warrants further study as a tool to support optimal resource allocation in LPH settings.

  8. Recruitment efforts to reduce adverse impact: targeted recruiting for personality, cognitive ability, and diversity.

    PubMed

    Newman, Daniel A; Lyon, Julie S

    2009-03-01

    Noting the presumed tradeoff between diversity and performance goals in contemporary selection practice, the authors elaborate on recruiting-based methods for avoiding adverse impact while maintaining aggregate individual productivity. To extend earlier work on the primacy of applicant pool characteristics for resolving adverse impact, they illustrate the advantages of simultaneous cognitive ability- and personality-based recruiting. Results of an algebraic recruiting model support general recruiting for cognitive ability, combined with recruiting for conscientiousness within the underrepresented group. For realistic recruiting effect sizes, this type of recruiting strategy greatly increases average performance of hires and percentage of hires from the underrepresented group. Further results from a policy-capturing study provide initial guidance on how features of organizational image can attract applicants with particular job-related personalities and abilities, in addition to attracting applicants on the basis of demographic background. (c) 2009 APA, all rights reserved.

  9. Impact of grandmultiparity on obstetric outcome in low resource setting.

    PubMed

    Agrawal, Smriti; Agarwal, Anjoo; Das, Vinita

    2011-08-01

    This study was undertaken to evaluate the impact of grandmultiparity on obstetric outcome in a low resource setting. Two hundred and eighty-two antenatal grandmultiparous women (parity ≥ 4) were compared with consecutive 564 antenatal women with parity 1-3. There were 13 403 deliveries over the study period from Jan 2006-December 2008 at CSMMU, Lucknow. The prevalence of grandmultipara was 2.3%. Grandmultipara were older (P < 0.001) and more commonly from rural areas (P < 0.001) as compared to the control group. The percentage of Muslims among grandmultipara (23.8%) was higher than among controls (16.5%), P < 0.01. Grandmultipara had significantly higher prevalence of anemia (P < 0.001), malpresentation (P = 0.01) and rupture uterus (P < 0.001). Abruptio placenta, placenta previa and obstructed labor were seen more often in grandmultipara, and the difference was statistically significant (P < 0.01 in each group). There was no difference in terms of mode of delivery, sex of newborn or the prevalence of low birthweight (<2.5 kg) babies. Stillbirths were more common in grandmultiparas (P < 0.001). There was one maternal death in the study group. Grandmultiparity continues to be of grave concern with an adverse impact on obstetric and perinatal outcome. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

  10. Resource impacts caused by recreation

    Treesearch

    David N. Cole

    1986-01-01

    The pursuit of recreational activities inevitably has an effect on the resource--vegetation, soil, wildlife, and water. Whether these impacts are considered to be positive or negative depends on the management objectives of the area affected. The severity of the positive or negative response, which dictates the acuteness of the need for mitigation measures, is also...

  11. Bounding the Resource Availability of Partially Ordered Events with Constant Resource Impact

    NASA Technical Reports Server (NTRS)

    Frank, Jeremy

    2004-01-01

    We compare existing techniques to bound the resource availability of partially ordered events. We first show that, contrary to intuition, two existing techniques, one due to Laborie and one due to Muscettola, are not strictly comparable in terms of the size of the search trees generated under chronological search with a fixed heuristic. We describe a generalization of these techniques called the Flow Balance Constraint to tightly bound the amount of available resource for a set of partially ordered events with piecewise constant resource impact We prove that the new technique generates smaller proof trees under chronological search with a fixed heuristic, at little increase in computational expense. We then show how to construct tighter resource bounds but at increased computational cost.

  12. Computer-Based Resource Accounting Model for Automobile Technology Impact Assessment

    DOT National Transportation Integrated Search

    1976-10-01

    A computer-implemented resource accounting model has been developed for assessing resource impacts of future automobile technology options. The resources tracked are materials, energy, capital, and labor. The model has been used in support of the Int...

  13. Climbers' attitudes toward recreation resource impacts in the Adirondack Park

    Treesearch

    Christopher A. Monz; Katherine E. Smith; Leah Knickerbocker

    2006-01-01

    Climbers arriving at trailheads to popular climbing areas in Adirondack Park, NY were surveyed as to the types of resource impacts they found to be offensive. Climbers were also asked about their degree of concern regarding crowding, noise and management of climbing areas. Some resource impacts, such as damage to trees as a result of poor climbing practices, are...

  14. Idaho National Laboratory Cultural Resource Monitoring Report for Fiscal Year 2016

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gilbert, Hollie Kae; Holmer, Marie Pilkington; Olson, Christina Liegh

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during fiscal year (FY) 2016. Overall monitoring included surveillance of the following 23 individual cultural resource localities: two locations with human remains, one of which is also a cave; seven additional caves; six prehistoric archaeological sites; four historic archaeological sites; one historic trail; Experimental Breeder Reactor I (EBR-I), a National Historic Landmark; Aircraft Nuclear Propulsion (ANP) objects located at EBR-I; and one Arco Naval Proving Ground (NPG) property, CF-633 and related objects and structures. Several INL work processes and projects weremore » also monitored to confirm compliance with original INL CRM recommendations and assess the effects of ongoing work. On one occasion, ground disturbing activities within the boundaries of the Critical Infrastructure Test Range Complex (CITRC) were observed by INL CRM staff prepared to respond to any additional finds of Native American human remains. Additionally, the CRM office was notified during two Trespass Investigations conducted by INL Security. Most of the cultural resources monitored in FY 2016 exhibited no adverse impacts, resulting in Type 1 impact assessments. However, Type 2 impacts were noted five times. Three previously reported Type 2 impacts were once again documented at the EBR-I National Historic Landmark, including spalling and deterioration of bricks due to inadequate drainage, minimal maintenance, and rodent infestation. The ANP engines and locomotive on display at the EBR-I Visitors Center also exhibited impacts related to long term exposure. Finally, most of the Arco NPG properties monitored at Central Facilities Area exhibited problems with lack of timely and appropriate maintenance as well as inadequate drainage. No new Type 3 or Type 4 impacts that adversely affected significant cultural resources and threatened

  15. Harry S. Truman Dam and Reservoir, Missouri, Mitigation of the Adverse Effects Upon the Local Paleontological Resources. Volume 2. Plan Maps of Excavations.

    DTIC Science & Technology

    1983-01-01

    7 A-A147 693 HARRY S TRUMAN D’AM AND RESERVOIR MISSOURI MITIGATION OF 1/ THE ADVERSE EFFEC. .0) ILLINOIS STATE MUSEUM SOCIETY SPRINGFIELD d d...BUREAU OF STANDARDS-.1963-A 1 2 qZTM II 0A MITIGATION OF THE ADVERSE EFFECTS UPON THE LOCAL PALEONTOLOGICAL RESOURCES OF THE HARRY S. TRUMAN DAM AND...RESERVOIR OSAGE RIVER BASIN, MISSOURI FINAL REPORT OF FINDINGS VOLUME II: PLAN MAPS OF EXCAVATIONS by Jeffrey J. Saunders, Ph.D. Illinois State Museum

  16. Surrogate species selection for assessing potential adverse environmental impacts of genetically engineered insect-resistant plants on non-target organisms

    PubMed Central

    Carstens, Keri; Cayabyab, Bonifacio; De Schrijver, Adinda; Gadaleta, Patricia G; Hellmich, Richard L; Romeis, Jörg; Storer, Nicholas; Valicente, Fernando H; Wach, Michael

    2014-01-01

    Most regulatory authorities require that developers of genetically engineered insect-resistant (GEIR) crops evaluate the potential for these crops to have adverse impacts on valued non-target organisms (NTOs), i.e., organisms not intended to be controlled by the trait. In many cases, impacts to NTOs are assessed using surrogate species, and it is critical that the data derived from surrogates accurately predict any adverse impacts likely to be observed from the use of the crop in the agricultural context. The key is to select surrogate species that best represent the valued NTOs in the location where the crop is going to be introduced, but this selection process poses numerous challenges for the developers of GE crops who will perform the tests, as well as for the ecologists and regulators who will interpret the test results. These issues were the subject of a conference “Surrogate Species Selection for Assessing Potential Adverse Environmental Impacts of Genetically Engineered Plants on Non-Target Organisms” convened by the Center for Environmental Risk Assessment, ILSI Research Foundation. This report summarizes the proceedings of the conference, including the presentations, discussions and the points of consensus agreed to by the participants. PMID:24637519

  17. Surrogate species selection for assessing potential adverse environmental impacts of genetically engineered insect-resistant plants on non-target organisms.

    PubMed

    Carstens, Keri; Cayabyab, Bonifacio; De Schrijver, Adinda; Gadaleta, Patricia G; Hellmich, Richard L; Romeis, Jörg; Storer, Nicholas; Valicente, Fernando H; Wach, Michael

    2014-01-01

    Most regulatory authorities require that developers of genetically engineered insect-resistant (GEIR) crops evaluate the potential for these crops to have adverse impacts on valued non-target organisms (NTOs), i.e., organisms not intended to be controlled by the trait. In many cases, impacts to NTOs are assessed using surrogate species, and it is critical that the data derived from surrogates accurately predict any adverse impacts likely to be observed from the use of the crop in the agricultural context. The key is to select surrogate species that best represent the valued NTOs in the location where the crop is going to be introduced, but this selection process poses numerous challenges for the developers of GE crops who will perform the tests, as well as for the ecologists and regulators who will interpret the test results. These issues were the subject of a conference "Surrogate Species Selection for Assessing Potential Adverse Environmental Impacts of Genetically Engineered Plants on Non-Target Organisms" convened by the Center for Environmental Risk Assessment, ILSI Research Foundation. This report summarizes the proceedings of the conference, including the presentations, discussions and the points of consensus agreed to by the participants.

  18. 76 FR 50494 - Water Resources Management Plan/Environmental Impact Statement, Mojave National Preserve, San...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... Resources Management Plan/Environmental Impact Statement, Mojave National Preserve, San Bernardino County... Resources Management Plan/Environmental Impact Statement for Mojave National Preserve. SUMMARY: Pursuant to... preparing a Water Resources Management Plan/Environmental Impact Statement (WRMP/EIS). This plan is intended...

  19. A survey of Ethiopian physicians' experiences of bedside rationing: extensive resource scarcity, tough decisions and adverse consequences.

    PubMed

    Defaye, Frehiwot Berhane; Desalegn, Dawit; Danis, Marion; Hurst, Samia; Berhane, Yemane; Norheim, Ole Frithjof; Miljeteig, Ingrid

    2015-10-14

    Resource scarcity in health care is a universal challenge. In high-income settings, bedside rationing is commonly discussed and debated as a means to addressing scarcity. However, little is known about physicians' experiences in resource-limited contexts in low- income countries. Here we describe physicians' experiences regarding scarcity of resources, bedside rationing, use of various strategies to save resources, and perceptions of the consequences of rationing in Ethiopia. A national survey was conducted amongst physicians from 49 public hospitals using stratified, multi-stage sampling in six regions. All physicians in the selected hospitals were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. In total, 587 physicians responded (91% response rate). The majority had experienced system-wide shortages of various types of medical services. The services most frequently reported to be in short supply, either daily or weekly, were access to surgery, specialist and intensive care units, drug prescriptions and admission to hospital (52, 49, 46, 47 and 46% respectively). The most common rationing strategies used daily or weekly were limiting laboratory tests, hospital drugs, radiological investigations and providing second best treatment (47, 47, 47 and 39% respectively). Availability of institutional or national guidelines for whom to see and treat first was lacking. Almost all respondents had witnessed different adverse consequences of resource scarcity; 54% reported seeing patients who, in their estimation, had died due to resource scarcity. Almost 9 out of 10 physicians were so troubled by limited resources that they often regretted their choice of profession. This study provides the first glimpses of the untold story of resource shortage and bedside rationing in Ethiopia. Physicians encounter numerous dilemmas due to resource scarcity, and they report they lack adequate guidance for how to handle

  20. A Framework for Quantitative Assessment of Impacts Related to Energy and Mineral Resource Development

    DOE PAGES

    Haines, Seth S.; Diffendorfer, Jay E.; Balistrieri, Laurie; ...

    2013-05-15

    Natural resource planning at all scales demands methods for assessing the impacts of resource development and use, and in particular it requires standardized methods that yield robust and unbiased results. Building from existing probabilistic methods for assessing the volumes of energy and mineral resources, we provide an algorithm for consistent, reproducible, quantitative assessment of resource development impacts. The approach combines probabilistic input data with Monte Carlo statistical methods to determine probabilistic outputs that convey the uncertainties inherent in the data. For example, one can utilize our algorithm to combine data from a natural gas resource assessment with maps of sagemore » grouse leks and pinon-juniper woodlands in the same area to estimate possible future habitat impacts due to possible future gas development. As another example: one could combine geochemical data and maps of lynx habitat with data from a mineral deposit assessment in the same area to determine possible future mining impacts on water resources and lynx habitat. The approach can be applied to a broad range of positive and negative resource development impacts, such as water quantity or quality, economic benefits, or air quality, limited only by the availability of necessary input data and quantified relationships among geologic resources, development alternatives, and impacts. In conclusion, the framework enables quantitative evaluation of the trade-offs inherent in resource management decision-making, including cumulative impacts, to address societal concerns and policy aspects of resource development.« less

  1. A framework for quantitative assessment of impacts related to energy and mineral resource development

    USGS Publications Warehouse

    Haines, Seth S.; Diffendorfer, James; Balistrieri, Laurie S.; Berger, Byron R.; Cook, Troy A.; Gautier, Donald L.; Gallegos, Tanya J.; Gerritsen, Margot; Graffy, Elisabeth; Hawkins, Sarah; Johnson, Kathleen; Macknick, Jordan; McMahon, Peter; Modde, Tim; Pierce, Brenda; Schuenemeyer, John H.; Semmens, Darius; Simon, Benjamin; Taylor, Jason; Walton-Day, Katherine

    2013-01-01

    Natural resource planning at all scales demands methods for assessing the impacts of resource development and use, and in particular it requires standardized methods that yield robust and unbiased results. Building from existing probabilistic methods for assessing the volumes of energy and mineral resources, we provide an algorithm for consistent, reproducible, quantitative assessment of resource development impacts. The approach combines probabilistic input data with Monte Carlo statistical methods to determine probabilistic outputs that convey the uncertainties inherent in the data. For example, one can utilize our algorithm to combine data from a natural gas resource assessment with maps of sage grouse leks and piñon-juniper woodlands in the same area to estimate possible future habitat impacts due to possible future gas development. As another example: one could combine geochemical data and maps of lynx habitat with data from a mineral deposit assessment in the same area to determine possible future mining impacts on water resources and lynx habitat. The approach can be applied to a broad range of positive and negative resource development impacts, such as water quantity or quality, economic benefits, or air quality, limited only by the availability of necessary input data and quantified relationships among geologic resources, development alternatives, and impacts. The framework enables quantitative evaluation of the trade-offs inherent in resource management decision-making, including cumulative impacts, to address societal concerns and policy aspects of resource development.

  2. 75 FR 29583 - Special Resource Study and Environmental Impact Statement, Coltsville, Hartford, CT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ... DEPARTMENT OF THE INTERIOR National Park Service Special Resource Study and Environmental Impact...: Notice of Termination of the Environmental Impact Statement for the Coltsville Special Resource Study in... Service (NPS) undertook a special resource study (SRS) of the Coltsville Historic District in Hartford...

  3. Understanding Climate Change Impacts on Water Resources

    EPA Pesticide Factsheets

    This training module will increase your understanding of the causes of climate change, its potential impacts on water resources, and the challenges it brings. You also will learn about how managers are working to make the United States more resilient..

  4. [IBEAS design: adverse events prevalence in Latin American hospitals].

    PubMed

    Aranaz-Andrés, J M; Aibar-Remón, C; Limón-Ramírez, R; Amarilla, A; Restrepo, F R; Urroz, O; Sarabia, O; Inga, R; Santivañez, A; Gonseth-García, J; Larizgoitia-Jauregui, I; Agra-Varela, Y; Terol-García, E

    2011-01-01

    To describe the methodological characteristics of the IBEAS study: adverse events prevalence in Latin American hospitals, with the aim of analysing the magnitude, significance and impact of adverse events (AE); to identify the main problems associated with patient safety AE; to increase the capacity of professionals involved in patient safety; and the setting up of patient safety agendas in the participating countries. A patient safety study launched in 35 Latin American hospitals through the analysis of AE in 5 countries: Argentina, Colombia, Costa Rica, Mexico and Peru, using a cross-sectional study using a review of clinical records as the main method. The implications of using a cross-sectional design when studying AE are described, in terms of resources required, internal validity and usefulness related to risk management. The cross-sectional design seems an efficient methodology in terms of time and resources spent, as well as being easy to carry out. Although the cross-sectional design does not review the all hospital episodes, it is able to provide a reliable estimate of prevalence and to support a surveillance system. Because of a possible survival bias, it is likely that the AE which led to hospital admissions will be overestimated, as well as the health related infections or those adverse events which are difficult to identify if the patient is not examined (e.g. contusions). Communication with the ward staff (if the patient is still hospitalised) help in finding the causality and their prevention. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

  5. Proposed methods and endpoints for defining and assessing adverse environmental impact (AEI) on fish communities/populations in Tennessee River reservoirs.

    PubMed

    Hickman, Gary D; Brown, Mary L

    2002-06-07

    Two multimetric indices have been developed to help address fish community (reservoir fish assemblage index [RFAI]) and individual population quality (sport fishing index [SFI]) in Tennessee River reservoirs. The RFAI, with characteristics similar to the index of biotic integrity (IBI) used in stream fish community determinations, was developed to monitor the existing condition of resident fish communities. The index, which incorporates standardized electrofishing of littoral areas and experimental gill netting for limnetic bottom-dwelling species, has been used to determine residential fish community response to various anthropogenic impacts in southeastern reservoirs. The SFI is a multimetric index designed to address the quality of the fishery for individual resident sport fish species in a particular lake or reservoir[4]. The SFI incorporates measures of fish population aspects and angler catch and pressure estimates. This paper proposes 70% of the maximum RFAI score and 10% above the average SFI score for individual species as "screening" endpoints for balanced indigenous populations (BIP) or adverse environmental impact (AEI). Endpoints for these indices indicate: (1) communities/populations are obviously balanced indigenous populations (BIP) indicating no adverse environmental impact (AEI), or are "screened out"; (2) communities/populations are considered to be potentially impacted; and (3) where the resident fish community/population should be considered adversely impacted. Suggestions are also made concerning how examination of individual metric scores can help determine the source or cause of the impact.

  6. Stakeholder analysis methodologies resource book

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Babiuch, W.M.; Farhar, B.C.

    1994-03-01

    Stakeholder analysis allows analysts to identify how parties might be affected by government projects. This process involves identifying the likely impacts of a proposed action and stakeholder groups affected by that action. Additionally, the process involves assessing how these groups might be affected and suggesting measures to mitigate any adverse effects. Evidence suggests that the efficiency and effectiveness of government actions can be increased and adverse social impacts mitigated when officials understand how a proposed action might affect stakeholders. This report discusses how to conduct useful stakeholder analyses for government officials making decisions on energy-efficiency and renewable-energy technologies and theirmore » commercialization. It discusses methodological issues that may affect the validity and reliability of findings, including sampling, generalizability, validity, ``uncooperative`` stakeholder groups, using social indicators, and the effect of government regulations. The Appendix contains resource directories and a list of specialists in stakeholder analysis and involvement.« less

  7. INL Cultural Resource Monitoring Report for FY 2015

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pace, Brenda Ringe; Olson, Christina Liegh; Gilbert, Hollie Kae

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during fiscal year (FY) 2015. Throughout the year, 67 total monitoring visits were completed, with several especially sensitive resources visited on more than one occasion. Overall, FY 2015 monitoring included surveillance of the following 49 individual cultural resource localities: three locations with human remains, one of which is also a cave; nine additional caves; twenty prehistoric archaeological sites; five historic archaeological sites; two historic trails; Experimental Breeder Reactor I (EBR-I), a National Historic Landmark; Aircraft Nuclear Propulsion (ANP) objects located atmore » EBR-I; and eight Arco Naval Proving Ground (NPG) property types. Several INL work processes and projects were also monitored to confirm compliance with original INL CRM recommendations and assess the effects of ongoing work. On two occasions, ground disturbing activities within the boundaries of the Power Burst Facility/Critical Infrastructure Test Range Complex (PBF/CITRC) were observed by INL CRM staff prepared to respond to any additional finds of Native American human remains. Finally, the current location housing INL Archives and Special Collections was evaluated once. Most of the cultural resources monitored in FY 2015 exhibited no adverse impacts, resulting in Type 1 impact assessments. However, Type 2 impacts were noted 13 times. In one case, a portion of a historic trail was graded without prior review or coordination with the INL CRM Office, resulting in impacts to the surface of the trail and one archaeological site. Evidence of unauthorized artifact collection/ looting was also documented at three archaeological sites located along INL powerlines. Federal agents concluded a FY 2012 investigation by filing civil charges and levying fine under the Archaeological Resource Protection Act against one INL employee for

  8. A Holistic Look at Minimizing Adverse Environmental Impact Under Section 316(b) of the Clean Water Act

    DOE PAGES

    Veil, John A.; Puder, Markus G.; Littleton, Debra J.; ...

    2002-01-01

    Section 316(b) of the Clean Water Act (CWA) requires that “the location, design, construction, and capacity of cooling water intake structures reflect the best technology available for minimizing adverse environmental impact.” As the U.S. Environmental Protection Agency (EPA) develops new regulations to implement Section 316(b), much of the debate has centered on adverse impingement and entrainment impacts of cooling-water intake structures. Depending on the specific location and intake layout, once-through cooling systems withdrawing many millions of gallons of water per day can, to a varying degree, harm fish and other aquatic organisms in the water bodies from which the coolingmore » water is withdrawn. Therefore, opponents of once-through cooling systems have encouraged the EPA to require wet or dry cooling tower systems as the best technology available (BTA), without considering site-specific conditions. However, within the context of the broader scope of the CWA mandate, this focus seems too narrow. Therefore, this article examines the phrase “minimizing adverse environmental impact” in a holistic light. Emphasis is placed on the analysis of the terms “environmental” and “minimizing.” Congress chose “environmental” in lieu of other more narrowly focused terms like “impingement and entrainment,” “water quality,” or “aquatic life.” In this light, BTA for cooling-water intake structures must minimize the entire suite of environmental impacts, as opposed to just those associated with impingement and entrainment. Wet and dry cooling tower systems work well to minimize entrainment and impingement, but they introduce other equally important impacts because they impose an energy penalty on the power output of the generating unit. The energy penalty results from a reduction in plant operating efficiency and an increase in internal power consumption. As a consequence of the energy penalty, power companies must generate additional

  9. Assessing planetary and regional nitrogen boundaries related to food security and adverse environmental impacts

    NASA Astrophysics Data System (ADS)

    de Vries, Wim; Kros, Hans; Kroeze, Carolien; Seitzinger, Sybil

    2014-05-01

    In this presentation, we first discuss the concept of -, governance interest in- and criticism on planetary boundaries, specifically with respect to the nitrogen (N) cycle. We then systematically evaluate the criticism and argue that planetary N boundaries need to include both the benefits and adverse impacts of reactive N (Nr) and the spatial variability of Nr impacts, in terms of shortage and surplus, being main arguments for not deriving such boundaries. Next, we present an holistic approach for an updated planetary N boundary by considering the need to: (i) avoid adverse impacts of elevated Nr emissions to water, air and soils, and (ii) feed the world population in an adequate way. The derivation of a planetary N boundary, in terms of anthropogenic fixation of di-nitrogen (N2) by growing legumes and production of N fertilizer, is illustrated by (i) identification of multiple threat N indicators and setting critical limits for them, (ii) back calculating critical N losses from critical limits for N indicators, while accounting for the spatial variability of indicators and their exceedance and (iii) back calculating critical N fixation rates from critical N losses. The derivation of the needed planetary N fixation is assessed from the global population, the recommended dietary N consumption per capita and the N use efficiency in the complete chain from N fixation to N consumption. Results of example applications show that the previously suggested planetary N boundary of 25% of the current value is too low in view of needed N fixation and also unnecessary in view of most environmental impacts. We also illustrate the impacts of changes in the N use efficiency on planetary boundaries in terms of critical N fixation rates.

  10. Adverse childhood experiences: assessing the impact on health and school engagement and the mitigating role of resilience.

    PubMed

    Bethell, Christina D; Newacheck, Paul; Hawes, Eva; Halfon, Neal

    2014-12-01

    The ongoing longitudinal Adverse Childhood Experiences Study of adults has found significant associations between chronic conditions; quality of life and life expectancy in adulthood; and the trauma and stress associated with adverse childhood experiences, including physical or emotional abuse or neglect, deprivation, or exposure to violence. Less is known about the population-based epidemiology of adverse childhood experiences among US children. Using the 2011-12 National Survey of Children's Health, we assessed the prevalence of adverse childhood experiences and associations between them and factors affecting children's development and lifelong health. After we adjusted for confounding factors, we found lower rates of school engagement and higher rates of chronic disease among children with adverse childhood experiences. Our findings suggest that building resilience-defined in the survey as "staying calm and in control when faced with a challenge," for children ages 6-17-can ameliorate the negative impact of adverse childhood experiences. We found higher rates of school engagement among children with adverse childhood experiences who demonstrated resilience, as well as higher rates of resilience among children with such experiences who received care in a family-centered medical home. We recommend a coordinated effort to fill knowledge gaps and translate existing knowledge about adverse childhood experiences and resilience into national, state, and local policies, with a focus on addressing childhood trauma in health systems as they evolve during ongoing reform. Project HOPE—The People-to-People Health Foundation, Inc.

  11. A holistic model for evaluating the impact of individual technology-enhanced learning resources.

    PubMed

    Pickering, James D; Joynes, Viktoria C T

    2016-12-01

    The use of technology within education has now crossed the Rubicon; student expectations, the increasing availability of both hardware and software and the push to fully blended learning environments mean that educational institutions cannot afford to turn their backs on technology-enhanced learning (TEL). The ability to meaningfully evaluate the impact of TEL resources nevertheless remains problematic. This paper aims to establish a robust means of evaluating individual resources and meaningfully measure their impact upon learning within the context of the program in which they are used. Based upon the experience of developing and evaluating a range of mobile and desktop based TEL resources, this paper outlines a new four-stage evaluation process, taking into account learner satisfaction, learner gain, and the impact of a resource on both the individual and the institution in which it has been adapted. A new multi-level model of TEL resource evaluation is proposed, which includes a preliminary evaluation of need, learner satisfaction and gain, learner impact and institutional impact. Each of these levels are discussed in detail, and in relation to existing TEL evaluation frameworks. This paper details a holistic, meaningful evaluation model for individual TEL resources within the specific context in which they are used. It is proposed that this model is adopted to ensure that TEL resources are evaluated in a more meaningful and robust manner than is currently undertaken.

  12. Potential impacts of global warming on water resources in southern California.

    PubMed

    Beuhler, M

    2003-01-01

    Global warming will have a significant impact on water resources within the 20 to 90-year planning period of many water projects. Arid and semi-arid regions such as Southern California are especially vulnerable to anticipated negative impacts of global warming on water resources. Long-range water facility planning must consider global climate change in the recommended mix of new facilities needed to meet future water requirements. The generally accepted impacts of global warming include temperature, rising sea levels, more frequent and severe floods and droughts, and a shift from snowfall to rain. Precipitation changes are more difficult to predict. For Southern California, these impacts will be especially severe on surface water supplies. Additionally, rising sea levels will exacerbate salt-water intrusion into freshwater and impact the quality of surface water supplies. Integrated water resources planning is emerging as a tool to develop water supplies and demand management strategies that are less vulnerable to the impacts of global warming. These tools include water conservation, conjunctive use of surface and groundwater and desalination of brackish water and possibly seawater. Additionally, planning for future water needs should include explicit consideration of the potential range of global warming impacts through techniques such as scenario planning.

  13. The Risk of Adverse Impact in Selections Based on a Test with Known Effect Size

    ERIC Educational Resources Information Center

    De Corte, Wilfried; Lievens, Filip

    2005-01-01

    The authors derive the exact sampling distribution function of the adverse impact (AI) ratio for single-stage, top-down selections using tests with known effect sizes. Subsequently, it is shown how this distribution function can be used to determine the risk that a future selection decision on the basis of such tests will result in an outcome that…

  14. Emergency department overcrowding: the impact of resource scarcity on physician job satisfaction.

    PubMed

    Rondeau, Kent V; Francescutti, Louis H

    2005-01-01

    Emergency departments in most developed countries have been experiencing significant overcrowding under a regime of severe resource constraints. Physicians in emergency departments increasingly find themselves toiling in workplaces that are characterized by diminished availability of, limited access to, and decreased stability of critical resources. Severe resource constraints have the potential to greatly weaken the overall job satisfaction of emergency physicians. This article examines the impact of hospital resource constraints on the job satisfaction of a large sample of emergency physicians in Canada. After controlling for workflow and patient characteristics and for various institutional and physician characteristics, institutional resource constraints are found to be major contributors to emergency physician job dissatisfaction. Resource factors that have the greatest impact on job satisfaction include availability of emergency room physicians, access to hospital technology and emergency beds, and stability of financial (investment) resources.

  15. Lessons learned for reducing the negative impact of adverse events on patients, health professionals and healthcare organizations.

    PubMed

    Mira, Jose Joaquin; Lorenzo, Susana; Carrillo, Irene; Ferrús, Lena; Silvestre, Carmen; Astier, Pilar; Iglesias-Alonso, Fuencisla; Maderuelo, Jose Angel; Pérez-Pérez, Pastora; Torijano, Maria Luisa; Zavala, Elena; Scott, Susan D

    2017-08-01

    To summarize the knowledge about the aftermath of adverse events (AEs) and develop a recommendation set to reduce their negative impact in patients, health professionals and organizations in contexts where there is no previous experiences and apology laws are not present. Review studies published between 2000 and 2015, institutional websites and experts' opinions on patient safety. Studies published and websites on open disclosure, and the second and third victims' phenomenon. Four Focus Groups participating 27 healthcare professionals. Study characteristic and outcome data were abstracted by two authors and reviewed by the research team. Fourteen publications and 16 websites were reviewed. The recommendations were structured around eight areas: (i) safety and organizational policies, (ii) patient care, (iii) proactive approach to preventing reoccurrence, (iv) supporting the clinician and healthcare team, (v) activation of resources to provide an appropriate response, (vi) informing patients and/or family members, (vii) incidents' analysis and (viii) protecting the reputation of health professionals and the organization. Recommendations preventing aftermath of AEs have been identified. These have been designed for the hospital and the primary care settings; to cope with patient's emotions and for tacking the impact of AE in the second victim's colleagues. Its systematic use should help for the establishment of organizational action plans after an AE. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  16. A tool to determine financial impact of adverse events in health care: healthcare quality calculator.

    PubMed

    Yarbrough, Wendell G; Sewell, Andrew; Tickle, Erin; Rhinehardt, Eric; Harkleroad, Rod; Bennett, Marc; Johnson, Deborah; Wen, Li; Pfeiffer, Matthew; Benegas, Manny; Morath, Julie

    2014-12-01

    Hospital leaders lack tools to determine the financial impact of poor patient outcomes and adverse events. To provide health-care leaders with decision support for investments to improve care, we created a tool, the Healthcare Quality Calculator (HQCal), which uses institution-specific financial data to calculate impact of poor patient outcomes or quality improvement on present and future margin. Excel and Web-based versions of the HQCal were based on a cohort study framework and created with modular components including major drivers of cost and reimbursement. The Healthcare Quality Calculator (HQCal) compares payment, cost, and profit/loss for patients with and without poor outcomes or quality issues. Cost and payment information for groups with and without quality issues are used by the HQCal to calculate profit or loss. Importantly, institution-specific payment and cost data are used to calculate financial impact and attributable cost associated with poor patient outcomes, adverse events, or quality issues. Because future cost and reimbursement changes can be forecast, the HQCal incorporates a forward-looking component. The flexibility of the HQCal was demonstrated using surgical site infections after abdominal surgery and postoperative surgical airway complications. The Healthcare Quality Calculator determines financial impact of poor patient outcomes and the benefit of initiatives to improve quality. The calculator can identify quality issues that would provide the largest financial benefit if improved; however, it cannot identify specific interventions. The calculator provides a tool to improve transparency regarding both short- and long-term financial consequences of funding, or failing to fund, initiatives to close gaps in quality or improve patient outcomes.

  17. Regional economic impacts of Grand Canyon river runners.

    PubMed

    Hjerpe, Evan E; Kim, Yeon-Su

    2007-10-01

    Economic impact analysis (EIA) of outdoor recreation can provide critical social information concerning the utilization of natural resources. Outdoor recreation and other non-consumptive uses of resources are viewed as environmentally friendly alternatives to extractive-type industries. While outdoor recreation can be an appropriate use of resources, it generates both beneficial and adverse socioeconomic impacts on rural communities. The authors used EIA to assess the regional economic impacts of rafting in Grand Canyon National Park. The Grand Canyon region of northern Arizona represents a rural US economy that is highly dependent upon tourism and recreational expenditures. The purpose of this research is twofold. The first is to ascertain the previously unknown regional economic impacts of Grand Canyon river runners. The second purpose is to examine attributes of these economic impacts in terms of regional multipliers, leakage, and types of employment created. Most of the literature on economic impacts of outdoor recreation has focused strictly on the positive economic impacts, failing to illuminate the coinciding adverse and constraining economic impacts. Examining the attributes of economic impacts can highlight deficiencies and constraints that limit the economic benefits of recreation and tourism. Regional expenditure information was obtained by surveying non-commercial boaters and commercial outfitters. The authors used IMPLAN input-output modeling to assess direct, indirect, and induced effects of Grand Canyon river runners. Multipliers were calculated for output, employment, and income. Over 22,000 people rafted on the Colorado River through Grand Canyon National Park in 2001, resulting in an estimated $21,100,000 of regional expenditures to the greater Grand Canyon economy. However, over 50% of all rafting-related expenditures were not captured by the regional economy and many of the jobs created by the rafting industry are lower-wage and seasonal. Policy

  18. Measuring and moderating the water resource impact of biofuel production and trade

    NASA Astrophysics Data System (ADS)

    Fingerman, Kevin Robert

    Energy systems and water resources are inextricably linked, especially in the case of bioenergy, which can require up to three orders of magnitude more water than other energy carriers. Water scarcity already affects about 1 in 5 people globally, and stands to be exacerbated in many locales by current biofuel expansion plans. This dissertation engages with several of the analytical and governance challenges raised by this connection between bioenergy expansion and global water resources. My examination begins with an overview of important concepts in water resource analysis, followed by a review of current literature on the water impacts of most major energy pathways. I then report on a case study of ethanol fuel in California. This work employed a coupled agro-climatic and life cycle assessment (LCA) model to estimate the water resource impacts of several bioenergy expansion scenarios at a county-level resolution. It shows that ethanol production in California regularly consumes more than 1000 gallons of water per gallon of fuel produced, and that 99% of life-cycle water consumption occurs in the feedstock cultivation phase. This analysis then delves into the complexity of life cycle impact assessment for water resources. Despite improvements in water accounting methods, impact assessment must contend with the fact that different water sources are not necessarily commensurable, and that impacts depend on the state of the resource base that is drawn upon. I adapt water footprinting and LCA techniques to the bioenergy context, describing comprehensive inventory approaches and developing a process for characterizing (weighting) consumption values to enable comparison across resource bases. This process draws on metrics of water stress, accounting for environmental flow requirements, climatic variability, and non-linearity of water stress effects. My assessment framework was developed in hopes that it would be useful in managing the risks and impacts it describes. The

  19. Hydrological externalities and livelihoods impacts: Informed communities for better resource management

    NASA Astrophysics Data System (ADS)

    Reddy, V. Ratna

    2012-01-01

    SummaryHydrological knowledge or information has mostly remained in the domain of scientific community. The communities that interact with the hydrological aspects such as groundwater and surface water on a day to day basis are hardly aware of the information that could critically influence their livelihoods. From the perspective of the communities' information pertaining to groundwater aquifer characters, potential to provide the water resource, surface groundwater interactions in varying geo-hydrological conditions are important. The 'public good' nature of the resources and their linkages with ecological systems gives rise to externalities that could be pervasive. In a number of countries, especially the developing countries, groundwater is the single largest source of drinking as well as irrigation water. In the absence of scientific information with the communities, extraction of groundwater resources for productive purposes has become a risky venture leading to adverse impacts on livelihoods. The externalities associated with over exploitation of groundwater resources and the resulting widespread well failure is identified as one of the main reasons for pushing farmers into debt trap and one of the reasons for farmer suicides in India. The negative externalities are increasingly becoming severe in the context of climate variability. This paper attempts to highlight the importance of hydrological information to the user communities from a socioeconomic perspective using a newly developed framework 'REDUCE' based on theories of effective communication. It shows, based on the evidence, how farming communities are getting affected in the absence of the basic hydrological information across socioeconomic groups. It is argued, using relevant information that the negative externalities could be mitigated to a large extent with proper dissemination of information among the communities and capacitating them to measure and use the information on their own. In order to

  20. Creating a Resource Center for Homeschoolers: The Impact of Technology.

    ERIC Educational Resources Information Center

    Javid, Mahnaz A.

    1998-01-01

    Summarizes the findings of a two-month case study of Edmonds Cyberschool (Washington), a resource center for homeschoolers. The study focused on the impact of technology on students' learning as indicated in three areas: attitude toward technology, the use of technology, and value of technology versus other available resources. (Author/LRW)

  1. Impact of adverse life events on individuals with low and high schizotypy in a nonpatient sample.

    PubMed

    Kocsis-Bogár, Krisztina; Miklósi, Mónika; Forintos, Dóra Perczel

    2013-03-01

    The aims of this study were to gain a better understanding of adverse life events connected with the development of schizotypal personality traits and, also, to examine whether subclinical schizotypy has a relationship with vulnerability to traumatic intrusions and avoidance. In a cross-sectional design, 198 undergraduate students completed the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE), the Impact of Event Scale (IES), and Paykel's Life Events Scale, together with other relevant scales. The number of adverse life events was significantly related to overall schizotypy measured by O-LIFE scores and positive schizotypy measured by the Unusual Experiences (UnEx) subscale. The subjective severity of life events was significantly related to Cognitive Disorganization (CogDis). Measures of positive schizotypy (UnEx and CogDis) were significantly related to the scores on the IES and on the intrusion and avoidance subscales, too. Adverse life events are associated with schizotypal personality traits, which contribute to a tendency for traumatic intrusions, even in a nonpatient sample.

  2. [Impacts of cross-habitat resource subsidies on ecosystems: A review.

    PubMed

    Zhang, Yi Xin; Xiang, Hong Yong

    2017-02-01

    The flux of matter, energy and nutrients across ecosystems, i.e., resource subsidy, is a fundamental attribute of ecosystems, as well as one of basic research questions in ecology. Common subsidies include leaf litter and terrestrial insects that fall into waters, the adults of aquatic insects, spawning salmon. The allocthonous input of resource subsidy can influence individual organisms, populations, communities, biodiversity and ecosystem functioning, such as enhancing individual growth, increasing species abundance and diversity, affecting community structure, enhancing secondary productivity, influencing food-chain length and food web. Due to increased human impacts on environments, especially at aspects of land use, climate change and invasive species, the influence of anthropogenic disturbance on cross-ecosystem resource subsidies will be intensified at both spacial and temporary scales, so that ecosystems will face severer threats. Accordingly, future ecological researches in this field should emphasize the following aspects: impacts of single and multiple stressors on subsidies and ecosystems, implementation of dynamic resource subsidies on ecosystem restoration and management, the dark sides of subsidy relating with pollutants, and basic ecological research on cross-ecosystem resource subsidy in tropics and sub-tropics, as well in China.

  3. Impact of childhood adversity on the course and suicidality of depressive disorders: the CRESCEND study.

    PubMed

    Kim, Sung-Wan; Kang, Hee-Ju; Kim, Seon-Young; Kim, Jae-Min; Yoon, Jin-Sang; Jung, Sung-Won; Lee, Min-Soo; Yim, Hyeon-Woo; Jun, Tae-Youn

    2013-10-01

    The impact of childhood adversity persists across the life course. This study aimed to investigate the associations of childhood adversity with the course, suicidality, and treatment outcomes of depressive disorders. A total of 919 people with depressive disorders were recruited. Childhood adversities (≤12 years old) were ascertained using a checklist, in sexual abuse, physical abuse by parents, and separation of parents. Various assessment scales were administered at baseline and over 12 weeks of antidepressants treatment. All three forms of childhood adversity were associated with an increased likelihood of experiencing more current stressful events. Scores on the Beck Depression Inventory and Hamilton Anxiety Rating Scale were significantly higher in participants with a history of sexual abuse. Scores on the Beck Depression Inventory, Hamilton Depression Rating Scale, and Perceived Stress Scale were significantly higher, and scores on the WHO Quality of life instrument were significantly lower in participants with a history of physical abuse by parents. They were more likely to receive augmentation and combination treatment after the initial antidepressant treatment, whereas overall response rates to treatment did not differ. Scores on the Beck Scale for suicide ideation were significantly higher after treatment and/or at baseline in patients with sexual or physical abuse. Physical illness was more prevalent in individuals with physical abuse by parents or separation of parents. Depressive patients with a history of childhood adversities had more severe and chronic forms of depression with high suicidality. More intensive treatment with particular clinical attention is indicated for this special population. © 2013 Wiley Periodicals, Inc.

  4. Evaluation of a Broad-Spectrum Partially Automated Adverse Event Surveillance System: A Potential Tool for Patient Safety Improvement in Hospitals With Limited Resources.

    PubMed

    Saikali, Melody; Tanios, Alain; Saab, Antoine

    2017-11-21

    The aim of the study was to evaluate the sensitivity and resource efficiency of a partially automated adverse event (AE) surveillance system for routine patient safety efforts in hospitals with limited resources. Twenty-eight automated triggers from the hospital information system's clinical and administrative databases identified cases that were then filtered by exclusion criteria per trigger and then reviewed by an interdisciplinary team. The system, developed and implemented using in-house resources, was applied for 45 days of surveillance, for all hospital inpatient admissions (N = 1107). Each trigger was evaluated for its positive predictive value (PPV). Furthermore, the sensitivity of the surveillance system (overall and by AE category) was estimated relative to incidence ranges in the literature. The surveillance system identified a total of 123 AEs among 283 reviewed medical records, yielding an overall PPV of 52%. The tool showed variable levels of sensitivity across and within AE categories when compared with the literature, with a relatively low overall sensitivity estimated between 21% and 44%. Adverse events were detected in 23 of the 36 AE categories defined by an established harm classification system. Furthermore, none of the detected AEs were voluntarily reported. The surveillance system showed variable sensitivity levels across a broad range of AE categories with an acceptable PPV, overcoming certain limitations associated with other harm detection methods. The number of cases captured was substantial, and none had been previously detected or voluntarily reported. For hospitals with limited resources, this methodology provides valuable safety information from which interventions for quality improvement can be formulated.

  5. Natural biotic resources in LCA: Towards an impact assessment model for sustainable supply chain management.

    PubMed

    Crenna, Eleonora; Sozzo, Sara; Sala, Serenella

    2018-01-20

    Natural resources, biotic and abiotic, are fundamental from both the ecological and socio-economic point of view, being at the basis of life-support. However, since the demand for finite resources continues to increase, the sustainability of current production and consumption patterns is questioned both in developed and developing countries. A transition towards an economy based on biotic renewable resources (bio-economy) is considered necessary in order to support a steady provision of resources, representing an alternative to an economy based on fossil and abiotic resources. However, to ensure a sustainable use of biotic resources, there is the need of properly accounting for their use along supply chains as well as defining a robust and comprehensive impact assessment model. Since so far naturally occurring biotic resources have gained little attention in impact assessment methods, such as life cycle assessment, the aim of this study is to enable the inclusion of biotic resources in the assessment of products and supply chains. This paper puts forward a framework for biotic resources assessment, including: i) the definition of system boundaries between ecosphere and technosphere, namely between naturally occurring and man-made biotic resources; ii) a list of naturally occurring biotic resources which have a commercial value, as basis for building life cycle inventories (NOBR, e.g. wild animals, plants etc); iii) an impact pathway to identify potential impacts on both resource provision and ecosystem quality; iv) a renewability-based indicator (NOBRri) for the impact assessment of naturally occurring biotic resources, including a list of associated characterization factors. The study, building on a solid review of literature and of available statistical data, highlights and discusses the critical aspects and paradoxes related to biotic resource inclusion in LCA: from the system boundaries definition up to the resource characterization.

  6. The Impact of Postnatal Depression and Associated Adversity on Early Mother-Infant Interactions and Later Infant Outcome.

    ERIC Educational Resources Information Center

    Murray, Lynne; And Others

    1996-01-01

    Examined the impact of maternal depression and adversity on mother-infant face-to-face interactions at 2 months, and on subsequent infant cognitive development and attachment. Disturbances in early mother-infant interactions were found to be predictive of poorer infant cognitive outcomes at 18 months. (MDM)

  7. The two sides of adversity: the effect of distant versus recent adversity on updating emotional content in working memory.

    PubMed

    Levens, Sara M; Armstrong, Laura Marie; Orejuela-Dávila, Ana I; Alverio, Tabitha

    2017-09-01

    Previous research suggests that adversity can have both adaptive and maladaptive effects, yet the emotional and working memory processes that contribute to more or less adaptive outcomes are unclear. The present study sought to investigate how updating emotional content differs in adolescents who have experienced past, recent, or no adversity. Participants who had experienced distant adversity (N = 53), no adversity (N = 58), or recent adversity only (N = 20) performed an emotion n-back task with emotional facial expressions. Results revealed that the distant adversity group exhibited significantly faster reaction times (RTs) than the no adversity and recent adversity only groups. In contrast, the recent adversity only group exhibited significantly slower RTs and more errors than the distant adversity and no adversity groups. These results suggest an emotion and executive control pathway by which both the benefits and negative effects of adversity may be conferred. Results also highlight the importance of time in assessing the impact of adversity.

  8. Estimation of potential impacts and natural resource damages of oil.

    PubMed

    McCay, Deborah French; Rowe, Jill Jennings; Whittier, Nicole; Sankaranarayanan, Sankar; Etkin, Dagmar Schmidt

    2004-02-27

    Methods were developed to estimate the potential impacts and natural resource damages resulting from oil spills using probabilistic modeling techniques. The oil fates model uses wind data, current data, and transport and weathering algorithms to calculate mass balance of fuel components in various environmental compartments (water surface, shoreline, water column, atmosphere, sediments, etc.), oil pathway over time (trajectory), surface distribution, shoreline oiling, and concentrations of the fuel components in water and sediments. Exposure of aquatic habitats and organisms to whole oil and toxic components is estimated in the biological model, followed by estimation of resulting acute mortality and ecological losses. Natural resource damages are based on estimated costs to restore equivalent resources and/or ecological services, using Habitat Equivalency Analysis (HEA) and Resource Equivalency Analysis (REA) methods. Oil spill modeling was performed for two spill sites in central San Francisco Bay, three spill sizes (20th, 50th, and 95th percentile volumes from tankers and larger freight vessels, based on an analysis of likely spill volumes given a spill has occurred) and four oil types (gasoline, diesel, heavy fuel oil, and crude oil). The scenarios were run in stochastic mode to determine the frequency distribution, mean and standard deviation of fates, impacts, and damages. This work is significant as it demonstrates a statistically quantifiable method for estimating potential impacts and financial consequences that may be used in ecological risk assessment and cost-benefit analyses. The statistically-defined spill volumes and consequences provide an objective measure of the magnitude, range and variability of impacts to wildlife, aquatic organisms and shorelines for potential spills of four oil/fuel types, each having distinct environmental fates and effects.

  9. 76 FR 17962 - Strengthening the Scientific Understanding of Climate Change Impacts on Freshwater Resources of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... Understanding of Climate Change Impacts on Freshwater Resources of the United States AGENCY: U.S. Geological... Scientific Understanding of Climate Change Impacts on Freshwater Resources of the United States''. The report reviews key issues related to freshwater resource data and climate change and identifies next steps to...

  10. Computational Approaches for Identifying Adverse Outcome Pathways

    EPA Science Inventory

    Adverse Outcome Pathways (AOPs) provide a framework for organizing toxicity information to improve predictions of the potential adverse impact of environment stressors on humans or wildlife populations, but these benefits are currently limited by the small number of AOPs currentl...

  11. Impact of e-resources on learning in biochemistry: first-year medical students' perceptions.

    PubMed

    Varghese, Joe; Faith, Minnie; Jacob, Molly

    2012-05-16

    E-learning resources (e-resources) have been widely used to facilitate self-directed learning among medical students. The Department of Biochemistry at Christian Medical College (CMC), Vellore, India, has made available e-resources to first-year medical students to supplement conventional lecture-based teaching in the subject. This study was designed to assess students' perceptions of the impact of these e-resources on various aspects of their learning in biochemistry. Sixty first-year medical students were the subjects of this study. At the end of the one-year course in biochemistry, the students were administered a questionnaire that asked them to assess the impact of the e-resources on various aspects of their learning in biochemistry. Ninety-eight percent of students had used the e-resources provided to varying extents. Most of them found the e-resources provided useful and of a high quality. The majority of them used these resources to prepare for periodic formative and final summative assessments in the course. The use of these resources increased steadily as the academic year progressed. Students said that the extent to which they understood the subject (83%) and their ability to answer questions in assessments (86%) had improved as a result of using these resources. They also said that they found biochemistry interesting (73%) and felt motivated to study the subject (59%). We found that first-year medical students extensively used the e-resources in biochemistry that were provided. They perceived that these resources had made a positive impact on various aspects of their learning in biochemistry. We conclude that e-resources are a useful supplement to conventional lecture-based teaching in the medical curriculum.

  12. Tourism's impacts on natural resources: A positive case from China.

    PubMed

    Li, Wenjun; Zhang, Qian; Liu, Chunyan; Xue, Qifu

    2006-10-01

    Tourism development may result in negative impacts on natural resources owing to overuse and mismanagement. However, tourism may also play positive roles in natural resource conservation, which has rarely been verified in practice, although some researchers have demonstrated this in theory. In this article, taking the Jiuzhaigou Biosphere Reserve as a case study area, we conducted an analysis for the environmental impacts from tourism development based on social survey and interpretation of remote sensing images. The results show that the natural environment was not degraded and some indicators are even improving because all the residents have participated in tourism and given up farming and hunting. It is concluded that it is possible to use tourism as a way to balance natural resource conservation and economic development under the preconditions of making effective policies to encourage and help local people participate in tourism business and to benefit from it.

  13. Tourism's Impacts on Natural Resources: A Positive Case from China

    NASA Astrophysics Data System (ADS)

    Li, Wenjun; Zhang, Qian; Liu, Chunyan; Xue, Qifu

    2006-10-01

    Tourism development may result in negative impacts on natural resources owing to overuse and mismanagement. However, tourism may also play positive roles in natural resource conservation, which has rarely been verified in practice, although some researchers have demonstrated this in theory. In this article, taking the Jiuzhaigou Biosphere Reserve as a case study area, we conducted an analysis for the environmental impacts from tourism development based on social survey and interpretation of remote sensing images. The results show that the natural environment was not degraded and some indicators are even improving because all the residents have participated in tourism and given up farming and hunting. It is concluded that it is possible to use tourism as a way to balance natural resource conservation and economic development under the preconditions of making effective policies to encourage and help local people participate in tourism business and to benefit from it.

  14. Force Reduction Impacts on Resourcing Army Operational Requirements

    DTIC Science & Technology

    2017-03-10

    scenarios involving parametric changes to demand for and supply of manpower and equipment from the institutional Army. This type of mission- based ...i SPECIAL REPORT Force Reduction Impacts on Resourcing Army Operational Requirements By Dynamics Research Corporation In Partial... Research .................................................................................................. 12 2.1.2 Identifying and Collecting Unit

  15. Simulated Impacts of El Nino/Southern Oscillation on United States Water Resources

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Thomson, Allison M.; Brown, Robert A.; Rosenberg, Norman J.

    The El Nino/Southern Oscillation alters global weather patterns with consequences for fresh water quality and supply. ENSO events impact regions and natural resource sectors around the globe. For example, in 1997-98, a strong El Ni?o brought warm ocean temperatures, flooding and record snowfall to the west coast of the US. Research on ENSO events and their impacts has improved long range weather predictions, potentially reducing the damage and economic cost of these anomalous weather patterns. Here, we simulate the impacts of four types of ENSO states on water resources in the conterminous United States. We distinguish between Neutral, El Ni?o,more » La Ni?a and strong El Ni?o years over the period of 1960-1989. Using climate statistics that characterize these ENSO states to drive the HUMUS water resources model, we examine the effects of 'pure' ENSO events, without complications from transition periods. Strong El Ni?o is not simply an amplification of El Ni?o; it leads to strikingly different consequences for climate and water resources.« less

  16. Impact of e-resources on learning in biochemistry: first-year medical students’ perceptions

    PubMed Central

    2012-01-01

    Background E-learning resources (e-resources) have been widely used to facilitate self-directed learning among medical students. The Department of Biochemistry at Christian Medical College (CMC), Vellore, India, has made available e-resources to first-year medical students to supplement conventional lecture-based teaching in the subject. This study was designed to assess students’ perceptions of the impact of these e-resources on various aspects of their learning in biochemistry. Methods Sixty first-year medical students were the subjects of this study. At the end of the one-year course in biochemistry, the students were administered a questionnaire that asked them to assess the impact of the e-resources on various aspects of their learning in biochemistry. Results Ninety-eight percent of students had used the e-resources provided to varying extents. Most of them found the e-resources provided useful and of a high quality. The majority of them used these resources to prepare for periodic formative and final summative assessments in the course. The use of these resources increased steadily as the academic year progressed. Students said that the extent to which they understood the subject (83%) and their ability to answer questions in assessments (86%) had improved as a result of using these resources. They also said that they found biochemistry interesting (73%) and felt motivated to study the subject (59%). Conclusions We found that first-year medical students extensively used the e-resources in biochemistry that were provided. They perceived that these resources had made a positive impact on various aspects of their learning in biochemistry. We conclude that e-resources are a useful supplement to conventional lecture-based teaching in the medical curriculum. PMID:22510159

  17. The Health Impact Assessment (HIA) Resource and Tool Compilation

    EPA Pesticide Factsheets

    The compilation includes tools and resources related to the HIA process and can be used to collect and analyze data, establish a baseline profile, assess potential health impacts, and establish benchmarks and indicators for monitoring and evaluation.

  18. Adverse events in British hospitals: preliminary retrospective record review

    PubMed Central

    Vincent, Charles; Neale, Graham; Woloshynowych, Maria

    2001-01-01

    Objectives To examine the feasibility of detecting adverse events through record review in British hospitals and to make preliminary estimates of the incidence and costs of adverse events. Design Retrospective review of 1014 medical and nursing records. Setting Two acute hospitals in Greater London area. Main outcome measure Number of adverse events. Results 110 (10.8%) patients experienced an adverse event, with an overall rate of adverse events of 11.7% when multiple adverse events were included. About half of these events were judged preventable with ordinary standards of care. A third of adverse events led to moderate or greater disability or death. Conclusions These results suggest that adverse events are a serious source of harm to patients and a large drain on NHS resources. Some are major events; others are frequent, minor events that go unnoticed in routine clinical care but together have massive economic consequences. PMID:11230064

  19. The impact of childhood adversity on the persistence of psychotic symptoms: a systematic review and meta-analysis.

    PubMed

    Trotta, A; Murray, R M; Fisher, H L

    2015-01-01

    Evidence suggests that childhood adversity is associated with the development of psychotic experiences (PE), psychotic symptoms and disorders. However, less is known regarding the impact of early adversity on the persistence of PE and clinically relevant psychosis. Thus we conducted a systematic review of the association between childhood adversity and the course of PE and symptoms over time. A systematic search of Medline, EMBASE and PsychINFO databases was undertaken to identify articles published between January 1956 and November 2014. We included studies conducted on general population samples, individuals at ultra-high risk (UHR) of psychosis, and patients with full-blown psychotic disorders. A meta-analysis was performed on a subgroup. A total of 20 studies were included. Of these, 17 reported positive associations between exposure to overall or specific subtypes of childhood adversity and persistence of PE or clinically relevant psychotic symptoms. A meta-analysis of nine studies yielded a weighted odds ratio of 1.76 [95% confidence interval (CI) 1.19-2.32, p < 0.001] for general population studies and 1.55 (95% CI 0.32-2.77, p = 0.007) for studies conducted using clinical populations. The available evidence is limited but tentatively suggests that reported exposure to adverse events in childhood is associated with persistence of PE and clinically relevant psychotic symptoms. This partially strengthens the case for addressing the consequences of early adversity in individuals presenting with psychotic phenomena to improve long-term outcomes. However, the heterogeneity of studies was high which urges caution in interpreting the results and highlights the need for more methodologically robust studies.

  20. The impact of outpatient chemotherapy-related adverse events on the quality of life of breast cancer patients.

    PubMed

    Tachi, Tomoya; Teramachi, Hitomi; Tanaka, Kazuhide; Asano, Shoko; Osawa, Tomohiro; Kawashima, Azusa; Yasuda, Masahiro; Mizui, Takashi; Nakada, Takumi; Noguchi, Yoshihiro; Tsuchiya, Teruo; Goto, Chitoshi

    2015-01-01

    The objective of our study was to clarify the impact of adverse events associated with the initial course of outpatient chemotherapy on the quality of life of breast cancer patients. We conducted a survey to assess the quality of life in 48 breast cancer patients before and after receiving their first course of outpatient chemotherapy at Gifu Municipal Hospital. Patients completed the European Quality of Life 5 Dimensions and Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs before and after 1 course of outpatient chemotherapy. European Quality of Life 5 Dimensions utility value and Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs total score decreased significantly after chemotherapy (p<0.001 and p = 0.018, respectively). The mean scores for the activity, physical condition, and psychological condition subscales of the Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs decreased significantly after chemotherapy (p = 0.003, p<0.001, and p = 0.032, respectively), whereas the social relationships score increased significantly (p<0.001). Furthermore, in the evaluation of quality of life according to individual adverse events, the decrease in quality of life after chemotherapy in terms of the European Quality of Life 5 Dimensions utility value and the Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs total score was greater in anorexic patients than in non-anorexic patients (p = 0.009 and p<0.001, respectively). This suggests that anorexia greatly reduces quality of life. Our findings reveal that anticancer drug-related adverse events, particularly anorexia, reduce overall quality of life following the first course of outpatient chemotherapy in current breast cancer patients. These findings are extremely useful and important in understanding the impact of anticancer drug-related adverse events on quality of life.

  1. Holes Creek, Water Resources Development. Volume I. Main Report and Environmental Impact Statement.

    DTIC Science & Technology

    1980-09-01

    Miami River also cause problems on the lower reaches of both creeks. The Miami Conservancy District has constructed levees along the Miami River to...design concepts to reduce adverse impacts to fish and wildlife habitat. These concepts include the construction of a low flow channel, installation of...pools and riffles, preservation of a small woodlot, and in certain areas restricting construction to one bank only. The remaining detrimental impacts are

  2. Food security and sustainable resource management

    NASA Astrophysics Data System (ADS)

    McLaughlin, Dennis; Kinzelbach, Wolfgang

    2015-07-01

    The projected growth in global food demand until mid-century will challenge our ability to continue recent increases in crop yield and will have a significant impact on natural resources. The water and land requirements of current agriculture are significantly less than global reserves but local shortages are common and have serious impacts on food security. Recent increases in global trade have mitigated some of the effects of spatial and temporal variability. However, trade has a limited impact on low-income populations who remain dependent on subsistence agriculture and local resources. Potential adverse environmental impacts of increased agricultural production include unsustainable depletion of water and soil resources, major changes in the global nitrogen and phosphorous cycles, human health problems related to excessive nutrient and pesticide use, and loss of habitats that contribute to agricultural productivity. Some typical case studies from China illustrate the connections between the need for increased food production and environmental stress. Sustainable options for decreasing food demand and for increasing production include reduction of food losses on both the producer and consumer ends, elimination of unsustainable practices such as prolonged groundwater overdraft, closing of yield gaps with controlled expansions of fertilizer application, increases in crop yield and pest resistance through advances in biotechnology, and moderate expansion of rain fed and irrigated cropland. Calculations based on reasonable assumptions suggest that such measures could meet the food needs of an increasing global population while protecting the environment.

  3. Sex-specific impact of early-life adversity on chronic pain: a large population-based study in Japan.

    PubMed

    Yamada, Keiko; Matsudaira, Ko; Tanaka, Eizaburo; Oka, Hiroyuki; Katsuhira, Junji; Iso, Hiroyasu

    2017-01-01

    Responses to early-life adversity may differ by sex. We investigated the sex-specific impact of early-life adversity on chronic pain, chronic multisite pain, and somatizing tendency with chronic pain. We examined 4229 respondents aged 20-79 years who participated in the Pain Associated Cross-Sectional Epidemiological Survey in Japan. Outcomes were: 1) chronic pain prevalence, 2) multisite pain (≥3 sites) prevalence, and 3) multiple somatic symptoms (≥3 symptoms) among respondents with chronic pain related to the presence or absence of early-life adversity. Multivariable-adjusted odds ratios (ORs) were calculated with 95% confidence intervals using a logistic regression model including age, smoking status, exercise routine, sleep time, body mass index, household expenditure, and the full distribution of scores on the Mental Health Inventory-5. We further adjusted for pain intensity when we analyzed the data for respondents with chronic pain. The prevalence of chronic pain was higher among respondents reporting the presence of early-life adversity compared with those reporting its absence, with multivariable ORs of 1.62 (1.22-2.15, p <0.01) in men and 1.47 (1.13-1.90, p <0.01) in women. Among women with chronic pain, early-life adversity was associated with multisite pain and multiple somatic symptoms; multivariable ORs were 1.78 (1.22-2.60, p <0.01) for multisite pain and 1.89 (1.27-2.83, p <0.01) for ≥3 somatic symptoms. No associations were observed between early-life adversity and chronic multisite pain or multiple somatic symptoms among men with chronic pain. Early-life adversity may be linked to a higher prevalence of chronic pain among both sexes and to multisite pain and somatizing tendency among women with chronic pain.

  4. 76 FR 57760 - Notice of Availability of Draft Resource Management Plan and Draft Environmental Impact Statement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... Availability of Draft Resource Management Plan and Draft Environmental Impact Statement for the Colorado River... prepared a Draft Resource Management Plan (RMP) and Draft Environmental Impact Statement (EIS) for the... alternative) seeks to allocate limited resources among competing human interests, land uses, and conservation...

  5. Shale Gas and Oil in Germany - Resources and Environmental Impacts

    NASA Astrophysics Data System (ADS)

    Ladage, Stefan; Blumenberg, Martin; Houben, Georg; Pfunt, Helena; Gestermann, Nicolai; Franke, Dieter; Erbacher, Jochen

    2017-04-01

    In light of the controversial debate on "unconventional" oil and gas resources and the environmental impacts of "fracking", the Federal Institute for Geosciences and Natural Resources (BGR) conducted a comprehensive resource assessment of shale gas and light tight oil in Germany and studied the potential environmental impacts of shale gas development and hydraulic fracturing from a geoscientific perspective. Here, we present our final results (BGR 2016), incorporating the majority of potential shale source rock formations in Germany. Besides shale gas, light tight oil has been assessed. According to our set of criteria - i.e. thermal maturity 0.6-1.2 %vitrinite reflectance (VR; oil) and >1.2 % VR (gas) respectively, organic carbon content > 2%, depth between 500/1000 m and 5000 m as well as a net thickness >20 m - seven potentially generative shale formations were indentified, the most important of them being the Lower Jurassic (Toarcian) Posidonia shale with both shale gas and tight oil potential. The North German basin is by far the most prolific basin. The resource assessment was carried out using a volumetric in-place approach. Variability inherent in the input parameters was accounted for using Monte-Carlo simulations. Technically recoverable resources (TRR) were estimated using recent, production-based recovery factors of North American shale plays and also employing Monte-Carlo simulations. In total, shale gas TRR range between 320 and 2030 bcm and tight oil TRR between 13 and 164 Mio. t in Germany. Tight oil potential is therefore considered minor, whereas the shale gas potential exceeds that of conventional resources by far. Furthermore an overview of numerical transport modelling approaches concerning environmental impacts of the hydraulic fracturing is given. These simulations are based on a representative lithostratigraphy model of the North-German basin, where major shale plays can be expected. Numerical hydrogeological modelling of frac fluid

  6. Trail resource impacts and an examination of alternative assessment techniques

    USGS Publications Warehouse

    Marion, J.L.; Leung, Y.-F.

    2001-01-01

    Trails are a primary recreation resource facility on which recreation activities are performed. They provide safe access to non-roaded areas, support recreational opportunities such as hiking, biking, and wildlife observation, and protect natural resources by concentrating visitor traffic on resistant treads. However, increasing recreational use, coupled with poorly designed and/or maintained trails, has led to a variety of resource impacts. Trail managers require objective information on trails and their conditions to monitor trends, direct trail maintenance efforts, and evaluate the need for visitor management and resource protection actions. This paper reviews trail impacts and different types of trail assessments, including inventory, maintenance, and condition assessment approaches. Two assessment methods, point sampling and problem assessment, are compared empirically from separate assessments of a 15-mile segment of the Appalachian Trail in Great Smoky Mountains National Park. Results indicate that point sampling and problem assessment methods yield distinctly different types of quantitative information. The point sampling method provides more accurate and precise measures of trail characteristics that are continuous or frequent (e.g., tread width or exposed soil). The problem assessment method is a preferred approach for monitoring trail characteristics that can be easily predefined or are infrequent (e.g., excessive width or secondary treads), particularly when information on the location of specific trail impact problems is needed. The advantages and limitations of these two assessment methods are examined in relation to various management and research information needs. The choice and utility of these assessment methods are also discussed.

  7. Bioregional Assessments: Determining the Impacts of Coal Resource Development on Water Resources in Australia through Groundwater, Surface Water and Ecological Modelling

    NASA Astrophysics Data System (ADS)

    Peeters, L. J.; Post, D. A.; Crosbie, R.; Holland, K.

    2017-12-01

    While extraction of methane from shale gas deposits has been the principal source of the recent expansion of the industry in the United States, in Australia extraction of methane from coal bed methane deposits (termed `coal seam gas' in Australia) has been the focus to date. The two sources of methane share many of the same characteristics including the potential requirement for hydraulic fracturing. However, as coal seam gas deposits generally occur at shallower depths than shale gas, the potential impacts of extraction on surface and groundwater resources may be of even greater concern. The Australian Federal Government commissioned a multi-disciplinary programme of bioregional assessments to improve understanding of the potential impacts of coal seam gas and large coal mining activities on water resources and water-dependent assets across six bioregions Australia. A bioregional assessment is a transparent scientific analysis of the ecology, hydrology, geology and hydrogeology of a bioregion with explicit assessment of the potential direct, indirect and cumulative impacts of coal seam gas and large coal mining development on water resources. The first step in the analysis is to establish the most likely scenario for coal development in each region and establish a causal pathway linking coal development to impacts to the social, economic and ecological functioning of water resources. This forms the basis for a sequence of probabilistic geological, hydrogeological, hydrological and ecological models to quantify the probability of potential impacts. This suite of models is developed independent of the proponents and regulators of coal resource developments and so can provide unbiased information to all stakeholders. To demonstrate transparency of the modelling, all inputs, outputs and executables will be available from http://www.bioregionalassessments.gov.au. The analysis delineated a zone of potential hydrological change for each region, outside of which impacts

  8. Managing the impact of gold panning activities within the context of integrated water resources management planning in the Lower Manyame Sub-Catchment, Zambezi Basin, Zimbabwe

    NASA Astrophysics Data System (ADS)

    Zwane, Nonhlanhla; Love, David; Hoko, Zvikomborero; Shoko, Dennis

    Riverbed alluvial gold panning activities are a cause for degradation of river channels and banks as well as water resources, particularly through accelerated erosion and siltation, in many areas of Zimbabwe. The lower Manyame sub-catchment located in the Northern part of the country is one such area. This study analysed the implications of cross-sectoral coordination of the management of panning and its impacts. This is within the context of conflicts of interests and responsibilities. A situational analysis of different stakeholders from sectors that included mining, environment, water, local government and water users who were located next to identified panning sites, as well as panners was carried out. Selected sites along the Dande River were observed to assess the environmental effects. The study determined that all stakeholder groups perceived siltation and river bank degradation as the most severe effect of panning on water resources, yet there were divergent views with regards to coordination of panning management. The Water Act of 1998 does not give enough power to management institutions including the Lower Manyame Sub-catchment Council to protect water resources from the impacts of panning, despite the fact that the activities affect the water resource base. The Mines and Minerals Act of 1996 remains the most powerful legislation, while mining sector activities adversely affect environmental resources. Furthermore, complexities were caused by differences in the definition of water resources management boundaries as compared to the overall environmental resources management boundaries according to the Environmental Management Act (EMA) of 2000, and by separate yet parallel water and environmental planning processes. Environmental sector institutions according to the EMA are well linked to local government functions and resource management is administrative, enhancing efficient coordination.

  9. Environmental impacts of food trade via resource use and greenhouse gas emissions

    NASA Astrophysics Data System (ADS)

    Dalin, Carole; Rodríguez-Iturbe, Ignacio

    2016-03-01

    Agriculture will need to significantly intensify in the next decades to continue providing essential nutritive food to a growing global population. However, it can have harmful environmental impacts, due to the use of natural and synthetic resources and the emission of greenhouse gases, which alter the water, carbon and nitrogen cycles, and threaten the fertility, health and biodiversity of landscapes. Because of the spatial heterogeneity of resource productivity, farming practices, climate, and land and water availability, the environmental impact of producing food is highly dependent on its origin. For this reason, food trade can either increase or reduce the overall environmental impacts of agriculture, depending on whether or not the impact is greater in the exporting region. Here, we review current scientific understanding of the environmental impacts of food trade, focusing on water and land use, pollution and greenhouse gas emissions. In the case of water, these impacts are mainly beneficial. However, in the cases of pollution and greenhouse gas emissions, this conclusion is not as clear. Overall, there is an urgent need for a more comprehensive, integrated approach to estimate the global impacts of food trade on the environment. Second, research is needed to improve the evaluation of some key aspects of the relative value of each resource depending on the local and regional biophysical and socio-economic context. Finally, to enhance the impact of such evaluations and their applicability in decision-making, scenario analyses and accounting of key issues like deforestation and groundwater exhaustion will be required.

  10. Impacts of Demand-Side Resources on Electric Transmission Planning

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hadley, Stanton W.; Sanstad, Alan H.

    2015-01-01

    Will demand resources such as energy efficiency (EE), demand response (DR), and distributed generation (DG) have an impact on electricity transmission requirements? Five drivers for transmission expansion are discussed: interconnection, reliability, economics, replacement, and policy. With that background, we review the results of a set of transmission studies that were conducted between 2010 and 2013 by electricity regulators, industry representatives, and other stakeholders in the three physical interconnections within the United States. These broad-based studies were funded by the US Department of Energy and included scenarios of reduced load growth due to EE, DR, and DG. While the studies weremore » independent and used different modeling tools and interconnect-specific assumptions, all provided valuable results and insights. However, some caveats exist. Demand resources were evaluated in conjunction with other factors, and limitations on transmission additions between scenarios made understanding the role of demand resources difficult. One study, the western study, included analyses over both 10- and 20-year planning horizons; the 10-year analysis did not show near-term reductions in transmission, but the 20-year indicated fewer transmission additions, yielding a 36percent capital cost reduction. In the eastern study the reductions in demand largely led to reductions in local generation capacity and an increased opportunity for low-cost and renewable generation to export to other regions. The Texas study evaluated generation changes due to demand, and is in the process of examining demand resource impacts on transmission.« less

  11. Estimating the Economic Impacts of Recreation Response to Resource Management Alternatives

    Treesearch

    Donald B.K. English; J. Michael Bowker; John C. Bergstrom; H. Ken Cordell

    1995-01-01

    Managing forest resources involves tradeoffs and making decisions among resource management alternatives. Some alternatives will lead to changes in the level of recreation visitation and the amount of associated visitor spending. Thus, the alternatives can affect local economies. This paper reports a method that can be used to estimate the economic impacts of such...

  12. 76 FR 72718 - Notice of Availability of the Draft Baker Resource Management Plan and Environmental Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-25

    ....HAG11-0127] Notice of Availability of the Draft Baker Resource Management Plan and Environmental Impact... Draft Resource Management Plan (RMP) and Draft Environmental Impact Statement (EIS) for the Baker... conditions, and changes in resource management practices since the Baker RMP of 1989. The Draft RMP/EIS was...

  13. Adverse reactions and other factors that impact subsequent blood donation visits.

    PubMed

    Custer, Brian; Rios, Jorge A; Schlumpf, Karen; Kakaiya, Ram M; Gottschall, Jerome L; Wright, David J

    2012-01-01

    The importance of adverse reactions in terms of donor safety recently has received significant attention, but their role in subsequent donation behavior has not been thoroughly investigated. Six REDS-II blood centers provided data for this analysis. Summary minor and major adverse reaction categories were created. The influence of adverse reactions on donation was examined in two ways: Kaplan-Meier curves were generated to determine the cumulative pattern of first return, and adjusted odds ratios (AORs) for demographic and other factors positively and negatively associated with return were estimated using multivariable logistic regression. Donors who had major reactions had longer times to return than donors with minor or no reactions. The AOR of returning for donors with major reactions was 0.32 (95% confidence interval [CI], 0.28-0.37) and with minor reactions 0.59 (95% CI, 0.56-0.62) when compared to donors who did not have reactions. Conversely, the most important factors positively associated with return were the number of donations in the previous year and increasing age. Subsequent return, whether a major, minor, or no reaction occurred, varied by blood center. Factors that are associated with the risk of having adverse reactions were not substantial influences on the return after adverse reactions. Having an adverse reaction leads to significantly lower odds of subsequent donation irrespective of previous donation history. Factors that have been associated with a greater risk of adverse reactions were not important positive or negative predictors of return after a reaction. © 2011 American Association of Blood Banks.

  14. The divergent impact of catechol-O-methyltransferase (COMT) Val158Met genetic polymorphisms on executive function in adolescents with discrete patterns of childhood adversity.

    PubMed

    Zhang, Huihui; Li, Jie; Yang, Bei; Ji, Tao; Long, Zhouting; Xing, Qiquan; Shao, Di; Bai, Huayu; Sun, Jiwei; Cao, Fenglin

    2018-02-01

    Catechol-O-methyltransferase (COMT) Val 158 Met functional polymorphisms play a crucial role in the development of executive function (EF), but their effect may be moderated by environmental factors such as childhood adversity. The present study aimed at testing the divergent impact of the COMT Val 158 Met genotype on EF in non-clinical adolescents with discrete patterns of childhood adversity. A total of 341 participants completed the Childhood Trauma Questionnaire, the self-reported version of the Behavior Rating Inventory of Executive Function, and self-administered questionnaires on familial function. The participants' COMT Val 158 Met genotype was determined. Associations among the variables were explored using latent class analysis and general linear models. We found that Val/Val homozygotes showed significantly worse performance on behavioral shift, relative to Met allele carriers (F=5.921, p=0.015, Partial η 2 =0.018). Moreover, three typical patterns of childhood adversity, namely, low childhood adversity (23.5%), childhood neglect (59.8%), and high childhood adversity (16.7%), were found. Both childhood neglect and high childhood adversity had a negative impact on each aspect of EF and on global EF performance. Importantly, these results provided evidence for significant interaction effects, as adolescents with the Val/Val genotype showed inferior behavioral shift performance than Met carriers (F=6.647, p=0.010, Partial η 2 =0.020) in the presence of high childhood adversity. Furthermore, there were no differences between the genotypes for childhood neglect and low childhood adversity. Overall, this is the first study to show that an interaction between the COMT genotype and childhood adversity affects EF in non-clinical adolescents. These results suggest that the COMT genotype may operate as a susceptibility gene vulnerable to an adverse environment. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Resource for Evaluating the Economic Impact of Local Food System Initiatives

    ERIC Educational Resources Information Center

    Jablonski, Becca B. R.; O'Hara, Jeffrey K.; McFadden, Dawn Thilmany; Tropp, Debra

    2016-01-01

    Local food system stakeholders are confronted with challenges when attempting to ascertain the economic impacts of food system investments. The U.S. Department of Agriculture Agricultural Marketing Service commissioned a team of economists to develop a resource to provide support to stakeholders interested in understanding the economic impacts of…

  16. 75 FR 49483 - Notice of Availability of the Final Environmental Impact Statement (FEIS) for Training Range and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... time period. It also examines potential impacts to surrounding lands and/or local communities. In.... Adverse impacts to other resource areas were negligible or minor. The Final EIS is available at local... Impact Statement (FEIS) for Training Range and Garrison Support Facilities Construction and Operation at...

  17. Climate change impact assessments on the water resources of India under extensive human interventions.

    PubMed

    Madhusoodhanan, C G; Sreeja, K G; Eldho, T I

    2016-10-01

    Climate change is a major concern in the twenty-first century and its assessments are associated with multiple uncertainties, exacerbated and confounded in the regions where human interventions are prevalent. The present study explores the challenges for climate change impact assessment on the water resources of India, one of the world's largest human-modified systems. The extensive human interventions in the Energy-Land-Water-Climate (ELWC) nexus significantly impact the water resources of the country. The direct human interventions in the landscape may surpass/amplify/mask the impacts of climate change and in the process also affect climate change itself. Uncertainties in climate and resource assessments add to the challenge. Formulating coherent resource and climate change policies in India would therefore require an integrated approach that would assess the multiple interlinkages in the ELWC nexus and distinguish the impacts of global climate change from that of regional human interventions. Concerted research efforts are also needed to incorporate the prominent linkages in the ELWC nexus in climate/earth system modelling.

  18. Impact of Early Life Adversity on Reward Processing in Young Adults: EEG-fMRI Results from a Prospective Study over 25 Years

    PubMed Central

    Boecker, Regina; Holz, Nathalie E.; Buchmann, Arlette F.; Blomeyer, Dorothea; Plichta, Michael M.; Wolf, Isabella; Baumeister, Sarah; Meyer-Lindenberg, Andreas; Banaschewski, Tobias

    2014-01-01

    Several lines of evidence have implicated the mesolimbic dopamine reward pathway in altered brain function resulting from exposure to early adversity. The present study examined the impact of early life adversity on different stages of neuronal reward processing later in life and their association with a related behavioral phenotype, i.e. attention deficit/hyperactivity disorder (ADHD). 162 healthy young adults (mean age = 24.4 years; 58% female) from an epidemiological cohort study followed since birth participated in a simultaneous EEG-fMRI study using a monetary incentive delay task. Early life adversity according to an early family adversity index (EFA) and lifetime ADHD symptoms were assessed using standardized parent interviews conducted at the offspring's age of 3 months and between 2 and 15 years, respectively. fMRI region-of-interest analysis revealed a significant effect of EFA during reward anticipation in reward-related areas (i.e. ventral striatum, putamen, thalamus), indicating decreased activation when EFA increased. EEG analysis demonstrated a similar effect for the contingent negative variation (CNV), with the CNV decreasing with the level of EFA. In contrast, during reward delivery, activation of the bilateral insula, right pallidum and bilateral putamen increased with EFA. There was a significant association of lifetime ADHD symptoms with lower activation in the left ventral striatum during reward anticipation and higher activation in the right insula during reward delivery. The present findings indicate a differential long-term impact of early life adversity on reward processing, implicating hyporesponsiveness during reward anticipation and hyperresponsiveness when receiving a reward. Moreover, a similar activation pattern related to lifetime ADHD suggests that the impact of early life stress on ADHD may possibly be mediated by a dysfunctional reward pathway. PMID:25118701

  19. OntoADR a semantic resource describing adverse drug reactions to support searching, coding, and information retrieval.

    PubMed

    Souvignet, Julien; Declerck, Gunnar; Asfari, Hadyl; Jaulent, Marie-Christine; Bousquet, Cédric

    2016-10-01

    Efficient searching and coding in databases that use terminological resources requires that they support efficient data retrieval. The Medical Dictionary for Regulatory Activities (MedDRA) is a reference terminology for several countries and organizations to code adverse drug reactions (ADRs) for pharmacovigilance. Ontologies that are available in the medical domain provide several advantages such as reasoning to improve data retrieval. The field of pharmacovigilance does not yet benefit from a fully operational ontology to formally represent the MedDRA terms. Our objective was to build a semantic resource based on formal description logic to improve MedDRA term retrieval and aid the generation of on-demand custom groupings by appropriately and efficiently selecting terms: OntoADR. The method consists of the following steps: (1) mapping between MedDRA terms and SNOMED-CT, (2) generation of semantic definitions using semi-automatic methods, (3) storage of the resource and (4) manual curation by pharmacovigilance experts. We built a semantic resource for ADRs enabling a new type of semantics-based term search. OntoADR adds new search capabilities relative to previous approaches, overcoming the usual limitations of computation using lightweight description logic, such as the intractability of unions or negation queries, bringing it closer to user needs. Our automated approach for defining MedDRA terms enabled the association of at least one defining relationship with 67% of preferred terms. The curation work performed on our sample showed an error level of 14% for this automated approach. We tested OntoADR in practice, which allowed us to build custom groupings for several medical topics of interest. The methods we describe in this article could be adapted and extended to other terminologies which do not benefit from a formal semantic representation, thus enabling better data retrieval performance. Our custom groupings of MedDRA terms were used while performing signal

  20. Adversity and psychosis: a 10-year prospective study investigating synergism between early and recent adversity in psychosis.

    PubMed

    Lataster, J; Myin-Germeys, I; Lieb, R; Wittchen, H-U; van Os, J

    2012-05-01

    Recent studies have suggested that early adverse events, such as childhood trauma, may promote enduring liability for psychosis whereas more recent adverse events may act as precipitants. Examination of these environmental dynamics, however, requires prospective studies in large samples. This study examines whether the association between recent adverse events and psychosis is moderated by exposure to early adversity. A random regional representative population sample of 3021 adolescents and young adults in Munich, Germany, was assessed three times over a period of up to 10 years, collecting information on sociodemographic factors, environmental exposures, and measures of psychopathology and associated clinical relevance. Evidence of statistical non-additivity between early adversity (two levels) and more recent adversity (four levels) was assessed in models of psychotic symptoms. Analyses were a priori corrected for age, gender, cannabis use, and urbanicity. Early and recent adversity were associated with each other (RR = 1.32, 95% CI 1.06-1.66; P = 0.014) and displayed statistical non-additivity at the highest level of exposure to recent adversity (χ(2) = 4.59; P = 0.032). The findings suggest that early adversity may impact on later expression of psychosis either by increasing exposure to later adversity and/or by rendering individuals more sensitive to later adversity if it is severe. © 2011 John Wiley & Sons A/S.

  1. Unpacking the impact of adverse childhood experiences on adult mental health.

    PubMed

    Merrick, Melissa T; Ports, Katie A; Ford, Derek C; Afifi, Tracie O; Gershoff, Elizabeth T; Grogan-Kaylor, Andrew

    2017-07-01

    Exposure to childhood adversity has an impact on adult mental health, increasing the risk for depression and suicide. Associations between Adverse Childhood Experiences (ACEs) and several adult mental and behavioral health outcomes are well documented in the literature, establishing the need for prevention. The current study analyzes the relationship between an expanded ACE score that includes being spanked as a child and adult mental health outcomes by examining each ACE separately to determine the contribution of each ACE. Data were drawn from Wave II of the CDC-Kaiser ACE Study, consisting of 7465 adult members of Kaiser Permanente in southern California. Dichotomous variables corresponding to each of the 11 ACE categories were created, with ACE score ranging from 0 to 11 corresponding to the total number of ACEs experienced. Multiple logistic regression modeling was used to examine the relationship between ACEs and adult mental health outcomes adjusting for sociodemographic covariates. Results indicated a graded dose-response relationship between the expanded ACE score and the likelihood of moderate to heavy drinking, drug use, depressed affect, and suicide attempts in adulthood. In the adjusted models, being spanked as a child was significantly associated with all self-reported mental health outcomes. Over 80% of the sample reported exposure to at least one ACE, signifying the potential to capture experiences not previously considered by traditional ACE indices. The findings highlight the importance of examining both cumulative ACE scores and individual ACEs on adult health outcomes to better understand key risk and protective factors for future prevention efforts. Copyright © 2017. Published by Elsevier Ltd.

  2. Scoring Method of a Situational Judgment Test: Influence on Internal Consistency Reliability, Adverse Impact and Correlation with Personality?

    ERIC Educational Resources Information Center

    De Leng, W. E.; Stegers-Jager, K. M.; Husbands, A.; Dowell, J. S.; Born, M. Ph.; Themmen, A. P.

    2017-01-01

    Situational Judgment Tests (SJTs) are increasingly used for medical school selection. Scoring an SJT is more complicated than scoring a knowledge test, because there are no objectively correct answers. The scoring method of an SJT may influence the construct and concurrent validity and the adverse impact with respect to non-traditional students.…

  3. Estimating the Potential Impact of Tobacco Control Policies on Adverse Maternal and Child Health Outcomes in the United States Using the SimSmoke Tobacco Control Policy Simulation Model.

    PubMed

    Levy, David; Mohlman, Mary Katherine; Zhang, Yian

    2016-05-01

    Numerous studies document the causal relationship between prenatal smoking and adverse maternal and child health (MCH) outcomes. Studies also reveal the impact that tobacco control policies have on prenatal smoking. The purpose of this study is to estimate the effect of tobacco control policies on prenatal smoking prevalence and adverse MCH outcomes. The US SimSmoke simulation model was extended to consider adverse MCH outcomes. The model estimates prenatal smoking prevalence and, applying standard attribution methods, uses estimates of MCH prevalence and relative smoking risks to estimate smoking-attributable MCH outcomes over time. The model then estimates the effect of tobacco control policies on adverse birth outcomes averted. Different tobacco control policies have varying impacts on the number of smoking-attributable adverse MCH birth outcomes. Higher cigarette taxes and comprehensive marketing bans individually have the biggest impact with a 5% to 10% reduction across all outcomes for the period from 2015 to 2065. The policies with the lowest impact (2%-3% decrease) during this period are cessation treatment, health warnings, and complete smoke-free laws. Combinations of all policies with each tax level lead to 23% to 28% decreases across all outcomes. Our findings demonstrate the substantial impact of strong tobacco control policies for preventing adverse MCH outcomes, including long-term health implications for children exposed to low birth weight and preterm birth. These benefits are often overlooked in discussions of tobacco control. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Idaho National Laboratory Cultural Resource Monitoring Report for FY 2009

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brenda R. Pace; Julie B. Braun

    2009-10-01

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during fiscal year 2009 (FY 2009). Throughout the year, thirty-eight cultural resource localities were revisited including: two locations with Native American human remains, one of which is a cave, two additional caves, twenty-two prehistoric archaeological sites, six historic homesteads, two historic stage stations, two historic trails, and two nuclear resources, including Experimental Breeder Reactor-I, which is a designated National Historic Landmark. Several INL project areas were also monitored in FY 2009 to assess project compliance with cultural resource recommendations and monitormore » the effects of ongoing project activities. Although impacts were documented at a few locations and trespassing citations were issued in one instance, no significant adverse effects that would threaten the National Register eligibility of any resources were observed. Monitoring also demonstrated that several INL projects generally remain in compliance with recommendations to protect cultural resources.« less

  5. Environmental impacts of dispersed development from federal infrastructure projects.

    PubMed

    Southerland, Mark T

    2004-06-01

    Dispersed development, also referred to as urban growth or sprawl, is a pattern of low-density development spread over previously rural landscapes. Such growth can result in adverse impacts to air quality, water quality, human health, aquatic and terrestrial ecosystems, agricultural land, military training areas, water supply and wastewater treatment, recreational resources, viewscapes, and cultural resources. The U.S. Environmental Protection Agency (U.S. EPA) is charged with protecting public health and the environment, which includes consideration of impacts from dispersed development. Specifically, because federal infrastructure projects can affect the progress of dispersed development, the secondary impacts resulting from it must be assessed in documents prepared under the National Environmental Policy Act (NEPA). The Council on Environmental Quality (CEQ) has oversight for NEPA and Section 309 of the Clean Air Act requires that U.S. EPA review and comment on federal agency NEPA documents. The adverse effects of dispersed development can be induced by federal infrastructure projects including transportation, built infrastructure, modifications in natural infrastructure, public land conversion and redevelopment of properties, construction of federal facilities, and large traffic or major growth generation developments requiring federal permits. This paper presents an approach that U.S. EPA reviewers and NEPA practitioners can use to provide accurate, realistic, and consistent analysis of secondary impacts of dispersed development resulting from federal infrastructure projects. It also presents 24 measures that can be used to mitigate adverse impacts from dispersed development by modifying project location and design, participating in preservation or restoration activities, or informing and supporting local communities in planning.

  6. Computers as learning resources in the health sciences: impact and issues.

    PubMed Central

    Ellis, L B; Hannigan, G G

    1986-01-01

    Starting with two computer terminals in 1972, the Health Sciences Learning Resources Center of the University of Minnesota Bio-Medical Library expanded its instructional facilities to ten terminals and thirty-five microcomputers by 1985. Computer use accounted for 28% of total center circulation. The impact of these resources on health sciences curricula is described and issues related to use, support, and planning are raised and discussed. Judged by their acceptance and educational value, computers are successful health sciences learning resources at the University of Minnesota. PMID:3518843

  7. Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood.

    PubMed

    Heinonen, Erkki; Knekt, Paul; Härkänen, Tommi; Virtala, Esa; Lindfors, Olavi

    2018-06-01

    Childhood adversities frequently precede adulthood depression and anxiety. Yet, how they impact needed treatment duration, type or focus in these common disorders, is unclear. For developing more individualized and precise interventions, we investigated whether specific early adversities associate with patients' distinct psychiatric problems, psychological vulnerabilities, and suitability for psychotherapy. A total of 221 depressed and anxious adult outpatients (excluding psychotic, severe personality, bipolar, and substance abuse disorders) referred from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire (CFAQ). They also filled self-reports on interpersonal behavior and problems, perceived competence, dispositional optimism, sense of coherence, defenses, and psychiatric history. Clinicians assessed the patients' symptomatology, personality, object relations, cognitive performance, and psychotherapy suitability. Regression analyses were conducted. Childhood adversities predicted both worse current psychological functioning (e.g., interpersonal problems), and better clinician-rated capacities for benefiting from psychotherapy (e.g. self-reflection, capacity for interaction). Parental problems had the most numerous negative associations to psychological functioning. Best capacities for psychotherapy were predicted by recollected family unhappiness. Associations with psychiatric criteria were, however, largely non-significant. In conclusion, for psychosocial treatment planning, patients' early adversities may indicate both vulnerability and resources. As childhood adversities are frequent among treatment-seekers, further studies examining how early adversities predict psychotherapy outcome are needed. Copyright © 2018. Published by Elsevier B.V.

  8. Ongoing adverse mental health impact of the earthquake sequence in Christchurch, New Zealand.

    PubMed

    Spittlehouse, Janet K; Joyce, Peter R; Vierck, Esther; Schluter, Philip J; Pearson, John F

    2014-08-01

    In September 2010 Christchurch, New Zealand, was struck by a 7.1 magnitude earthquake, followed by a prolonged sequence of significant aftershocks including a fatal aftershock in February 2011. Christchurch City has experienced widespread damage, ongoing disruption and building demolitions resulting in many difficulties for the residents of the Christchurch area. We explore what impact the earthquakes have had on the mental and physical health of a random sample of 50-year-olds who live in the Christchurch area. The 295 participants were selected from the electoral rolls for participation in the CHALICE study, a longitudinal study of ageing. Self-reported health status was assessed using the standardised Short Form 36 version 2 health survey (SF-36v2), a 36-item questionnaire, and results from the eight subscales compared to a national health survey. Mood disorders were assessed and the results were compared to other local and national studies. Since the onset of the earthquakes and throughout the study period, participating middle-aged Christchurch residents have mean SF-36v2 scores significantly lower than population norms in the mental health, vitality, social functioning and role-emotional subscales (Cohen's d ranged from -0.270 to -0.357, all p < 0.001), while there was no evidence of reduced physical health. Rates of current major depressive disorder were 7.5% in the earthquake survivors compared to 5.1% and 3.7% in other historical, local and national surveys. Similarly, bipolar disorder prevalence was 2.8% in the earthquake survivors compared to 2.2% and 1.4% in other studies. Eighteen months after the first earthquake the significant adverse impact on mental health clearly continues. The ongoing provision of additional mental health services and consideration of these adverse mental health effects in relation to other social policies remains necessary and fundamental. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  9. Childhood Adversity and Pain Sensitization.

    PubMed

    You, Dokyoung Sophia; Meagher, Mary W

    Childhood adversity is a vulnerability factor for chronic pain. However, the underlying pain mechanisms influenced by childhood adversity remain unknown. The aim of the current study was to evaluate the impact of childhood adversity on dynamic pain sensitivity in young adults. After screening for childhood adverse events and health status, healthy individuals reporting low (below median; n = 75) or high levels of adversity (the top 5%; n = 51) were invited for pain testing. Both groups underwent heat pain threshold and temporal summation of second pain (TSSP) testing after reporting depressive symptoms. TSSP refers to a progressive increase in pain intensity with repetition of identical noxious stimuli and is attributed to central sensitization. Changes in pain ratings over time (slope) were computed for TSSP sensitization and decay of subsequent aftersensations. The high-adversity group showed greater TSSP sensitization (meanslope, 0.75; SDpositive slope, 1.78), and a trend toward a slower decay (meanslope, -11.9; SD, 3.4), whereas the low-adversity group showed minimal sensitization (meanslope, 0.07; SDnear-zero slope, 1.77), F(1,123) = 5.84, p = .017 and faster decay (meanslope, -13.1; SD, 3.4), F(1,123) = 3.79, p = .054. This group difference remained significant even after adjusting for adult depressive symptoms (p = .033). No group difference was found in heat pain threshold (p = .85). Lastly, the high-adversity group showed blunted cardiac and skin conductance responses. These findings suggest that enhancement of central sensitization may provide a mechanism underlying the pain hypersensitivity and chronicity linked to childhood adversity.

  10. Potential impacts of water diversion on fishery resources in the Great Lakes

    USGS Publications Warehouse

    Manny, Bruce A.

    1984-01-01

    Uses of Great Lakes water within the Great Lakes basin are steadily increasing, and critical water shortages elsewhere may add to the demands for diversions of water out of the basin in the near future. The impacts of such diversions on fish in the Great Lakes must be considered in the context of in-basin uses of the water, because in-basin uses already adversely affect the fishery resources. Temporary in-basin water withdrawals from Lake Michigan by industry in 1980 equaled 260% of the total volume of water between the shoreline and the 10-meter depth - the littoral waters most heavily used by fish as spawning and nursery grounds. Nearly 100% of the fish removed by these water withdrawals were killed. Enough young alewives (Alosa pseudoharengus) and rainbow smelt (Osmerus mordax) in Lake Michigan and young yellow perch (Perca flavescens) in western Lake Erie have been removed at water intakes in recent years to reduce the productivity and biomass of adult fish stocks. Out-of-basin diversions of water at Chicago and at the Welland Canal, channel modifications in the St. Clair River, and in-basin consumptive water withdrawals have lowered the annual mean water level of Lakes Michigan and Huron by about 27 cm and that of Lake Erie by about 10 cm, dewatering wetlands that historically served as spawning and nursery habitat for many valuable fish species. The dollar value of fish lost to water diversions and withdrawals has not yet been estimated, but water withdrawals alone have already reduced the annual economic impact of the Great Lakes fisheries, which has been estimated to be 1.16 billion dollars.

  11. [Direct costs and clinical aspects of adverse drug reactions in patients admitted to a level 3 hospital internal medicine ward].

    PubMed

    Tribiño, Gabriel; Maldonado, Carlos; Segura, Omar; Díaz, Jorge

    2006-03-01

    Adverse drug reactions (ADRs) occur frequently in hospitals and increase costs of health care; however, few studies have quantified the clinical and economic impact of ADRs in Colombia. These impacts were evaluated by calculating costs associated with ADRs in patients hospitalized in the internal medicine ward of a Level 3 hospital located in Bogotá, Colombia. In addition, salient clinical features of ADRs were identified and characterized. Intensive follow-ups for a cohort of patients were conducted for a five month period in order to detect ADRs; different ways to classify them, according to literature, were considered as well. Information was collected using the INVIMA reporting format, and causal probability was evaluated with the Naranjo algorithm. Direct costs were calculated from the perspective of payer, based on the following costs: additional hospital stay, medications, paraclinical tests, additional procedures, patient displacement to intermediate or intensive care units, and other costs. Of 836 patients admitted to the service, 268 adverse drug reactions were detected in 208 patients (incidence proportion 25.1%, occurence rate 0.32). About the ADRs found, 74.3% were classified as probable, 92.5% were type A, and 81.3% were moderate. The body system most often affected was the circulatory system (33.9%). Drugs acting on the blood were most frequently those ones associated with adverse reactions (37.6%). The costs resulting from medical care of adverse drug reactions varied from COL dollar 93,633,422 (USD dollar 35,014.92) to COL dollar 122,155,406 (USD dollar 45,680.94), according to insurance type, during the study period. Adverse drug reactions have a significant negative health and financial impact on patient welfare. Because of the substantial resources required for their medical care and the significant proportion of preventable adverse reactions, active programs of institutional pharmacovigilance are highly recommended.

  12. The Impacts of the Great Recession on State Natural Resource Extension Programs

    ERIC Educational Resources Information Center

    Serenari, Christopher; Peterson, M. Nils; Bardon, Robert E.; Brown, Robert D.

    2013-01-01

    The Great Recession contributed to major budget cuts for natural resource Extension programs in the United States. Despite the potentially large cuts, their impacts and how Extension has adapted their programs have not been evaluated. We begin addressing these needs with surveys of Association of Natural Resource Extension Professionals members…

  13. Idaho National Laboratory Cultural Resource Monitoring Report for FY 2010

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    INL Cultural Resource Management Office

    2010-10-01

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during fiscal year 2010 (FY 2010). Throughout the year, thirty-three cultural resource localities were revisited, including somethat were visited more than once, including: two locations with Native American human remains, one of which is a cave, two additional caves, twenty-six prehistoric archaeological sites, two historic stage stations, and Experimental Breeder Reactor-I, which is a designated National Historic Landmark. The resources that were monitored included seventeen that are routinely visited and sixteen that are located in INL project areas. Although impacts weremore » documented at a few locations and one trespassing incident (albeit sans formal charges) was discovered, no significant adverse effects that would threaten the National Register eligibility of any resources were observed. Monitoring also demonstrated that several INL projects generally remain in compliance with recommendations to protect cultural resources.« less

  14. Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter?

    PubMed Central

    Friedman, Esther M.; Montez, Jennifer Karas; Sheehan, Connor McDevitt; Guenewald, Tara L.; Seeman, Teresa E.

    2015-01-01

    Objective Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. Method We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health. Results The best-fitting specification of quantity of events was a linear measure reflecting a dose–response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women’s risk of heart disease. Discussion Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures. PMID:25903978

  15. Applying Adverse Outcome Pathways (AOPs) to support Integrated Approaches to Testing and Assessment (IATA).

    PubMed

    Tollefsen, Knut Erik; Scholz, Stefan; Cronin, Mark T; Edwards, Stephen W; de Knecht, Joop; Crofton, Kevin; Garcia-Reyero, Natalia; Hartung, Thomas; Worth, Andrew; Patlewicz, Grace

    2014-12-01

    Chemical regulation is challenged by the large number of chemicals requiring assessment for potential human health and environmental impacts. Current approaches are too resource intensive in terms of time, money and animal use to evaluate all chemicals under development or already on the market. The need for timely and robust decision making demands that regulatory toxicity testing becomes more cost-effective and efficient. One way to realize this goal is by being more strategic in directing testing resources; focusing on chemicals of highest concern, limiting testing to the most probable hazards, or targeting the most vulnerable species. Hypothesis driven Integrated Approaches to Testing and Assessment (IATA) have been proposed as practical solutions to such strategic testing. In parallel, the development of the Adverse Outcome Pathway (AOP) framework, which provides information on the causal links between a molecular initiating event (MIE), intermediate key events (KEs) and an adverse outcome (AO) of regulatory concern, offers the biological context to facilitate development of IATA for regulatory decision making. This manuscript summarizes discussions at the Workshop entitled "Advancing AOPs for Integrated Toxicology and Regulatory Applications" with particular focus on the role AOPs play in informing the development of IATA for different regulatory purposes. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Impact of Market-Based Disturbance on the Composition of West Virginia's Forest Resource

    Treesearch

    William G. Luppold; John E. Baumgras; John E. Baumgras

    2000-01-01

    The eastern hardwood resource has been shaped by a combination of human and natural disturbances. This impact on the forest resources of West Virginia has been especially dramatic. This resource has changed from a virgin forest dominated white oak, chestnut, spruce, white pine, and hemlock in the late 19th century, to one dominated by red oak in the 1950's, to...

  17. Impact of negation salience and cognitive resources on negation during attitude formation.

    PubMed

    Boucher, Kathryn L; Rydell, Robert J

    2012-10-01

    Because of the increased cognitive resources required to process negations, past research has shown that explicit attitude measures are more sensitive to negations than implicit attitude measures. The current work demonstrated that the differential impact of negations on implicit and explicit attitude measures was moderated by (a) the extent to which the negation was made salient and (b) the amount of cognitive resources available during attitude formation. When negations were less visually salient, explicit but not implicit attitude measures reflected the intended valence of the negations. When negations were more visually salient, both explicit and implicit attitude measures reflected the intended valence of the negations, but only when perceivers had ample cognitive resources during encoding. Competing models of negation processing, schema-plus-tag and fusion, were examined to determine how negation salience impacts the processing of negations.

  18. Adverse childhood experience and asthma onset: a systematic review.

    PubMed

    Exley, Daniel; Norman, Alyson; Hyland, Michael

    2015-06-01

    Adverse childhood experiences such as abuse and neglect are associated with subsequent immune dysregulation. Some studies show an association between adverse childhood experiences and asthma onset, although significant disparity in results exists in the published literature. We aimed to review available studies employing a prospective design that investigates associations between adverse childhood experience and asthma. A search protocol was developed and studies were drawn from four electronic journal databases. Studies were selected in accordance with pre-set inclusion criteria and relevant data were extracted. 12 studies, assessing data from a total of 31 524 individuals, were identified that investigate the impact of a range of adverse childhood experiences on the likelihood of developing asthma. Evidence suggests that chronic stress exposure and maternal distress in pregnancy operate synergistically with known triggers such as traffic-related air pollution to increase asthma risk. Chronic stress in early life is associated with an increased risk of asthma onset. There is evidence that adverse childhood experience increases the impact of traffic-related air pollution and inconsistent evidence that adverse childhood experience has an independent effect on asthma onset. Copyright ©ERS 2015.

  19. Resource Security Impacts Men’s Female Breast Size Preferences

    PubMed Central

    Swami, Viren; Tovée, Martin J.

    2013-01-01

    It has been suggested human female breast size may act as signal of fat reserves, which in turn indicates access to resources. Based on this perspective, two studies were conducted to test the hypothesis that men experiencing relative resource insecurity should perceive larger breast size as more physically attractive than men experiencing resource security. In Study 1, 266 men from three sites in Malaysia varying in relative socioeconomic status (high to low) rated a series of animated figures varying in breast size for physical attractiveness. Results showed that men from the low socioeconomic context rated larger breasts as more attractive than did men from the medium socioeconomic context, who in turn perceived larger breasts as attractive than men from a high socioeconomic context. Study 2 compared the breast size judgements of 66 hungry versus 58 satiated men within the same environmental context in Britain. Results showed that hungry men rated larger breasts as significantly more attractive than satiated men. Taken together, these studies provide evidence that resource security impacts upon men’s attractiveness ratings based on women’s breast size. PMID:23483919

  20. Impact of Design Trade Studies on System Human Resources.

    ERIC Educational Resources Information Center

    Whalen, Gary V.; Askren, William B.

    This study focused on two objectives. The first objective was to identify and classify the characteristics of conceptual design trade studies that have high potential impact on human resource requirements of Air Force weapon systems. The approach used was a case history review and analysis of 129 F-15 aircraft design trade studies. The analysis…

  1. [Impact of health care reform on human resources and employment management].

    PubMed

    Brito Quintana, P E

    2000-01-01

    According to those in charge of health sector reform, human resources are the key component of health sector reform processes and offer health services their greatest competitive advantage. With the help of the Observatory for Human Resources within Health Sector Reform promoted by the Pan American Health Organization and other groups, countries of the Region of the Americas have now begun to gather, in a methodical fashion, tangible evidence of the decisive importance of human resources within health sector reform initiatives and particularly of the impact of these initiatives on health personnel. This mutual influence is the main theme of this article, which explores the most disturbing aspects of health sector reform from a human resources perspective, including job instability and conflicting interests of employers and employees.

  2. Evaluating Impacts of Land Use/Land Cover Change on Water Resources in Semiarid Regions

    NASA Astrophysics Data System (ADS)

    Scanlon, B. R.; Faunt, C. C.; Pool, D. R.; Reedy, R. C.

    2017-12-01

    Land use/land cover (LU/LC) changes play an integral role in water resources by controlling the partitioning of water at the land surface. Here we evaluate impacts of changing LU/LC on water resources in response to climate variation and change and land use change related to agriculture using data from semiarid regions in the southwestern U.S. Land cover changes in response to climate can amplify or dampen climate impacts on water resources. Changes from wet Pleistocene to much drier Holocene climate resulted in expansion of perennial vegetation, amplifying climate change impacts on water resources by reducing groundwater recharge as shown in soil profiles in the southwestern U.S.. In contrast, vegetation response to climate extremes, including droughts and floods, dampen impacts of these extremes on water resources, as shown by water budget monitoring in the Mojave Desert. Agriculture often involves changes from native perennial vegetation to annual crops increasing groundwater recharge in many semiarid regions. Irrigation based on conjunctive use of surface water and groundwater increases water resource availability, as shown in the Central Valley of California and in southern Arizona. Surface water irrigation in these regions is enhanced by water transported from more humid settings through extensive pipelines. These projects have reversed long-term declining groundwater trends in some regions. While irrigation design has often focused on increased efficiency, "more crop per drop", optimal water resource management may benefit more from inefficient (e.g. flood irrigation) surface-water irrigation combined with efficient (e.g. subsurface drip) irrigation to maximize groundwater recharge, as seen in parts of the Central Valley. Flood irrigation of perennial crops, such as almonds and vineyards, during winter is being considered in the Central Valley to enhance groundwater recharge. Managed aquifer recharge can be considered a special case of conjunctive use of

  3. Assessing Stress-Related Treatment Needs among Girls at Risk for Poor Functional Outcomes: The Impact of Cumulative Adversity, Criterion Traumas, and Non-Criterion Events

    PubMed Central

    Lansing, Amy E.; Plante, Wendy Y.; Beck, Audrey N.

    2016-01-01

    Despite growing recognition that cumulative adversity (total stressor exposure), including complex trauma, increases the risk for psychopathology and impacts development, assessment strategies lag behind: Trauma-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (parental separations) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: 1) an average of 14 adverse Criterion-A and non-Criterion event exposures; 2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; 3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and 4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities. PMID:27745922

  4. Assessing stress-related treatment needs among girls at risk for poor functional outcomes: The impact of cumulative adversity, criterion traumas, and non-criterion events.

    PubMed

    Lansing, Amy E; Plante, Wendy Y; Beck, Audrey N

    2017-05-01

    Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: (1) an average of 14 adverse Criterion-A and non-Criterion event exposures; (2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; (3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and (4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. The potential impacts of biomass feedstock production on water resource availability.

    PubMed

    Stone, K C; Hunt, P G; Cantrell, K B; Ro, K S

    2010-03-01

    Biofuels are a major topic of global interest and technology development. Whereas bioenergy crop production is highly dependent on water, bioenergy development requires effective allocation and management of water. The objectives of this investigation were to assess the bioenergy production relative to the impacts on water resource related factors: (1) climate and weather impact on water supplies for biomass production; (2) water use for major bioenergy crop production; and (3) potential alternatives to improve water supplies for bioenergy. Shifts to alternative bioenergy crops with greater water demand may produce unintended consequences for both water resources and energy feedstocks. Sugarcane and corn require 458 and 2036 m(3) water/m(3) ethanol produced, respectively. The water requirements for corn grain production to meet the US-DOE Billion-Ton Vision may increase approximately 6-fold from 8.6 to 50.1 km(3). Furthermore, climate change is impacting water resources throughout the world. In the western US, runoff from snowmelt is occurring earlier altering the timing of water availability. Weather extremes, both drought and flooding, have occurred more frequently over the last 30 years than the previous 100 years. All of these weather events impact bioenergy crop production. These events may be partially mitigated by alternative water management systems that offer potential for more effective water use and conservation. A few potential alternatives include controlled drainage and new next-generation livestock waste treatment systems. Controlled drainage can increase water available to plants and simultaneously improve water quality. New livestock waste treatments systems offer the potential to utilize treated wastewater to produce bioenergy crops. New technologies for cellulosic biomass conversion via thermochemical conversion offer the potential for using more diverse feedstocks with dramatically reduced water requirements. The development of bioenergy

  6. Explaining the black-white gap in cognitive test scores: Toward a theory of adverse impact.

    PubMed

    Cottrell, Jonathan M; Newman, Daniel A; Roisman, Glenn I

    2015-11-01

    In understanding the causes of adverse impact, a key parameter is the Black-White difference in cognitive test scores. To advance theory on why Black-White cognitive ability/knowledge test score gaps exist, and on how these gaps develop over time, the current article proposes an inductive explanatory model derived from past empirical findings. According to this theoretical model, Black-White group mean differences in cognitive test scores arise from the following racially disparate conditions: family income, maternal education, maternal verbal ability/knowledge, learning materials in the home, parenting factors (maternal sensitivity, maternal warmth and acceptance, and safe physical environment), child birth order, and child birth weight. Results from a 5-wave longitudinal growth model estimated on children in the NICHD Study of Early Child Care and Youth Development from ages 4 through 15 years show significant Black-White cognitive test score gaps throughout early development that did not grow significantly over time (i.e., significant intercept differences, but not slope differences). Importantly, the racially disparate conditions listed above can account for the relation between race and cognitive test scores. We propose a parsimonious 3-Step Model that explains how cognitive test score gaps arise, in which race relates to maternal disadvantage, which in turn relates to parenting factors, which in turn relate to cognitive test scores. This model and results offer to fill a need for theory on the etiology of the Black-White ethnic group gap in cognitive test scores, and attempt to address a missing link in the theory of adverse impact. (c) 2015 APA, all rights reserved).

  7. Idaho National Laboratory Cultural Resource Monitoring Report for FY 2008

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brenda R. Pace

    2009-01-01

    This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during fiscal year 2008 (FY 2008). Throughout the year, 45 cultural resource localities were revisited including: two locations of heightened Shoshone-Bannock tribal sensitivity, four caves, one butte, twenty-eight prehistoric archaeological sites, three historic homesteads, two historic stage stations, one historic canal construction camp, three historic trails, and Experimental Breeder Reactor-I, which is a designated National Historic Landmark. Several INL project areas were also monitored in FY 2008 to assess project compliance with cultural resource recommendations, confirm the locations of previously recordedmore » cultural resources in relation to project activities, to assess the damage caused by fire-fighting efforts, and to watch for cultural materials during ground disturbing activities. Although impacts were documented at a few locations, no significant adverse effects that would threaten the National Register eligibility of any resource were observed. Monitoring also demonstrated that INL projects generally remain in compliance with recommendations to protect cultural resources« less

  8. Parental perspectives of screening for adverse childhood experiences in pediatric primary care.

    PubMed

    Conn, Anne-Marie; Szilagyi, Moira A; Jee, Sandra H; Manly, Jody T; Briggs, Rahil; Szilagyi, Peter G

    2018-03-01

    Pediatricians recognize a need to mitigate the negative impact that adverse childhood experiences (ACEs) can have on health and development. However, ACEs screening and interventions in primary care pediatrics may be inhibited by concerns about parental perceptions. We assessed parent perspectives of screening for ACEs in the pediatric primary care setting, to understand their views on the potential impact of their ACEs on their parenting and to identify opportunities for pediatric anticipatory guidance. We used purposive sampling to recruit parents of children <6 years receiving care at an urban, pediatric clinic. Semistructured questions guided 1:1 interviews that were later coded by multiple researchers to verify reliability. A thematic framework approach guided analysis and identified main themes and subthemes. We reached thematic saturation after 15 parent interviews, which consistently revealed 3 interrelated themes. First, parents strongly supported ACEs screening as a bridge to needed services, and they recommended using a trauma-sensitive, person-centered approach in pediatric practices. Second, parents understood the intergenerational impact of ACEs and expressed a desire to break the cycle of adversity. Finally, parents saw their child's pediatrician as a potential change-agent who could provide support to meet their parenting goals. Parents want to discuss their ACEs and receive help and guidance from pediatricians. Furthermore, they perceive their child's pediatrician as having an important role to play in meeting their parenting goals. It is important to ensure that pediatricians have the training, skills and familiarity with available resources to meet parental expectations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. Water Resource Impacts Embedded in the Western US Electrical Energy Trade; Current Patterns and Adaptation to Future Drought

    NASA Astrophysics Data System (ADS)

    Adams, E. A.; Herron, S.; Qiu, Y.; Tidwell, V. C.; Ruddell, B. L.

    2013-12-01

    Water resources are a key element in the global coupled natural-human (CNH) system, because they are tightly coupled with the world's social, environmental, and economic subsystems, and because water resources are under increasing pressure worldwide. A fundamental adaptive tool used especially by cities to overcome local water resource scarcity is the outsourcing of water resource impacts through substitutionary economic trade. This is generally understood as the indirect component of a water footprint, and as ';virtual water' trade. This work employs generalized CNH methods to reveal the trade in water resource impacts embedded in electrical energy within the Western US power grid, and utilizes a general equilibrium economic trade model combined with drought and demand growth constraints to estimate the future status of this trade. Trade in embedded water resource impacts currently increases total water used for electricity production in the Western US and shifts water use to more water-limited States. Extreme drought and large increases in electrical energy demand increase the need for embedded water resource impact trade, while motivating a shift to more water-efficient generation technologies and more water-abundant generating locations. Cities are the largest users of electrical energy, and in the 21st Century will outsource a larger fraction of their water resource impacts through trade. This trade exposes cities to risks associated with disruption of long-distance transmission and distant hydrological droughts.

  10. The impact of climate change on the water resource

    NASA Astrophysics Data System (ADS)

    Perac, Marija Å.; Grgurevac, Anamarija

    2010-05-01

    The EU has defined dangerous climate change as an increase in 2 degrees Celsius of average global temperatures. Rising global temperatures will lead to an intensification of hydrological cycle, resulting in dryer dry season, and subsequently heightened risk of more extreme and frequent floods and drought. Climate change is caused by greenhouse gasses ( GHGs), which enhance the " greenhouse " properties of the earth's atmosphere. These gasses allow solar radiation from the sun to travel through the atmosphere but prevent the reflected heat from escaping back into space. This causes the earth's temperature to rise. Changing climate will also have significant impacts on the availability of water as well as the quality of water that is available and accessible. Possibly, climate change magnificent impact at water cycles in Croatia. It means more droughts, it will have impact in agriculture and natural systems, specially swamp areas. Also, it will be come to reduction river flows, and maybe lower underground water level which used for water supply. Climate change can be impact on intensity of floods and quality/quantity of water.Successes of climate change in Croatia are: decrease volume of precipitation at whole state area; long drought years directly water quantity for irrigation; decreasing drinking water. Ponder able for next 40 years mean temperature will be increase for 2,5 C. It assumes that sea level will be increase at 65 - 100 cm. It will be endanger cities and settlements besides coast ( cities: Split, Zadar; west coast of Istra; delta of Neretva; islands: Krk, Cres, Lošinj…). Suggestions for next activities: monitoring and notation hydro meteorological information's; account impact of climate change on the: evaporation, drain, water balance, water management activity, make a region impact study of a possibly account on the water resources. Maintaining and development of water resources and agrotehnical systems and application water management strategy

  11. Weight-of-evidence evaluation of an adverse outcome ...

    EPA Pesticide Factsheets

    Ongoing honey bee colony losses are of significant international concern because of the essential role these insects play in pollinating staple food crops. Chemical and non-chemical stressors both have been implicated as possible contributors to colony failure, however, the potential role of commonly-used neonicotinoid insecticides has emerged as particularly concerning. Neonicotinoids act on the nicotinic acetylcholine receptor (nAChR) to eliminate target pest insects, however, mounting evidence indicates that these chemicals may adversely affect beneficial pollinators, such as the honey bee, via impacts on learning and memory thereby affecting foraging success. However, the mechanisms linking activation of the nAChR to adverse effects on learning and memory are uncertain. Additionally, clear connections between observed impacts on individual bees and colony level effects are lacking. Therefore, the objective of this work was to develop adverse outcome pathways (AOPs) as a means to evaluate the biological plausibility and empirical evidence supporting (or refuting) the linkage between the nAChR and colony level impacts. Development of these AOPs has led to the identification of research gaps which, for example, may be of high priority in understanding how perturbation of pathways involved in neurotransmission can adversely affect honey bee health, causing colony instability and further failure. From this effort, an AOP network also was developed, laying the f

  12. The Sensitivity of Adverse Event Cost Estimates to Diagnostic Coding Error

    PubMed Central

    Wardle, Gavin; Wodchis, Walter P; Laporte, Audrey; Anderson, Geoffrey M; Baker, Ross G

    2012-01-01

    Objective To examine the impact of diagnostic coding error on estimates of hospital costs attributable to adverse events. Data Sources Original and reabstracted medical records of 9,670 complex medical and surgical admissions at 11 hospital corporations in Ontario from 2002 to 2004. Patient specific costs, not including physician payments, were retrieved from the Ontario Case Costing Initiative database. Study Design Adverse events were identified among the original and reabstracted records using ICD10-CA (Canadian adaptation of ICD10) codes flagged as postadmission complications. Propensity score matching and multivariate regression analysis were used to estimate the cost of the adverse events and to determine the sensitivity of cost estimates to diagnostic coding error. Principal Findings Estimates of the cost of the adverse events ranged from $16,008 (metabolic derangement) to $30,176 (upper gastrointestinal bleeding). Coding errors caused the total cost attributable to the adverse events to be underestimated by 16 percent. The impact of coding error on adverse event cost estimates was highly variable at the organizational level. Conclusions Estimates of adverse event costs are highly sensitive to coding error. Adverse event costs may be significantly underestimated if the likelihood of error is ignored. PMID:22091908

  13. Impact of a Web-Based Adaptive Supplemental Digital Resource on Student Mathematics Performance

    ERIC Educational Resources Information Center

    Sharp, Laurie A.; Hamil, Marc

    2018-01-01

    Much literature has presented evidence that supplemental digital resources enhance student performance with mathematics. The purpose of this study was to explore the impact of a web-adaptive digital resource, Think Through Math©, on student performance with state-mandated annual standardized mathematics assessments. This study utilized a…

  14. Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review.

    PubMed

    Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott

    2015-01-01

    Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

  15. Factors Associated with Whether Pediatricians Inquire about Parents’ Adverse Childhood Experiences

    PubMed Central

    Szilagyi, Moira; Kerker, Bonnie D.; Storfer-Isser, Amy; Stein, Ruth E.K.; Garner, Andrew; O’Connor, Karen G.; Hoagwood, Kimberly E.; Horwitz, Sarah McCue

    2017-01-01

    Objective Cumulative adverse childhood experiences (ACE) can have profound and lasting effects on parenting. Parents with a history of multiple ACE have greater challenges modulating their own stress responses and helping their children adapt to life stressors. This paper examines pediatric practice in inquiring about parents’ childhood adversities as of 2013. Methods Using data from the 85th Periodic Survey of the American Academy of Pediatrics (AAP), we restricted analyses to the 302 pediatricians exclusively practicing general pediatrics who answered questions regarding their beliefs about childhood stressors, their role in advising parents, and whether they asked about parents’ ACE. Weighted descriptive and logistic regression analyses were conducted. Results Despite endorsing the influence of positive parenting on a child’s life-course trajectory (96%), that their advice can impact parenting skills (79%), and that screening for social-emotional risks is within their scope of practice ((81%), most pediatricians (61%) did not inquire about parents’ ACE. Pediatricians who believed that their advice influences positive parenting skills inquired about more parents’ ACE Conclusion As of 2013, few pediatricians inquired about parents’ ACE despite recognizing their negative impact on parenting behaviors and child development‥ Research is needed regarding the best approaches to the prevention and amelioration of ACE and the promotion of family and child resilience. Pediatricians need resources and education about the AAP’s proposed dyadic approach to assessing family and child risk factors and strengths and to providing guidance and management. PMID:27157045

  16. Factors Associated With Whether Pediatricians Inquire About Parents' Adverse Childhood Experiences.

    PubMed

    Szilagyi, Moira; Kerker, Bonnie D; Storfer-Isser, Amy; Stein, Ruth E K; Garner, Andrew; O'Connor, Karen G; Hoagwood, Kimberly E; McCue Horwitz, Sarah

    2016-01-01

    Cumulative adverse childhood experiences (ACE) can have profound and lasting effects on parenting. Parents with a history of multiple ACE have greater challenges modulating their own stress responses and helping their children adapt to life stressors. We examined pediatric practice in inquiring about parents' childhood adversities as of 2013. Using data from the 85th Periodic Survey of the American Academy of Pediatrics (AAP), we restricted analyses to the 302 pediatricians exclusively practicing general pediatrics who answered questions regarding their beliefs about childhood stressors, their role in advising parents, and whether they asked about parents' ACEs. Weighted descriptive and logistic regression analyses were conducted. Despite endorsing the influence of positive parenting on a child's life-course trajectory (96%), that their advice can impact parenting skills (79%), and that screening for social-emotional risks is within their scope of practice (81%), most pediatricians (61%) did not inquire about parents' ACE. Pediatricians who believed that their advice influences positive parenting skills inquired about more parents' ACE. As of 2013, few pediatricians inquired about parents' ACEs despite recognizing their negative impact on parenting behaviors and child development. Research is needed regarding the best approaches to the prevention and amelioration of ACEs and the promotion of family and child resilience. Pediatricians need resources and education about the AAP's proposed dyadic approach to assessing family and child risk factors and strengths and to providing guidance and management. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Adverse impacts of pasture abandonment in Himalayan protected areas: Testing the efficiency of a Natural Resource Management Plan (NRMP)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nautiyal, Sunil; Kaechele, Harald

    2007-03-15

    The high elevational areas in the Himalayas of India are dominated by forests and alpine pastures. There are many protected areas in the region, including Nanda Devi Biosphere Reserve (NDBR) and Valley of Flowers (VOF) where natural resource management plan (NRMP) has been implemented for the conservation of biodiversity. This has affected the traditional animal husbandry system, as well as the vegetation dynamics of alpine pastures. An integrated approach to studying the impact of NRMP in the region has been applied by us. First, a survey was conducted regarding livestock management, data pertaining the livestock husbandry, the role of animalmore » husbandry in economics of rural household, and socioeconomics. Second, field based study on phytosociology of some important alpine herbs was done to enumerate the density and species richness in different land mark of the region. Thereafter, satellite data and Geographic Information System (GIS) were used to develop a land cover map of the area and to note changes in the landscape over time after implementation of NRMP. From an economic point of view the implementation of such plan is a setback to the rural economy. However, the ecological perspective of such models is a threat to the diversity of alpine pastures. The invasion of bushes/thorny bushes/shrubs and weeds with their luxuriant growth is changing the vegetation index and dynamics. Consequently, the diversity of herbs in alpine pastures of the Himalayan Mountains is in jeopardy. Overall, the situation is leading to landscape change in the region. This study is helpful for generating useful outcomes and strategies considering the question or debate 'is grazing good or bad for pasture ecosystems in the Himalayas?'.« less

  18. The curvilinear relationship of early-life adversity and successful aging: the mediating role of mental health.

    PubMed

    Höltge, Jan; Mc Gee, Shauna L; Thoma, Myriam V

    2018-02-15

    The steeling effect suggests that early-life adversity can have a beneficial impact later in life. However, little is known about its underlying mechanisms and long-term outcomes . The study aimed to examine the role of early-life adversity (ELA) on successful aging, and whether this relationship can be explained by mental and physical health. Socio-demographics, early-life adversity (ELA), individual quality of life (iQoL), and mental and physical health of 270 individuals (M age = 66.82 years, 71.5% female) were assessed. Polynomial regressions and mediation analyses were conducted. Significant inverse U-shaped associations were found between ELA and iQoL (β = -.59, p = .005) and between ELA and mental health (β = -.64, p = .002), but not between ELA and physical health. Furthermore, mental health significantly mediated the relationship between ELA and iQoL (b = -.84, BCa CI [-1.66, -.27]). Highest level of individual quality of life (i.e. successful aging) was related to a moderate amount of ELA. Additionally, mental health significantly mediated this relationship. These findings suggest that some amount of ELA could be beneficial for successful aging. Resource-focused interventions are needed to improve health and promote successful aging for an underdetected, at-risk subgroup with low early-life adversity.

  19. The impact of health information technology adoption by outpatient facilities on pregnancy outcomes.

    PubMed

    Deily, Mary E; Hu, Tianyan; Terrizzi, Sabrina; Chou, Shin-Yi; Meyerhoefer, Chad D

    2013-02-01

    Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Administrative claims data on 491,832 births in Pennsylvania during 1998-2004 from the Pennsylvania Health Care Cost Containment Council and HIT applications data from the Dorenfest Institute. Fixed-effects regression analysis of the impact of HIT at NHFs on adverse birth outcomes and resource use. Greater use of clinical HIT applications by NHFs is associated with reduced incidence of obstetric trauma and preventable complications, as well as longer lengths of stay. In addition, the beneficial effects of HIT increase the longer that technologies have been in use. However, we find no consistent evidence on whether or how nonclinical HIT in NHFs affects either resource use or health outcomes. Clinical HIT applications at NHFs may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies. © Health Research and Educational Trust.

  20. The Impact of Health Information Technology Adoption by Outpatient Facilities on Pregnancy Outcomes

    PubMed Central

    Deily, Mary E; Hu, Tianyan; Terrizzi, Sabrina; Chou, Shin-Yi; Meyerhoefer, Chad D

    2013-01-01

    Objective Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Data Sources Administrative claims data on 491,832 births in Pennsylvania during 1998–2004 from the Pennsylvania Health Care Cost Containment Council and HIT applications data from the Dorenfest Institute. Study Design Fixed-effects regression analysis of the impact of HIT at NHFs on adverse birth outcomes and resource use. Principal Findings Greater use of clinical HIT applications by NHFs is associated with reduced incidence of obstetric trauma and preventable complications, as well as longer lengths of stay. In addition, the beneficial effects of HIT increase the longer that technologies have been in use. However, we find no consistent evidence on whether or how nonclinical HIT in NHFs affects either resource use or health outcomes. Conclusions Clinical HIT applications at NHFs may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies. PMID:22742682

  1. Potential resource and toxicity impacts from metals in waste electronic devices.

    PubMed

    Woo, Seung H; Lee, Dae Sung; Lim, Seong-Rin

    2016-04-01

    As a result of the continuous release of new electronic devices, existing electronic devices are quickly made obsolete and rapidly become electronic waste (e-waste). Because e-waste contains a variety of metals, information about those metals with the potential for substantial environmental impact should be provided to manufacturers, recyclers, and disposers to proactively reduce this impact. This study assesses the resource and toxicity (i.e., cancer, noncancer, and ecotoxicity) potentials of various heavy metals commonly found in e-waste from laptop computers, liquid-crystal display (LCD) monitors, LCD TVs, plasma TVs, color cathode ray tube (CRT) TVs, and cell phones and then evaluates such potentials using life cycle impact-based methods. Resource potentials derive primarily from Cu, Sb, Ag, and Pb. Toxicity potentials derive primarily from Pb, Ni, and Hg for cancer toxicity; from Pb, Hg, Zn, and As for noncancer toxicity; and from Cu, Pb, Hg, and Zn for ecotoxicity. Therefore, managing these heavy metals should be a high priority in the design, recycling, and disposal stages of electronic devices. © 2015 SETAC.

  2. Demands and Job Resources in the Child Care Workforce: Swiss Lead Teacher and Assistant Teacher Assessments

    ERIC Educational Resources Information Center

    Bloechliger, Olivia R.; Bauer, Georg F.

    2016-01-01

    Center-based child care has been struggling with poor health and high turnover rates of child care staff and their adverse impact on care quality for decades. Yet little is known about personal and structural antecedents of job resources and job demands that are valid predictors of health and turnover in the child care workforce. Research…

  3. Adverse environments and children's creativity development: transforming the notion of "success in adversity" in China.

    PubMed

    Cheng, Li; Tan, Mei; Liu, Zhengkui

    2015-01-01

    China has been undergoing great social change due to its new focus on urbanization and globalization. Such change has had a tremendous adverse impact on the living conditions of millions of young children, simultaneously generating new interest in children's creativity development. The intersection of these two issues has important implications for China's future as it brings together one of China's core cultural values-"success in adversity"-the importance of creativity, and very real social and economic needs. "Success in adversity" reflects the strongly held belief that individuals who suffer adverse environments can rise to excellence and success through persistence, effort, and creativity. In this article, we briefly explore the historical sources of this belief and how it is closely related to the Chinese conception of creativity. We then present some studies on the creativity of some of China's migrant children. Findings show that while migrant children as a group may not generally exhibit higher creativity than their urban peers as hypothesized, indications of resilience and creative potential suggest that the notion of success in adversity may contribute to the positive development of China's migrant children more substantially when it is informed by research and augmented by research-supported policy. © 2015 Wiley Periodicals, Inc.

  4. The association of chronic adversity with psychiatric disorder and disorder severity in adolescents.

    PubMed

    Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Fleiz, Clara; Medina-Mora, Maria Elena

    2011-09-01

    The purpose of this paper is to estimate the impact of chronic adversity on psychopathology in adolescents, taking into account the type of adversity, number of adversities experienced and type of psychiatric disorder, as well as to estimate the impact on severity of the disorder. A total of 3,005 male and female adolescents from the Mexican Adolescent Mental Health Survey aged 12-17 years were interviewed in a stratified multistage general population probability survey. Assessment of 20 DSM-IV disorders, disorder severity and 12 chronic childhood adversities were assessed with the adolescent version of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A). Family dysfunction adversities including abuse presented the most consistent associations between chronic adversity and psychopathology and their impact was generally non-specific with regard to the type of disorder. Parental divorce, parental death and economic adversity were not individually associated with psychopathology. Among those with a psychiatric disorder, sexual abuse and family violence were associated with having a seriously impairing disorder. The odds of having a psychiatric disorder and a serious disorder increased with increasing numbers of adversities; however, each additional adversity increased the odds at a decreasing rate. While the study design does not allow for conclusions regarding causality, these findings suggest general pathways from family dysfunction to psychopathology rather than specific associations between particular adversities and particular disorders, and provide further evidence for the importance of family-focused intervention and prevention efforts.

  5. The impact of childhood adversity on suicidality and clinical course in treatment-resistant depression.

    PubMed

    Tunnard, Catherine; Rane, Lena J; Wooderson, Sarah C; Markopoulou, Kalypso; Poon, Lucia; Fekadu, Abebaw; Juruena, Mario; Cleare, Anthony J

    2014-01-01

    Childhood adversity is a risk factor for the development of depression and can also affect clinical course. We investigated this specifically in treatment-resistant depression (TRD). One hundred and thirty-seven patients with TRD previously admitted to an inpatient affective disorders unit were included. Clinical, demographic and childhood adversity (physical, sexual, emotional abuse; bullying victimization, traumatic events) data were obtained during admission. Associations between childhood adversity, depressive symptoms and clinical course were investigated. Most patients had experienced childhood adversity (62%), with traumatic events (35%) and bullying victimization (29%) most commonly reported. Childhood adversity was associated with poorer clinical course, including earlier age of onset, episode persistence and recurrence. Logistic regression analyses revealed childhood adversity predicted lifetime suicide attempts (OR 2.79; 95% CI 1.14, 6.84) and childhood physical abuse predicted lifetime psychosis (OR 3.42; 95% CI 1.00, 11.70). The cross-sectional design and retrospective measurement of childhood adversity are limitations of the study. Childhood adversity was common amongst these TRD patients and was associated with poor clinical course, psychosis and suicide attempts. Routine assessment of early adversity may help identify at risk individuals and inform clinical intervention. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Community Level Stressors and Their Impacts on Food ...

    EPA Pesticide Factsheets

    Research is needed to understand a community’s food resources, utilization of those resources, and how the built and natural environment impact access to resources and potential chemical exposures. This research will identify stressors, relationships between those stressors, and explore potential interactions between food resources and chemical and non-chemical stressors. By evaluating various chemical and non-chemical stressors, an understanding of a community’s food resources and utilization with potential exposures can be obtained. With this understanding about the community’s potential dietary exposures and contributing factors, it will be possible to evaluate ways to mitigate and alleviate issues that could impact public health. The objectives of this research are 1) to obtain information on a community’s environmental exposures (chemical and non-chemical stressors) from various available databases and data and 2) to evaluate impacts on dietary exposure which may lead to adverse public health outcomes. This research will enhance public tools, in particular, the Community-Focused Exposure and Risk Screening Tool (CFERST), which can be utilized by community leaders in decision making by bridging all pertinent information to inform policy. Community level health analyses can support protective actions, be used by communities to identify and prioritize their risks based on scientific data and ensure that resources are directed where they will provi

  7. The impact of adverse child and adult experiences on recovery from serious mental illness.

    PubMed

    Stumbo, Scott P; Yarborough, Bobbi Jo H; Paulson, Robert I; Green, Carla A

    2015-12-01

    The purpose of this study was to compare effects of adverse childhood experiences and adverse adult experiences on recovery from serious mental illnesses. As part of a mixed-methods study of recovery from serious mental illnesses, we interviewed and administered questionnaires to 177 members of a not-for-profit health plan over a 2-year period. Participants had a diagnosis of bipolar disorder, affective psychosis, schizophrenia, or schizoaffective disorder. Data for analyses came from standardized self-reported measures; outcomes included recovery, functioning, quality of life, and psychiatric symptoms. Adverse events in childhood and adulthood were evaluated as predictors. Child and adult exposures to adverse experiences were high, at 91% and 82%, respectively. Cumulative lifetime exposure to adverse experiences (childhood plus adult experiences) was 94%. In linear regression analyses, adverse adult experiences were more important predictors of outcomes than adverse childhood experiences. Adult experiences were associated with lower recovery scores, quality of life, mental and physical functioning and social functioning and greater psychiatric symptoms. Emotional neglect in adulthood was associated with lower recovery scores. Early and repeated exposure to adverse events was common in this sample of people with serious mental illnesses. Adverse adult experiences were stronger predictors of worse functioning and lower recovery levels than were childhood experiences. Focusing clinical attention on adult experiences of adverse or traumatic events may result in greater benefit than focusing on childhood experiences alone. (c) 2015 APA, all rights reserved).

  8. The Impact of Adverse Child and Adult Experiences on Recovery from Serious Mental Illness

    PubMed Central

    Stumbo, Scott P.; Yarborough, Bobbi Jo H.; Paulson, Robert I.; Green, Carla A.

    2015-01-01

    Objective To compare effects of adverse childhood experiences and adverse adult experiences on recovery from serious mental illnesses. Methods As part of a mixed-methods study of recovery from serious mental illnesses, we interviewed and administered questionnaires to 177 members of a not-for-profit health plan over a two-year period. Participants had a diagnosis of bipolar disorder, affective psychosis, schizophrenia or schizoaffective disorder. Data for analyses came from standardized self-reported measures; outcomes included recovery, functioning, quality of life, and psychiatric symptoms. Adverse events in childhood and adulthood were evaluated as predictors. Results Child and adult exposures to adverse experiences were high, at 91% and 82% respectively. Cumulative lifetime exposure to adverse experiences (childhood plus adult experiences) was 94%. In linear regression analyses, adverse adult experiences were more important predictors of outcomes than adverse childhood experiences. Adult experiences were associated with lower recovery scores, quality of life, mental and physical functioning, social functioning, and greater psychiatric symptoms. Emotional neglect in adulthood was associated with lower recovery scores. Conclusions and Implications for Practice Early and repeated exposure to adverse events was common in this sample of people with serious mental illnesses. Adverse adult experiences were stronger predictors of worse functioning and lower recovery levels than were childhood experiences. Focusing clinical attention on adult experiences of adverse or traumatic events may result in greater benefit than focusing on childhood experiences alone. PMID:26053533

  9. Freshwater Aquatic Nuisance Species Impacts and Management Costs and Benefits at Federal Water Resources Projects

    DTIC Science & Technology

    2006-09-01

    ERDC/TN ANSRP-06-3 September 2006 Freshwater Aquatic Nuisance Species Impacts and Management Costs and Benefits at Federal Water Resources...Cole, R. A. (2006). “ Freshwater aquatic nuisance species impacts and management costs and benefits at Federal Water resources projects,” ANSRP...Projects1 by Richard A. Cole THE ISSUE: A small fraction of the species that inhabit the nation’s fresh waters become aquatic nuisance species (ANS

  10. Final Plan to Study the Potential Impacts of Hydraulic Fracturing on Drinking Water Resources

    EPA Science Inventory

    The overall purpose of this study is to elucidate the relationship, if any, between hydraulic fracturing and drinking water resources. More specifically, the study has been designed to assess the potential impacts of hydraulic fracturing on drinking water resources and to identif...

  11. Selection of spatial scale for assessing impacts of groundwater-based water supply on freshwater resources.

    PubMed

    Hybel, A-M; Godskesen, B; Rygaard, M

    2015-09-01

    Indicators of the impact on freshwater resources are becoming increasingly important in the evaluation of urban water systems. To reveal the importance of spatial resolution, we investigated how the choice of catchment scale influenced the freshwater impact assessment. Two different indicators were used in this study: the Withdrawal-To-Availability ratio (WTA) and the Water Stress Index (WSI). Results were calculated for three groundwater based Danish urban water supplies (Esbjerg, Aarhus, and Copenhagen). The assessment was carried out at three spatial levels: (1) the groundwater body level, (2) the river basin level, and (3) the regional level. The assessments showed that Copenhagen's water supply had the highest impact on the freshwater resource per cubic meter of water abstracted, with a WSI of 1.75 at Level 1. The WSI values were 1.64 for Aarhus's and 0.81 for Esbjerg's water supply. Spatial resolution was identified as a major factor determining the outcome of the impact assessment. For the three case studies, WTA and WSI were 27%-583% higher at Level 1 than impacts calculated for the regional scale. The results highlight that freshwater impact assessments based on regional data, rather than sub-river basin data, may dramatically underestimate the actual impact on the water resource. Furthermore, this study discusses the strengths and shortcomings of the applied indicator approaches. A sensitivity analysis demonstrates that although WSI has the highest environmental relevance, it also has the highest uncertainty, as it requires estimations of non-measurable environmental water requirements. Hence, the development of a methodology to obtain more site-specific and relevant estimations of environmental water requirements should be prioritized. Finally, the demarcation of the groundwater resource in aquifers remains a challenge for establishing a consistent method for benchmarking freshwater impacts caused by groundwater abstraction. Copyright © 2015 Elsevier

  12. Introduction to special section on impacts of land use change on water resources

    USGS Publications Warehouse

    Stonestrom, David A.; Scanlon, Bridget R.; Zhang, Lu

    2009-01-01

    Changes in land use have potentially large impacts on water resources, yet quantifying these impacts remains among the more challenging problems in hydrology. Water, food, energy, and climate are linked through complex webs of direct and indirect effects and feedbacks. Land use is undergoing major changes due not only to pressures for more efficient food, feed, and fiber production to support growing populations but also due to policy shifts that are creating markets for biofuel and agricultural carbon sequestration. Hydrologic systems embody flows of water, solutes, sediments, and energy that vary even in the absence of human activity. Understanding land use impacts thus necessitates integrated scientific approaches. Field measurements, remote sensing, and modeling studies are shedding new light on the modes and mechanisms by which land use changes impact water resources. Such studies can help deconflate the interconnected influences of human actions and natural variations on the quantity and quality of soil water, surface water, and groundwater, past, present, and future.

  13. Remote sensing in Michigan for land resource management: Highway impact assessment

    NASA Technical Reports Server (NTRS)

    1972-01-01

    An existing section of M-14 freeway constructed in 1964 and a potential extension from Ann Arbor to Plymouth, Michigan provided an opportunity for investigating the potential uses of remote sensing techniques in providing projective information needed for assessing the impact of highway construction. Remote sensing data included multispectral scanner imagery and aerial photography. Only minor effects on vegetation, soils, and land use were found to have occurred in the existing corridor. Adverse changes expected to take place in the corridor proposed for extension of the freeway can be minimized by proper design of drainage ditches and attention to good construction practices. Remote sensing can be used to collect and present many types of data useful for highway impact assessment on land use, vegetation categories and species, soil properties and hydrologic characteristics.

  14. Columbia River System Operation Review : Final Environmental Impact Statement, Appendix D: Cultural Resources.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Columbia River System Operation Review

    1995-11-01

    This study attempts to identify and analyze the impacts of the System Operating Strategy (SOS) alternatives on cultural resources. The impacts include effects on Native American traditional cultural values, properties and practices. They also include effects on archeological or historic properties meeting the criteria of the National Register of Historic Places. In addition to responding to the requirements of the National Environmental Policy Act (NEPA), this analysis addresses the requirements of the National Historic Preservation Act (NHPA), the Archeological Resources Protection Act (ARPA), the Native American Graves Protection and Repatriation Act (NAGPRA), the Native American Religious Freedom Act (NARFA), andmore » other relevant legislation. To meet their legally mandated cultural resources requirements, the SOR agencies will develop agreements and Implementation Plans with the appropriate State Historic Preservation Officers (SHPOs), Tribes, and the Advisory Council on Historic Preservation (ACHP) detailing the measures necessary to best manage the resource. The planning and implementation activities will be staged over a number of years in consultation with affected Tribes.« less

  15. Impact of air pollution and temperature on adverse birth outcomes: Madrid, 2001-2009.

    PubMed

    Arroyo, Virginia; Díaz, Julio; Carmona, Rocío; Ortiz, Cristina; Linares, Cristina

    2016-11-01

    Low birth weight (<2500 g) (LBW), premature birth (<37 weeks of gestation) (PB), and late foetal death (<24 h of life) (LFD) are causes of perinatal morbi-mortality, with short- and long-term social and economic health impacts. This study sought to identify gestational windows of susceptibility during pregnancy and to analyse and quantify the impact of different air pollutants, noise and temperature on the adverse birth outcomes. Time-series study to assess the impact of mean daily PM 2.5 , NO 2 and O 3 (μg/m 3 ), mean daily diurnal (Leqd) and nocturnal (Leqn) noise levels (dB(A)), maximum and minimum daily temperatures (°C) on the number of births with LBW, PB or LFD in Madrid across the period 2001-2009. We controlled for linear trend, seasonality and autoregression. Poisson regression models were fitted for quantification of the results. The final models were expressed as relative risk (RR) and population attributable risk (PAR). Leqd was observed to have the following impacts in LBW: at onset of gestation, in the second trimester and in the week of birth itself. NO 2 had an impact in the second trimester. In the case of PB, the following: Leqd in the second trimester, Leqn in the week before birth and PM 2.5 in the second trimester. In the case of LFD, impacts were observed for both PM 2.5 in the third trimester, and minimum temperature. O 3 proved significant in the first trimester for LBW and PB, and in the second trimester for LFD. Pollutants concentrations, noise and temperature influenced the weekly average of new-borns with LBW, PB and LFD in Madrid. Special note should be taken of the effect of diurnal noise on LBW across the entire pregnancy. The exposure of pregnant population to the environmental factors analysed should therefore be controlled with a view to reducing perinatal morbi-mortality. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Multimorbidity in chronic disease: impact on health care resources and costs

    PubMed Central

    McPhail, Steven M

    2016-01-01

    Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied). There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to directly observe sustained and measurable health and quality of life benefits. Research in the field has indicated that the impact of multimorbidity on health care costs and resources will likely differ across health systems, regions, disease combinations, and person

  17. Identification and Prioritization of Relationships between Environmental Stressors and Adverse Human Health Impacts.

    PubMed

    Bell, Shannon M; Edwards, Stephen W

    2015-11-01

    There are > 80,000 chemicals in commerce with few data available describing their impacts on human health. Biomonitoring surveys, such as the NHANES (National Health and Nutrition Examination Survey), offer one route to identifying possible relationships between environmental chemicals and health impacts, but sparse data and the complexity of traditional models make it difficult to leverage effectively. We describe a workflow to efficiently and comprehensively evaluate and prioritize chemical-health impact relationships from the NHANES biomonitoring survey studies. Using a frequent itemset mining (FIM) approach, we identified relationships between chemicals and health biomarkers and diseases. The FIM method identified 7,848 relationships between 219 chemicals and 93 health outcomes/biomarkers. Two case studies used to evaluate the FIM rankings demonstrate that the FIM approach is able to identify published relationships. Because the relationships are derived from the vast majority of the chemicals monitored by NHANES, the resulting list of associations is appropriate for evaluating results from targeted data mining or identifying novel candidate relationships for more detailed investigation. Because of the computational efficiency of the FIM method, all chemicals and health effects can be considered in a single analysis. The resulting list provides a comprehensive summary of the chemical/health co-occurrences from NHANES that are higher than expected by chance. This information enables ranking and prioritization on chemicals or health effects of interest for evaluation of published results and design of future studies. Bell SM, Edwards SW. 2015. Identification and prioritization of relationships between environmental stressors and adverse human health impacts. Environ Health Perspect 123:1193-1199; http://dx.doi.org/10.1289/ehp.1409138.

  18. Impact of Adverse Events Following Immunization in Viet Nam in 2013 on chronic hepatitis B infection.

    PubMed

    Li, Xi; Wiesen, Eric; Diorditsa, Sergey; Toda, Kohei; Duong, Thi Hong; Nguyen, Lien Huong; Nguyen, Van Cuong; Nguyen, Tran Hien

    2016-02-03

    Adverse Events Following Immunization in Viet Nam in 2013 led to substantial reductions in hepatitis B vaccination coverage (both the birth dose and the three-dose series). In order to estimate the impact of the reduction in vaccination coverage on hepatitis B transmission and future mortality, a widely-used mathematical model was applied to the data from Viet Nam. Using the model, we estimated the number of chronic infections and deaths that are expected to occur in the birth cohort in 2013 and the number of excessive infections and deaths attributable to the drop in immunization coverage in 2013. An excess of 90,137 chronic infections and 17,456 future deaths were estimated to occur in the 2013 birth cohort due to the drop in vaccination coverage. This analysis highlights the importance of maintaining high vaccination coverage and swiftly responding to reported Adverse Events Following Immunization in order to regain consumer confidence in the hepatitis B vaccine. Copyright © 2015 World Health Organization; licensee Elsevier. Published by Elsevier Ltd.. All rights reserved.

  19. Quality of life in children with adverse drug reactions: a narrative and systematic review.

    PubMed

    Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

    2015-10-01

    Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn's disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. © 2014 The British Pharmacological Society.

  20. Quality of life in children with adverse drug reactions: a narrative and systematic review

    PubMed Central

    Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

    2015-01-01

    Aims Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. Methods We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Results Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn’s disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. Conclusions To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. PMID:24833305

  1. 18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

  2. 18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

  3. 18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

  4. 18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

  5. Adverse Environments and Children's Creativity Development: Transforming the Notion of "Success in Adversity" in China

    ERIC Educational Resources Information Center

    Cheng, Li; Tan, Mei; Liu, Zhengkui

    2015-01-01

    China has been undergoing great social change due to its new focus on urbanization and globalization. Such change has had a tremendous adverse impact on the living conditions of millions of young children, simultaneously generating new interest in children's creativity development. The intersection of these two issues has important implications…

  6. Impacts of Groundwater Pumping on Regional and Global Water Resources

    NASA Technical Reports Server (NTRS)

    Wada, Yoshihide

    2016-01-01

    Except frozen water in ice and glaciers (68%), groundwater is the world's largest distributed store of freshwater (30%), and has strategic importance to global food and water security. In this chapter, the most recent advances assessing human impact on regional and global groundwater resources are reviewed. This chapter critically evaluates the recently advanced modeling approaches quantifying the effect of groundwater pumping in regional and global groundwater resources and the evidence of feedback to the Earth system including sea-level rise associated with groundwater use. At last, critical challenges and opportunities are identified in the use of groundwater to adapt to growing food demand and uncertain climate.

  7. Impact of Adverse Childhood Experiences on Psychotic-Like Symptoms and Stress Reactivity in Daily Life in Nonclinical Young Adults

    PubMed Central

    Ballespí, Sergi; Mitjavila, Mercè; Myin-Germeys, Inez; Kwapil, Thomas R.; Barrantes-Vidal, Neus

    2016-01-01

    Background There is increasing interest in elucidating the association of different childhood adversities with psychosis-spectrum symptoms as well as the mechanistic processes involved. This study used experience sampling methodology to examine (i) associations of a range of childhood adversities with psychosis symptom domains in daily life; (ii) whether associations of abuse and neglect with symptoms are consistent across self-report and interview methods of trauma assessment; and (iii) the role of different adversities in moderating affective, psychotic-like, and paranoid reactivity to situational and social stressors. Method A total of 206 nonclinical young adults were administered self-report and interview measures to assess childhood abuse, neglect, bullying, losses, and general traumatic events. Participants received personal digital assistants that signaled them randomly eight times daily for one week to complete questionnaires about current experiences, including symptoms, affect, and stress. Results Self-reported and interview-based abuse and neglect were associated with psychotic-like and paranoid symptoms, whereas only self-reported neglect was associated with negative-like symptoms. Bullying was associated with psychotic-like symptoms. Losses and general traumatic events were not directly associated with any of the symptom domains. All the childhood adversities were associated with stress reactivity in daily life. Interpersonal adversities (abuse, neglect, bullying, and losses) moderated psychotic-like and/or paranoid reactivity to situational and social stressors, whereas general traumatic events moderated psychotic-like reactivity to situational stress. Also, different interpersonal adversities exacerbated psychotic-like and/or paranoid symptoms in response to distinct social stressors. Discussion The present study provides a unique examination of how childhood adversities impact the expression of spectrum symptoms in the real world and lends support

  8. Impacts of Coal Seam Gas (Coal Bed Methane) Extraction on Water Resources in Australia

    NASA Astrophysics Data System (ADS)

    Post, David

    2017-04-01

    While extraction of methane from shale gas deposits has been the principal source of the recent expansion of the industry in the United States, in Australia extraction of methane from coal bed methane deposits (termed 'coal seam gas' in Australia) has been the focus to date. The two sources of methane share many of the same characteristics including the potential requirement for hydraulic fracturing. However, as coal seam gas deposits generally occur at shallower depths than shale gas, the potential impacts of extraction on surface and groundwater resources may be of even greater concern. In Australia, an Independent Expert Scientific Committee (IESC) has been established to provide scientific advice to federal and state government regulators on the impact that coal seam gas and large coal mining developments may have on water resources. This advice is provided to enable decisions to be informed by the best available science about the potential water-related impacts associated with these developments. To support this advice, the Australian Government Department of the Environment has implemented a programme of research termed 'bioregional assessments' to investigate these potential impacts. A bioregional assessment is defined as a scientific analysis of the ecology, hydrology, geology and hydrogeology of a bioregion with explicit assessment of the potential direct, indirect and cumulative impacts of coal seam gas and large coal mining development on water resources. These bioregional assessments are currently being carried out across large portions of eastern Australia underlain by coal reserves. Further details of the programme and results to date can be found at http://www.bioregionalassessments.gov.au. The bioregional assessment programme has modelled the impacts of coal seam gas development on surface and groundwater resources in three regions of eastern Australia, namely the Clarence-Moreton, Gloucester, and Namoi regions. This presentation will discuss the

  9. Integrated impacts of future electricity mix scenarios on select southeastern US water resources

    NASA Astrophysics Data System (ADS)

    Yates, D.; Meldrum, J.; Flores-Lopez, F.; Davis, Michelle

    2013-09-01

    Recent studies on the relationship between thermoelectric cooling and water resources have been made at coarse geographic resolution and do not adequately evaluate the localized water impacts on specific rivers and water bodies. We present the application of an integrated electricity generation-water resources planning model of the Apalachicola/Chattahoochee/Flint (ACF) and Alabama-Coosa-Tallapoosa (ACT) rivers based on the regional energy deployment system (ReEDS) and the water evaluation and planning (WEAP) system. A future scenario that includes a growing population and warmer, drier regional climate shows that benefits from a low-carbon, electricity fuel-mix could help maintain river temperatures below once-through coal-plants. These impacts are shown to be localized, as the cumulative impacts of different electric fuel-mix scenarios are muted in this relatively water-rich region, even in a warmer and drier future climate.

  10. 18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time limit for...

  11. Assessing climate change impacts on water resources in remote mountain regions

    NASA Astrophysics Data System (ADS)

    Buytaert, Wouter; De Bièvre, Bert

    2013-04-01

    From a water resources perspective, remote mountain regions are often considered as a basket case. They are often regions where poverty is often interlocked with multiple threats to water supply, data scarcity, and high uncertainties. In these environments, it is paramount to generate locally relevant knowledge about water resources and how they impact local livelihoods. This is often problematic. Existing environmental data collection tends to be geographically biased towards more densely populated regions, and prioritized towards strategic economic activities. Data may also be locked behind institutional and technological barriers. These issues create a "knowledge trap" for data-poor regions, which is especially acute in remote and hard-to-reach mountain regions. We present lessons learned from a decade of water resources research in remote mountain regions of the Andes, Africa and South Asia. We review the entire tool chain of assessing climate change impacts on water resources, including the interrogation and downscaling of global circulation models, translating climate variables in water availability and access, and assessing local vulnerability. In global circulation models, mountain regions often stand out as regions of high uncertainties and lack of agreement of future trends. This is partly a technical artifact because of the different resolution and representation of mountain topography, but it also highlights fundamental uncertainties in climate impacts on mountain climate. This problem also affects downscaling efforts, because regional climate models should be run in very high spatial resolution to resolve local gradients, which is computationally very expensive. At the same time statistical downscaling methods may fail to find significant relations between local climate properties and synoptic processes. Further uncertainties are introduced when downscaled climate variables such as precipitation and temperature are to be translated in hydrologically

  12. How Does Scale of Implementation Impact the Environmental Sustainability of Wastewater Treatment Integrated with Resource Recovery?

    PubMed

    Cornejo, Pablo K; Zhang, Qiong; Mihelcic, James R

    2016-07-05

    Energy and resource consumptions required to treat and transport wastewater have led to efforts to improve the environmental sustainability of wastewater treatment plants (WWTPs). Resource recovery can reduce the environmental impact of these systems; however, limited research has considered how the scale of implementation impacts the sustainability of WWTPs integrated with resource recovery. Accordingly, this research uses life cycle assessment (LCA) to evaluate how the scale of implementation impacts the environmental sustainability of wastewater treatment integrated with water reuse, energy recovery, and nutrient recycling. Three systems were selected: a septic tank with aerobic treatment at the household scale, an advanced water reclamation facility at the community scale, and an advanced water reclamation facility at the city scale. Three sustainability indicators were considered: embodied energy, carbon footprint, and eutrophication potential. This study determined that as with economies of scale, there are benefits to centralization of WWTPs with resource recovery in terms of embodied energy and carbon footprint; however, the community scale was shown to have the lowest eutrophication potential. Additionally, technology selection, nutrient control practices, system layout, and topographical conditions may have a larger impact on environmental sustainability than the implementation scale in some cases.

  13. The impact of endocrine supplementation on adverse events in septic shock.

    PubMed

    Bissell, Brittany D; Erdman, Michael J; Smotherman, Carmen; Kraemer, Dale F; Ferreira, Jason A

    2015-12-01

    The objective of this study was to compare the incidence of severe adverse events of vasopressin vs hydrocortisone for endocrine support therapy in patients with septic shock. This was a retrospective, propensity-matched cohort of patients admitted to the medical intensive care unit with septic shock between February 2012 and February 2015. Patients were included if vasopressin or hydrocortisone was administered for hemodynamic support secondary to norepinephrine. In the unmatched cohort of 124 patients, vasopressin was associated with a significant decrease in the number of severe adverse events (P=.03). In the matched cohort, severe adverse events occurred 3 times as often in patients receiving hydrocortisone; however, this difference was not statistically significant. (odds ratio, 3.33; 95% confidence interval, 0.92-12.11; P=.06). In the matched cohort, vasopressin was associated with a faster time to hemodynamic stability (P<.05) and discontinuation of hemodynamic support (P<.01) with an increased requirement for third-line therapy (P<.01). No statistical differences were seen in length of stay (intensive care unit and hospital), length of mechanical ventilation, and in-hospital mortality. Given the lower incidence of adverse events and faster time to hemodynamic stability, vasopressin appears to be the most advantageous endocrine agent for hemodynamic support in septic shock. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. An Impact Evaluation of the Resource Access Projects 1980-1981.

    ERIC Educational Resources Information Center

    Empson, Judith V.; And Others

    This report presents findings of the fifth impact evaluation of Head Start's 15 Resource Access Projects (RAPs), offering data for the 1980-81 program year. RAPs are the designated liaison between Head Start grantees and state and local education systems, and they also train Head Start staff to work with handicapped children and their families.…

  15. Occidental Geothermal, Inc. , Oxy geothermal power plant No. 1. Final environmental impact report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1981-12-01

    The project-specific environmental analysis covers the following: geology, soils, water resources, biology, air quality, noise, waste management, health, safety, transportation, energy and material resources, cultural resources, socioeconomics, public services, land use, and aesthetics. Other topics covered are: the cumulative envionmental analysis; unavoidable significant adverse environmental effects; irreversible environmental changes and irretrievable commitments of energy and materials; the relationship between local short-term uses of man's environment and the maintenance and enhancement of long-term productivity; growth-inducing impacts; and alternatives to the proposed action. (MHR)

  16. Ventral striatal activity links adversity and reward processing in children.

    PubMed

    Kamkar, Niki H; Lewis, Daniel J; van den Bos, Wouter; Morton, J Bruce

    2017-08-01

    Adversity impacts many aspects of psychological and physical development including reward-based learning and decision-making. Mechanisms relating adversity and reward processing in children, however, remain unclear. Here, we show that adversity is associated with potentiated learning from positive outcomes and impulsive decision-making, but unrelated to learning from negative outcomes. We then show via functional magnetic resonance imaging that the link between adversity and reward processing is partially mediated by differences in ventral striatal response to rewards. The findings suggest that early-life adversity is associated with alterations in the brain's sensitivity to rewards accounting, in part, for the link between adversity and altered reward processing in children. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis.

    PubMed

    Nurius, Paula S; Green, Sara; Logan-Greene, Patricia; Borja, Sharon

    2015-07-01

    Growing evidence suggests that toxic stressors early in life not only convey developmental impacts but also augment risk of proliferating chains of additional stressors that can overwhelm individual coping and undermine recovery and health. Examining trauma within a life course stress process perspective, we posit that early childhood adversity carries a unique capacity to impair adult psychological well-being both independent of and cumulative with other contributors, including social disadvantage and stressful adult experiences. This study uses data from a representative population-based health survey (N=13,593) to provide one of the first multivariate assessments of unique, cumulative, and moderated effects of adverse childhood experiences (ACEs) toward explaining 3 related yet distinct measures of adult mental health: perceived well-being, psychological distress, and impaired daily activities. Results demonstrate support for each set of hypothesized associations, including exacerbation and amelioration of ACEs effects by adult stress and resilience resources, respectively. Implications for services and future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Life Course Pathways of Adverse Childhood Experiences Toward Adult Psychological Well-Being: A Stress Process Analysis

    PubMed Central

    Nurius, Paula S.; Green, Sara; Logan-Greene, Patricia; Borja, Sharon

    2015-01-01

    Growing evidence suggests that toxic stressors early in life not only convey developmental impacts but also augment risk of proliferating chains of additional stressors that can overwhelm individual coping and undermine recovery and health. Examining trauma within a life course stress process perspective, we posit that early childhood adversity carries a unique capacity to impair adult psychological well-being both independent of and cumulative with other contributors, including social disadvantage and stressful adult experiences. This study uses data from a representative population-based health survey (N = 13,593) to provide one of the first multivariate assessments of unique, cumulative, and moderated effects of adverse childhood experiences (ACEs) toward explaining 3 related yet distinct measures of adult mental health: perceived well-being, psychological distress, and impaired daily activities. Results demonstrate support for each set of hypothesized associations, including exacerbation and amelioration of ACEs effects by adult stress and resilience resources, respectively. Implications for services and future research are discussed. PMID:25846195

  19. Impact of remote sensing upon the planning, management, and development of water resources

    NASA Technical Reports Server (NTRS)

    Loats, H. L.; Fowler, T. R.; Frech, S. L.

    1974-01-01

    A survey of the principal water resource users was conducted to determine the impact of new remote data streams on hydrologic computer models. The analysis of the responses and direct contact demonstrated that: (1) the majority of water resource effort of the type suitable to remote sensing inputs is conducted by major federal water resources agencies or through federally stimulated research, (2) the federal government develops most of the hydrologic models used in this effort; and (3) federal computer power is extensive. The computers, computer power, and hydrologic models in current use were determined.

  20. Impact of trends in resources, environment and development on demographic prospects.

    PubMed

    Keyfitz, N

    1984-01-01

    This paper addresses the impact of trends in resources, environment and development on demographic prospects by investigating whether ecological considerations can improve the accuracy of population projections. It identifies the degree to which population is resources-determined. The basic classic relationship that resources determine population is increasingly inapplicable as the level of technology rises and institutions are formed. The major defect in attmepts to relate population directly to land and energy flow is that they suppose all other factors remain constant. If, however, the increase of population on the fixed land itself pushes technology, and that in turn makes it possible for a larger population to live on the same land, the attempt to express population as a pure function of land is entirely frustrated. Given a challenge that is severe but not overwhelming, a natural environment that is difficult but not impossible, plus a culture that builds responsiveness into its children in each generation, the inert adjustment of population numbers to food supplies seems to give way to the active adjustment of food supplies to population. Those who need the most because of their poverty are the ones who advance the least. Government is another intermediate agent between the environment that would limit population and the population itself. It acts as an agent of adaptation of population to land. The emergence of the world grain market, which has detached individuals from dependence on their local ecological base, has lifted the resource constraint. A method to improve the accuracy of population projections is proposed, based on projecting the condition of resources and the environment, followed by the intermediate variables of technology and institutions for a given future time. Population projection for each year to that date would be done by interpolation, rather than by extrapolation. Birth control, the effect of urbanization and the impact of development

  1. Colorectal cancer screening and adverse childhood experiences: Which adversities matter?

    PubMed

    Alcalá, Héctor E; Keim-Malpass, Jessica; Mitchell, Emma

    2017-07-01

    Adverse Childhood Experiences (ACEs) have been associated with an increased risk of a variety of diseases, including cancer. However, research has not paid enough attention to the association between ACEs and cancer screening. As such, the present study examined the association between ACEs and ever using colorectal cancer (CRC) screening, among adults age 50 and over. Analyses used the 2011 Behavioral Risk Factor Surveillance System (n=24,938) to model odds of ever engaging in CRC screening from nine different adversities. Bivariate and multivariate models were fit. In bivariate models, physical abuse, having parents that were divorced or separated, and living in a household where adults treated each other violently were associated with lower odds of engaging in CRC. In multivariate models that accounted for potential confounders, emotional and sexual abuse were each associated with higher odds of engaging in CRC. Results suggest potential pathways by which early childhood experiences can impact future health behaviors. Future research should examine this association longitudinally. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Are prenatal care resources distributed efficiently across high-risk and low-risk mothers?

    PubMed

    Mukhopadhyay, Sankar; Wendel, Jeanne

    2008-09-01

    The Institute for Clinical Systems Improvement recommends reducing the number of prenatal care visits recommended for low-risk women, citing evidence from a randomized clinical trial indicating that the reduction would not adversely impact infant health. We investigate the implicit hypothesis that prenatal care resources are not distributed efficiently across high-risk and low-risk women. Using clinic-reported prenatal care and an inclusive measure of infant health, we report evidence indicating inefficient resource utilization: prenatal care only boosts infant health when mothers have specific pre-existing diagnoses, but women with high potential to benefit from care do not obtain more care than other women.

  3. Analysis of High Plains Resource Risk and Economic Impacts

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tidwell, Vincent C.; Vargas, Vanessa N; Jones, Shannon M

    2016-04-01

    The importance of the High Plains Aquifer is broadly recognized as is its vulnerability to continued overuse. T his study e xplore s how continued depletions of the High Plains Aquifer might impact both critical infrastructure and the economy at the local, r egional , and national scale. This analysis is conducted at the county level over a broad geographic region within the states of Kansas and Nebraska. In total , 140 counties that overlie the High Plains Aquifer in these two states are analyzed. The analysis utilizes future climate projections to estimate crop production. Current water use and managementmore » practices are projected into the future to explore their related impact on the High Plains Aquifer , barring any changes in water management practices, regulat ion, or policy. Finally, the impact of declining water levels and even exhaustion of groundwater resources are projected for specific sectors of the economy as well as particular elements of the region's critical infrastructure.« less

  4. Adverse effects of public health interventions: a conceptual framework.

    PubMed

    Lorenc, Theo; Oliver, Kathryn

    2014-03-01

    Public health interventions may have a range of adverse effects. However, there is limited guidance as to how evaluations should address the possibility of adverse effects. This discussion paper briefly presents a framework for thinking about the potential harms of public health interventions, focusing on the following categories: direct harms; psychological harms; equity harms; group and social harms; and opportunity harms. We conclude that the possibility of adverse effects needs to be taken into account by those implementing and evaluating interventions, and requires a broad perspective on the potential impacts of public health strategies.

  5. Land- and resource-use issues at the Valles Caldera

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Intemann, P.R.

    The Valles Caldera possesses a wealth of resources from which various private parties as well as the public at large can benefit. Among the most significant of these are the geothermal energy resource and the natural resource. Wildlife, scenic, and recreational resources can be considered components of the natural resource. In addition, Native Americans in the area value the Valles Caldera as part of their religion. The use of land in the caldera to achieve the full benefits of one resource may adversely affect the value of other resources. Measures can be taken to minimize adverse affects and to maximizemore » the benefits of all the varied resources within the caldera as equitably as possible. An understanding of present and potential land and resource uses in the Caldera, and who will benefit from these uses, can lead to the formulation of such measures.« less

  6. Environmental adversities and psychotic symptoms: The impact of timing of trauma, abuse, and neglect.

    PubMed

    Schalinski, Inga; Breinlinger, Susanne; Hirt, Vanessa; Teicher, Martin H; Odenwald, Michael; Rockstroh, Brigitte

    2017-11-13

    Trauma and adverse childhood experiences (ACE) occur more often in mental illness, including psychosis, than in the general population. Individuals with psychosis (cases) report a higher number and severity (dose) of adversities than healthy controls. While a dose-dependent increase of adversities has been related to more severe psychopathology, the role of type and timing is still insufficiently understood on the exacerbation of positive and negative psychotic symptoms. Moreover, dissociative symptoms were examined as potential mediator between adversities and severity of psychotic symptoms. Exposure to adversities were assessed by interviews in n=180 cases and n=70 controls. In cases, symptom severities were obtained for psychotic symptoms and dissociation. Conditioned random forest regression determined the importance of type and timing of ACE for positive and negative symptom severity, and mediator analyses evaluated the role of dissociative symptoms in the relationship between adversities and psychotic symptoms. Cases experienced substantially more abuse and neglect than controls. Adversities were related in a dose-dependent manner to psychotic disorder. An array of adversities was associated with more severe positive symptoms, while the conditioned random forest regression depicted neglect at age 10 as the most important predictor. Dissociative symptoms mediated the small relation of trauma load in childhood and positive symptoms. The role of trauma and ACE on psychotic symptoms can be specified by neglect during frontocortical development in the exacerbation of positive symptoms. The mediating role of dissociation is restricted to the relation of childhood trauma and positive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. The Yampa River basin, Colorado and Wyoming : a preview to expanded coal-resource development and its impacts on regional water resources

    USGS Publications Warehouse

    Steele, Timothy Doak; Bauer, D.P.; Wentz, D.A.; Warner, J.W.

    1979-01-01

    Expanded coal production and conversion in the Yampa River basin , Colorado and Wyoming, may have substantial impacts on water resources, environmental amenities, and socioeconomic conditions. Preliminary results of a 3-year basin assessment by the U.S. Geological Survey are given for evaluation of surface- and ground-water resources using available data, modeling analysis of waste-load capacity of a Yampa River reach affected by municipal wastewater-treatment plant effluents, and semiquantitative descriptions of ambient air- and water-quality conditions. Aspects discussed are possible constraints on proposed development due to basin compacts and laws regulating water resources, possible changes in environmental-control regulations, and policies on energy-resource leasing and land use that will influence regional economic development. (Woodard-USGS)

  8. Heterotaxy syndrome: impact of ventricular morphology on resource utilization.

    PubMed

    Amula, Venugopal; Ellsworth, German L; Bratton, Susan L; Arrington, Cammon B; Witte, Madolin K

    2014-01-01

    Patients with heterotaxy syndrome (HS) have significant cardiac and extracardiac anomalies that impact outcome. To improve the management of this complex patient population, we performed a comprehensive analysis of their anatomic and clinical features along with an evaluation of resource utilization data. The objectives were to describe anatomic and clinical features of patients with HS syndrome treated at a single center from 1992 to 2011 focusing on the impact of ventricular morphology (univentricular [UV] vs. biventricular [BV]) on clinical outcomes and resource utilization. Clinical and echocardiographic data from patients with HS were abstracted from medical records. Health care costs were indexed to inflation. Seventy-eight patients were identified with HS ranging in age from 1 day to 29 years old. UV morphology was present in 46 patients (59 %), most commonly with right-ventricular dominance (36 of 46). The presence of extra cardiac anomalies did not differ between the UV and BV groups (82 vs. 78 %) nor did morbidities, such as need for enteral tube feedings (47 vs. 25 %) or pacemaker placement (24 vs. 25 %). Mortality was 28 % in the entire cohort: 39 % in univentricuar patients versus 10.5 % in those with biventricular anatomy. Hospital length of stay for medical illnesses was similar in both groups, but length of stay after surgery was significantly longer in UV than BV patients. Among survivors, UV patients had greater median hospital costs (TeX 67,732, p < 0.001), but when this was adjusted for mortality and variable follow-up, there were no differences in health care costs within the first year of life. Significant health care dollars are used to manage children with HS, the majority of which involve expenses related to surgical care. Although patients with biventricular morphology have better survival, morbidity and resource utilization are similar to those for UV patients especially within the first year of life.

  9. BDNF Val 66 Met and 5-HTTLPR genotype moderate the impact of early psychosocial adversity on plasma brain-derived neurotrophic factor and depressive symptoms: a prospective study.

    PubMed

    Buchmann, Arlette F; Hellweg, Rainer; Rietschel, Marcella; Treutlein, Jens; Witt, Stephanie H; Zimmermann, Ulrich S; Schmidt, Martin H; Esser, Günter; Banaschewski, Tobias; Laucht, Manfred; Deuschle, Michael

    2013-08-01

    Recent studies have emphasized an important role for neurotrophins, such as brain-derived neurotrophic factor (BDNF), in regulating the plasticity of neural circuits involved in the pathophysiology of stress-related diseases. The aim of the present study was to examine the interplay of the BDNF Val⁶⁶Met and the serotonin transporter promoter (5-HTTLPR) polymorphisms in moderating the impact of early-life adversity on BDNF plasma concentration and depressive symptoms. Participants were taken from an epidemiological cohort study following the long-term outcome of early risk factors from birth into young adulthood. In 259 individuals (119 males, 140 females), genotyped for the BDNF Val⁶⁶Met and the 5-HTTLPR polymorphisms, plasma BDNF was assessed at the age of 19 years. In addition, participants completed the Beck Depression Inventory (BDI). Early adversity was determined according to a family adversity index assessed at 3 months of age. Results indicated that individuals homozygous for both the BDNF Val and the 5-HTTLPR L allele showed significantly reduced BDNF levels following exposure to high adversity. In contrast, BDNF levels appeared to be unaffected by early psychosocial adversity in carriers of the BDNF Met or the 5-HTTLPR S allele. While the former group appeared to be most susceptible to depressive symptoms, the impact of early adversity was less pronounced in the latter group. This is the first preliminary evidence indicating that early-life adverse experiences may have lasting sequelae for plasma BDNF levels in humans, highlighting that the susceptibility to this effect is moderated by BDNF Val⁶⁶Met and 5-HTTLPR genotype. Copyright © 2013. Published by Elsevier B.V.

  10. 76 FR 22721 - Notice of Availability of Draft Resource Management Plans and Associated Environmental Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLWYR0000.L16100000.DP0000.LXSS042K0000] Notice of Availability of Draft Resource Management Plans and Associated Environmental Impact Statement for the Bighorn Basin Resource Management Plan Revision Project, Cody and Worland Field Offices...

  11. Examining the role of MEDLINE as a patient care information resource: an analysis of data from the Value of Libraries study.

    PubMed

    Dunn, Kathel; Marshall, Joanne Gard; Wells, Amber L; Backus, Joyce E B

    2017-10-01

    This study analyzed data from a study on the value of libraries to understand the specific role that the MEDLINE database plays in relation to other information resources that are available to health care providers and its role in positively impacting patient care. A previous study on the use of health information resources for patient care obtained 16,122 responses from health care providers in 56 hospitals about how providers make decisions affecting patient care and the role of information resources in that process. Respondents indicated resources used in answering a specific clinical question from a list of 19 possible resources, including MEDLINE. Study data were examined using descriptive statistics and regression analysis to determine the number of information resources used and how they were used in combination with one another. Health care professionals used 3.5 resources, on average, to aid in patient care. The 2 most frequently used resources were journals (print and online) and the MEDLINE database. Using a higher number of information resources was significantly associated with a higher probability of making changes to patient care and avoiding adverse events. MEDLINE was the most likely to be among consulted resources compared to any other information resource other than journals. MEDLINE is a critical clinical care tool that health care professionals use to avoid adverse events, make changes to patient care, and answer clinical questions.

  12. Human Resource Management in Hong Kong Preschools: The Impact of Falling Rolls on Staffing

    ERIC Educational Resources Information Center

    Ho, Choi-Wa Dora

    2009-01-01

    Purpose: The purpose of this paper is to discuss the impact of falling rolls on human resource management in local preschools in Hong Kong. It aims to argue that the developing role of leadership in creating a culture and procedures for collective participation in staff appraisal is important for human resource management in preschool settings.…

  13. Comparison of Personal Resources in Patients Who Differently Estimate the Impact of Multiple Sclerosis.

    PubMed

    Wilski, Maciej; Tomczak, Maciej

    2017-04-01

    Discrepancies between physicians' assessment and patients' subjective representations of the disease severity may influence physician-patient communication and management of a chronic illness, such as multiple sclerosis (MS). For these reasons, it is important to recognize factors that distinguish patients who differently estimate the impact of MS. The purpose of this study was to verify if the patients who overestimate or underestimate the impact of MS differ in their perception of personal resources from individuals presenting with a realistic appraisal of their physical condition. A total of 172 women and 92 men diagnosed with MS completed Multiple Sclerosis Impact Scale, University of Washington Self Efficacy Scale, Rosenberg Self-Esteem Scale, Body Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale, and Socioeconomic resources scale. Physician's assessment of health status was determined with Expanded Disability Status Scale. Linear regression analysis was conducted to identify the subsets of patients with various patterns of subjective health and Expanded Disability Status Scale (EDSS) scores. Patients overestimating the impact of their disease presented with significantly lower levels of self-esteem, self-efficacy in MS, and body esteem; furthermore, they perceived their condition more threatening than did realists and underestimators. They also assessed anti-MS treatment worse, had less socioeconomic resources, and received less support than underestimators. Additionally, underestimators presented with significantly better perception of their disease, self, and body than did realists. Self-assessment of MS-related symptoms is associated with specific perception of personal resources in coping with the disease. These findings may facilitate communication with patients and point to new directions for future research on adaptation to MS.

  14. The impact of work-related and personal resources on older workers' fatigue, work enjoyment and retirement intentions over time.

    PubMed

    Stynen, Dave; Jansen, Nicole W H; Kant, IJmert

    2017-12-01

    This study aims to examine the impact of work-related and personal resources on older workers' retirement intentions by studying the pathways (fatigue and work enjoyment) from resources to retirement intentions, the buffering role of resources for psychological job demands, in a cross-sectional and longitudinal timeframe. Longitudinal results on a subsample of full-time, older workers (n = 1642) from the Maastricht Cohort Study suggest that over four years of follow-up personal resources like personal mastery and perceived health related to less (prolonged) fatigue and more work enjoyment. Personal mastery also related to later retirement intentions. A work-related resource like decision authority related to less prolonged fatigue. (Prolonged) fatigue related to earlier retirement intentions, suggesting that fatigue may be a pathway to early retirement. Finally, little evidence was found for effect modification by resources. This prospective study indicates that work-related and personal resources may be useful for prolonging working careers. Practitioner Summary: To date, the impact of work-related and personal resources on older workers' retirement intentions is rarely studied. As this prospective study shows that resources may impact older workers' (prolonged) fatigue, work enjoyment and retirement intentions, the monitoring and fostering of resources is of importance for prolonging their working careers.

  15. Impact of Shale Gas Development on Water Resources: A Case Study in Northern Poland

    NASA Astrophysics Data System (ADS)

    Vandecasteele, Ine; Marí Rivero, Inés; Sala, Serenella; Baranzelli, Claudia; Barranco, Ricardo; Batelaan, Okke; Lavalle, Carlo

    2015-06-01

    Shale gas is currently being explored in Europe as an alternative energy source to conventional oil and gas. There is, however, increasing concern about the potential environmental impacts of shale gas extraction by hydraulic fracturing (fracking). In this study, we focussed on the potential impacts on regional water resources within the Baltic Basin in Poland, both in terms of quantity and quality. The future development of the shale play was modeled for the time period 2015-2030 using the LUISA modeling framework. We formulated two scenarios which took into account the large range in technology and resource requirements, as well as two additional scenarios based on the current legislation and the potential restrictions which could be put in place. According to these scenarios, between 0.03 and 0.86 % of the total water withdrawals for all sectors could be attributed to shale gas exploitation within the study area. A screening-level assessment of the potential impact of the chemicals commonly used in fracking was carried out and showed that due to their wide range of physicochemical properties, these chemicals may pose additional pressure on freshwater ecosystems. The legislation put in place also influenced the resulting environmental impacts of shale gas extraction. Especially important are the protection of vulnerable ground and surface water resources and the promotion of more water-efficient technologies.

  16. Impact of shale gas development on water resources: a case study in northern poland.

    PubMed

    Vandecasteele, Ine; Marí Rivero, Inés; Sala, Serenella; Baranzelli, Claudia; Barranco, Ricardo; Batelaan, Okke; Lavalle, Carlo

    2015-06-01

    Shale gas is currently being explored in Europe as an alternative energy source to conventional oil and gas. There is, however, increasing concern about the potential environmental impacts of shale gas extraction by hydraulic fracturing (fracking). In this study, we focussed on the potential impacts on regional water resources within the Baltic Basin in Poland, both in terms of quantity and quality. The future development of the shale play was modeled for the time period 2015-2030 using the LUISA modeling framework. We formulated two scenarios which took into account the large range in technology and resource requirements, as well as two additional scenarios based on the current legislation and the potential restrictions which could be put in place. According to these scenarios, between 0.03 and 0.86% of the total water withdrawals for all sectors could be attributed to shale gas exploitation within the study area. A screening-level assessment of the potential impact of the chemicals commonly used in fracking was carried out and showed that due to their wide range of physicochemical properties, these chemicals may pose additional pressure on freshwater ecosystems. The legislation put in place also influenced the resulting environmental impacts of shale gas extraction. Especially important are the protection of vulnerable ground and surface water resources and the promotion of more water-efficient technologies.

  17. Proving that less is more: linking resources to outcomes.

    PubMed

    Ebener, M K; Baugh, K; Formella, N M

    1996-01-01

    Advocates of inpatient managed care employing clinical pathways are confident that this patient management strategy reduces cost while promoting optimal patient outcomes. Other health care professionals are concerned that cost reductions place patients at higher risk for adverse health events. Research is needed to demonstrate the true impact of cost-containment strategies on clinical outcomes. The article describes a study in progress comparing patients conventionally managed by their physicians with similar patients whose overall management involved a nurse case manager. This study explores the issue of resource costs that can be linked to clinical and financial outcome measures.

  18. The Incidence, Nature and Consequences of Adverse Events in Iranian Hospitals.

    PubMed

    Akbari Sari, Ali; Doshmangir, Leila; Torabi, Fereshteh; Rashidian, Arash; Sedaghat, Mojtaba; Ghomi, Robabeh; Prasopa-Plaizier, Nittita

    2015-12-01

    Adverse events are relatively common in healthcare, leading to extensive harm to patients and a significant drain on healthcare resources. Identifying the extent, nature and consequences of adverse events is an important step in preventing adverse events and their consequences which is the subject of this study. This is a retrospective review of medical records randomly selected from patients admitted to 4 general hospitals, staying more than 24 hours and discharged between April and September 2012. We randomly selected 1200 records and completed the record review for 1162 of these records. Standard forms (RF1 and RF2) were used to review medical records in two stages by nurses and medical doctors. Eighty-five (7.3%) of the 1162 records had an adverse event during the admission; and in 43 (3.7%) of the 1162 records, the patient was admitted to the hospital due to an adverse event that occurred before the admission. Therefore, a total of 128 (11.0%) adverse events occurred in 126 (10.9) records as two patients had more than one adverse event. Forty-four (34.3%) of these 128 adverse events were considered preventable. This study confirms that adverse events, particularly adverse drug reactions, post-operative infections, bedsore and hospital acquired infections are common and potentially preventable sources of harm to patients in Iranian hospitals.

  19. Increasing the Adaptive Capacity of the Organism When Exposed to Adverse Environmental Factors Through Phytoadaptogens

    NASA Astrophysics Data System (ADS)

    Babii, N. V.; Pomozova, V. A.; Kiseleva, T. F.; Romanenko, V. O.

    2017-07-01

    The Problem of improving the quality of life of the population in modern conditions is the most relevant. The level of human health largely depends on the quality of the environment. Of special importance are the risk factors for the spread of diseases like environmental pollution, social conditions and bad habits. To the emergence of ecologically dependent diseases leads the combined impact of technogenic, social-economic, natural-climatic factors. The introduction of the principles of biotechnology, nanotechnology and innovations in industrial processing of plant resources, especially natural adaptogens, contributes to the production of balanced, ecologically clean food products functional purpose, the use of which will significantly minimize the adverse effects of the environment on humans.

  20. Assessing climate change impacts on fresh water resources of the Athabasca River Basin, Canada.

    PubMed

    Shrestha, Narayan Kumar; Du, Xinzhong; Wang, Junye

    2017-12-01

    Proper management of blue and green water resources is important for the sustainability of ecosystems and for the socio-economic development of river basins such as the Athabasca River Basin (ARB) in Canada. For this reason, quantifying climate change impacts on these water resources at a finer temporal and spatial scale is often necessary. In this study, we used a Soil and Water Assessment Tool (SWAT) to assess climate change impacts on fresh water resources, focusing explicitly on the impacts to both blue and green water. We used future climate data generated by the Canadian Center for Climate Modelling and Analysis Regional Climate Model (CanRCM4) with a spatial resolution of 0.22°×0.22° (~25km) for two emission scenarios (RCP 4.5 and 8.5). Results projected the climate of the ARB to be wetter by 21-34% and warmer by 2-5.4°C on an annual time scale. Consequently, the annual average blue and green water flow was projected to increase by 16-54% and 11-34%, respectively, depending on the region, future period, and emission scenario. Furthermore, the annual average green water storage at the boreal region was expected to increase by 30%, while the storage was projected to remain fairly stable or decrease in other regions, especially during the summer season. On average, the fresh water resources in the ARB are likely to increase in the future. However, evidence of temporal and spatial heterogeneity could pose many future challenges to water resource planners and managers. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  1. Adverse childhood experiences and health anxiety in adulthood.

    PubMed

    Reiser, Sarah J; McMillan, Katherine A; Wright, Kristi D; Asmundson, Gordon J G

    2014-03-01

    Childhood experiences are thought to predispose a person to the development of health anxiety later in life. However, there is a lack of research investigating the influence of specific adverse experiences (e.g., childhood abuse, household dysfunction) on this condition. The current study examined the cumulative influence of multiple types of childhood adversities on health anxiety in adulthood. Adults 18-59 years of age (N=264) completed a battery of measures to assess adverse childhood experiences, health anxiety, and associated constructs (i.e., negative affect and trait anxiety). Significant associations were observed between adverse childhood experiences, health anxiety, and associated constructs. Hierarchical multiple regression analysis indicted that adverse childhood experiences were predictive of health anxiety in adulthood; however, the unique contribution of these experience were no longer significant following the inclusion of the other variables of interest. Subsequently, mediation analyses indicated that both negative affect and trait anxiety independently mediated the relationship between adverse childhood experiences and health anxiety in adulthood. Increased exposure to adverse childhood experiences is associated with higher levels of health anxiety in adulthood; this relationship is mediated through negative affect and trait anxiety. Findings support the long-term negative impact of cumulative adverse childhood experiences and emphasize the importance of addressing negative affect and trait anxiety in efforts to prevent and treat health anxiety. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Modifiable Resilience Factors to Childhood Adversity for Clinical Pediatric Practice.

    PubMed

    Traub, Flora; Boynton-Jarrett, Renée

    2017-05-01

    Childhood adversity is highly prevalent and associated with risk for poor health outcomes in childhood and throughout the life course. Empirical literature on resilience over the past 40 years has identified protective factors for traumatized children that improve health outcomes. Despite these empirical investigations of resilience, there is limited integration of these findings into proactive strategies to mitigate the impact of adverse childhood experiences. We review the state of resilience research, with a focus on recent work, as it pertains to protecting children from the health impacts of early adversity. We identify and document evidence for 5 modifiable resilience factors to improve children's long- and short-term health outcomes, including fostering positive appraisal styles in children and bolstering executive function, improving parenting, supporting maternal mental health, teaching parents the importance of good self-care skills and consistent household routines, and offering anticipatory guidance about the impact of trauma on children. We conclude with 10 recommendations for pediatric practitioners to leverage the identified modifiable resilience factors to help children withstand, adapt to, and recover from adversity. Taken together, these recommendations constitute a blueprint for a trauma-informed medical home. Building resilience in pediatric patients offers an opportunity to improve the health and well-being of the next generation, enhance national productivity, and reduce spending on health care for chronic diseases. Copyright © 2017 by the American Academy of Pediatrics.

  3. 76 FR 57759 - Notice of Availability of Draft Resource Management Plan and Draft Environmental Impact Statement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... Availability of Draft Resource Management Plan and Draft Environmental Impact Statement for the Kremmling Field... Management Act of 1976 (FLPMA), as amended, the Bureau of Land Management (BLM) has prepared a Draft Resource... alternatives for future [[Page 57760

  4. Impact of food, housing, and transportation insecurity on ART adherence: a hierarchical resources approach.

    PubMed

    Cornelius, Talea; Jones, Maranda; Merly, Cynthia; Welles, Brandi; Kalichman, Moira O; Kalichman, Seth C

    2017-04-01

    Antiretroviral therapy (ART) has transformed HIV into a manageable illness. However, high levels of adherence must be maintained. Lack of access to basic resources (food, transportation, and housing) has been consistently associated with suboptimal ART adherence. Moving beyond such direct effects, this study takes a hierarchical resources approach in which the effects of access to basic resources on ART adherence are mediated through interpersonal resources (social support and care services) and personal resources (self-efficacy). Participants were 915 HIV-positive men and women living in Atlanta, GA, recruited from community centers and infectious disease clinics. Participants answered baseline questionnaires, and provided prospective data on ART adherence. Across a series of nested models, a consistent pattern emerged whereby lack of access to basic resources had indirect, negative effects on adherence, mediated through both lack of access to social support and services, and through lower treatment self-efficacy. There was also a significant direct effect of lack of access to transportation on adherence. Lack of access to basic resources negatively impacts ART adherence. Effects for housing instability and food insecurity were fully mediated through social support, access to services, and self-efficacy, highlighting these as important targets for intervention. Targeting service supports could be especially beneficial due to the potential to both promote adherence and to link clients with other services to supplement food, housing, and transportation. Inability to access transportation had a direct negative effect on adherence, suggesting that free or reduced cost transportation could positively impact ART adherence among disadvantaged populations.

  5. Diagnosis of potential stressors adversely affecting benthic ...

    EPA Pesticide Factsheets

    Greenwich Bay is an urbanized embayment of Narragansett Bay potentially impacted by multiple stressors. The present study identified the important stressors affecting Greenwich Bay benthic fauna. First, existing data and information were used to confirm that the waterbody was impaired. Second, the presence of source, stressor, and effect were established. Then linkages between source, stressor, and effect were developed. This allows identification of probable stressors adversely affecting the waterbody. Three pollutant categories were assessed: chemicals, nutrients, and suspended sediments. This weight of evidence approach indicated that Greenwich Bay was primarily impacted by eutrophication-related stressors. The sediments of Greenwich Bay were carbon enriched and low dissolved oxygen concentrations were commonly seen, especially in the western portions of Greenwich Bay. The benthic community was depauperate, as would be expected under oxygen stress. Although our analysis indicated that contaminant loads in Greenwich Bay were at concentrations where adverse effects might be expected, no toxicity was observed, as a result of high levels of organic carbon in these sediments reducing contaminant bioavailability. Our analysis also indicated that suspended sediment impacts were likely nonexistent for much of the Bay. This analysis demonstrates that the diagnostic procedure was useful to organize and assess the potential stressors impacting the ecological well-being

  6. The Impact of Academic Library Resources on Undergraduates' Degree Completion

    ERIC Educational Resources Information Center

    Soria, Krista M.; Fransen, Jan; Nackerud, Shane

    2017-01-01

    The purpose of this study was to examine the impact of first-year undergraduates' (n = 5,368) use of academic library resources in their first year on their degree completion or continued enrollment after four years of study. Propensity score matching techniques were used to construct treatment (library users) and control (library nonusers) groups…

  7. Self-regulation and selective exposure: the impact of depleted self-regulation resources on confirmatory information processing.

    PubMed

    Fischer, Peter; Greitemeyer, Tobias; Frey, Dieter

    2008-03-01

    In the present research, the authors investigated the impact of self-regulation resources on confirmatory information processing, that is, the tendency of individuals to systematically prefer standpoint-consistent information to standpoint-inconsistent information in information evaluation and search. In 4 studies with political and economic decision-making scenarios, it was consistently found that individuals with depleted self-regulation resources exhibited a stronger tendency for confirmatory information processing than did individuals with nondepleted self-regulation resources. Alternative explanations based on processes of ego threat, cognitive load, and mood were ruled out. Mediational analyses suggested that individuals with depleted self-regulation resources experienced increased levels of commitment to their own standpoint, which resulted in increased confirmatory information processing. In sum, the impact of ego depletion on confirmatory information search seems to be more motivational than cognitive in nature.

  8. Parallel Harmony Search Based Distributed Energy Resource Optimization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ceylan, Oguzhan; Liu, Guodong; Tomsovic, Kevin

    2015-01-01

    This paper presents a harmony search based parallel optimization algorithm to minimize voltage deviations in three phase unbalanced electrical distribution systems and to maximize active power outputs of distributed energy resources (DR). The main contribution is to reduce the adverse impacts on voltage profile during a day as photovoltaics (PVs) output or electrical vehicles (EVs) charging changes throughout a day. The IEEE 123- bus distribution test system is modified by adding DRs and EVs under different load profiles. The simulation results show that by using parallel computing techniques, heuristic methods may be used as an alternative optimization tool in electricalmore » power distribution systems operation.« less

  9. Geographic Distribution of Healthy Resources and Adverse Pregnancy Outcomes.

    PubMed

    Young, Christopher; Laurent, Olivier; Chung, Judith H; Wu, Jun

    2016-08-01

    Objective To determine the risk of gestational diabetes (GDM) and preeclampsia associated with various community resources. Methods An ecological study was performed in Los Angeles and Orange counties in California. Fast food restaurants, supermarkets, grocery stores, gyms, health clubs and green space were identified using Google © Maps Extractor and through the Southern California Association of Government. California Birth Certificate data was used to identify cases of GDM and preeclampsia. Unadjusted and adjusted risk ratios were calculated using negative binomial regression. Results There were 9692 cases of GDM and 6288 cases of preeclampsia corresponding to incidences of 2.5 and 1.4 % respectively. The adjusted risk of GDM was reduced in zip codes with greater concentration of grocery stores [relative risk (RR) 0.95, 95 % confidence interval (CI) 0.92-0.99] and supermarkets (RR 0.94, 95 % CI 0.90-0.98). There were no significant relationships between preeclampsia and the concentration of fast food restaurants, grocery store, supermarkets or the amount of green space. Conclusion The distribution of community resources has a significant association with the risk of developing GDM but not preeclampsia.

  10. The impact of resource loss on Holocaust survivors facing war and terrorism in Israel

    PubMed Central

    Dekel, R.; Hobfoll, S. E.

    2009-01-01

    We examined the distress level of 102 Holocaust survivors in Israel during a recent period of continuous exposure of the Israeli population to terror and the threat of missile attack. Based on the Conservation of Resources (COR) theory, we explored the contribution of losses suffered during the Holocaust and of current loss of resources due to terror attacks on their distress level. Twenty one percent of the sample had probable PTSD and high psychological distress levels in general. Current loss of psychosocial resources contributed significantly to survivors’ current PTSD symptomatology and general psychological distress, above the contribution of the previous Holocaust-related loss. Our findings support COR theory, which states that traumatic events are associated with ongoing and often rapid loss of resources. Resource loss, in turn, is associated with higher distress levels. Moreover, current loss of resources compounds the impact of earlier resource losses incurred during the Holocaust. PMID:17453549

  11. The Canadian Immunization Monitoring Program, ACTive (IMPACT): Active surveillance for vaccine adverse events and vaccine-preventable diseases

    PubMed Central

    Bettinger, JA; Halperin, SA; Vaudry, W; Law, BJ; Scheifele, DW

    2014-01-01

    For almost 25 years the Canadian Immunization Monitoring Program, ACTive (IMPACT) has been conducting active surveillance for severe adverse events following immunization (AEFIs) and vaccine-preventable diseases in children. The network, which consists of volunteer paediatric infectious diseases investigators at 12 tertiary care paediatric hospitals, is an important component of Canada’s AEFI monitoring. The network employs nurses at each of the sites to search for and report possible AEFIs to local, provincial and national public health authorities. The active nature of the surveillance ensures a high level of vigilance for severe AEFIs in children. PMID:29769912

  12. LAND USE AS A MITIGATION STRATEGY FOR THE WATER QUALITY IMPACTS OF GLOBAL WARMING: A SCENARIO ANALYSIS ON TWO WATERSHEDS IN THE OHIO RIVER BASIN

    EPA Science Inventory

    This study uses an integrative approach to study the water quality impacts of future global climate and land use changes. In this study, changing land use types were used as a mitigation strategy to reduce the adverse impacts of global climate change on water resources. The Thorn...

  13. LAND USE AS A MITIGATION STRATEGY FOR THE WATER QUALITY IMPACTS OF GLOBAL WARMING: A SCENARIO ANALYSIS ON TWO WATERSHEDS IN THE OHIO RIVER BASIN

    EPA Science Inventory

    This study uses an integrative approach to study the water quality impacts of future global climate and land use changes. In this study, changing land use types was used as a mitigation strategy to reduce the adverse impacts of global climate change on water resources. The climat...

  14. LAND USE AS A MITIGATON STRATEGY FOR THE WATER QUALITY IMPACTS OF GLOBAL WARMING: A SCENARIO ANALYSIS ON TWO WATERSHEDS IN THE OHIO RIVER BASIN

    EPA Science Inventory

    This study uses an integrative approach to study the water quality impacts of future global climate and land use changes. Changing land use types was used as a nitigation strategy to reduce the adverse impacts of global climate change on water resources. The climate scenarios wer...

  15. Individual differences in early adolescents' latent trait cortisol (LTC): Relation to early adversity.

    PubMed

    Stroud, Catherine B; Chen, Frances R; Doane, Leah D; Granger, Douglas A

    2016-09-01

    Substantial evidence suggests that youth who experience early adversity exhibit alterations in hypothalamic pituitary adrenal (HPA) axis functioning, thereby increasing risk for negative health outcomes. However, few studies have explored whether early adversity alters enduring trait indicators of HPA axis activity. Using objective contextual stress interviews with adolescents and their mothers to assess early adversity, we examined the cumulative impact of nine types of early adversity on early adolescents girls' latent trait cortisol (LTC). Adolescents (n = 122; M age = 12.39 years) provided salivary cortisol samples three times a day (waking, 30 min post-waking, and bedtime) over 3 days. Latent state-trait modeling indicated that the waking and 30 min post-waking samples contributed to a LTC factor. Moreover, greater early adversity was associated with a lower LTC level. Implications of LTC for future research examining the impact of early adversity on HPA axis functioning are discussed. © 2016 Wiley Periodicals, Inc. Dev Psychobiol 58:700-713, 2016. © 2016 Wiley Periodicals, Inc.

  16. Adverse Drug Events in Children: How Big is the Problem?

    PubMed

    Zed, Peter J

    2015-01-01

    Adverse drug events in children is an under appreciated but significant cause of health care contact resulting in ED visits and hospital admissions with associated resource utilization. In recent years we have started to better understand the impact of ADEs in children but there remains significant questions that must be addressed to further improve our understanding of the etiology of these ADEs and strategies for prevention and management. This paper will describe what is known regarding the frequency, severity, preventability and classification of ADEs in children. It will also describe some of the challenges and unanswered questions regarding patient, drug and system factors, which contribute to ADEs in children. Finally, areas of future research will be identified to further improve our understanding of ADEs in children to inform prevention strategies as well as early recognition and management approaches to minimize the significant ADEs can have on children, families and our health care system.

  17. Research on environmental impacts of tourism in China: progress and prospect.

    PubMed

    Zhong, Linsheng; Deng, Jinyang; Song, Zengwen; Ding, Peiyi

    2011-11-01

    With the rapid development of tourism industry in China since 1980, the country has experienced an increasing use of its natural and cultural environment for tourism, resulting in tourism resources being adversely impacted in many tourism destinations. This paper described the research progress in tourism impacts on the environment in the context of China through a review of the growing literature in this field. Specifically, research on tourism impacts on the biophysical and socio-cultural environments, tourism carrying capacity, environmental quality assessment, and measures for the protection and management of tourism resources was reviewed. The review found that the majority of research was qualitative and descriptive in nature, and there was a lack of case studies and theoretical development. Future research should focus on the evaluation of environmental impacts, particularly those gradual cumulative impacts on the tourism environment; examination of the quantitative relationship between the impact and the level of tourism use for different activities; development of methods to estimate the carrying capacity; and understanding of positive impacts of tourism. Copyright © 2011. Published by Elsevier Ltd.

  18. The Impact of Library Resources and Services on the Scholarly Activity of Medical Faculty and Residents.

    PubMed

    Quesenberry, Alexandria C; Oelschlegel, Sandy; Earl, Martha; Leonard, Kelsey; Vaughn, Cynthia J

    2016-01-01

    Librarians at an academic medical center library gathered data to determine if library services and resources impacted scholarly activity. A survey was developed and sent out to faculty and residents asking how they used the library during scholarly activity. Sixty-five faculty members and residents responded to the survey. The majority of respondents involved with scholarly activity use the library's services and resources. PubMed is the most frequently used database. The positive results show the library impacts the scholarly activity of medical faculty and residents.

  19. Genetic moderation of multiple pathways linking early cumulative socioeconomic adversity and young adults' cardiometabolic disease risk.

    PubMed

    Wickrama, Kandauda A S; Lee, Tae Kyoung; O'Neal, Catherine Walker

    2018-02-01

    Recent research suggests that psychosocial resources and life stressors are mediating pathways explaining socioeconomic variation in young adults' health risks. However, less research has examined both these pathways simultaneously and their genetic moderation. A nationally representative sample of 11,030 respondents with prospective data collected over 13 years from the National Study of Adolescent to Adult Health was examined. First, the association between early cumulative socioeconomic adversity and young adults' (ages 25-34) cardiometabolic disease risk, as measured by 10 biomarkers, through psychosocial resources (educational attainment) and life stressors (accelerated transition to adulthood) was examined. Second, moderation of these pathways by the serotonin transporter linked polymorphic region gene (5-HTTLPR) was examined. There was evidence for the association between early socioeconomic adversity and young adults' cardiometabolic disease risk directly and indirectly through educational attainment and accelerated transitions. These direct and mediating pathways were amplified by the 5-HTTLPR polymorphism. These findings elucidate how early adversity can have an enduring influence on young adults' cardiometabolic disease risk directly and indirectly through psychosocial resources and life stressors and their genetic moderation. This information suggests that effective intervention and prevention programs should focus on early adversity, youth educational attainment, and their transition to young adulthood.

  20. 18 CFR 1301.19 - Appeals on initial adverse agency determination on correction or amendment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Appeals on initial... Water Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Privacy Act § 1301.19 Appeals on initial adverse.... If the reviewing official finds good cause for an extension, TVA will inform the appellant in writing...

  1. Significance of direct and indirect impacts of climate change on groundwater resources in the Olifants River basin: A review

    NASA Astrophysics Data System (ADS)

    Nkhonjera, German K.; Dinka, Megersa O.

    2017-11-01

    This paper considers the extent and usefulness of reviewing existing literature on the significance of direct and indirect impacts of climate change on groundwater resources with emphasis on examples from the Olifants River basin. Here, the existing literature were extensively reviewed, with discussions centred mainly on the impacts of climate change on groundwater resources and challenges in modelling climate change impacts on groundwater resources. Since in the hydrological cycle, the hydrological components such as evaporation, temperature, precipitation, and groundwater, are the major drivers of the present and future climate, a detailed discussion is done on the impact of climate change on these hydrological components to determine to what extent the hydrological cycle has already been affected as a result of climate change. The uncertainties, constraints and limitations in climate change research have also been reviewed. In addition to the research gaps discussed here, the emphasis on the need of extensive climate change research on the continent, especially as climate change impacts on groundwater, is discussed. Overall, the importance of conducting further research in climate change, understanding the significance of the impact of climate change on water resources such as groundwater, and taking actions to effectively meet the adaptation needs of the people, emerge as an important theme in this review.

  2. [Adverse reaction caused by rabies vaccine in China: a Meta-analysis].

    PubMed

    Zhang, X R; Wu, Z G; Zhang, W S

    2017-06-10

    Objective: To conduct a Meta-analysis on the rate of adverse reaction related to rabies vaccine, so as to provide reference for rabies vaccine immunization in China. Methods: We electronically searched databases including CNKI, VIP information resource integration service platform, WanFang Data, CBM, PubMed and The Cochrane Library, to collect studies on Chinese people who had received full rabies vaccination and recording all the adverse reactions, from January 2000 to July 2016. Inclusion and exclusion criteria were strictly followed. Meta-analysis for the adverse reaction rate was performed using the R software. Results: A total of 29 related papers had met the inclusion criteria, with no publication bias noticed. A total number of 11 020 cases had adverse reactions, among all the 94 222 respondents, with an incidence of adverse reactions as 1.04 % -47.78 % . The overall incidence rate of adverse reaction was 9.82 % (95 %CI : 7.58 % -12.72 % ). A combined local adverse reaction rate appeared as 12.05 % (95 % CI : 9.26 % -15.69 % ). The systemic adverse reaction rate was 9.06 % (95 %CI : 7.07 % -11.61 % ). The overall adverse reaction rate on aqueous vaccine was 32.39 % (95 %CI : 21.88 % -47.94 % ). Combined adverse reaction rate of freeze dried vaccine appeared as 8.65 % (95 %CI : 4.54 % -16.51 % ). Significant differences were seen between both groups ( P <0.05). Conclusions: The local adverse reaction rate caused by rabies vaccination was higher than the systemic adverse reaction rate. The adverse reaction rate of aqueous rabies vaccine was higher than that of freeze dried rabies vaccine. Our results suggested that the aqueous vaccine should gradually be eliminated.

  3. The impact of herbal drug use on adverse drug reaction profiles of patients on antiretroviral therapy in zimbabwe.

    PubMed

    Mudzviti, Tinashe; Maponga, Charles C; Khoza, Star; Ma, Qing; Morse, Gene D

    2012-01-01

    Background. The main objective was to determine the impact of herbal drug use on adverse drug reactions in patients on antiretroviral therapy (ART). Methodology. Patients receiving first-line ART from the national roll-out program participated in this cross-sectional study. Participants were interviewed and a data collection sheet was used to collect information from the corresponding medical record. Results. The majority (98.2%) of participants were using at least one herbal drug together with ART. The most common herbal remedies used were Allium Sativum (72.7%), Bidens pilosa (66.0%), Eucalyptus globulus (52.3%), Moringa oleifera (44.1%), Lippia javanica (36.3%), and Peltoforum africanum (34.3%). Two indigenous herbs, Musakavakadzi (OR = 0.25; 95% CI 0.076-0.828) and Peltoforum africanum (OR = 0.495; 95% CI 0.292-0.839) reduced the occurrence of adverse drug events. Conclusions. The use of herbal drugs is high in the HIV-infected population and there is need for pharmacovigilance programs to recognize the role they play in altering ADR profiles.

  4. The Impact of Herbal Drug Use on Adverse Drug Reaction Profiles of Patients on Antiretroviral Therapy in Zimbabwe

    PubMed Central

    Mudzviti, Tinashe; Maponga, Charles C.; Khoza, Star; Ma, Qing; Morse, Gene D.

    2012-01-01

    Background. The main objective was to determine the impact of herbal drug use on adverse drug reactions in patients on antiretroviral therapy (ART). Methodology. Patients receiving first-line ART from the national roll-out program participated in this cross-sectional study. Participants were interviewed and a data collection sheet was used to collect information from the corresponding medical record. Results. The majority (98.2%) of participants were using at least one herbal drug together with ART. The most common herbal remedies used were Allium Sativum (72.7%), Bidens pilosa (66.0%), Eucalyptus globulus (52.3%), Moringa oleifera (44.1%), Lippia javanica (36.3%), and Peltoforum africanum (34.3%). Two indigenous herbs, Musakavakadzi (OR = 0.25; 95% CI 0.076–0.828) and Peltoforum africanum (OR = 0.495; 95% CI 0.292–0.839) reduced the occurrence of adverse drug events. Conclusions. The use of herbal drugs is high in the HIV-infected population and there is need for pharmacovigilance programs to recognize the role they play in altering ADR profiles. PMID:22506106

  5. Assessment of nitrogen ceilings for Dutch agricultural soils to avoid adverse environmental impacts.

    PubMed

    de Vries, W; Kros, H; Oenema, O; Erisman, J W

    2001-11-09

    In the Netherlands, high traffic density and intensive animal husbandry have led to high emissions of reactive nitrogen (N) into the environment. This leads to a series of environmental impacts, including: (1) nitrate (NO3) contamination of drinking water, (2) eutrophication of freshwater lakes, (3) acidification and biodiversity impacts on terrestrial ecosystems, (4) ozone and particle formation affecting human health, and (5) global climate change induced by emissions of N2O. Measures to control reactive N emissions were, up to now, directed towards those different environmental themes. Here we summarize the results of a study to analyse the agricultural N problem in the Netherlands in an integrated way, which means that all relevant aspects are taken into account simultaneously. A simple N balance model was developed, representing all crucial processes in the N chain, to calculate acceptable N inputs to the farm (so-called N ceiling) and to the soil surface (application in the field) by feed concentrates, organic manure, fertiliser, deposition, and N fixation. The N ceilings were calculated on the basis of critical limits for NO 3 concentrations in groundwater, N concentrations in surface water, and ammonia (NH3) emission targets related to the protection of biodiversity of natural areas. Results show that in most parts of the Netherlands, except the western and the northern part, the N ceilings are limited by NH 3 emissions, which are derived from critical N loads for nature areas, rather than limits for both ground- and surface water. On the national scale, the N ceiling ranges between 372 and 858 kton year(-1) depending on the choice of critical limits. The current N import is 848 kton year(-1). A decrease of nearly 60% is needed to reach the ceilings that are necessary to protect the environment against all adverse impacts of N pollution from agriculture.

  6. Optimizing Land and Water Resources for Agriculture in the Krishna River Basin, India

    NASA Astrophysics Data System (ADS)

    Jain Figueroa, A.; McLaughlin, D.

    2017-12-01

    Many estimates suggest that the world needs a 50% increase in food production to meet the demands of the 2050 global population. Cropland expansion and yield improvements are unlikely to be sufficient and could have adverse environmental impacts. This work focuses on reallocating limited land and water resources to improve efficiency and increase benefits. We accomplish this by combining optimization methods, global data sources, and hydrologic modeling to identify opportunities for increasing crop production of subsistence and/or cash crops, subject to sustainability contraints. Our approach identifies the tradeoffs between the population that can be fed with local resources, revenue from crop exports, and environmental benefit from riparian flows. We focus our case study on India's Krishna river basin, a semi-arid region with a high proportion of subsistence farmers, a diverse crop mix, and increasing stress on water resources.

  7. Impact of demographic change, socioeconomics, and health care resources on life expectancy in Cambodia, Laos, and Myanmar.

    PubMed

    Chan, Moon Fai; Taylor, Beverly Joan

    2013-05-01

    Demographic and socioeconomic changes and the availability of health care resources were collected to examine the impacts on life expectancy in Cambodia, Laos, and Myanmar. An ecological design collecting 29 years (1980-2008) data for three Southeast Asian countries. Life expectancy, demographics, socioeconomic status, and health care resources were collected. The structural equation model indicates that more available health care resources and socioeconomic advantages were more likely to increase life expectancy. By contrast, demographic change was more likely to increase life expectancy by way of health care resources. Results show that factors that had direct impacts on life expectancy in all three countries were socioeconomic status and health care resources. Demographic changes had an indirect influence on life expectancy via health care resources. These findings suggest that policymakers should be focusing on how to remove the barriers that impede access to health care services during economic downturns. In addition, how to increase preventive care for the populations that have less access to health care in communities. © 2012 Wiley Periodicals, Inc.

  8. Adverse Childhood Experiences, Coping Resources, and Mental Health Problems among Court-Involved Youth

    ERIC Educational Resources Information Center

    Logan-Greene, Patricia; Tennyson, Robert L.; Nurius, Paula S.; Borja, Sharon

    2017-01-01

    Background: Mental health problems are gaining attention among court-involved youth with emphasis on the role of childhood adversity, but assessment lags. Objective: The present study uses a commonly delivered assessment tool to examine mental health problems (current mental health problem, mental health interfered with probation goals, and…

  9. Global impacts of conversions from natural to agricultural ecosystems on water resources: Quantity versus quality

    NASA Astrophysics Data System (ADS)

    Scanlon, Bridget R.; Jolly, Ian; Sophocleous, Marios; Zhang, Lu

    2007-03-01

    Past land use changes have greatly impacted global water resources, with often opposing effects on water quantity and quality. Increases in rain-fed cropland (460%) and pastureland (560%) during the past 300 years from forest and grasslands decreased evapotranspiration and increased recharge (two orders of magnitude) and streamflow (one order of magnitude). However, increased water quantity degraded water quality by mobilization of salts, salinization caused by shallow water tables, and fertilizer leaching into underlying aquifers that discharge to streams. Since the 1950s, irrigated agriculture has expanded globally by 174%, accounting for ˜90% of global freshwater consumption. Irrigation based on surface water reduced streamflow and raised water tables resulting in waterlogging in many areas (China, India, and United States). Marked increases in groundwater-fed irrigation in the last few decades in these areas has lowered water tables (≤1 m/yr) and reduced streamflow. Degradation of water quality in irrigated areas has resulted from processes similar to those in rain-fed agriculture: salt mobilization, salinization in waterlogged areas, and fertilizer leaching. Strategies for remediating water resource problems related to agriculture often have opposing effects on water quantity and quality. Long time lags (decades to centuries) between land use changes and system response (e.g., recharge, streamflow, and water quality), particularly in semiarid regions, mean that the full impact of land use changes has not been realized in many areas and remediation to reverse impacts will also take a long time. Future land use changes should consider potential impacts on water resources, particularly trade-offs between water, salt, and nutrient balances, to develop sustainable water resources to meet human and ecosystem needs.

  10. Global impacts of conversions from natural to agricultural ecosystems on water resources: Quantity versus quality

    USGS Publications Warehouse

    Scanlon, Bridget R.; Jolly, Ian; Sophocleous, Marios; Zhang, Lu

    2007-01-01

    Past land use changes have greatly impacted global water resources, with often opposing effects on water quantity and quality. Increases in rain‐fed cropland (460%) and pastureland (560%) during the past 300 years from forest and grasslands decreased evapotranspiration and increased recharge (two orders of magnitude) and streamflow (one order of magnitude). However, increased water quantity degraded water quality by mobilization of salts, salinization caused by shallow water tables, and fertilizer leaching into underlying aquifers that discharge to streams. Since the 1950s, irrigated agriculture has expanded globally by 174%, accounting for ∼90% of global freshwater consumption. Irrigation based on surface water reduced streamflow and raised water tables resulting in waterlogging in many areas (China, India, and United States). Marked increases in groundwater‐fed irrigation in the last few decades in these areas has lowered water tables (≤1 m/yr) and reduced streamflow. Degradation of water quality in irrigated areas has resulted from processes similar to those in rain‐fed agriculture: salt mobilization, salinization in waterlogged areas, and fertilizer leaching. Strategies for remediating water resource problems related to agriculture often have opposing effects on water quantity and quality. Long time lags (decades to centuries) between land use changes and system response (e.g., recharge, streamflow, and water quality), particularly in semiarid regions, mean that the full impact of land use changes has not been realized in many areas and remediation to reverse impacts will also take a long time. Future land use changes should consider potential impacts on water resources, particularly trade‐offs between water, salt, and nutrient balances, to develop sustainable water resources to meet human and ecosystem needs.

  11. Clinical review: insulin pump-associated adverse events in adults and children.

    PubMed

    Ross, P L; Milburn, J; Reith, D M; Wiltshire, E; Wheeler, B J

    2015-12-01

    Insulin pumps are a vital and rapidly developing tool in the treatment of type 1 diabetes mellitus in both adults and children. Many studies have highlighted outcomes and assessed their potential advantages, but much of the data on adverse outcomes are limited and often based on outdated technology. We aimed to review and summarize the available literature on insulin pump-associated adverse events in adults and children. A literature search was undertaken using PubMed, EMBASE, and the Cochrane library. Articles were then screened by title, followed by abstract, and full text as needed. A by-hand search of reference lists in identified papers was also utilised. All searches were limited to English language material, but no time limits were used. Current and past literature regarding insulin pump-associated adverse events is discussed, including potential metabolic and non-metabolic adverse events, in particular: pump malfunction; infusion set/site issues; and cutaneous problems. We show that even with modern technology, adverse events are common, occurring in over 40 % of users per year, with a minority, particularly in children, requiring hospital management. Hyperglycaemia and ketosis are now the most common consequences of adverse events and are usually associated with infusion set failure. This differs from older technology where infected infusion sites predominated. This timely review covers all potential insulin pump-associated adverse events, including their incidence, features, impacts, and contributory factors such as the pump user. The importance of ongoing anticipatory education and support for patients and families using this intensive insulin technology is highlighted, which if done well should improve the overall experience of pump therapy for users, and hopefully reduce the incidence and impact of severe adverse events.

  12. Impact of remote sensing upon the planning, management, and development of water resources

    NASA Technical Reports Server (NTRS)

    Castruccio, P. A.; Loats, H. L.; Fowler, T. R.; Frech, S. L.

    1975-01-01

    Principal water resources users were surveyed to determine the impact of remote data streams on hydrologic computer models. Analysis of responses demonstrated that: most water resources effort suitable to remote sensing inputs is conducted through federal agencies or through federally stimulated research; and, most hydrologic models suitable to remote sensing data are federally developed. Computer usage by major water resources users was analyzed to determine the trends of usage and costs for the principal hydrologic users/models. The laws and empirical relationships governing the growth of the data processing loads were described and applied to project the future data loads. Data loads for ERTS CCT image processing were computed and projected through the 1985 era.

  13. Methods developed to elucidate nursing related adverse events in Japan.

    PubMed

    Yamagishi, Manaho; Kanda, Katsuya; Takemura, Yukie

    2003-05-01

    Financial resources for quality assurance in Japanese hospitals are limited and few hospitals have quality monitoring systems of nursing service systems. However, recently its necessity has been recognized. This study has cost effectively used adverse event occurrence rates as indicators of the quality of nursing service, and audited methods of collecting data on adverse events to elucidate their approximate true numbers. Data collection was conducted in July, August and November 2000 at a hospital in Tokyo that administered both primary and secondary health care services (281 beds, six wards, average length of stay 23 days). We collected adverse events through incident reports, logs, check-lists, nurse interviews, medication error questionnaires, urine leucocyte tests, patient interviews and medical records. Adverse events included the unplanned removals of invasive lines, medication errors, falls, pressure sores, skin deficiencies, physical restraints, and nosocomial infections. After evaluating the time and useful outcomes of each source, it soon became clear that we could elucidate adverse events most consistently and cost-effectively through incident reports, check lists, nurse interviews, urine leucocyte tests and medication error questionnaires. This study suggests that many hospitals in Japan could monitor the quality of the nursing service using these sources.

  14. Free text adversity statements as part of a contextualised admissions process: a qualitative analysis.

    PubMed

    Owen, Lysa E; Anderson, Stephanie Ann; Dowell, Johnathan S

    2018-04-02

    Medical schools globally are encouraged to widen access and participation for students from less privileged backgrounds. Many strategies have been implemented to address this inequality, but much still needs to be done to ensure fair access for all. In the literature, adverse circumstances include financial issues, poor educational experience and lack of professional-status parents. In order to take account of adverse circumstances faced by applicants, The University of Dundee School of Medicine offers applicants the opportunity to report circumstances which may have resulted in disadvantage. Applicants do this by completing a free text statement, known as an 'adversity statement', in addition to the other application information. This study analysed adversity statements submitted by applicants during two admissions cycles. Analysis of content and theme was done to identify the information applicants wished to be taken into consideration, and what range of adverse circumstances individuals reported. This study used a qualitative approach with thematic analysis to categorise the adversity statements. The data was initially analysed to create a coding framework which was then applied to the whole data set. Each coded segment was then analysed for heterogeneity and homogeneity, segments merged into generated themes, or to create sub-themes. The data set comprised a total of 384 adversity statements. These showed a wide range of detail involving family, personal health, education and living circumstances. Some circumstances, such as geographical location, have been identified and explored in previous research, while others, such as long term health conditions, have had less attention in the literature. The degree of impact, the length of statement and degree of detail, demonstrated wide variation between submissions. This study adds to the debate on best practice in contextual admissions and raises awareness of the range of circumstances and impact applicants wish to

  15. Recording Adverse Events Following Joint Arthroplasty: Financial Implications and Validation of an Adverse Event Assessment Form.

    PubMed

    Lee, Matthew J; Mohamed, Khalid M S; Kelly, John C; Galbraith, John G; Street, John; Lenehan, Brian J

    2017-09-01

    In Ireland, funding of joint arthroplasty procedures has moved to a pay-by-results national tariff system. Typically, adverse clinical events are recorded via retrospective chart-abstraction methods by administrative staff. Missed or undocumented events not only affect the quality of patient care but also may unrealistically skew budgetary decisions that impact fiscal viability of the service. Accurate recording confers clinical benefits and financial transparency. The aim of this study was to compare a prospectively implemented adverse events form with the current national retrospective chart-abstraction method in terms of pay-by-results financial implications. An adverse events form adapted from a similar validated model was used to prospectively record complications in 51 patients undergoing total hip or knee arthroplasties. Results were compared with the same cohort using an existing data abstraction method. Both data sets were coded in accordance with current standards for case funding. Overall, 114 events were recorded during the study through prospective charting of adverse events, compared with 15 events documented by customary method (a significant discrepancy). Wound drainage (15.8%) was the most common complication, followed by anemia (7.9%), lower respiratory tract infections (7.9%), and cardiac events (7%). A total of €61,956 ($67,778) in missed funding was calculated as a result. This pilot study demonstrates the ability to improve capture of adverse events through use of a well-designed assessment form. Proper perioperative data handling is a critical aspect of financial subsidies, enabling optimal allocation of funds. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Family Adversity and Resilience Measures in Pediatric Acute Care Settings.

    PubMed

    O'Malley, Donna M; Randell, Kimberly A; Dowd, M Denise

    2016-01-01

    Adverse childhood experiences (ACEs) impact health across the life course. The purpose of this study was to identify caregiver ACEs, current adversity, and resilience in families seeking care in pediatric acute care settings. Study aims included identifying demographic characteristics, current adversities, and resilience measures associated with caregiver ACEs ≥4. A cross-sectional survey study design was used and a convenience sample (n = 470) recruited at emergency and urgent care settings of a large Midwest pediatric hospital system. Measures were self-reported. The original 10-item ACEs questionnaire measured caregiver past adversity. Current adversity was measured using the 10-item IHELP. The six-item Brief Resiliency Scale measured resilience, and WHO-5 Well-Being Index was used to measure depressive affect. Compared to participants with ACEs score of 0-3 participants with ACEs ≥4 were more likely to have multiple current adversities, increased risk of depression, and lower resilience. Caregivers using pediatric acute care settings carry a high burden of ACEs and current adversities. Caregiver ACEs are associated with current child experiences of adversity. Caregivers socioeconomic status and education level may not be an accurate indicator of a family's risks or needs. Pediatric acute care settings offer opportunities to access, intervene, and prevent childhood adversity. © 2016 Wiley Periodicals, Inc.

  17. Impact of climate change on groundwater resources in Southern Austria

    NASA Astrophysics Data System (ADS)

    Reszler, C.; Harum, T.; Poltnig, W.; Saccon, P.; Reichl, P.; Ruch, C.; Kopeinig, C.; Freundl, G.; Schlamberger, J.; Zessar, H.; Suette, G.

    2012-04-01

    Groundwater is the most important source for drinking water in Austria. In some parts of Southern Austria water resources already are very vulnerable to unfavourable climate conditions. This paper summarizes case studies of estimating the impact of climate change on groundwater recharge and groundwater flow in Southern Austria in the frame of the ETC-Alpine Space project ALP-WATER-SCARCE. In several pilot regions a distributed hydrological model was set up to simulate groundwater recharge and groundwater flow for a period of 10 to 30 years. The pilot sites range from mountainous catchments with steep hillslopes to Alpine valleys and flatlands with pore aquifers. In the model period comprehensive land data and meteorological data were used, and the models were calibrated to available stream gauge data. Additional low flow monitoring in the frame of the project also allowed for a more detailed regional analysis in some catchments. The simulations were firstly used to extend runoff and groundwater recharge depths on an annual basis up to 200 years into the past by regression analysis with long time meteorological parameters (HISTALP). The historical view shows that groundwater flow and recharge in most of the pilot regions decreased since the beginning of the 20th century, which is mainly the effect of climate change. Changes of land use are of minor relevance in most of the regions. Second, by the calibrated model scenarios were simulated to quantify the impact of a possible future change in the climatic conditions on water resources. The scenarios were generated by altering the model input by a "Delta-Change", under consideration of the historical development. These scenarios can be interpreted as "what if"-scenarios to quantify the sensitivity of the hydrological systems on these climatic variables. The results are compared with actual and projected water uses as a basis for regional water resources management.

  18. Agricultural Impacts on Water Resources: Recommendations for Successful Applied Research

    NASA Astrophysics Data System (ADS)

    Harmel, D.

    2014-12-01

    We, as water resource professionals, are faced with a truly monumental challenge - that is feeding the world's growing population and ensuring it has an adequate supply of clean water. As researchers and educators it is good for us to regularly remember that our research and outreach efforts are critical to people around the world, many of whom are desperate for solutions to water quality and supply problems and their impacts on food supply, land management, and ecosystem protection. In this presentation, recommendations for successful applied research on agricultural impacts on water resources will be provided. The benefits of building multidisciplinary teams will be illustrated with examples related to the development and world-wide application of the ALMANAC, SWAT, and EPIC/APEX models. The value of non-traditional partnerships will be shown by the Soil Health Partnership, a coalition of agricultural producers, chemical and seed companies, and environmental advocacy groups. The results of empowering decision-makers with useful data will be illustrated with examples related to bacteria source and transport data and the MANAGE database, which contains runoff nitrogen and phosphorus data for cultivated, pasture, and forest land uses. The benefits of focusing on sustainable solutions will be shown through examples of soil testing, fertilizers application, on-farm profit analysis, and soil health assessment. And the value of welcoming criticism will be illustrated by the development of a framework to estimate and publish uncertainty in measured discharge and water quality data. The good news for researchers is that the agricultural industry is faced with profitability concerns and the need to wisely utilize soil and water resources, and simultaneously state and federal agencies crave sound-science to improve decision making, policy, and regulation. Thus, the audience for and beneficiaries of agricultural research are ready and hungry for applied research results.

  19. A Water Resources Management Model to Evaluate Climate Change Impacts in North-Patagonia, Argentina

    NASA Astrophysics Data System (ADS)

    Bucciarelli, L. F.; Losano, F. T.; Marizza, M.; Cello, P.; Forni, L.; Young, C. A.; Girardin, L. O.; Nadal, G.; Lallana, F.; Godoy, S.; Vallejos, R.

    2014-12-01

    Most recently developed climate scenarios indicate a potential future increase in water stress in the region of Comahue, located in the North-Patagonia, Argentina. This region covers about 140,000 km2 where the Limay River and the Neuquén River converge into the Negro River, constituting the largest integrated basins in Argentina providing various uses of water resources: a) hydropower generation, contributing 15% of the national electricity market; b) fruit-horticultural products for local markets and export; c) human and industrial water supply; d) mining and oil exploitation, including Vaca Muerta, second world largest reserves of shale gas and fourth world largest reserves of shale-oil. The span of multiple jurisdictions and the convergence of various uses of water resources are a challenge for integrated understanding of economically and politically driven resource use activities on the natural system. The impacts of climate change on the system could lead to water resource conflicts between the different political actors and stakeholders. This paper presents the results of a hydrological simulation of the Limay river and Neuquén river basins using WEAP (Water Evaluation and Planning) considering the operation of artificial reservoirs located downstream at a monthly time step. This study aims to support policy makers via integrated tools for water-energy planning under climate uncertainties, and to facilitate the formulation of water policy-related actions for future water stress adaptation. The value of the integrated resource use model is that it can support local policy makers understand the implications of resource use trade-offs under a changing climate: 1) water availability to meet future growing demand for irrigated areas; 2) water supply for hydropower production; 3) increasing demand of water for mining and extraction of unconventional oil; 4) potential resource use conflicts and impacts on vulnerable populations.

  20. Outreach efforts related to mitigating impacts on cultural resources : a survey of state practice.

    DOT National Transportation Integrated Search

    2011-01-01

    When transportation projects impact cultural resources that are significant in American archaeology, architecture, : history, engineering or similar activities, federal and state laws require that Caltrans and other state and local : transportation a...

  1. Using widely spaced observations of land use, forest attributes, and intrusions to map resource potential and human impact probability

    Treesearch

    Victor A. Rudis

    2000-01-01

    Scant information exists about the spatial extent of human impact on forest resource supplies, i.e., depreciative and nonforest uses. I used observations of ground-sampled land use and intrusions on forest land to map the probability of resource use and human impact for broad areas. Data came from a seven-state survey region (Alabama, Arkansas, Louisiana, Mississippi,...

  2. Using widely spaced observations of land use, forest attributes, and intrusions to map resource potential and human impact probability

    Treesearch

    Victor A. Rudis

    2000-01-01

    Scant information exists about the spatial extent of human impact on forest resource supplies, i.e., depreciative and nonforest uses. I used observations of ground-sampled land use and intrusions on forest land to map the probability of resource use and human impact for broad areas. Data came from a seven State survey region (Alabama, Arkansas, Louisiana, Mississippi,...

  3. The Impact of Resource Constraints on the Psychological Well-Being of Survivors of Intimate Partner Violence over Time

    ERIC Educational Resources Information Center

    Beeble, Marisa L.; Bybee, Deborah; Sullivan, Cris M.

    2010-01-01

    This study examined the impact of resource constraints on the psychological well-being of survivors of intimate partner violence (IPV), testing whether resource constraints is one mechanism that partially mediates the relationship between IPV and women's well-being. Although within-woman changes in resource constraints did not mediate the…

  4. Standard Information Models for Representing Adverse Sensitivity Information in Clinical Documents.

    PubMed

    Topaz, M; Seger, D L; Goss, F; Lai, K; Slight, S P; Lau, J J; Nandigam, H; Zhou, L

    2016-01-01

    Adverse sensitivity (e.g., allergy and intolerance) information is a critical component of any electronic health record system. While several standards exist for structured entry of adverse sensitivity information, many clinicians record this data as free text. This study aimed to 1) identify and compare the existing common adverse sensitivity information models, and 2) to evaluate the coverage of the adverse sensitivity information models for representing allergy information on a subset of inpatient and outpatient adverse sensitivity clinical notes. We compared four common adverse sensitivity information models: Health Level 7 Allergy and Intolerance Domain Analysis Model, HL7-DAM; the Fast Healthcare Interoperability Resources, FHIR; the Consolidated Continuity of Care Document, C-CDA; and OpenEHR, and evaluated their coverage on a corpus of inpatient and outpatient notes (n = 120). We found that allergy specialists' notes had the highest frequency of adverse sensitivity attributes per note, whereas emergency department notes had the fewest attributes. Overall, the models had many similarities in the central attributes which covered between 75% and 95% of adverse sensitivity information contained within the notes. However, representations of some attributes (especially the value-sets) were not well aligned between the models, which is likely to present an obstacle for achieving data interoperability. Also, adverse sensitivity exceptions were not well represented among the information models. Although we found that common adverse sensitivity models cover a significant portion of relevant information in the clinical notes, our results highlight areas needed to be reconciled between the standards for data interoperability.

  5. Measuring the impact of computer resource quality on the software development process and product

    NASA Technical Reports Server (NTRS)

    Mcgarry, Frank; Valett, Jon; Hall, Dana

    1985-01-01

    The availability and quality of computer resources during the software development process was speculated to have measurable, significant impact on the efficiency of the development process and the quality of the resulting product. Environment components such as the types of tools, machine responsiveness, and quantity of direct access storage may play a major role in the effort to produce the product and in its subsequent quality as measured by factors such as reliability and ease of maintenance. During the past six years, the NASA Goddard Space Flight Center has conducted experiments with software projects in an attempt to better understand the impact of software development methodologies, environments, and general technologies on the software process and product. Data was extracted and examined from nearly 50 software development projects. All were related to support of satellite flight dynamics ground-based computations. The relationship between computer resources and the software development process and product as exemplified by the subject NASA data was examined. Based upon the results, a number of computer resource-related implications are provided.

  6. Biomarkers of adverse drug reactions.

    PubMed

    Carr, Daniel F; Pirmohamed, Munir

    2018-02-01

    Adverse drug reactions can be caused by a wide range of therapeutics. Adverse drug reactions affect many bodily organ systems and vary widely in severity. Milder adverse drug reactions often resolve quickly following withdrawal of the casual drug or sometimes after dose reduction. Some adverse drug reactions are severe and lead to significant organ/tissue injury which can be fatal. Adverse drug reactions also represent a financial burden to both healthcare providers and the pharmaceutical industry. Thus, a number of stakeholders would benefit from development of new, robust biomarkers for the prediction, diagnosis, and prognostication of adverse drug reactions. There has been significant recent progress in identifying predictive genomic biomarkers with the potential to be used in clinical settings to reduce the burden of adverse drug reactions. These have included biomarkers that can be used to alter drug dose (for example, Thiopurine methyltransferase (TPMT) and azathioprine dose) and drug choice. The latter have in particular included human leukocyte antigen (HLA) biomarkers which identify susceptibility to immune-mediated injuries to major organs such as skin, liver, and bone marrow from a variety of drugs. This review covers both the current state of the art with regard to genomic adverse drug reaction biomarkers. We also review circulating biomarkers that have the potential to be used for both diagnosis and prognosis, and have the added advantage of providing mechanistic information. In the future, we will not be relying on single biomarkers (genomic/non-genomic), but on multiple biomarker panels, integrated through the application of different omics technologies, which will provide information on predisposition, early diagnosis, prognosis, and mechanisms. Impact statement • Genetic and circulating biomarkers present significant opportunities to personalize patient therapy to minimize the risk of adverse drug reactions. ADRs are a significant heath issue

  7. Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study

    PubMed Central

    Nabi, Hermann; Kivimäki, Mika; Batty, G. David; Shipley, Martin J.; Britton, Annie; Brunner, Eric J.; Vahtera, Jussi; Lemogne, Cédric; Elbaz, Alexis; Singh-Manoux, Archana

    2013-01-01

    Aim Response to stress can vary greatly between individuals. However, it remains unknown whether perceived impact of stress on health is associated with adverse health outcomes. We examined whether individuals who report that stress adversely affects their health are at increased risk of coronary heart disease (CHD) compared with those who report that stress has no adverse health impact. Methods and results Analyses are based on 7268 men and women (mean age: 49.5 years, interquartile range: 11 years) from the British Whitehall II cohort study. Over 18 years of follow-up, there were 352 coronary deaths or first non-fatal myocardial infarction (MI) events. After adjustment for sociodemographic characteristics, participants who reported at baseline that stress has affected their health ‘a lot or extremely’ had a 2.12 times higher (95% CI 1.52–2.98) risk of coronary death or incident non-fatal MI when compared with those who reported no effect of stress on their health. This association was attenuated but remained statistically significant after adjustment for biological, behavioural, and other psychological risk factors including perceived stress levels, and measures of social support; fully adjusted hazard ratio: 1.49 (95% CI 1.01–2.22). Conclusions In this prospective cohort study, the perception that stress affects health, different from perceived stress levels, was associated with an increased risk of coronary heart disease. Randomized controlled trials are needed to determine whether disease risk can be reduced by increasing clinical attention to those who complain that stress greatly affects their health. PMID:23804585

  8. Population Trends of Central European Montane Birds Provide Evidence for Adverse Impacts of Climate Change on High-Altitude Species.

    PubMed

    Flousek, Jiří; Telenský, Tomáš; Hanzelka, Jan; Reif, Jiří

    2015-01-01

    Climate change is among the most important global threats to biodiversity and mountain areas are supposed to be under especially high pressure. Although recent modelling studies suggest considerable future range contractions of montane species accompanied with increased extinction risk, data allowing to test actual population consequences of the observed climate changes and identifying traits associated to their adverse impacts are very scarce. To fill this knowledge gap, we estimated long-term population trends of montane birds from 1984 to 2011 in a central European mountain range, the Giant Mountains (Krkonoše), where significant warming occurred over this period. We then related the population trends to several species' traits related to the climate change effects. We found that the species breeding in various habitats at higher altitudes had more negative trends than species breeding at lower altitudes. We also found that the species moved upwards as a response to warming climate, and these altitudinal range shifts were associated with more positive population trends at lower altitudes than at higher altitudes. Moreover, long-distance migrants declined more than residents or species migrating for shorter distances. Taken together, these results indicate that the climate change, besides other possible environmental changes, already influences populations of montane birds with particularly adverse impacts on high-altitude species such as water pipit (Anthus spinoletta). It is evident that the alpine species, predicted to undergo serious climatically induced range contractions due to warming climate in the future, already started moving along this trajectory.

  9. Impacts of Coal Seam Gas (Coal Bed Methane) Extraction on Water Resources in Australia

    NASA Astrophysics Data System (ADS)

    Post, David

    2016-04-01

    While extraction of methane from shale gas deposits has been the principal source of the recent expansion of the industry in the United States and Europe, in Australia extraction of methane from coal bed methane deposits (termed 'coal seam gas' in Australia) has been the focus to date. The two sources of methane share many of the same characteristics including the potential requirement for hydraulic fracturing. However, as coal seam gas deposits generally occur at shallower depths than shale gas, the potential impacts of extraction on surface and groundwater resources may be of even greater concern. In Australia, an Independent Expert Scientific Committee (IESC) has been established to provide scientific advice to federal and state government regulators on the impact that coal seam gas and large coal mining developments may have on water resources. This advice is provided to enable decisions to be informed by the best available science about the potential water-related impacts associated with these developments. To support this advice, the Australian Government Department of the Environment has implemented a programme of research termed 'bioregional assessments' to investigate these potential impacts. A bioregional assessment is defined as a scientific analysis of the ecology, hydrology, geology and hydrogeology of a bioregion with explicit assessment of the potential direct, indirect and cumulative impacts of coal seam gas and large coal mining development on water resources. These bioregional assessments are currently being carried out across large portions of eastern Australia underlain by coal reserves. Further details of the programme and results to date can be found at http://www.bioregionalassessments.gov.au. Surface water and groundwater modelling is now complete for two regions where coal seam gas development may proceed, namely the Clarence-Moreton and Gloucester regions in eastern New South Wales. This presentation will discuss how the results of these

  10. Latent Classes and Cumulative Impacts of Adverse Childhood Experiences.

    PubMed

    Barboza, Gia Elise

    2018-05-01

    Studies of adverse childhood experiences (ACEs) have gauged severity using a cumulative risk (CR) index. Few studies have focused on the nature of the context of adversity and their association with psychosocial outcomes. The objective of this study was to examine the patterning of ACEs and to explore the resultant patterns' association with HIV risk-taking, problem drinking, and depressive symptoms in adulthood. Latent class analysis (LCA) was used to identify homogeneous, mutually exclusive "classes" of 11 of the most commonly used ACEs. The LCA resulted in four high-risk profiles and one low-risk profile, which were labeled: (1) highly abusive and dysfunctional (3.3%; n = 1,983), (2) emotionally abusive alcoholic with parental conflict (6%, n = 3,303), (3) sexual abuse only (4.3%, n = 2,260), (4) emotionally abusive and alcoholic (30.3%, n = 17,460), and (5) normative, low risk (56.3%, n = 32,950). Compared to the low-risk class, each high-risk profile was differentially associated with adult psychosocial outcomes even when the conditional CR within that class was similar. The results further our understanding about the pattern of ACEs and the unique pathways to poor health. Implications for child welfare systems when dealing with individuals who have experienced multiple forms of early childhood maltreatment and/or household dysfunction are discussed.

  11. Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review

    PubMed Central

    2010-01-01

    Background Psychological factors and socioeconomic status (SES) have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation) have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of psychological factors such as

  12. Childhood adversity profiles and adult psychopathology in a representative Northern Ireland study.

    PubMed

    McLafferty, Margaret; Armour, Cherie; McKenna, Aine; O'Neill, Siobhan; Murphy, Sam; Bunting, Brendan

    2015-10-01

    Childhood adversities are key aetiological factors in the onset and persistence of psychopathology. The aims of this study were to identify childhood adversity profiles, and investigate the relationship between the adversity classes and psychopathology in Northern Ireland. The study utilized data from the Northern Ireland Study of Health and Stress, an epidemiological survey (N=1986), which used the CIDI to examine mental health disorders and associated risk factors. Latent Class Analysis revealed 3 distinct typologies; a low risk class (n=1709; 86%), a poly-adversity class (n=122; 6.1%), and an economic adversity class (n=155; 7.8%). Logistic Regression models revealed that individuals in the economic adversity class had a heightened risk of anxiety and substance disorders, with individuals in the poly-adversity class more likely to have a range of mental health problems and suicidality. The findings indicate the importance of considering the impact of co-occurring childhood adversities when planning treatment, prevention, and intervention programmes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Final Plan to Study the Potential Impacts of Hydraulic Fracturing on Drinking Water Resources (02-24-2012)

    EPA Science Inventory

    The overall purpose of this study is to elucidate the relationship, if any, between hydraulic fracturing and drinking water resources. More specifically, the study has been designed to assess the potential impacts of hydraulic fracturing on drinking water resources and to identif...

  14. An integrated study of earth resources in the State of California using remote sensing techniques. [supply, demand, and impact of California water resources

    NASA Technical Reports Server (NTRS)

    Colwell, R. N.; Burgy, R. H.; Algazi, V. R.; Draeger, W. C.; Estes, J. E.; Bowden, L. W. (Principal Investigator)

    1974-01-01

    The author has identified the following significant results. The supply, demand, and impact relationships of California's water resources as exemplified by the Feather River project and other aspects of the California Water Plan are discussed.

  15. Impact of Lumbar Fusion on Health Care Resource Utilization.

    PubMed

    Mina, Curtis; Carreon, Leah Y; Glassman, Steven D

    2016-02-01

    A longitudinal cohort. The aim of this study was to determine the extent of health care resource utilization decrease 2 years after lumbar spinal fusion. Despite the assumption that surgery will minimize the need for ongoing nonsurgical treatment, the impact of lumbar fusion on subsequent health care resource utilization has not been effectively studied. Patients who had continuous coverage by a major insurer during the year before decompression and posterolateral instrumented spinal fusion, and the 2 and a half years following were identified. All charges processed during this time-period were collected. Charges associated with the index surgery, the 90-day postoperative period, and those unrelated to spinal care were excluded. Associations with Oswestry Disability Index (ODI) score improvement at 2 years after surgery and health care resource utilization were determined. Sixty-six patients were included in the analysis. The mean age was 59 years and 39% were males. There was a decrease in health care utilization costs 1 year after surgery ($3267.59) compared with pre-op ($4246.32), but this was not statistically significant (P = 0.197). There was a statistically significant decrease in costs during the second year after surgery ($1420.97) compared with either pre-op (P = 0.000) or 1-year costs (P = 0.001). No statistically significant correlations could be found between change in ODI scores and costs incurred at either year post-op. Health care utilization decreased at 1 year and significantly at 2 years after lumbar fusion. However, there was no correlation between use of nonsurgical resources and clinical outcome based on ODI scores. This raises the question as to whether these resources were used in a rational manner. This cooperative study between a major insurer and a tertiary spine center provides improved insight into the cost profile of lumbar fusion surgery. Further study is needed to determine whether ongoing post-op treatment is necessary

  16. AOP-DB Frontend: A user interface for the Adverse Outcome Pathways Database.

    EPA Science Inventory

    The EPA Adverse Outcome Pathway Database (AOP-DB) is a database resource that aggregates association relationships between AOPs, genes, chemicals, diseases, pathways, species orthology information, ontologies. The AOP-DB frontend is a simple yet powerful AOP-DB user interface in...

  17. AOP-DB Frontend: A user interface for the Adverse Outcome Pathways Database

    EPA Science Inventory

    The EPA Adverse Outcome Pathway Database (AOP-DB) is a database resource that aggregates association relationships between AOPs, genes, chemicals, diseases, pathways, species orthology information, ontologies. The AOP-DB frontend is a simple yet powerful user interface in the for...

  18. Impact of pollen resources drift on common bumblebees in NW Europe.

    PubMed

    Roger, Nathalie; Moerman, Romain; Carvalheiro, Luísa Gigante; Aguirre-Guitiérrez, Jesús; Jacquemart, Anne-Laure; Kleijn, David; Lognay, Georges; Moquet, Laura; Quinet, Muriel; Rasmont, Pierre; Richel, Aurore; Vanderplanck, Maryse; Michez, Denis

    2017-01-01

    Several bee species are experiencing significant population declines. As bees exclusively rely on pollen for development and survival, such declines could be partly related to changes in their host plant abundance and quality. Here, we investigate whether generalist bumblebee species, with stable population trends over the past years, adapted their diets in response to changes in the distribution and chemical quality of their pollen resources. We selected five common species of bumblebee in NW Europe for which we had a precise description of their pollen diet through two time periods ('prior to 1950' and '2004-2005'). For each species, we assessed whether the shift in their pollen diet was related with the changes in the suitable area of their pollen resources. Concurrently, we evaluated whether the chemical composition of pollen resources changed over time and experimentally tested the impact of new major pollen species on the development of B. terrestris microcolonies. Only one species (i.e. B. lapidarius) significantly included more pollen from resources whose suitable area expanded. This opportunist pattern could partly explain the expansion of B. lapidarius in Europe. Regarding the temporal variation in the chemical composition of the pollen diet, total and essential amino acid contents did not differ significantly between the two time periods while we found significant differences among plant species. This result is driven by the great diversity of resources used by bumblebee species in both periods. Our bioassay revealed that the shift to new major pollen resources allowed microcolonies to develop, bringing new evidence on the opportunist feature of bumblebee in their diets. Overall, this study shows that the response to pollen resource drift varies among closely related pollinators, and a species-rich plant community ensures generalist species to select a nutrient-rich pollen diet. © 2016 John Wiley & Sons Ltd.

  19. Water Resources Management for Shale Energy Development

    NASA Astrophysics Data System (ADS)

    Yoxtheimer, D.

    2015-12-01

    The increase in the exploration and extraction of hydrocarbons, especially natural gas, from shale formations has been facilitated by advents in horizontal drilling and hydraulic fracturing technologies. Shale energy resources are very promising as an abundant energy source, though environmental challenges exist with their development, including potential adverse impacts to water quality. The well drilling and construction process itself has the potential to impact groundwater quality, however if proper protocols are followed and well integrity is established then impacts such as methane migration or drilling fluids releases can be minimized. Once a shale well has been drilled and hydraulically fractured, approximately 10-50% of the volume of injected fluids (flowback fluids) may flow out of the well initially with continued generation of fluids (produced fluids) throughout the well's productive life. Produced fluid TDS concentrations often exceed 200,000 mg/L, with elevated levels of strontium (Sr), bromide (Br), sodium (Na), calcium (Ca), barium (Ba), chloride (Cl), radionuclides originating from the shale formation as well as fracturing additives. Storing, managing and properly disposisng of these fluids is critical to ensure water resources are not impacted by unintended releases. The most recent data in Pennsylvania suggests an estimated 85% of the produced fluids were being recycled for hydraulic fracturing operations, while many other states reuse less than 50% of these fluids and rely moreso on underground injection wells for disposal. Over the last few years there has been a shift to reuse more produced fluids during well fracturing operations in shale plays around the U.S., which has a combination of economic, regulatory, environmental, and technological drivers. The reuse of water is cost-competitive with sourcing of fresh water and disposal of flowback, especially when considering the costs of advanced treatment to or disposal well injection and lessens

  20. Commentary: Childhood Exposure to Environmental Adversity and the Well-Being of People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Emerson, E.

    2013-01-01

    People with intellectual disabilities have poorer health than their non-disabled peers. They are also more likely to be exposed to a wide range of environmental adversities in childhood. Research undertaken in the general population has demonstrated that exposure to environmental adversity in childhood can have an adverse impact on health and…

  1. Impact of Extended-Duration Shifts on Medical Errors, Adverse Events, and Attentional Failures

    PubMed Central

    Barger, Laura K; Ayas, Najib T; Cade, Brian E; Cronin, John W; Rosner, Bernard; Speizer, Frank E; Czeisler, Charles A

    2006-01-01

    Background A recent randomized controlled trial in critical-care units revealed that the elimination of extended-duration work shifts (≥24 h) reduces the rates of significant medical errors and polysomnographically recorded attentional failures. This raised the concern that the extended-duration shifts commonly worked by interns may contribute to the risk of medical errors being made, and perhaps to the risk of adverse events more generally. Our current study assessed whether extended-duration shifts worked by interns are associated with significant medical errors, adverse events, and attentional failures in a diverse population of interns across the United States. Methods and Findings We conducted a Web-based survey, across the United States, in which 2,737 residents in their first postgraduate year (interns) completed 17,003 monthly reports. The association between the number of extended-duration shifts worked in the month and the reporting of significant medical errors, preventable adverse events, and attentional failures was assessed using a case-crossover analysis in which each intern acted as his/her own control. Compared to months in which no extended-duration shifts were worked, during months in which between one and four extended-duration shifts and five or more extended-duration shifts were worked, the odds ratios of reporting at least one fatigue-related significant medical error were 3.5 (95% confidence interval [CI], 3.3–3.7) and 7.5 (95% CI, 7.2–7.8), respectively. The respective odds ratios for fatigue-related preventable adverse events, 8.7 (95% CI, 3.4–22) and 7.0 (95% CI, 4.3–11), were also increased. Interns working five or more extended-duration shifts per month reported more attentional failures during lectures, rounds, and clinical activities, including surgery and reported 300% more fatigue-related preventable adverse events resulting in a fatality. Conclusions In our survey, extended-duration work shifts were associated with an

  2. Early life adversity and telomere length: a meta-analysis.

    PubMed

    Ridout, K K; Levandowski, M; Ridout, S J; Gantz, L; Goonan, K; Palermo, D; Price, L H; Tyrka, A R

    2018-04-01

    Early adversity, in the form of abuse, neglect, socioeconomic status and other adverse experiences, is associated with poor physical and mental health outcomes. To understand the biologic mechanisms underlying these associations, studies have evaluated the relationship between early adversity and telomere length, a marker of cellular senescence. Such results have varied in regard to the size and significance of this relationship. Using meta-analytic techniques, we aimed to clarify the relationship between early adversity and telomere length while exploring factors affecting the association, including adversity type, timing and study design. A comprehensive search in July 2016 of PubMed/MEDLINE, PsycINFO and Web of Science identified 2462 studies. Multiple reviewers appraised studies for inclusion or exclusion using a priori criteria; 3.9% met inclusion criteria. Data were extracted into a structured form; the Newcastle-Ottawa Scale assessed study quality, validity and bias. Forty-one studies (N=30 773) met inclusion criteria. Early adversity and telomere length were significantly associated (Cohen's d effect size=-0.35; 95% CI, -0.46 to -0.24; P<0.0001). Sensitivity analyses revealed no outlier effects. Adversity type and timing significantly impacted the association with telomere length (P<0.0001 and P=0.0025, respectively). Subgroup and meta-regression analyses revealed that medication use, medical or psychiatric conditions, case-control vs longitudinal study design, methodological factors, age and smoking significantly affected the relationship. Comprehensive evaluations of adversity demonstrated more extensive telomere length changes. These results suggest that early adversity may have long-lasting physiological consequences contributing to disease risk and biological aging.

  3. Assessing the impacts of extended drought conditions and global warming on groundwater resources in Iowa

    NASA Astrophysics Data System (ADS)

    Acar, O.; Franz, K.; Simpkins, W. W.

    2013-12-01

    Extended drought conditions that affected much of the U.S. throughout 2012 and continued into 2013 are bringing climate change to the forefront of public attention. Long-term effects of an extended dry spell on groundwater is especially concerning as these resources are essential for meeting drinking water demands, supporting agricultural and industrial activities, and maintaining water levels in rivers and lakes. Thus, the impact of extended drought conditions on the entire hydrologic cycle needs to be well understood to guide future resource and land management decisions. This study aims to explore the impact of extended drought conditions on groundwater resources in a representative Iowa watershed using Regional Climate Model scenarios implemented through HydroGeoSphere, a physically-based, surface water-groundwater model. Estimating the impacts of climate changes on groundwater resources requires representation of the full hydrological system, i.e. the connection between the atmospheric and surface-subsurface processes, in a realistic way. In the HydroGeoSphere model, surface and subsurface flow equations are solved simultaneously, and the interdependence of processes like actual evapotranspiration and recharge is handled explicitly. Using such state-of-the-art modeling tools, we seek to address the consequences of changing climate extremes (that have already been experienced and expected to continue over long periods in the future) on the hydrologic cycle of our pilot study area, the South Fork watershed in north-central Iowa. The results will provide a baseline for investigating mitigation strategies in agricultural practices and water use due to changes in the wet and dry cycles of the regional hydrologic cycle.

  4. Children and youth's biopsychosocial wellbeing in the context of energy resource activities.

    PubMed

    Cox, Robin S; Irwin, Pamela; Scannell, Leila; Ungar, Michael; Bennett, Trevor Dixon

    2017-10-01

    Children and youth emerge as key populations that are impacted by energy resource activities, in part because of their developmental vulnerabilities, as well as the compounding effects of energy systems on their families, communities, and physical environments. While there is a larger literature focused on fossil fuel emissions and children, the impacts of many aspects of energy systems on children and youth remain under examined and scattered throughout the health, social science, and environmental science literatures. This systematic interdisciplinary review examines the biological, psychosocial, and economic impacts of energy systems identified through social science research - specifically focused on household and industrial extraction and emissions - on children and youth functioning. A critical interpretive search of interdisciplinary and international social sciences literature was conducted using an adaptive protocol focusing on the biopsychosocial and economic impacts of energy systems on children and youth. The initial results were complemented with a purposeful search to extend the breadth and depth of the final collection of articles. Although relatively few studies have specifically focused on children and youth in this context, the majority of this research uncovers a range of negative health impacts that are directly and indirectly related to the development and ongoing operations of natural resource production, particularly oil and gas, coal, and nuclear energy. Psychosocial and cultural effects, however, remain largely unexamined and provide a rich avenue for further research. This synthesis identifies an array of adverse biopsychosocial health outcomes on children and youth of energy resource extraction and emissions, and identifies gaps that will drive future research in this area. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Impact of Knowledge Resources Linked to an Electronic Health Record on Frequency of Unnecessary Tests and Treatments

    ERIC Educational Resources Information Center

    Goodman, Kenneth; Grad, Roland; Pluye, Pierre; Nowacki, Amy; Hickner, John

    2012-01-01

    Introduction: Electronic knowledge resources have the potential to rapidly provide answers to clinicians' questions. We sought to determine clinicians' reasons for searching these resources, the rate of finding relevant information, and the perceived clinical impact of the information they retrieved. Methods: We asked general internists, family…

  6. Using self-report and adverse event measures to track health's impact on productivity in known groups.

    PubMed

    Allen, Harris M; Bunn, William B

    2003-09-01

    The use of survey data to measure and monitor health and productivity differences between groups is an issue of increasing importance. This article examines the capacity of productivity self-reports (derived from surveys) and adverse event measures (derived from administrative sources) to differentiate groups with a priori known characteristics. A replication strategy is used to test the contributions that productivity self-reports make, alone as well as above and beyond measures of adverse events, to the discrimination of 5 pairs of groups classified by clinical, job type, and demographic criteria. These tests are conducted on representative samples of the active, largely blue-collar employee population at International Truck and Engine Corporation. The results show that both productivity self-reports and adverse event measures differentiate and track known groups. Even in the presence of highly significant effects from adverse event measures, self-reports improve the assessment of productivity. We conclude that: 1) although the joint use of self-reports and adverse event measures is the better approach, practitioners can use self-reports with the expectation that this method will track group differences in health and productivity when adverse event measures are not available; and 2) survey self-reports make unique and independent contributions when adverse events measures are used.

  7. Life adversity is associated with smoking relapse after a quit attempt.

    PubMed

    Lemieux, Andrine; Olson, Leif; Nakajima, Motohiro; Schulberg, Lauren; al'Absi, Mustafa

    2016-09-01

    Multiple cross-sectional studies have linked adverse childhood events and adult adversities to current smoking, lifetime smoking, and former smoking. To date, however, there have been no direct observational studies assessing the influence of adversities on smoking relapse. We prospectively followed 123 participants, 86 of whom were habitual smokers, from pre-quit ad libitum smoking to four weeks post-quit. Thirty-seven non-smokers were also tested in parallel as a comparison group. Subjects provided biological samples for confirmation of abstinence status and self-report history of adversities such as abuse, neglect, family dysfunction, incarceration, and child-parent separation. They also completed mood and smoking withdrawal symptom measures. The results indicated that within non-smokers and smokers who relapsed within the first month of a quit attempt, but not abstainers, females had significantly higher adversity scores than males. Cigarette craving, which was independent from depressive affect, increased for low adversity participants, but not those with no adversity nor high adversity. These results demonstrate that sex and relapse status interact to predict adversity and that craving for nicotine may be an important additional mediator of relapse. These results add further support to the previous cross-sectional evidence of an adversity and smoking relationship. Further studies to clarify how adversity complicates smoking cessation and impacts smoking behaviors are warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Could Crop Height Impact the Wind Resource at Agriculturally Productive Wind Farm Sites?

    NASA Astrophysics Data System (ADS)

    Vanderwende, B. J.; Lundquist, J. K.

    2013-12-01

    The agriculture-intensive United States Midwest and Great Plains regions feature some of the best wind resources in the nation. Collocation of cropland and wind turbines introduces complex meteorological interactions that could affect both agriculture and wind power production. Crop management practices may modify the wind resource through alterations of land-surface properties. In this study, we used the Weather Research and Forecasting (WRF) model to estimate the impact of crop height variations on the wind resource in the presence of a large turbine array. We parameterized a hypothetical array of 121 1.8 MW turbines at the site of the 2011 Crop/Wind-energy Experiment field campaign using the WRF wind farm parameterization. We estimated the impact of crop choices on power production by altering the aerodynamic roughness length in a region approximately 65 times larger than that occupied by the turbine array. Roughness lengths of 10 cm and 25 cm represent a mature soy crop and a mature corn crop respectively. Results suggest that the presence of the mature corn crop reduces hub-height wind speeds and increases rotor-layer wind shear, even in the presence of a large wind farm which itself modifies the flow. During the night, the influence of the surface was dependent on the boundary layer stability, with strong stability inhibiting the surface drag from modifying the wind resource aloft. Further investigation is required to determine the optimal size, shape, and crop height of the roughness modification to maximize the economic benefit and minimize the cost of such crop management practices.

  9. Search strategies to identify information on adverse effects: a systematic review

    PubMed Central

    Golder, Su; Loke, Yoon

    2009-01-01

    Objectives: The review evaluated studies of electronic database search strategies designed to retrieve adverse effects data for systematic reviews. Methods: Studies of adverse effects were located in ten databases as well as by checking references, hand-searching, searching citations, and contacting experts. Two reviewers screened the retrieved records for potentially relevant papers. Results: Five thousand three hundred thirteen citations were retrieved, yielding 19 studies designed to develop or evaluate adverse effect filters, of which 3 met the inclusion criteria. All 3 studies identified highly sensitive search strategies capable of retrieving over 95% of relevant records. However, 1 study did not evaluate precision, while the level of precision in the other 2 studies ranged from 0.8% to 2.8%. Methodological issues in these papers included the relatively small number of records, absence of a validation set of records for testing, and limited evaluation of precision. Conclusions: The results indicate the difficulty of achieving highly sensitive searches for information on adverse effects with a reasonable level of precision. Researchers who intend to locate studies on adverse effects should allow for the amount of resources and time required to conduct a highly sensitive search. PMID:19404498

  10. Epilepsy and adverse quality of life in surgically resected meningioma.

    PubMed

    Tanti, M J; Marson, A G; Jenkinson, M D

    2017-09-01

    Meningiomas are common intracranial tumors, and despite surgery or therapy with anti-epileptic drugs (AEDs), many patients suffer from seizures. Epilepsy has a significant impact on quality of life (QoL) in non-tumor populations, but the impact of epilepsy on QoL in patients with meningioma is unknown. Our aim was to evaluate the impact of epilepsy on QoL in patients that have undergone resection of a benign meningioma. We recruited meningioma patients without epilepsy (n=109), meningioma patients with epilepsy (n=56), and epilepsy patients without meningioma (n=64). QoL was measured with the Short Form 36 version 2 (SF-36), the Functional Assessment of Cancer Therapy (FACT-BR), and the Liverpool Adverse Events Profile (LAEP). Regression analyses identified significant determinants of QoL. Patients with meningioma and epilepsy had poorer QoL scores than meningioma patients without epilepsy in all measures. In FACT-BR, this difference was significant. Multiple regression analyses demonstrated that current AED use had a greater impact on QoL scores than recent seizures. Other variables associated with impaired QoL included depression, unemployment, and meningioma attributed symptoms. Epilepsy has a negative impact on quality of life in patients with benign meningioma. AED use is correlated with impaired QoL and raised LAEP scores, suggesting that AEDs and adverse effects may have led to impaired QoL in our meningioma patients with epilepsy. The severity of epilepsy in our meningioma population was comparatively mild; therefore, a more conservative approach to AED therapy may be indicated in an attempt to minimize adverse effects. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Adverse psychological outcomes following colposcopy and related procedures: a systematic review.

    PubMed

    O'Connor, M; Gallagher, P; Waller, J; Martin, C M; O'Leary, J J; Sharp, L

    2016-01-01

    Although colposcopy is the leading follow-up option for women with abnormal cervical cytology, little is known about its psychological consequences. We performed a systematic review to examine: (1) what, if any, are the adverse psychological outcomes following colposcopy and related procedures; (2) what are the predictors of adverse psychological outcomes post-colposcopy; and (3) what happens to these outcomes over time. Five electronic databases (PubMed, PsychINFO, CINAHL, Web of Science, Scopus) were searched for studies published in English between January 1986 and February 2014. Eligible studies assessed psychological wellbeing at one or more time-points post-colposcopy. Two reviewers independently screened titles and abstracts. Full texts of potentially eligible papers were reviewed. Data were abstracted from, and a quality appraisal performed of, eligible papers. Twenty-three papers reporting 16 studies were eligible. Colposcopy and related procedures can lead to adverse psychological outcomes, particularly anxiety. Ten studies investigated predictors of adverse psychological outcomes; management type and treatment had no impact on this. Seven studies investigated temporal trends in psychological outcomes post-colposcopy; findings were mixed, especially in relation to anxiety and distress. Studies were methodologically heterogeneous. Follow-up investigations and procedures for abnormal cervical cytology can cause adverse psychological outcomes among women. However, little is known about the predictors of these outcomes or how long they persist. There is a need for a more standardised approach to the examination of the psychological impact of colposcopy, especially longer-term outcomes. Follow-up investigations for abnormal cervical cytology can cause adverse psychological outcome among women. © 2015 Royal College of Obstetricians and Gynaecologists.

  12. Impact of patient communication problems on the risk of preventable adverse events in acute care settings

    PubMed Central

    Bartlett, Gillian; Blais, Régis; Tamblyn, Robyn; Clermont, Richard J.; MacGibbon, Brenda

    2008-01-01

    Background Up to 50% of adverse events that occur in hospitals are preventable. Language barriers and disabilities that affect communication have been shown to decrease quality of care. We sought to assess whether communication problems are associated with an increased risk of preventable adverse events. Methods We randomly selected 20 general hospitals in the province of Quebec with at least 1500 annual admissions. Of the 145 672 admissions to the selected hospitals in 2000/01, we randomly selected and reviewed 2355 charts of patients aged 18 years or older. Reviewers abstracted patient characteristics, including communication problems, and details of hospital admission, and assessed the cause and preventability of identified adverse events. The primary outcome was adverse events. Results Of 217 adverse events, 63 (29%) were judged to be preventable, for an overall population rate of 2.7% (95% confidence interval [CI] 2.1%–3.4%). We found that patients with preventable adverse events were significantly more likely than those without such events to have a communication problem (odds ratio [OR] 3.00; 95% CI 1.43–6.27) or a psychiatric disorder (OR 2.35; 95% CI 1.09–5.05). Patients who were admitted urgently were significantly more likely than patients whose admissions were elective to experience an event (OR 1.64, 95% CI 1.07–2.52). Preventable adverse events were mainly due to drug errors (40%) or poor clinical management (32%). We found that patients with communication problems were more likely than patients without these problems to experience multiple preventable adverse events (46% v. 20%; p = 0.05). Interpretation Patients with communication problems appeared to be at highest risk for preventable adverse events. Interventions to reduce the risk for these patients need to be developed and evaluated. PMID:18519903

  13. Applying Aggregate Exposure Pathway and Adverse Outcome ...

    EPA Pesticide Factsheets

    Hazard assessment for nanomaterials often involves applying in vitro dose-response data to estimate potential health risks that arise from exposure to products that contain nanomaterials. However, much uncertainty is inherent in relating bioactivities observed in an in vitro system to the perturbations of biological mechanisms that lead to apical adverse health outcomes in living organisms. The Adverse Outcome Pathway (AOP) framework addresses this uncertainty by acting as a scaffold onto which in vitro toxicity testing and other data can be arranged to aid in the interpretation of these results in terms of biologically-relevant responses, as an AOP connects an upstream molecular initiating event (MIE) to a downstream adverse outcome. In addition to hazard assessment, risk estimation also requires reconciling in vitro concentrations sufficient to produce bioactivity with in vivo concentrations that can trigger a MIE at the relevant biological target. Such target site exposures (TSEs) can be estimated by integrating pharmacokinetic considerations with environmental and exposure factors. Environmental and exposure data have been historically scattered in various resources, such as monitoring data for air pollutants or exposure models for specific chemicals. The Aggregate Exposure Pathway (AEP) framework is introduced to organize existing knowledge concerning biologically, chemically, and physically plausible, as well as empirically supported, links between the i

  14. The impact of resource quality on the evolution of virulence in spatially heterogeneous environments.

    PubMed

    Su, Min; Boots, Mike

    2017-03-07

    Understanding the drivers of parasite evolution and in particular disease virulence remains a major focus of evolutionary theory. Here, we examine the role of resource quality and in particular spatial environmental heterogeneity in the distribution of these resources on the evolution of virulence. There may be direct effects of resources on host susceptibility and pathogenicity alongside effects on reproduction that indirectly impact host-parasite population dynamics. Therefore, we assume that high resource quality may lead to both increased host reproduction and/or increased disease resistance. In completely mixed populations there is no effect of resource quality on the outcome of disease evolution. However, when there are local interactions higher resource quality generally selects for higher virulence/transmission for both linear and saturating transmission-virulence trade-off assumptions. The exception is that in castrators (i.e., infected hosts have no reproduction), higher virulence is selected for both low and high resource qualities at mixed local and global infection. Heterogeneity in the distribution of environment resources only has an effect on the outcome in castrators where random distributions generally select for higher virulence. Overall, our results further underline the importance of considering spatial structure in order to understand evolutionary processes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts.

    PubMed

    Handel, Benjamin R

    2013-12-01

    This paper investigates consumer inertia in health insurance markets, where adverse selection is a potential concern. We leverage a major change to insurance provision that occurred at a large firm to identify substantial inertia, and develop and estimate a choice model that also quantifies risk preferences and ex ante health risk. We use these estimates to study the impact of policies that nudge consumers toward better decisions by reducing inertia. When aggregated, these improved individual-level choices substantially exacerbate adverse selection in our setting, leading to an overall reduction in welfare that doubles the existing welfare loss from adverse selection.

  16. 40 CFR 125.85 - May alternative requirements be authorized?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirement at issue or would result in significant adverse impacts on local air quality, significant adverse impacts on local water resources other than impingement or entrainment, or significant adverse impacts on... the wholly out of proportion cost or the significant adverse impacts on local air quality, significant...

  17. 40 CFR 125.85 - May alternative requirements be authorized?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirement at issue or would result in significant adverse impacts on local air quality, significant adverse impacts on local water resources other than impingement or entrainment, or significant adverse impacts on... the wholly out of proportion cost or the significant adverse impacts on local air quality, significant...

  18. The thermal impact of subsurface building structures on urban groundwater resources - A paradigmatic example.

    PubMed

    Epting, Jannis; Scheidler, Stefan; Affolter, Annette; Borer, Paul; Mueller, Matthias H; Egli, Lukas; García-Gil, Alejandro; Huggenberger, Peter

    2017-10-15

    Shallow subsurface thermal regimes in urban areas are increasingly impacted by anthropogenic activities, which include infrastructure development like underground traffic lines as well as industrial and residential subsurface buildings. In combination with the progressive use of shallow geothermal energy systems, this results in the so-called subsurface urban heat island effect. This article emphasizes the importance of considering the thermal impact of subsurface structures, which commonly is underestimated due to missing information and of reliable subsurface temperature data. Based on synthetic heat-transport models different settings of the urban environment were investigated, including: (1) hydraulic gradients and conductivities, which result in different groundwater flow velocities; (2) aquifer properties like groundwater thickness to aquitard and depth to water table; and (3) constructional features, such as building depths and thermal properties of building structures. Our results demonstrate that with rising groundwater flow velocities, the heat-load from building structures increase, whereas down-gradient groundwater temperatures decrease. Thermal impacts on subsurface resources therefore have to be related to the permeability of aquifers and hydraulic boundary conditions. In regard to the urban settings of Basel, Switzerland, flow velocities of around 1 md -1 delineate a marker where either down-gradient temperature deviations or heat-loads into the subsurface are more relevant. Furthermore, no direct thermal influence on groundwater resources should be expected for aquifers with groundwater thicknesses larger 10m and when the distance of the building structure to the groundwater table is higher than around 10m. We demonstrate that measuring temperature changes down-gradient of subsurface structures is insufficient overall to assess thermal impacts, particularly in urban areas. Moreover, in areas which are densely urbanized, and where groundwater flow

  19. The Impact of Library Resource Utilization on Undergraduate Students' Academic Performance: A Propensity Score Matching Design

    ERIC Educational Resources Information Center

    Kot, Felly Chiteng; Jones, Jennifer L.

    2015-01-01

    This study uses three cohorts of first-time, full-time undergraduate students (N = 8,652) at a large, metropolitan, public research university to examine the impact of student use of three library resources (workstations, study rooms, and research clinics) on academic performance. To deal with self-selection bias and estimate this impact more…

  20. Analyzing climate change impacts on water resources under uncertainty using an integrated simulation-optimization approach

    NASA Astrophysics Data System (ADS)

    Zhuang, X. W.; Li, Y. P.; Nie, S.; Fan, Y. R.; Huang, G. H.

    2018-01-01

    An integrated simulation-optimization (ISO) approach is developed for assessing climate change impacts on water resources. In the ISO, uncertainties presented as both interval numbers and probability distributions can be reflected. Moreover, ISO permits in-depth analyses of various policy scenarios that are associated with different levels of economic consequences when the promised water-allocation targets are violated. A snowmelt-precipitation-driven watershed (Kaidu watershed) in northwest China is selected as the study case for demonstrating the applicability of the proposed method. Results of meteorological projections disclose that the incremental trend of temperature (e.g., minimum and maximum values) and precipitation exist. Results also reveal that (i) the system uncertainties would significantly affect water resources allocation pattern (including target and shortage); (ii) water shortage would be enhanced from 2016 to 2070; and (iii) the more the inflow amount decreases, the higher estimated water shortage rates are. The ISO method is useful for evaluating climate change impacts within a watershed system with complicated uncertainties and helping identify appropriate water resources management strategies hedging against drought.

  1. Impact of cancer anorexia-cachexia syndrome on health-related quality of life and resource utilisation: A systematic review.

    PubMed

    Tarricone, Rosanna; Ricca, Giada; Nyanzi-Wakholi, Barbara; Medina-Lara, Antonieta

    2016-03-01

    Cancer anorexia-cachexia syndrome (CACS) negatively impacts patients' quality of life (QoL) and increases the burden on healthcare resources. To review published CACS data regarding health-related QOL (HRQoL) and its economic impact on the healthcare system. Searches were conducted in MEDLINE, EMBASE, DARE, and NHS EED databases. A total of 458 HRQoL and 189 healthcare resources utilisation abstracts were screened, and 42 and 2 full-text articles were included, respectively. The EORTC QLQ-C30 and FAACT instruments were most favoured for assessing HRQOL but none of the current tools cover all domains affected by CACS. Economic estimates for managing CACS are scarce, with studies lacking a breakdown of healthcare resource utilisation items. HRQoL instruments that can better assess and incorporate all the domains affected by CACS are required. Rigorous assessment of costs and benefits of treatment are needed to understand the magnitude of the impact of CACS. Copyright © 2016. Published by Elsevier Ireland Ltd.

  2. Impacts of Coal Seam Gas (Coal Bed Methane) Extraction on Water Resources in Australia

    NASA Astrophysics Data System (ADS)

    Post, David

    2015-04-01

    While extraction of methane from shale gas deposits has been the principal source of the recent expansion of the industry in the United States and Europe, in Australia extraction of methane from coal bed methane deposits (termed 'coal seam gas' in Australia) has been the focus to date. The two sources of methane share many of the same characteristics including the potential requirement for hydraulic fracturing. However as coal seam gas deposits generally occur at shallower depths than shale gas the potential impacts of extraction and hydraulic fracturing on surface and groundwater resources may be of even greater concern for coal seam gas than for shale gas. In Australia an Independent Expert Scientific Committee (IESC) has been established to provide scientific advice to federal and state government regulators on the impact that coal seam gas and large coal mining developments may have on water resources. This advice is provided to enable decisions to be informed by the best available science about the potential water-related impacts associated with these developments. To support this advice the Australian Government Department of the Environment has implemented a three-year programme of research termed 'bioregional assessments' to investigate these potential impacts. A bioregional assessment is defined as a scientific analysis of the ecology, hydrology, geology and hydrogeology of a bioregion with explicit assessment of the potential direct, indirect and cumulative impacts of coal seam gas and large coal mining development on water resources. These bioregional assessments are currently being carried out across large portions of eastern Australia underlain by coal reserves. Further details of the program and results to date can be found at http://www.bioregionalassessments.gov.au. In this presentation the methodology for undertaking bioregional assessments will be described and the application of this methodology to six priority bioregions in eastern Australia

  3. Impacts of groundwater management on energy resources and greenhouse gas emissions in California.

    PubMed

    Hendrickson, Thomas P; Bruguera, Maya

    2018-09-15

    California faces significant energy and water infrastructure planning challenges in response to a changing climate. Immediately following the most severe recorded drought, the state experienced one of its wettest water years in recorded history. Despite the recent severe wet weather, much of the state's critical groundwater systems have not recovered from the drought. The recent Sustainable Groundwater Management Act (SGMA) aims to eliminate future depletion risks, but may force California basins to seek alternative water sources by limiting groundwater withdrawals during droughts. These alternative water resources, such as recycled water or desalination, can have significantly higher energy demands in treatment and supply than local groundwater or surface water resources. This research developed potential scenarios of water supply sources for five overdrafted groundwater basins, and modeled the impacts of these scenarios on energy demands and greenhouse gas (GHG) emissions for water supply systems. Our results reveal that energy demands and GHG emissions in different water supply scenarios can vary substantially between basins, but could increase statewide energy consumption as much as 2% and GHG emissions by 0.5. These results highlight the need to integrate these energy and GHG impacts into water resource management. Better understanding these considerations enables water supply planners to avoid potential unintended consequences (i.e., increased energy demands and GHG emissions) of enhancing drought resilience. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Analysis of the Environmental Impact of Insulin Infusion Sets Based on Loss of Resources with Waste

    PubMed Central

    Pfützner, Andreas; Musholt, Petra B; Malmgren-Hansen, Bjoern; Nilsson, Nils H; Forst, Thomas

    2011-01-01

    Insulin pump therapy [continuous subcutaneous insulin infusion (CSII)] requires regular change of infusion sets every 2-3 days in order to minimize the risk of skin irritations or other adverse events. This has been discussed to be a potential burden to the environment. The purpose of this analysis was to perform an environmental assessment of insulin pump infusion sets based on loss of resources occurring during incineration of the discarded products and by means of a lifecycle concept used to weight a material in relation to its rareness on earth and its consumption. In addition to five infusion sets (Inset30, InsetII, Comfort, Quick-set, and Cleo), a patch pump (Omnipod) was also included in this analysis. The annual loss in waste of the so called “person reserve” of 3 days of catheter use was compared with daily consumption of a cup of coffee in a disposable paper cup and to a soft drink in an aluminum can. The weight-based loss in resources through waste for the infusion sets (except for Cleo) corresponded to 70-200% of the loss of resources for a coffee cup (Cleo, 320%; Omnipod, 1,821,600%) and to 1-3% of the loss from an aluminum soft drink can (Cleo, 5%; Omnipod, 31,200%). The loss or resources by use of infusion sets used in insulin pump therapy appears to be low and is similar to the burden induced by the uptake of one cup of coffee per day. The loss or resources with regular CSII is considerably lower than the loss or resources induced by patch pumps. PMID:21880223

  5. All Unhappy Childhoods Are Unhappy in Their Own Way-Differential Impact of Dimensions of Adverse Childhood Experiences on Adult Mental Health and Health Behavior.

    PubMed

    Westermair, Anna L; Stoll, Anne M; Greggersen, Wiebke; Kahl, Kai G; Hüppe, Michael; Schweiger, Ulrich

    2018-01-01

    Adverse childhood experiences have consistently been linked with poor mental and somatic health in adulthood. However, due to methodological restraints of the main lines of research using cumulative or selective models, little is known about the differential impact of different dimensions of adverse childhood experiences. Therefore, we gathered data from 396 psychiatric in-patients on the Adverse Childhood Experiences (ACE) questionnaire, extracted dimensions using factor analysis and compared this dimensional model of adverse childhood experiences to cumulative and selective models. Household Dysfunction (violence against the mother, parental divorce, substance abuse or incarceration of a household member) was associated with poor health behaviors (smoking, alcohol dependency and obesity as proxy marker for an imbalance between energy intake and physical activity) and with poorer socio-economic achievement (lower education and income) in adulthood. The previously reported associations of maltreatment and sexual abuse with these outcome criteria could not be corroborated. Both Maltreatment (emotional and physical neglect and abuse) and Sexual Abuse predicted BPD, PTSD and suicidal behavior. However, the two ACE dimensions showed sufficiently divergent validity to warrant separate consideration in future studies: Maltreatment was associated with affective and anxiety disorders such as social phobia, panic disorder and major depressive disorder, whereas Sexual Abuse was associated with dysregulation of bodily sensations such as pain intensity and hunger/satiation. Also, we found both quantitative and qualitative evidence for the superiority of the dimensional approach to exploring the consequences of adverse childhood experiences in comparison to the cumulative and selective approaches.

  6. 40 CFR 125.135 - May alternative requirements be authorized?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... impacts on local water resources other than impingement or entrainment, or significant adverse impacts on... wholly out of proportion cost or the significant adverse impacts on local water resources other than... 40 Protection of Environment 22 2011-07-01 2011-07-01 false May alternative requirements be...

  7. 40 CFR 125.135 - May alternative requirements be authorized?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... impacts on local water resources other than impingement or entrainment, or significant adverse impacts on... wholly out of proportion cost or the significant adverse impacts on local water resources other than... 40 Protection of Environment 21 2010-07-01 2010-07-01 false May alternative requirements be...

  8. WE-FG-201-00: High Impact Technologies for Low Resource Environments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, andmore » (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd.« less

  9. Impacts of the 2004 tsunami on groundwater resources in Sri Lanka

    USGS Publications Warehouse

    Illangasekare, Tissa H.; Tyler, Scott W.; Clement, T. Prabhakar; Villholth, Karen G.; Perera, A.P.G.R.L.; Obeysekera, Jayantha; Gunatilaka, Ananda; Panabokke, C.R.; Hyndman, David W.; Cunningham, Kevin J.; Kaluarachchi, Jagath J.; Yeh, William W.‐G.; Van Genuchten, Martinus T. van; Jensen, Karsten H.

    2006-01-01

    The 26 December 2004 tsunami caused widespread destruction and contamination of coastal aquifers across southern Asia. Seawater filled domestic open dug wells and also entered the aquifers via direct infiltration during the first flooding waves and later as ponded seawater infiltrated through the permeable sands that are typical of coastal aquifers. In Sri Lanka alone, it is estimated that over 40,000 drinking water wells were either destroyed or contaminated. From February through September 2005, a team of United States, Sri Lankan, and Danish water resource scientists and engineers surveyed the coastal groundwater resources of Sri Lanka to develop an understanding of the impacts of the tsunami and to provide recommendations for the future of coastal water resources in south Asia. In the tsunami‐affected areas, seawater was found to have infiltrated and mixed with fresh groundwater lenses as indicated by the elevated groundwater salinity levels. Seawater infiltrated through the shallow vadose zone as well as entered aquifers directly through flooded open wells. Our preliminary transport analysis demonstrates that the intruded seawater has vertically mixed in the aquifers because of both forced and free convection. Widespread pumping of wells to remove seawater was effective in some areas, but overpumping has led to upconing of the saltwater interface and rising salinity. We estimate that groundwater recharge from several monsoon seasons will reduce salinity of many sandy Sri Lankan coastal aquifers. However, the continued sustainability of these small and fragile aquifers for potable water will be difficult because of the rapid growth of human activities that results in more intensive groundwater pumping and increased pollution. Long‐term sustainability of coastal aquifers is also impacted by the decrease in sand replenishment of the beaches due to sand mining and erosion.

  10. Development of a Novel Quantitative Adverse Outcome Pathway Predictive Model for Lung Cancer

    EPA Science Inventory

    Traditional methods for carcinogenicity testing are resource-intensive, retrospective, and time consuming. An increasing testing burden has generated interest in the adverse outcome pathway (AOP) concept as a tool to evaluate chemical safety in a more efficient, rapid and effecti...

  11. Constructing Adverse Outcome Pathways: a Demonstration of an Ontology-based Semantics Mapping Approach

    EPA Science Inventory

    Adverse outcome pathway (AOP) provides a conceptual framework to evaluate and integrate chemical toxicity and its effects across the levels of biological organization. As such, it is essential to develop a resource-efficient and effective approach to extend molecular initiating ...

  12. The Mahomet aquifer: A transboundary resource in east-central Illinois

    USGS Publications Warehouse

    Larson, D.R.; Mehnert, E.; Herzog, B.L.

    2003-01-01

    Emerging intrastate transboundary issues focus on use of the Mahomet aquifer, which underlies about fifteen counties and many other political entities in east-central Illinois. This sand and gravel aquifer in the lower part of the buried Mahomet Bedrock Valley ranges between four and fourteen miles wide and from about 50 to 200 feet thick. Much of the region's rural population, several large communities, and many small towns obtain water from the Mahomet aquifer, as do industrial, agricultural, and commercial users. Increased development of the Mahomet aquifer to meet growing demands for water has caused conflicts over real or perceived adverse effects. One result has been the creation of fifteen resource protection zones and twelve water authorities. For groundwater supplies, resource protection zones help municipalities protect water-supply wells from potential adverse impacts. Many resource protection zones overlap one another, however, so this situation could lead to disputes over use of the resource. The reason that several of the twelve water authorities were organized was to meet a challenge perceived from a demand to be placed on the aquifer, in other words, a potential for conflict of use. Complicating the situation is that some of the water authorities overlap the resource protection zones. This could lead to disputes not only about water use, but also over which jurisdiction has the authority to settle a dispute. The Mahomet Aquifer Consortium was recently organized by concerned people representing diverse groundwater interests at the local level, including the private sector, professional organizations, and various governmental units. The consortium brings together representatives of some groups that typically did not communicate with each other in the past. The consortium may provide a forum through which emerging transboundary issues pertaining to use of the Mahomet aquifer can be addressed. Because the consortium is a voluntary organization that

  13. Close Friends' Psychopathology as a Pathway From Early Adversity to Young Adulthood Depressive Symptoms.

    PubMed

    Raposa, Elizabeth B; Hammen, Constance L; Brennan, Patricia A

    2015-01-01

    Past research has highlighted the negative impact of early adverse experiences on childhood social functioning, including friendship selection, and later mental health. The current study explored the long-term effects of early adversity on young adults' close friends' psychological symptoms and the impact of these close friendships on later depressive symptoms. A prospective longitudinal design was used to examine 816 youth from a large community-based sample, who were followed from birth through age 25. Participants' mothers provided contemporaneous information about adversity exposure up to age 5, and participants completed questionnaires about their own depressive symptoms at age 20 and in their early 20s. Youth also nominated a best friend to complete questionnaires about his or her own psychopathology at age 20. Individuals who experienced more early adversity by age 5 had best friends with higher rates of psychopathology at age 20. Moreover, best friends' psychopathology predicted target youth depressive symptoms 2 to 5 years later. Results indicate that early adversity continues to affect social functioning throughout young adulthood and that best friendships marked by elevated psychopathology in turn negatively affect mental health. Findings have implications for clinical interventions designed to prevent the development of depressive symptoms in youth who have been exposed to early adversity.

  14. Close Friends’ Psychopathology as a Pathway from Early Adversity to Young Adulthood Depressive Symptoms

    PubMed Central

    Raposa, Elizabeth; Hammen, Constance; Brennan, Patricia

    2014-01-01

    Objective Past research has highlighted the negative impact of early adverse experiences on childhood social functioning, including friendship selection, and later mental health. The current study explored the long-term effects of early adversity on young adults’ close friends’ psychological symptoms, and the impact of these close friendships on later depressive symptoms. Method A prospective longitudinal design was used to examine 816 youth from a large community-based sample, who were followed from birth through age 25. Participants’ mothers provided contemporaneous information about adversity exposure prior to age 5, and participants completed questionnaires about their own depressive symptoms at age 20 and in their early 20’s. Youth also nominated a best friend to complete questionnaires about their own psychopathology at age 20. Results Individuals who experienced more early adversity by age 5 had best friends with higher rates of psychopathology at age 20. Moreover, best friends’ psychopathology predicted target youth depressive symptoms two to five years later. Conclusions Results indicate that early adversity continues to affect social functioning throughout young adulthood, and that best friendships marked by elevated psychopathology in turn negatively affect mental health. Findings have implications for clinical interventions designed to prevent the development of depressive symptoms in youth who have been exposed to early adversity. PMID:24871609

  15. Assessing the Impact of Chlorinated-Solvent Sites on Metropolitan Groundwater Resources

    PubMed Central

    Brusseau, Mark L.; Narter, Matthew

    2014-01-01

    Chlorinated-solvent compounds are among the most common groundwater contaminants in the U.S.A. The majority of the many sites contaminated by chlorinated-solvent compounds are located in metropolitan areas, and most such areas have one or more chlorinated-solvent contaminated sites. Thus, contamination of groundwater by chlorinated-solvent compounds may pose a potential risk to the sustainability of potable water supplies for many metropolitan areas. The impact of chlorinated-solvent sites on metropolitan water resources was assessed for Tucson, AZ, by comparing the aggregate volume of extracted groundwater for all pump-and-treat systems associated with contaminated sites in the region to the total regional groundwater withdrawal. The analysis revealed that the aggregate volume of groundwater withdrawn for the pump-and-treat systems operating in Tucson, all of which are located at chlorinated-solvent contaminated sites, was 20% of the total groundwater withdrawal in the city for the study period. The treated groundwater was used primarily for direct delivery to local water supply systems or for reinjection as part of the pump-and-treat system. The volume of the treated groundwater used for potable water represented approximately 13% of the total potable water supply sourced from groundwater, and approximately 6% of the total potable water supply. This case study illustrates the significant impact chlorinated-solvent contaminated sites can have on groundwater resources and regional potable-water supplies. PMID:24116872

  16. Vaccine Adverse Events

    MedlinePlus

    ... use in the primary immunization series in infants Report Adverse Event Report a Vaccine Adverse Event Contact FDA (800) 835- ... back to top Popular Content Home Latest Recalls Report an Adverse Event MedWatch Safety Alerts News Releases ...

  17. The impact of herbal remedies on adverse effects and quality of life in HIV-infected individuals on antiretroviral therapy

    PubMed Central

    Bepe, Nyasha; Madanhi, Nathan; Mudzviti, Tinashe; Gavi, Samuel; Maponga, Charles Chiedza; Morse, Gene D

    2012-01-01

    Introduction Use of herbal remedies among HIV-infected individuals in Africa increased in the past decade, mainly due to traditional beliefs and at times inconsistent access to antiretroviral drugs. In Zimbabwe, accessibility and availability of antiretroviral drugs has increased in recent years; however, the use of herbal remedies remains high. This study was conducted to determine the impact of concomitant use of herbal remedies with antiretroviral drugs on adverse events and on quality of life. Methodology A convenient sample of HIV positive patients at Parirenyatwa group of hospitals' Family Care Clinic (Harare, Zimbabwe) was enrolled. A questionnaire was used to collect data on the adverse event experiences of the patients using herbal remedies for their HIV, as well as the types of herbal remedy used. Quality of life index was measured using an HIV/AIDS targeted quality of life (HAT-QOL) tool developed by the World Health Organization. Results Abdominal pain (odds ratio = 2.7, p-value = 0.01) and rash (odds ratio = 2.5, p-value = 0.02) had significant associations with using herbal remedies during antiretroviral therapy. Improved quality of life index was not significantly associated with herbal remedy use during antiretroviral therapy. Conclusions There is evidence to suggest that some traditional herbal remedies used in Zimbabwe may increase incidence of certain types of adverse events when used in combination with antiretroviral drugs. Use of herbal drugs in combination with antiretroviral therapy does not significantly improve quality of life index in comparison to antiretroviral drug use only. PMID:21330740

  18. Mismatch or allostatic load? Timing of life adversity differentially shapes gray matter volume and anxious temperament.

    PubMed

    Kuhn, Manuel; Scharfenort, Robert; Schümann, Dirk; Schiele, Miriam A; Münsterkötter, Anna L; Deckert, Jürgen; Domschke, Katharina; Haaker, Jan; Kalisch, Raffael; Pauli, Paul; Reif, Andreas; Romanos, Marcel; Zwanzger, Peter; Lonsdorf, Tina B

    2016-04-01

    Traditionally, adversity was defined as the accumulation of environmental events (allostatic load). Recently however, a mismatch between the early and the later (adult) environment (mismatch) has been hypothesized to be critical for disease development, a hypothesis that has not yet been tested explicitly in humans. We explored the impact of timing of life adversity (childhood and past year) on anxiety and depression levels (N = 833) and brain morphology (N = 129). Both remote (childhood) and proximal (recent) adversities were differentially mirrored in morphometric changes in areas critically involved in emotional processing (i.e. amygdala/hippocampus, dorsal anterior cingulate cortex, respectively). The effect of adversity on affect acted in an additive way with no evidence for interactions (mismatch). Structural equation modeling demonstrated a direct effect of adversity on morphometric estimates and anxiety/depression without evidence of brain morphology functioning as a mediator. Our results highlight that adversity manifests as pronounced changes in brain morphometric and affective temperament even though these seem to represent distinct mechanistic pathways. A major goal of future studies should be to define critical time periods for the impact of adversity and strategies for intervening to prevent or reverse the effects of adverse childhood life experiences. © The Author (2015). Published by Oxford University Press.

  19. Mismatch or allostatic load? Timing of life adversity differentially shapes gray matter volume and anxious temperament

    PubMed Central

    Kuhn, Manuel; Scharfenort, Robert; Schümann, Dirk; Schiele, Miriam A.; Münsterkötter, Anna L.; Deckert, Jürgen; Domschke, Katharina; Haaker, Jan; Kalisch, Raffael; Pauli, Paul; Reif, Andreas; Romanos, Marcel; Zwanzger, Peter

    2016-01-01

    Traditionally, adversity was defined as the accumulation of environmental events (allostatic load). Recently however, a mismatch between the early and the later (adult) environment (mismatch) has been hypothesized to be critical for disease development, a hypothesis that has not yet been tested explicitly in humans. We explored the impact of timing of life adversity (childhood and past year) on anxiety and depression levels (N = 833) and brain morphology (N = 129). Both remote (childhood) and proximal (recent) adversities were differentially mirrored in morphometric changes in areas critically involved in emotional processing (i.e. amygdala/hippocampus, dorsal anterior cingulate cortex, respectively). The effect of adversity on affect acted in an additive way with no evidence for interactions (mismatch). Structural equation modeling demonstrated a direct effect of adversity on morphometric estimates and anxiety/depression without evidence of brain morphology functioning as a mediator. Our results highlight that adversity manifests as pronounced changes in brain morphometric and affective temperament even though these seem to represent distinct mechanistic pathways. A major goal of future studies should be to define critical time periods for the impact of adversity and strategies for intervening to prevent or reverse the effects of adverse childhood life experiences. PMID:26568620

  20. Understanding the impacts of medical tourism on health human resources in Barbados: a prospective, qualitative study of stakeholder perceptions.

    PubMed

    Snyder, Jeremy; Crooks, Valorie A; Turner, Leigh; Johnston, Rory

    2013-01-05

    Medical tourism is a global health practice where patients travel internationally with the intention of receiving medical services. A range of low, middle, and high income countries are encouraging investment in the medical tourism sector, including countries in the Caribbean targeting patients in North America and Europe. While medical tourism has the potential to provide economic and employment opportunities in destination countries, there are concerns that it could encourage the movement of health workers from the public to private health sector. We present findings from 19 semi-structured interviews with stakeholders across the public health care, private health care, government, allied business, and civil society sectors. These interviews were conducted in-person in Barbados and via phone. The interview transcripts were coded and a thematic analysis developed. Three themes were identified: 1) Stakeholder perceptions of the patterns and plans for health human resource usage by current and planned medical tourism facilities in Barbados. We found that while health human resource usage in the medical tourism sector has been limited, it is likely to grow in the future; 2) Anticipated positive impacts of medical tourism on health human resources and access to care in the public system. These benefits included improved quality control, training opportunities, and health worker retention; and 3) Anticipated negative impacts of medical tourism on health human resources and access to care in the public system. These impacts included longer wait times for care and a shift in planning priorities driven by the medical tourism sector. Stakeholders interviewed who were connected to medical tourism expansion or the tourism sector took a generally positive view of the likely impacts of medical tourism on health human resources in Barbados. However, stakeholders associated with the public health system and health equity expressed concern that medical tourism may spread

  1. Understanding the impacts of medical tourism on health human resources in Barbados: a prospective, qualitative study of stakeholder perceptions

    PubMed Central

    2013-01-01

    Background Medical tourism is a global health practice where patients travel internationally with the intention of receiving medical services. A range of low, middle, and high income countries are encouraging investment in the medical tourism sector, including countries in the Caribbean targeting patients in North America and Europe. While medical tourism has the potential to provide economic and employment opportunities in destination countries, there are concerns that it could encourage the movement of health workers from the public to private health sector. Methods We present findings from 19 semi-structured interviews with stakeholders across the public health care, private health care, government, allied business, and civil society sectors. These interviews were conducted in-person in Barbados and via phone. The interview transcripts were coded and a thematic analysis developed. Results Three themes were identified: 1) Stakeholder perceptions of the patterns and plans for health human resource usage by current and planned medical tourism facilities in Barbados. We found that while health human resource usage in the medical tourism sector has been limited, it is likely to grow in the future; 2) Anticipated positive impacts of medical tourism on health human resources and access to care in the public system. These benefits included improved quality control, training opportunities, and health worker retention; and 3) Anticipated negative impacts of medical tourism on health human resources and access to care in the public system. These impacts included longer wait times for care and a shift in planning priorities driven by the medical tourism sector. Conclusions Stakeholders interviewed who were connected to medical tourism expansion or the tourism sector took a generally positive view of the likely impacts of medical tourism on health human resources in Barbados. However, stakeholders associated with the public health system and health equity expressed concern

  2. Environmental justice and U.S. Forest Service hazardous fuels reduction: A spatial method for impact assessment of federal resource management actions

    Treesearch

    Mark D.O. Adams; Susan Charnley

    2018-01-01

    Natural resource managers of federal lands in the USA are often tasked with various forms of social and economic impact analysis. Federal agencies in the USA also have a mandate to analyze the potential environmental justice consequences of their activities. Relatively little is known about the environmental justice impacts of natural resource management in rural areas...

  3. Adverse life events in elderly patients with major depression or dysthymic disorder and in healthy-control subjects.

    PubMed

    Devanand, D P; Kim, Min Kyung; Paykina, Natalya; Sackeim, Harold A

    2002-01-01

    The authors compared elderly outpatients (> or =60 years) with major depression or dysthymic disorder and healthy-control subjects on the type and subjective impact of adverse life events. The Geriatric Adverse Life Events Scale (GALES) was developed for this purpose. Fifty patients with major depression, 79 patients with dysthymic disorder, and 40 healthy controls completed the GALES. Adverse life events during two time periods were assessed: the year before the evaluation, and the year before onset of the index episode (patients only). During the year before evaluation, patients with major depression reported more life events with greater negative impact, particularly for interpersonal conflicts, and dysthymic patients scored intermediate between patients and controls. Sum scores for perceived stress and negative impact on mood differed significantly among the groups: highest for major depression, intermediate for dysthymic disorder, and lowest for controls. During the year before onset, patients with major depression reported significantly higher sum scores for negative impact on mood than patients with dysthymic disorder. On several measures, patients with major depression perceived greater negative impact of life events than patients with dysthymic disorder and healthy controls, particularly for interpersonal conflicts. The subjective impact of adverse life events may play an important role in the expression of depressive illness in elderly patients, particularly in major depression, and it needs to be considered in clinical management.

  4. Methodology for computing the burden of disease of adverse events following immunization.

    PubMed

    McDonald, Scott A; Nijsten, Danielle; Bollaerts, Kaatje; Bauwens, Jorgen; Praet, Nicolas; van der Sande, Marianne; Bauchau, Vincent; de Smedt, Tom; Sturkenboom, Miriam; Hahné, Susan

    2018-03-24

    Composite disease burden measures such as disability-adjusted life-years (DALY) have been widely used to quantify the population-level health impact of disease or injury, but application has been limited for the estimation of the burden of adverse events following immunization. Our objective was to assess the feasibility of adapting the DALY approach for estimating adverse event burden. We developed a practical methodological framework, explicitly describing all steps involved: acquisition of relative or absolute risks and background event incidence rates, selection of disability weights and durations, and computation of the years lived with disability (YLD) measure, with appropriate estimation of uncertainty. We present a worked example, in which YLD is computed for 3 recognized adverse reactions following 3 childhood vaccination types, based on background incidence rates and relative/absolute risks retrieved from the literature. YLD provided extra insight into the health impact of an adverse event over presentation of incidence rates only, as severity and duration are additionally incorporated. As well as providing guidance for the deployment of DALY methodology in the context of adverse events associated with vaccination, we also identified where data limitations potentially occur. Burden of disease methodology can be applied to estimate the health burden of adverse events following vaccination in a systematic way. As with all burden of disease studies, interpretation of the estimates must consider the quality and accuracy of the data sources contributing to the DALY computation. © 2018 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd.

  5. Analyses of impacts of China's international trade on its water resources and uses

    NASA Astrophysics Data System (ADS)

    Zhang, Z. Y.; Yang, H.; Shi, M. J.; Zehnder, A. J. B.; Abbaspour, K. C.

    2011-04-01

    This study provides an insight into the impact of China's international trade of goods and services on its water resources and uses. Virtual water flows associated with China's international trade are quantified in an input-output framework. The analysis is scaled down to the sectoral and provincial levels to trace the origins and destinations of virtual water flows associated with the international trade. The results reveal that China is a net virtual water exporter of 4.7 × 1010 m3 year-1, accounting for 2.1% of its total water resources and 8.9% of the total water use. Water scarce regions tend to have higher percentages of virtual water export relative to their water resources and water uses. In the water scarce Huang-Huai-Hai region, the net virtual water export accounts for 7.9% of the region's water resources and 11.2% of its water uses. For individual sectors, major net virtual water exporters are those where agriculture provides raw materials in the initial process of the production chain and/or pollution intensity is high. The results suggest that China's economic gains from being a world "manufacture factory" have come at a high cost to its water resources and through pollution to its environment.

  6. Global impacts of energy demand on the freshwater resources of nations.

    PubMed

    Holland, Robert Alan; Scott, Kate A; Flörke, Martina; Brown, Gareth; Ewers, Robert M; Farmer, Elizabeth; Kapos, Valerie; Muggeridge, Ann; Scharlemann, Jörn P W; Taylor, Gail; Barrett, John; Eigenbrod, Felix

    2015-12-01

    The growing geographic disconnect between consumption of goods, the extraction and processing of resources, and the environmental impacts associated with production activities makes it crucial to factor global trade into sustainability assessments. Using an empirically validated environmentally extended global trade model, we examine the relationship between two key resources underpinning economies and human well--being-energy and freshwater. A comparison of three energy sectors (petroleum, gas, and electricity) reveals that freshwater consumption associated with gas and electricity production is largely confined within the territorial boundaries where demand originates. This finding contrasts with petroleum, which exhibits a varying ratio of territorial to international freshwater consumption, depending on the origin of demand. For example, although the United States and China have similar demand associated with the petroleum sector, international freshwater consumption is three times higher for the former than the latter. Based on mapping patterns of freshwater consumption associated with energy sectors at subnational scales, our analysis also reveals concordance between pressure on freshwater resources associated with energy production and freshwater scarcity in a number of river basins globally. These energy-driven pressures on freshwater resources in areas distant from the origin of energy demand complicate the design of policy to ensure security of fresh water and energy supply. Although much of the debate around energy is focused on greenhouse gas emissions, our findings highlight the need to consider the full range of consequences of energy production when designing policy.

  7. Global impacts of energy demand on the freshwater resources of nations

    PubMed Central

    Holland, Robert Alan; Scott, Kate A.; Flörke, Martina; Brown, Gareth; Ewers, Robert M.; Farmer, Elizabeth; Kapos, Valerie; Muggeridge, Ann; Taylor, Gail; Barrett, John; Eigenbrod, Felix

    2015-01-01

    The growing geographic disconnect between consumption of goods, the extraction and processing of resources, and the environmental impacts associated with production activities makes it crucial to factor global trade into sustainability assessments. Using an empirically validated environmentally extended global trade model, we examine the relationship between two key resources underpinning economies and human well-being—energy and freshwater. A comparison of three energy sectors (petroleum, gas, and electricity) reveals that freshwater consumption associated with gas and electricity production is largely confined within the territorial boundaries where demand originates. This finding contrasts with petroleum, which exhibits a varying ratio of territorial to international freshwater consumption, depending on the origin of demand. For example, although the United States and China have similar demand associated with the petroleum sector, international freshwater consumption is three times higher for the former than the latter. Based on mapping patterns of freshwater consumption associated with energy sectors at subnational scales, our analysis also reveals concordance between pressure on freshwater resources associated with energy production and freshwater scarcity in a number of river basins globally. These energy-driven pressures on freshwater resources in areas distant from the origin of energy demand complicate the design of policy to ensure security of fresh water and energy supply. Although much of the debate around energy is focused on greenhouse gas emissions, our findings highlight the need to consider the full range of consequences of energy production when designing policy. PMID:26627262

  8. Childhood Adversity, Religion, and Change in Adult Mental Health.

    PubMed

    Jung, Jong Hyun

    2018-02-01

    Research indicates that childhood adversity is associated with poor mental health in adulthood. The purpose of this study is to examine whether the deleterious long-term effects of childhood adversity on adult mental health are reduced for individuals who are involved in religious practices. Using longitudinal data from a representative sample of American adults ( N = 1,635), I find that religious salience and spirituality buffer the noxious effects of childhood abuse on change in positive affect over time. By contrast, these stress-buffering properties of religion fail to emerge when negative affect serves as the outcome measure. These results underscore the importance of religion as a countervailing mechanism that blunts the negative impact of childhood abuse on adult mental health over time. I discuss the theoretical implications of these findings for views about religion, childhood adversity, and mental health.

  9. Risk factors for alcoholism in the Oklahoma Family Health Patterns project: impact of early life adversity and family history on affect regulation and personality.

    PubMed

    Sorocco, Kristen H; Carnes, Nathan C; Cohoon, Andrew J; Vincent, Andrea S; Lovallo, William R

    2015-05-01

    This study examined the impact of early lifetime adversity (ELA) on affect regulation and personality in persons with family history (FH+) and without (FH-) a family history of alcoholism. We examined the impact of early life adversity in healthy young adults, 18-30 years of age enrolled in a long-term study on risk for alcohol and other substance abuse. ELA was assessed by a composite score of low socioeconomic status and personal experience of physical or sexual abuse and/or separation from parents before age 16, resulting in a score of 0, 1-2, or >3 adverse events. Unstable affect regulation and personality variables were obtained via self-report measures. Higher ELA scores were seen in FH+ (χ(2)=109.2, p<0.0001) and in women (χ(2)=17.82, p=0.0019). Although higher ELA predicted less emotional stability and more behavioral undercontrol, further analysis including both FH and ELA showed that FH+ persons are prone to poor affect regulation, negative moods, and have risky drinking and drug abuse tendencies independent of ELA level. ELA predicts reduced stress reactivity and poorer cognitive control over impulsive behaviors as shown elsewhere. The present work shows that FH+ have poor mood regulation and antisocial characteristics. The greater prevalence of ELA in FH+ persons indicates that life experience and FH+ work in tandem to result in risky patterns of alcohol and drug experimentation to elevate risk for alcoholism. Further studies of genetic and environmental contributions to alcoholism are called for. Published by Elsevier Ireland Ltd.

  10. The Impact of Adverse Childhood Experiences on an Urban Pediatric Population

    ERIC Educational Resources Information Center

    Burke, Nadine J.; Hellman, Julia L.; Scott, Brandon G.; Weems, Carl F.; Carrion, Victor G.

    2011-01-01

    Objective: The goal of this study was to investigate the adverse childhood experiences (ACEs) in youth in a low-income, urban community. Study design: Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. Medical chart documentation of ACEs as defined in previous studies were…

  11. Geospatial Strategy for Adverse Impact of Urban Heat Island in upper atmospheres of the earth Mountain Areas using LANDSAT ETM+ Sensors

    NASA Astrophysics Data System (ADS)

    Kumar, Amit; Vandana, Vandana

    2016-07-01

    We are living in the age of the rapidly growing population and changing environmental conditions with advanced technical capacity. This has been resulting in widespread land cover change. Among several human-induced environmental and urban thermal problems are reported to be negatively affecting urban residents in many ways. Urban Heat Islands exist in many large cities especially metropolitan cities and can significantly affect the permafrost layer in mountain areas. The adverse effect of urban heat island has become the subject of numerous studies in recent decades and is reflected in many major mountain cities around the world. The built-up structures in urbanized areas considerably alter land cover thereby affecting thermal energy flow which leads to the development of elevated surface and air temperature. The phenomenon Urban Heat Island implies 'island' of high temperature in cities, surrounded by relatively lower temperature in rural areas. The Urban Heat Island for the temporal period is estimated using geospatial techniques which are then utilized for the impact assessment of the climate of the surrounding regions and how it reduce the sustainability of the natural resources like air, vegetation. The knowledge of surface temperature is important for the study of urban climate and human health. The rapid growth of industries in peri-urban areas results in excessive warming and variations in weather conditions. It leads to soil degradation in frozen areas due to high temperature which leads to melting of snow in mountain areas Remotely sensed data of thermal infrared band in the region of 10.4-12.5 µm of EMR spectrum, available from LANDSAT- ETM+ is proved to be very helpful to identify urban heat islands. Thermal infrared data acquired during the daytime and night time can be used to monitor the heat island associated with urban areas as well as atmospheric pollution. The present paper describes the methodology and resolution dynamic urban heat island

  12. Impact of the HLA-B(*)58:01 Allele and Renal Impairment on Allopurinol-Induced Cutaneous Adverse Reactions.

    PubMed

    Ng, Chau Yee; Yeh, Yu-Ting; Wang, Chuang-Wei; Hung, Shuen-Iu; Yang, Chih-Hsun; Chang, Ya-Ching; Chang, Wan-Chun; Lin, Yu-Jr; Chang, Chee-Jen; Su, Shih-Chi; Fan, Wen-Lang; Chen, Der-Yuan; Wu, Yeong-Jian Jan; Tian, Ya-Chung; Hui, Rosaline Chung-Yee; Chung, Wen-Hung

    2016-07-01

    Allopurinol, a common drug for treating hyperuricemia, is associated with cutaneous adverse drug reactions ranging from mild maculopapular exanthema to life-threatening severe cutaneous adverse reactions, including drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis. We have previously reported that HLA-B*58:01 is strongly associated with allopurinol-induced severe cutaneous adverse reactions in Han Chinese, but the associations of the HLA-B*58:01 genotype in an allopurinol-induced hypersensitivity phenotype remain unclear. To investigate the comprehensive associations of HLA-B*58:01, we enrolled 146 patients with allopurinol-induced cutaneous adverse drug reactions (severe cutaneous adverse reactions, n = 106; maculopapular exanthema, n = 40) and 285 allopurinol-tolerant control subjects. Among these allopurinol-induced cutaneous adverse drug reactions, HLA-B*58:01 was strongly associated with severe cutaneous adverse reactions (odds ratio [OR] = 44.0; 95% confidence interval = 21.5-90.3; P = 2.6 × 10(-41)), and the association was correlated with disease severity (OR = 44.0 for severe cutaneous adverse reactions, OR = 8.5 for maculopapular exanthema). The gene dosage effect of HLA-B*58:01 also influenced the development of allopurinol-induced cutaneous adverse drug reactions (OR = 15.25 for HLA-B*58:01 heterozygotes and OR = 72.45 for homozygotes). Furthermore, coexistence of HLA-B*58:01 and renal impairment increased the risk and predictive accuracy of allopurinol-induced cutaneous adverse drug reactions (heterozygous HLA-B*58:01 and normal renal function: OR = 15.25, specificity = 82%; homozygous HLA-B*58:01 and severe renal impairment: OR = 1269.45, specificity = 100%). This HLA-B*58:01 correlation study suggests that patients with coexisting HLA-B*58:01 and renal impairment (especially estimated glomerular filtration rate < 30ml/minute/1.73 m(2)) should be cautious and avoid using

  13. Coal mining and the resource community cycle: A longitudinal assessment of the social impacts of the Coppabella coal mine

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lockie, S.; Franettovich, M.; Petkova-Timmer, V.

    Two social impact assessment (SIA) studies of Central Queensland's Coppabella coal mine were undertaken in 2002-2003 and 2006-2007. As ex post studies of actual change, these provide a reference point for predictive assessments of proposed resource extraction projects at other sites, while the longitudinal element added by the second study illustrates how impacts associated with one mine may vary over time due to changing economic and social conditions. It was found that the traditional coupling of local economic vitality and community development to the life cycle of resource projects - the resource community cycle - was mediated by labour recruitmentmore » and social infrastructure policies that reduced the emphasis on localised employment and investment strategies. and by the cumulative impacts of multiple mining projects within relative proximity to each other. The resource community cycle was accelerated and local communities forced to consider ways of attracting secondary investment and/or alternative industries early in the operational life of the Coppabella mine in order to secure significant economic benefits and to guard against the erosion of social capital and the ability to cope with future downturns in the mining sector.« less

  14. During stress, heart rate variability moderates the impact of childhood adversity in women with breast cancer.

    PubMed

    Tell, Dina; Mathews, Herbert L; Burr, Robert L; Witek Janusek, Linda

    2018-03-01

    Childhood adversity has long-lasting neuro-biological effects that can manifest as exaggerated stress responsivity to environmental challenge. These manifestations include a dysregulated hypothalamic-pituitary-adrenocortical (HPA) axis as well as increased levels of inflammatory mediators in response to stress. In this investigation, vagal parasympathetic activity was assessed for its capacity to moderate the relationship between childhood adversity and stress responsivity (cortisol and inflammation) during an acute laboratory challenge (Trier Social Stress Test-TSST). Thirty women recently diagnosed with breast cancer underwent the TSST during which their heart rate was recorded and saliva samples collected for measurement of cortisol and the proinflammatory cytokine, IL-6. Vagal activity during the TSST was calculated as the high-frequency (HF) component of heart rate variability (HRV). Vagal activity during the TSST moderated the effect of childhood adversity on both the cortisol and the IL-6 response. Women who had lower vagal stress-reactivity during the TSST and reported greater childhood adversity showed a larger rise in cortisol and IL-6 when compared to women with lower childhood adversity. The findings demonstrate that women with exposure to childhood adversity and low vagal stress-reactivity (reduced parasympathetic activity) exhibit an elevated stress response characterized by greater cortisol and proinflammatory cytokine release. Inflammatory burden and HPA dysregulation subsequent to stress may impair cancer control.

  15. How much will be economic impact of climate change on water resources? A Meta-Analytic Review of previous literature

    NASA Astrophysics Data System (ADS)

    Yoshikawa, S.; Iseri, Y.; Kanae, S.

    2016-12-01

    Water resources is vital in social and economic activities. Total global water use is increasing, mainly due to economic and population growth in developing countries. It has one of risk with high agreement and robust evidence that freshwater-related risks of climate change increase significantly with increasing greenhouse gas concentrations. It is difficult to compare the risk with other field risk (e.g. agriculture, forestry, sea level rise) for considering both adaptation and mitigation policy with the level of decision makers and public servants. Economic impacts of climate change on water scarcity has been estimated by economic researchers. We have no certainty at all about integration between hydrological and economical fields on global scale. In this study, we highlight key concerns about conventional estimations of economic impact on water resources through meta-analysis. The economic impact on water resource in same base year using consumer price index is shown with increase in the global mean temperature. We clarified four concerns which are involved in 1) classification of economic mechanism, 2) estimated items of economic impact, 3) difference in estimating equations, and 4) definition of parameters related with economic impact of climate change. This study would be essential to next challenge as transdisciplinary research between hydrologic and economic fields.

  16. Application of scenario-neutral methods to quantify impacts of climate change on water resources in East Africa

    NASA Astrophysics Data System (ADS)

    Ascott, M.; Macdonald, D.; Lapworth, D.; Tindimugaya, C.

    2017-12-01

    Quantification of the impact of climate change on water resources is essential for future resource planning. Unfortunately, climate change impact studies in African regions are often hindered by the extent in variability in future rainfall predictions, which also diverge from current drying trends. To overcome this limitation, "scenario-neutral" methods have been developed which stress a hydrological system using a wide range of climate futures to build a "climate response surface". We developed a hydrological model and scenario-neutral framework to quantify climate change impacts on river flows in the Katonga catchment, Uganda. Using the lumped catchment model GR4J, an acceptable calibration to historic daily flows (1966 - 2010, NSE = 0.69) was achieved. Using a delta change approach, we then systematically changed rainfall and PET inputs to develop response surfaces for key metrics, developed with Ugandan water resources planners (e.g. Q5, Q95). Scenarios from the CMIP5 models for 2030s and 2050s were then overlain on the response surface. The CMIP5 scenarios show consistent increases in temperature but large variability in rainfall increases, which results in substantial variability in increases in river flows. The developed response surface covers a wide range of climate futures beyond the CMIP5 projections, and can help water resources planners understand the sensitivity of water resource systems to future changes. When future climate scenarios are available, these can be directly overlain on the response surface without the need to re-run the hydrological model. Further work will consider using scenario-neutral approaches in more complex, semi-distributed models (e.g. SWAT), and will consider land use and socioeconomic change.

  17. All Unhappy Childhoods Are Unhappy in Their Own Way—Differential Impact of Dimensions of Adverse Childhood Experiences on Adult Mental Health and Health Behavior

    PubMed Central

    Westermair, Anna L.; Stoll, Anne M.; Greggersen, Wiebke; Kahl, Kai G.; Hüppe, Michael; Schweiger, Ulrich

    2018-01-01

    Adverse childhood experiences have consistently been linked with poor mental and somatic health in adulthood. However, due to methodological restraints of the main lines of research using cumulative or selective models, little is known about the differential impact of different dimensions of adverse childhood experiences. Therefore, we gathered data from 396 psychiatric in-patients on the Adverse Childhood Experiences (ACE) questionnaire, extracted dimensions using factor analysis and compared this dimensional model of adverse childhood experiences to cumulative and selective models. Household Dysfunction (violence against the mother, parental divorce, substance abuse or incarceration of a household member) was associated with poor health behaviors (smoking, alcohol dependency and obesity as proxy marker for an imbalance between energy intake and physical activity) and with poorer socio-economic achievement (lower education and income) in adulthood. The previously reported associations of maltreatment and sexual abuse with these outcome criteria could not be corroborated. Both Maltreatment (emotional and physical neglect and abuse) and Sexual Abuse predicted BPD, PTSD and suicidal behavior. However, the two ACE dimensions showed sufficiently divergent validity to warrant separate consideration in future studies: Maltreatment was associated with affective and anxiety disorders such as social phobia, panic disorder and major depressive disorder, whereas Sexual Abuse was associated with dysregulation of bodily sensations such as pain intensity and hunger/satiation. Also, we found both quantitative and qualitative evidence for the superiority of the dimensional approach to exploring the consequences of adverse childhood experiences in comparison to the cumulative and selective approaches. PMID:29875707

  18. [Management of adverse drug effects].

    PubMed

    Schlienger, R G

    2000-09-01

    Adverse drug reactions (ADRs) are still considered one of the main problems of drug therapy. ADRs are associated with considerable morbidity, mortality, decreased compliance and therapeutic success as well as high direct and indirect medical costs. Several considerations have to come into play when managing a potential ADR. It is critical to establish an accurate clinical diagnosis of the adverse event. Combining information about drug exposure together with considering other possible causes of the reaction is crucial to establish a causal relationship between the reaction and the suspected drug. Identification of the underlying pathogenesis of an ADR together with the severity of the reaction will have profound implications on continuation of drug therapy after an ADR. Since spontaneous reports about ADRs are a key stone of a functioning post-marketing surveillance system and therefore play a key role in improving drug safety, health care professionals are highly encouraged to report ADRs to a local or national organization. However, because the majority of ADRs is dose-dependent and therefore preventable, individualization of pharmacotherapy may have a major impact on reducing such events.

  19. Childhood social adversity and risk of depressive symptoms in adolescence in a US national sample.

    PubMed

    Björkenstam, Emma; Pebley, Anne R; Burström, Bo; Kosidou, Kyriaki

    2017-04-01

    Childhood social adversity has been associated with an increased risk of depression and other psychiatric disorders in adolescence and early adulthood. However, the role of timing and accumulation of adversities has not yet been established in longitudinal studies. We examined the association between childhood adversities and adolescent depressive symptoms, and the impact of timing and accumulation of adversity. Longitudinal data were obtained from the Child Development Supplement to the Panel Study of Income Dynamics (n=2223), a nationally representative survey of US families that incorporates data from parents and their children. Negative binomial regression analysis was used to estimate effects of childhood social adversity on adolescent depressive symptoms, presented as Incidence Rate Ratios with 95% confidence intervals. Children exposed to social adversity reported higher levels of adolescent depressive symptoms captured by two depression scales. Single-parent household and residential instability were particularly associated with depressive symptoms. A positive relationship was found between cumulative adversity and the risk of adolescent depression. The timing of exposure appeared to have little effect on the risk of adolescent depressive symptoms. The structure of the data implies that alternative causal pathways cannot be fully discounted. The self- or parent-reported data is subject to recall bias. Our findings support the long-term negative impact of childhood adversity on adolescent depressive symptoms, regardless of when in childhood the adversity occurs. Policies and interventions to reduce adolescent depressive symptoms need to consider the social background of the family as an important risk or protective factor. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Modeling Major Adverse Outcomes of Pediatric and Adult Patients With Congenital Heart Disease Undergoing Cardiac Catheterization: Observations From the NCDR IMPACT Registry (National Cardiovascular Data Registry Improving Pediatric and Adult Congenital Treatment).

    PubMed

    Jayaram, Natalie; Spertus, John A; Kennedy, Kevin F; Vincent, Robert; Martin, Gerard R; Curtis, Jeptha P; Nykanen, David; Moore, Phillip M; Bergersen, Lisa

    2017-11-21

    Risk standardization for adverse events after congenital cardiac catheterization is needed to equitably compare patient outcomes among different hospitals as a foundation for quality improvement. The goal of this project was to develop a risk-standardization methodology to adjust for patient characteristics when comparing major adverse outcomes in the NCDR's (National Cardiovascular Data Registry) IMPACT Registry (Improving Pediatric and Adult Congenital Treatment). Between January 2011 and March 2014, 39 725 consecutive patients within IMPACT undergoing cardiac catheterization were identified. Given the heterogeneity of interventional procedures for congenital heart disease, new procedure-type risk categories were derived with empirical data and expert opinion, as were markers of hemodynamic vulnerability. A multivariable hierarchical logistic regression model to identify patient and procedural characteristics predictive of a major adverse event or death after cardiac catheterization was derived in 70% of the cohort and validated in the remaining 30%. The rate of major adverse event or death was 7.1% and 7.2% in the derivation and validation cohorts, respectively. Six procedure-type risk categories and 6 independent indicators of hemodynamic vulnerability were identified. The final risk adjustment model included procedure-type risk category, number of hemodynamic vulnerability indicators, renal insufficiency, single-ventricle physiology, and coagulation disorder. The model had good discrimination, with a C-statistic of 0.76 and 0.75 in the derivation and validation cohorts, respectively. Model calibration in the validation cohort was excellent, with a slope of 0.97 (standard error, 0.04; P value [for difference from 1] =0.53) and an intercept of 0.007 (standard error, 0.12; P value [for difference from 0] =0.95). The creation of a validated risk-standardization model for adverse outcomes after congenital cardiac catheterization can support reporting of risk

  1. Patients' Perceptions of Physician-Patient Discussions and Adverse Events with Cancer Therapy.

    PubMed

    Hershman, Dawn; Calhoun, Elizabeth; Zapert, Kinga; Wade, Shawn; Malin, Jennifer; Barron, Rich

    2008-09-01

    OBJECTIVES: Patients with cancer who are treated with chemotherapy report adverse events during their treatment, which can affect their quality of life and increase the likelihood that their treatment will not be completed. In this study, patients' perceptions of the physician-patient relationship and communication about cancer-related issues, particularly adverse events were examined. METHODS: We surveyed 508 patients with cancer concerning the occurrence of adverse events and their relationship and communication with their physicians regarding cancer, treatment, and adverse events. RESULTS: Most individuals surveyed (>90%) discussed diagnosis, treatment plan, goals, and schedule, and potential adverse events with their physicians before initiating chemotherapy; approximately 75% of these individuals understood these topics completely or very well. Physician-patient discussions of adverse events were common, with tiredness, nausea and vomiting, and loss of appetite discussed prior to chemotherapy in over 80% of communications. These events were also the most often experienced (ranging in 95% to 64% of the respondents) along with low white blood cell counts (WBCs), which were experienced in 67% of respondents. Approximately 75% of the individuals reported that their overall quality of life was affected by adverse events. CONCLUSIONS: These findings suggest that discussions alone do not provide patients with sufficient understanding of the events, nor do they appear to adequately equip patients to cope with them. Therefore, efforts to improve cancer care should focus on developing tools to improve patients' understanding of the toxicities of chemotherapy, as well as providing resources to reduce the effects of adverse events.

  2. Dietary Supplement Adverse Event Report Data From the FDA Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS), 2004-2013.

    PubMed

    Timbo, Babgaleh B; Chirtel, Stuart J; Ihrie, John; Oladipo, Taiye; Velez-Suarez, Loy; Brewer, Vickery; Mozersky, Robert

    2018-05-01

    The Food and Drug Administration (FDA)'s Center for Food Safety and Applied Nutrition (CFSAN) oversees the safety of the nation's foods, dietary supplements, and cosmetic products. To present a descriptive analysis of the 2004-2013 dietary supplement adverse event report (AER) data from CAERS and evaluate the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act as pertaining to dietary supplements adverse events reporting. We queried CAERS for data from the 2004-2013 AERs specifying at least 1 suspected dietary supplement product. We extracted the product name(s), the symptom(s) reported, age, sex, and serious adverse event outcomes. We examined time trends for mandatory and voluntary reporting and performed analysis using SAS v9.4 and R v3.3.0 software. Of the total AERs (n = 15 430) received from January 1, 2004, through December 31, 2013, indicating at least 1 suspected dietary supplement product, 66.9% were mandatory, 32.2% were voluntary, and 0.9% were both mandatory and voluntary. Reported serious outcomes included death, life-threatening conditions, hospitalizations, congenital anomalies/birth defects and events requiring interventions to prevent permanent impairments (5.1%). The dietary supplement adverse event reporting rate in the United States was estimated at ~2% based on CAERS data. This study characterizes CAERS dietary supplement adverse event data for the 2004-2013 period and estimates a reporting rate of 2% for dietary supplement adverse events based on CAERS data. The findings show that the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act had a substantial impact on the reporting of adverse events.

  3. Impact of water allocation strategies to manage groundwater resources in Western Australia: Equity and efficiency considerations

    NASA Astrophysics Data System (ADS)

    Iftekhar, Md Sayed; Fogarty, James

    2017-05-01

    In many parts of the world groundwater is being depleting at an alarming rate. Where groundwater extraction is licenced, regulators often respond to resource depletion by reducing all individual licences by a fixed proportion. This approach can be effective in achieving a reduction in the volume of water extracted, but the approach is not efficient. In water resource management the issue of the equity-efficiency trade-off has been explored in a number of contexts, but not in the context of allocation from a groundwater system. To contribute to this knowledge gap we conduct an empirical case study for Western Australia's most important groundwater system: the Gnangara Groundwater System (GGS). Resource depletion is a serious issue for the GGS, and substantial reductions in groundwater extraction are required to stabilise the system. Using an individual-based farm optimization model we study both the overall impact and the distributional impact of a fixed percentage water allocation cut to horticulture sector licence holders. The model is parameterised using water licence specific data on farm area and water allocation. The modelling shows that much of the impact of water allocation reductions can be mitigated through changing the cropping mix and the irrigation technology used. The modelling also shows that the scope for gains through the aggregation of holdings into larger farms is much greater than the potential losses due to water allocation reductions. The impact of water allocation cuts is also shown to impact large farms more than small farms. For example, the expected loss in net revenue per ha for a 10-ha farm is around three times the expected loss per ha for a 1-ha farm; and the expected loss per ha for a 25-ha farm is around five times the expected loss per ha for a 1-ha farm.

  4. Potential Impact of Bioenergy Demand on the Sustainability of the Southern Forest Resource

    Treesearch

    Karen L. Abt; Robert C. Abt

    2012-01-01

    The use of woody biomass for the production of domestic bioenergy to meet policy-driven demands could lead to significant changes in the forest resource. These impacts may be limited if woody biomass from forests is defined as only the residues from logging. Yet, if only residue is used, the contribution of woody biomass to a renewable energy portfolio will also be...

  5. Environmental Impact Statement, Aubrey Lake, Elm Fork, Trinity River, Texas.

    DTIC Science & Technology

    1973-01-01

    the most expensive site location studied. For recreation, site 4 is equal to sites 1 and 2, but less desirable than site 3. V- 9 ( 5 ) Summay. An...IV-3 9 . Agricultural Resources IV-3 10. Adverse Impacts on the Lewisville Lake Project IV- 4 Section V - Alternatives to the Proposed Action 1. No...Elements V- 4 e. Recreational Elements V- 5 2. Alternatives That Will Meet All of the Authorized Project Purposes V- 5 a. Alternate Damsite Locations V-6

  6. Linking niche theory to ecological impacts of successful invaders: insights from resource fluctuation-specialist herbivore interactions.

    PubMed

    Gidoin, Cindy; Roques, Lionel; Boivin, Thomas

    2015-03-01

    Theories of species coexistence and invasion ecology are fundamentally connected and provide a common theoretical framework for studying the mechanisms underlying successful invasions and their ecological impacts. Temporal fluctuations in resource availability and differences in life-history traits between invasive and resident species are considered as likely drivers of the dynamics of invaded communities. Current critical issues in invasion ecology thus relate to the extent to which such mechanisms influence coexistence between invasive and resident species and to the ability of resident species to persist in an invasive-dominated ecosystem. We tested how a fluctuating resource, and species trait differences may explain and help predict long-term impacts of biological invasions in forest specialist insect communities. We used a simple invasion system comprising closely related invasive and resident seed-specialized wasps (Hymenoptera: Torymidae) competing for a well-known fluctuating resource and displaying divergent diapause, reproductive and phenological traits. Based on extensive long-term field observations (1977-2010), we developed a combination of mechanistic and statistical models aiming to (i) obtain a realistic description of the population dynamics of these interacting species over time, and (ii) clarify the respective contributions of fluctuation-dependent and fluctuation-independent mechanisms to long-term impact of invasion on the population dynamics of the resident wasp species. We showed that a fluctuation-dependent mechanism was unable to promote coexistence of the resident and invasive species. Earlier phenology of the invasive species was the main driver of invasion success, enabling the invader to exploit an empty niche. Phenology also had the greatest power to explain the long-term negative impact of the invasive on the resident species, through resource pre-emption. This study provides strong support for the critical role of species

  7. Plan to Study the Potential Impacts of Hydraulic Fracturing on Drinking Water Resources (Monterey, CA)

    EPA Science Inventory

    A summary of EPA's research relating to potential impacts of hydraulic fracturing on drinking water resources will be presented. Background about the study plan development will be presented along with an analysis of the water cycle as it relates to hydraulic fracturing processe...

  8. Impact of climate change on water resources in South Sikkim, India

    NASA Astrophysics Data System (ADS)

    Vishwakarma, C. A.; Pant, M.; Asthana, H.; Singh, P.; Rena, V.; Mukherjee, S.

    2016-12-01

    The Intergovernmental Panel on Climate Change (IPCC) estimates that the global mean temperature has increased by 0.6 ± 0.2°C since 1861 and predicts an increase of 2 to 4° C over the next 100 years. The direct effect of climate change on groundwater resources depends on the variation in the volume and distribution of groundwater and its recharge. Ingty and Bawa (2012) have summarized the detailed observation of climate change and its impact on biodiversity and natural resources in the Lachen valley, Sikkim using weather-based indicator of climate change like lesser snowfall, shifts in seasonal timing, uneven rainfall, accelerated glacial melt, and drying of water sources. South Sikkim is the most drought-prone area of the state and this is worst hit district by climate change. In Sikkim, more than three-fourths people feel that the water resources are drying up and out of them 60.2% believe that there is less snow at present time rather than the past. The subsurface aquifers are mainly recharged by precipitation or through the interaction of surface water bodies like lakes, glaciers, streams and rivers. But due to the effect of climate change the rate of precipitation and snow cover melting, the water scarcity problem had started. According to Indian Meteorological Department (Namthang AWS, South Sikkim), the annual precipitation has decreased from 2533 mm to 1503 mm. Spring is the main source of water in South Sikkim and most of the spring have become seasonal or dried. The average spring discharge data in the year 2000 was 100.18 l/m and after ten years it decreased by 26.12 l/m. With the decrease in precipitation and spring discharge, the agriculture productivity also get affected and it affect the socio-economic condition of South district. This study looks into various factors impacting the discharge at springs highlighting the effect of climate change induced precipitation pattern and land cover dynamics using SLURP (Semi-distributed Land Use based Runoff

  9. A signal detection method for temporal variation of adverse effect with vaccine adverse event reporting system data.

    PubMed

    Cai, Yi; Du, Jingcheng; Huang, Jing; Ellenberg, Susan S; Hennessy, Sean; Tao, Cui; Chen, Yong

    2017-07-05

    statistical power to detect the variation in reporting rates across years. The identified vaccine-event combinations with significant different reporting rates over years suggested potential safety issues due to changes in vaccines which require further investigation. We developed a statistical model to detect safety signals arising from heterogeneity of reporting rates of a given vaccine-event combinations across reporting years. This method detects variation in reporting rates over years with high power. The temporal trend of reporting rate across years may reveal the impact of vaccine update on occurrence of adverse events and provide evidence for further investigations.

  10. A Review of the Effects of Chronic Arsenic Exposure on Adverse Pregnancy Outcomes.

    PubMed

    Milton, Abul H; Hussain, Sumaira; Akter, Shahnaz; Rahman, Mijanur; Mouly, Tafzila A; Mitchell, Kane

    2017-05-23

    Exposure to arsenic has a number of known detrimental health effects but impact on pregnancy outcomes is not as widely recognized. This narrative review examines existing epidemiological evidence investigating the association between arsenic exposure via drinking water and adverse pregnancy outcomes. We reviewed published epidemiological studies from around the world on impact of chronic arsenic exposure on spontaneous abortion, stillbirth, neonatal death, post neonatal death, low birth weight and preterm baby. Plausible mechanisms of arsenic toxicity causing adverse pregnancy outcomes were also determined through literature review. There is convincing evidence to support the association between high inorganic arsenic exposure (>50 ppb) and spontaneous abortion, stillbirth and low birth weight. Limitations of certain studies include study design, small sample size, recall constraints and exposure assessment. There needs to be further research investigating the dose metered impact of arsenic exposure on pregnancy outcomes. Further research on impact of low-moderate arsenic concentration exposure on pregnancy outcomes will allow for appropriate public health policy recommendations.

  11. A Review of the Effects of Chronic Arsenic Exposure on Adverse Pregnancy Outcomes

    PubMed Central

    Milton, Abul H.; Hussain, Sumaira; Akter, Shahnaz; Rahman, Mijanur; Mouly, Tafzila A.; Mitchell, Kane

    2017-01-01

    Exposure to arsenic has a number of known detrimental health effects but impact on pregnancy outcomes is not as widely recognized. This narrative review examines existing epidemiological evidence investigating the association between arsenic exposure via drinking water and adverse pregnancy outcomes. We reviewed published epidemiological studies from around the world on impact of chronic arsenic exposure on spontaneous abortion, stillbirth, neonatal death, post neonatal death, low birth weight and preterm baby. Plausible mechanisms of arsenic toxicity causing adverse pregnancy outcomes were also determined through literature review. There is convincing evidence to support the association between high inorganic arsenic exposure (>50 ppb) and spontaneous abortion, stillbirth and low birth weight. Limitations of certain studies include study design, small sample size, recall constraints and exposure assessment. There needs to be further research investigating the dose metered impact of arsenic exposure on pregnancy outcomes. Further research on impact of low–moderate arsenic concentration exposure on pregnancy outcomes will allow for appropriate public health policy recommendations. PMID:28545256

  12. Adverse Housing Conditions and Early-Onset Delinquency.

    PubMed

    Jackson, Dylan B; Newsome, Jamie; Lynch, Kellie R

    2017-09-01

    Housing constitutes an important health resource for children. Research has revealed that, when housing conditions are unfavorable, they can interfere with child health, academic performance, and cognition. Little to no research, however, has considered whether adverse housing conditions and early-onset delinquency are significantly associated with one another. This study explores the associations between structural and non-structural housing conditions and delinquent involvement during childhood. Data from the Fragile Families and Child Wellbeing Study (FFCWS) were employed in this study. Each adverse housing condition was significantly associated with early-onset delinquency. Even so, disarray and deterioration were only significantly linked to early delinquent involvement in the presence of health/safety hazards. The predicted probability of early-onset delinquency among children exposed to housing risks in the presence of health/safety hazards was nearly three times as large as the predicted probability of early-onset delinquency among children exposed only to disarray and/or deterioration, and nearly four times as large as the predicted probability of early-onset delinquency among children exposed to none of the adverse housing conditions. The findings suggest that minimizing housing-related health/safety hazards among at-risk subsets of the population may help to alleviate other important public health concerns-particularly early-onset delinquency. Addressing household health/safety hazards may represent a fruitful avenue for public health programs aimed at the prevention of early-onset delinquency. © Society for Community Research and Action 2017.

  13. Impact of the new payment system on laparoscopic appendectomy in Korea.

    PubMed

    Kim, Jong Wan; Shin, Dong Woo; Chae, Jin Ju; Kim, Jeong Yeon; Park, Sung Gil

    2015-12-01

    Korea has a nationalized health system. The aim of this study was to evaluate the impact of the Korea diagnosis related group-based prospective payment system (K-DRG/PPS) on the use of medical resources and the rate of adverse events during laparoscopic appendectomy. We included patients who underwent laparoscopic appendectomy at Dongtan Sacred Heart Hospital, Korea, between November 2012 and February 2014. The patients were divided into two groups: before-DRG/PPS or after-DRG/PPS groups. The length of the postoperative hospital stay (LOS) and medical costs were indicators of the medical resources. Medical costs included those of the initial hospital stay, outpatient clinic, readmission, and the sum of these charges. Complication and readmission rates were indicators of the rates of adverse events. After the implementation of the DRG/PPS, length of the hospital stay decreased by 10% (4.9 d before versus 4.4 d after DRG/PPS; P < 0.001). The initial hospital stay and total cost were significantly lower in the after-DRG/PPS group (both P < 0.001). The complication rates during the initial hospital stay (3.5% before versus 2.3% after DRG/PPS; P = 0.225) and the readmission rates (4.3% versus 2.5%, respectively; P = 0.227) were statistically similar. This study shows that the K-DRG/PPS for laparoscopic appendectomy had no negative effect on the rate of adverse events and reduced the use of medical resources. Further evaluation of other procedures is required to determine the overall effects of the K-DRG/PPS. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. [What are hospitals and primary care doing to mitigate the social impact of serious adverse events].

    PubMed

    Mira, José Joaquín; Carrillo, Irene; Lorenzo, Susana

    To explore what hospitals and primary care (PC) are doing to reduce the negative social impact of a serious adverse event (AE). We surveyed 195 hospital (n=113) and PC (n=82) managers from eight autonomous communities to explore the level of implementation of five interventions recommended after an AE to protect the reputation of healthcare institutions. Most institutions (70, 45.2% PC, and 85, 54.8% hospitals) did not have a crisis plan to protect their reputation after an AE. Internal (p=0.0001) and external (p=0.012) communications were addressed better in PC than in hospitals. Very few institutions had defined the managers' role in case of an AE (10.7% hospitals versus 6.25% PC). A majority of healthcare institutions have not planned crisis intervention after an AE with severe consequences nor have they defined plans to recover citizens' trust after an AE. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Assessment of impacts of proposed coal-resource and related economic development on water resources, Yampa River basin, Colorado and Wyoming; a summary

    USGS Publications Warehouse

    Steele, Timothy Doak; Hillier, Donald E.

    1981-01-01

    Expanded mining and use of coal resources in the Rocky Mountain region of the western United States will have substantial impacts on water resources, environmental amenities, and social and economic conditions. The U.S. Geological Survey has completed a 3-year assessment of the Yampa River basin, Colorado and Wyoming, where increased coal-resource development has begun to affect the environment and quality of life. Economic projections of the overall effects of coal-resource development were used to estimate water use and the types and amounts of waste residuals that need to be assimilated into the environment. Based in part upon these projections, several physical-based models and other semiquantitative assessment methods were used to determine possible effects upon the basin's water resources. Depending on the magnitude of mining and use of coal resources in the basin, an estimated 0.7 to 2.7 million tons (0.6 to 2.4 million metric tons) of waste residuals may be discharged annually into the environment by coal-resource development and associated economic activities. If the assumed development of coal resources in the basin occurs, annual consumptive use of water, which was approximately 142,000 acre-feet (175 million cubic meters) during 1975, may almost double by 1990. In a related analysis of alternative cooling systems for coal-conversion facilities, four to five times as much water may be used consumptively in a wet-tower, cooling-pond recycling system as in once-through cooling. An equivalent amount of coal transported by slurry pipeline would require about one-third the water used consumptively by once-through cooling for in-basin conversion. Current conditions and a variety of possible changes in the water resources of the basin resulting from coal-resource development were assessed. Basin population may increase by as much as threefold between 1975 and 1990. Volumes of wastes requiring treatment will increase accordingly. Potential problems associated

  16. Adverse childhood exposures and reported child health at age 12.

    PubMed

    Flaherty, Emalee G; Thompson, Richard; Litrownik, Alan J; Zolotor, Adam J; Dubowitz, Howard; Runyan, Desmond K; English, Diana J; Everson, Mark D

    2009-01-01

    The relationship between adverse childhood exposures and poor health, illness, and somatic complaints at age 12 was examined. LONGSCAN (Consortium for Longitudinal Studies of Child Abuse and Neglect) tracks a group of children with variable risk for maltreatment. Of the participating child-caregiver dyads, 805 completed an interview when the child was age 4 or age 6, as well as interviews at age 8 and 12. The relationships between 8 categories of childhood adversity (psychological maltreatment, physical abuse, sexual abuse, child neglect, caregiver's substance/alcohol use, caregiver's depressive symptoms, caregiver's being treated violently, and criminal behavior in the household) and child health at age 12 were analyzed. The impact of adversity in the first 6 years of life and adversity in the second 6 years of life on child health were compared. Only 10% of the children had experienced no adversity, while more than 20% had experienced 5 or more types of childhood adversity. At age 12, 37% of the children sampled had some health complaint. Exposure to 5 or more adversities, particularly exposure in the second 6 years of life, was significantly associated with increased risks of any health complaint (odds ratio [OR] 2.24, 95% confidence interval [95% CI] 1.02-4.96), an illness requiring a doctor (OR 3.69, 95% CI 1.02-15.1), and caregivers' reports of child's somatic complaints (OR 3.37, 95% CI 1.14-1.0). There was no association between adverse exposures and self-rated poor health or self-rated somatic complaints. A comprehensive assessment of children's health should include a careful history of their past exposure to adverse conditions and maltreatment. Interventions aimed at reducing these exposures may result in better child health.

  17. The Influence of Childhood Adversity on Rural Black Men's Sexual Risk Behavior.

    PubMed

    Kogan, Steven M; Cho, Junhan; Oshri, Assaf

    2016-12-01

    Young Black men living in resource-poor rural environments are disproportionately affected by both adverse childhood experiences and HIV/STIs. The influence of childhood adversity on sexual risk behavior remains to be examined among this vulnerable population. In this study, we investigated the influence of overall adversity as well as three subcomponents, abusive parenting, parental neglect, and witnessing family violence, on men's engagement in sexual risk behavior. We hypothesized that adverse experiences would predict engagement in sexual risk behaviors including multiple sexual partnerships, inconsistent condom use, frequent sexual activity, and concurrent substance abuse and sexual activity. We tested formally the extent to which defensive relational schemas mediated these associations. Hypotheses were tested with data from 505 rural Black men (M age = 20.29, SD = 1.10) participating in the African American Men's Health Project. Participants were recruited using respondent-driven sampling. Self-report data were gathered from participants via audio computer-assisted self-interviews. Bi-factor analyses revealed that, in addition to a common adversity factor, neglect independently predicted sexual risk behavior. Men's defensive relational schemas partially mediated the influence of the common adversity factor as well as the neglect subcomponent on sexual risk behavior. The present research identified a potential risk factor for sexual risk behavior in an understudied and vulnerable population. Adverse childhood experiences in general, and neglect in particular, may place many young Black men at risk for engaging in sexual risk behavior due in part to the influence of these experiences on men's development of relational schemas characterized by defensiveness and mistrust.

  18. Impact of diseases and other disturbances on non-timber forest resources: A case study involving small mammals

    Treesearch

    John. E. Lundquist; James. P. Jr. Ward

    2004-01-01

    Part of the diversity of a forest is the variety of agents that can kill trees. These agents differ in the nature, magnitude, and patterns of their impacts on forest resources. Diseases, insect pests, and other small-scale disturbances are commonly assessed on the basis of their impacts on timber production. Tree mortality usually means reduced volume of living stems....

  19. Closing the loop: integrating human impacts on water resources to advanced land surface models

    NASA Astrophysics Data System (ADS)

    Zaitchik, B. F.; Nie, W.; Rodell, M.; Kumar, S.; Li, B.

    2016-12-01

    Advanced Land Surface Models (LSMs), including those used in the North American Land Data Assimilation System (NLDAS), offer a physically consistent and spatially and temporally complete analysis of the distributed water balance. These models are constrained both by physically-based process representation and by observations ingested as meteorological forcing or as data assimilation updates. As such, they have become important tools for hydrological monitoring and long-term climate analysis. The representation of water management, however, is extremely limited in these models. Recent advances have brought prognostic irrigation routines into models used in NLDAS, while assimilation of Gravity Recovery and Climate Experiment (GRACE) derived estimates of terrestrial water storage anomaly has made it possible to nudge models towards observed states in water storage below the root zone. But with few exceptions these LSMs do not account for the source of irrigation water, leading to a disconnect between the simulated water balance and the observed human impact on water resources. This inconsistency is unacceptable for long-term studies of climate change and human impact on water resources in North America. Here we define the modeling challenge, review instances of models that have begun to account for water withdrawals (e.g., CLM), and present ongoing efforts to improve representation of human impacts on water storage across models through integration of irrigation routines, water withdrawal information, and GRACE Data Assimilation in NLDAS LSMs.

  20. The impact of library instruction: do first-year medical students use library resources specifically highlighted during instructional sessions?*

    PubMed Central

    Rafferty, Ryan S.

    2013-01-01

    Objectives: The research sought to determine if first-year medical students consulted and cited resources specifically highlighted during library instructional sessions. Methods: Students attended a library resources instructional session. Resources that pertained to the students' assignment were demonstrated and discussed. The students created a report including citations from relevant literature. The citations were analyzed and categorized as: a resource discussed at the instructional session, a resource found on the course LibGuide, a library resource, course material, or some other resource. All citations were subcategorized as print or electronic. Results: Three years (2008–2011) of data analyzing 2,983 citations showed that 49.55% of all citations were from resources discussed during library instructional sessions; 21.86% came from resources with links on the course LibGuide; 77.51% were from library resources; and 90.68% came from electronic resources. Conclusion: Students cited resources specifically highlighted during library instructional sessions for their assignments. The percentage of all citations coming from resources highlighted during the instructional sessions or found on the course LibGuide indicates that library instruction had an impact on the students' work. PMID:23930092

  1. Library and information services: impact on patient care quality.

    PubMed

    Marshall, Joanne Gard; Morgan, Jennifer Craft; Thompson, Cheryl A; Wells, Amber L

    2014-01-01

    The purpose of this paper is to explore library and information service impact on patient care quality. A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Electronic collections and services provided by the library and the librarian contribute to patient care quality.

  2. CYP2B6*6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: impact on adverse effects

    PubMed Central

    Li, Yibai; Jackson, Kate A; Slon, Barry; Hardy, Janet R; Franco, Michael; William, Leeroy; Poon, Peter; Coller, Janet K; Hutchinson, Mark R; Currow, David C; Somogyi, Andrew A

    2015-01-01

    Aims Ketamine analgesia is limited by low intrinsic efficacy compounded by large interindividual variability in drug responses, possibly due to the heterogeneity in drug concentration. The CYP2B6*6 allele is associated with substantially reduced ketamine metabolism in vitro and, therefore, may affect ketamine clearance. Our aims were to examine the impact of the CYP2B6*6 allele on ketamine plasma clearance and on adverse effects in chronic pain patients. Methods CYP2B6 genotypes were identified in 49 chronic pain patients who received 24 h continuous subcutaneous infusions of ketamine. Steady-state plasma concentrations of ketamine (Css,k) and norketamine (Css,nk) were determined using HPLC. Results The median plasma clearance of ketamine after 100 mg 24 h–1 dose was significantly lower in patients with the CYP2B6*6/*6 (21.6 l h–1) and CYP2B6*1/*6 (40.6 l h–1) genotypes compared with patients with the CYP2B6*1/*1 genotype (68.1 l h–1, P < 0.001). The ketamine : norketamine plasma metabolic ratio was significantly higher in patients with the CYP2B6*6/*6 genotype than in those with the CYP2B6*1/*6 and the CYP2B6*1/*1 genotypes (P < 0.001). Patients who experienced adverse effects had lower plasma clearance (45.6 l h-1) than those who did not (52.6 l h-1, P = 0.04). The CYP2B6*6 genotype and age, and their combined impact explained 40%, 30% and 60% of the variation in Css,k, respectively. Similar results were observed after higher doses. Conclusions The CYP2B6*6 allele is associated with a substantial decrease in steady-state ketamine plasma clearance in chronic pain patients. The decreased clearance and resultant higher plasma concentrations may be associated with a higher incidence of ketamine adverse effects. PMID:25702819

  3. CYP2B6*6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: impact on adverse effects.

    PubMed

    Li, Yibai; Jackson, Kate A; Slon, Barry; Hardy, Janet R; Franco, Michael; William, Leeroy; Poon, Peter; Coller, Janet K; Hutchinson, Mark R; Currow, David C; Somogyi, Andrew A

    2015-08-01

    Ketamine analgesia is limited by low intrinsic efficacy compounded by large interindividual variability in drug responses, possibly due to the heterogeneity in drug concentration. The CYP2B6*6 allele is associated with substantially reduced ketamine metabolism in vitro and, therefore, may affect ketamine clearance. Our aims were to examine the impact of the CYP2B6*6 allele on ketamine plasma clearance and on adverse effects in chronic pain patients. CYP2B6 genotypes were identified in 49 chronic pain patients who received 24 h continuous subcutaneous infusions of ketamine. Steady-state plasma concentrations of ketamine (Css,k ) and norketamine (Css,nk ) were determined using HPLC. The median plasma clearance of ketamine after 100 mg 24 h(-1) dose was significantly lower in patients with the CYP2B6*6/*6 (21.6 l h(-1) ) and CYP2B6*1/*6 (40.6 l h(-1) ) genotypes compared with patients with the CYP2B6*1/*1 genotype (68.1 l h(-1) , P < 0.001). The ketamine : norketamine plasma metabolic ratio was significantly higher in patients with the CYP2B6*6/*6 genotype than in those with the CYP2B6*1/*6 and the CYP2B6*1/*1 genotypes (P < 0.001). Patients who experienced adverse effects had lower plasma clearance (45.6 l h(-1) ) than those who did not (52.6 l h(-1) , P = 0.04). The CYP2B6*6 genotype and age, and their combined impact explained 40%, 30% and 60% of the variation in Css,k , respectively. Similar results were observed after higher doses. The CYP2B6*6 allele is associated with a substantial decrease in steady-state ketamine plasma clearance in chronic pain patients. The decreased clearance and resultant higher plasma concentrations may be associated with a higher incidence of ketamine adverse effects. © 2015 The British Pharmacological Society.

  4. The dual impact of ecology and management on social incentives in marine common-pool resource systems.

    PubMed

    Klein, E S; Barbier, M R; Watson, J R

    2017-08-01

    Understanding how and when cooperative human behaviour forms in common-pool resource systems is critical to illuminating social-ecological systems and designing governance institutions that promote sustainable resource use. Before assessing the full complexity of social dynamics, it is essential to understand, concretely and mechanistically, how resource dynamics and human actions interact to create incentives and pay-offs for social behaviours. Here, we investigated how such incentives for information sharing are affected by spatial dynamics and management in a common-pool resource system. Using interviews with fishermen to inform an agent-based model, we reveal generic mechanisms through which, for a given ecological setting characterized by the spatial dynamics of the resource, the two 'human factors' of information sharing and management may heterogeneously impact various members of a group for whom theory would otherwise predict the same strategy. When users can deplete the resource, these interactions are further affected by the management approach. Finally, we discuss the implications of alternative motivations, such as equity among fishermen and consistency of the fleet's output. Our results indicate that resource spatial dynamics, form of management and level of depletion can interact to alter the sociality of people in common-pool resource systems, providing necessary insight for future study of strategic decision processes.

  5. Gender-related dimensions of childhood adversities in the general population.

    PubMed

    Coêlho, Bruno M; Santana, Geilson L; Viana, Maria C; Andrade, Laura H; Wang, Yuan-Pang

    2018-06-11

    Childhood adversities (CAs) comprise a group of negative experiences individuals may suffer in their lifetimes. The goal of the present study was to investigate the cluster discrimination of CAs through psychometric determination of the common attributes of such experiences for men and women. Parental mental illness, substance misuse, criminality, death, divorce, other parental loss, family violence, physical abuse, sexual abuse, neglect, physical illness, and economic adversity were assessed in a general-population sample (n=5,037). Exploratory and confirmatory factor analysis determined gender-related dimensions of CA. The contribution of each individual adversity was explored through Rasch analysis. Adversities were reported by 53.6% of the sample. A three-factor model of CA dimensions fit the data better for men, and a two-factor model for women. For both genders, the dimension of family maladjustment - encompassing physical abuse, neglect, parental mental disorders, and family violence - was the core cluster of CAs. Women endorsed more CAs than men. Rasch analysis found that sexual abuse, physical illness, parental criminal behavior, parental divorce, and economic adversity were difficult to report in face-to-face interviews. CAs embrace sensitive personal information, clustering of which differed by gender. Acknowledging CAs may have an impact on medical and psychiatric outcomes in adulthood.

  6. The impact of dual bronchodilation on cardiovascular serious adverse events and mortality in COPD: a quantitative synthesis

    PubMed Central

    Rogliani, Paola; Matera, Maria Gabriella; Ora, Josuel; Cazzola, Mario; Calzetta, Luigino

    2017-01-01

    Objective Long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) are burdened by the potential risk of inducing cardiovascular serious adverse events (SAEs) in COPD patients. Since the risk of combining a LABA with a LAMA could be greater, we have carried out a quantitative synthesis to investigate the cardiovascular safety profile of LABA/LAMA fixed-dose combinations (FDCs). Methods A pair-wise and network meta-analysis was performed by using the data of the repository database ClinicalTrials.gov concerning the impact of approved LABA/LAMA FDCs versus monocomponents and/or placebo on cardiovascular SAEs in COPD. Results Overall, LABA/LAMA FDCs did not significantly (P>0.05) modulate the risk of cardiovascular SAEs versus monocomponents. However, the network meta-analysis indicated that aclidinium/formoterol 400/12 µg and tiotropium/olodaterol 5/5 µg were the safest FDCs, followed by umeclidinium/vilanterol 62.5/25 µg which was as safe as placebo, whereas glycopyrronium/formoterol 14.9/9.6, glycopyrronium/indacaterol 15.6/27.5 µg, and glycopyrronium/indacaterol 50/110 µg were the least safe FDCs. No impact on mortality was detected for each specific FDC. Conclusion This meta-analysis indicates that LABA/LAMA FDC therapy is characterized by an excellent cardiovascular safety profile in COPD patients. However, the findings of this quantitative synthesis have been obtained from populations that participated in randomized clinical trials, and were devoid of major cardiovascular diseases. Thus, post-marketing surveillance and observational studies may help to better define the real impact of specific FDCs with regard to the cardiovascular risk. PMID:29255354

  7. Climate change impact on water resources - Example of an anthropized basin (Llobregat, Spain)

    NASA Astrophysics Data System (ADS)

    Versini, P.-A.; Pouget, L.; Mc Ennis, S.; Guiu Carrio, R.; Sempere-Torres, D.; Escaler, I.

    2012-04-01

    The impact of climate change is one of the central topics of study by water agencies and companies. Indeed, the forecasted increase of atmospheric temperature may change the amount, frequency and intensity of precipitation and affect the hydrological cycle: runoff, infiltration, aquifer recharge, etc… Moreover, global change combining climate change but also land use and water demand changes, may cause very important impacts on water availability and quality. Global change scenarios in Spain describe a general trend towards increased temperature and water demand, and reduced precipitation as a result of its geographical situation and socio-economic characteristics. The European project WATER CHANGE (included in the LIFE + Environment Policy and Governance program) aims to develop a modeling system to assess the Global Change impacts, and their associated uncertainties, on water availability for water supply and water use. Its objective is to help river basin agencies and water companies in their long term planning and in the definition of adaptation measures. This work presents the results obtained by applying the modelling system to the Llobregat river basin (Spain). This is an anthropized catchment of about 5000 km2, where water resources are used for different purposes, such as drinking water production, agriculture irrigation, industry and hydroelectric energy production. Based on future global change scenarios, the water resources system has been assessed in terms of water deficit and supply. A cost-benefit analysis has also been conducted in order to evaluate every realistic measure that could optimize and improve the system.

  8. Modern maize hybrids in Northeast China exhibit increased yield potential and resource use efficiency despite adverse climate change.

    PubMed

    Chen, Xiaochao; Chen, Fanjun; Chen, Yanling; Gao, Qiang; Yang, Xiaoli; Yuan, Lixing; Zhang, Fusuo; Mi, Guohua

    2013-03-01

    The impact of global changes on food security is of serious concern. Breeding novel crop cultivars adaptable to climate change is one potential solution, but this approach requires an understanding of complex adaptive traits for climate-change conditions. In this study, plant growth, nitrogen (N) uptake, and yield in relation to climatic resource use efficiency of nine representative maize cultivars released between 1973 and 2000 in China were investigated in a 2-year field experiment under three N applications. The Hybrid-Maize model was used to simulate maize yield potential in the period from 1973 to 2011. During the past four decades, the total thermal time (growing degree days) increased whereas the total precipitation and sunshine hours decreased. This climate change led to a reduction of maize potential yield by an average of 12.9% across different hybrids. However, the potential yield of individual hybrids increased by 118.5 kg ha(-1)  yr(-1) with increasing year of release. From 1973 to 2000, the use efficiency of sunshine hours, thermal time, and precipitation resources increased by 37%, 40%, and 41%, respectively. The late developed hybrids showed less reduction in yield potential in current climate conditions than old cultivars, indicating some adaptation to new conditions. Since the mid-1990s, however, the yield impact of climate change exhibited little change, and even a slight worsening for new cultivars. Modern breeding increased ear fertility and grain-filling rate, and delayed leaf senescence without modification in net photosynthetic rate. The trade-off associated with delayed leaf senescence was decreased grain N concentration rather than increased plant N uptake, therefore N agronomic efficiency increased simultaneously. It is concluded that modern maize hybrids tolerate the climatic changes mainly by constitutively optimizing plant productivity. Maize breeding programs in the future should pay more attention to cope with the limiting

  9. An integrated hydrological modeling approach for detection and attribution of climatic and human impacts on coastal water resources

    NASA Astrophysics Data System (ADS)

    Feng, Dapeng; Zheng, Yi; Mao, Yixin; Zhang, Aijing; Wu, Bin; Li, Jinguo; Tian, Yong; Wu, Xin

    2018-02-01

    Water resources in coastal areas can be profoundly influenced by both climate change and human activities. These climatic and human impacts are usually intertwined and difficult to isolate. This study developed an integrated model-based approach for detection and attribution of climatic and human impacts and applied this approach to the Luanhe Plain, a typical coastal area in northern China. An integrated surface water-groundwater model was developed for the study area using GSFLOW (coupled groundwater and surface-water flow). Model calibration and validation were performed for background years between 1975 and 2000. The variation in water resources between the 1980s and 1990s was then quantitatively attributed to climate variability, groundwater pumping and changes in upstream inflow. Climate scenarios for future years (2075-2100) were also developed by downscaling the projections in CMIP5. Potential water resource responses to climate change, as well as their uncertainty, were then investigated through integrated modeling. The study results demonstrated the feasibility and value of the integrated modeling-based analysis for water resource management in areas with complex surface water-groundwater interaction. Specific findings for the Luanhe Plain included the following: (1) During the historical period, upstream inflow had the most significant impact on river outflow to the sea, followed by climate variability, whereas groundwater pumping was the least influential. (2) The increase in groundwater pumping had a dominant influence on the decline in groundwater change, followed by climate variability. (3) Synergetic and counteractive effects among different impacting factors, while identified, were not significant, which implied that the interaction among different factors was not very strong in this case. (4) It is highly probable that future climate change will accelerate groundwater depletion in the study area, implying that strict regulations for groundwater

  10. The Noise from Wind Turbines: Potential Adverse Impacts on Children's Well-Being

    ERIC Educational Resources Information Center

    Bronzaft, Arline L.

    2011-01-01

    Research linking loud sounds to hearing loss in youngsters is now widespread, resulting in the issuance of warnings to protect children's hearing. However, studies attesting to the adverse effects of intrusive sounds and noise on children's overall mental and physical health and well-being have not received similar attention. This, despite the…

  11. AOP-DB: A database resource for the exploration of Adverse Outcome Pathways through integrated association networks.

    EPA Science Inventory

    The Adverse Outcome Pathway (AOP) framework describes the progression of a toxicity pathway from molecular perturbation to population-level outcome in a series of measurable, mechanistic responses. The controlled, computer-readable vocabulary that defines an AOP has the ability t...

  12. Adverse Outcome Pathways: From Research to Regulation ...

    EPA Pesticide Factsheets

    An adverse outcome pathway (AOP) organizes existing knowledge on chemical mode of action, starting with a molecular initiating event such as receptor binding, continuing through key events, and ending with an adverse outcome such as reproductive impairment. AOPs can help identify knowledge gaps where more research is needed to understand the underlying mechanisms, aid in chemical hazard characterization, and guide the development of new testing approaches that use fewer or no animals. A September 2014 workshop co-sponsored by NICEATM and PCRM considered how the AOP concept could improve regulatory assessments of chemical toxicity. Scientists from 21 countries, representing industry, academia, regulatory agencies, and special interest groups, attended the workshop, titled Adverse Outcome Pathways: From Research to Regulation. Workshop plenary presentations were followed by breakout sessions that considered regulatory acceptance of AOPs and AOP-based tools, criteria for building confidence in an AOP for regulatory use, and requirements to build quantitative AOPs and AOP networks. Discussions during the closing session emphasized a need to increase transparent and inclusive collaboration, especially with disciplines outside of toxicology. Additionally, to increase impact, working groups should be established to systematically prioritize and develop AOPs. Multiple collaborative projects and follow-up activities resulted from the workshop. This manuscript provides a

  13. Tourism impacts of Three Mile Island and other adverse events: Implications for Lincoln County and other rural counties bisected by radioactive wastes intended for Yucca Mountain

    NASA Astrophysics Data System (ADS)

    Himmelberger, Jeffery J.; Baughman, Mike; Ogneva-Himmelberger, Yelena A.

    1995-11-01

    Whether the proposed Yucca Mountain nuclear waste repository system will adversely impact tourism in southern Nevada is an open question of particular importance to visitor-oriented rural counties bisected by planned waste transportatin corridors (highway or rail). As part of one such county's repository impact assessment program, tourism implications of Three Mile Island (TMI) and other major hazard events have beem revisited to inform ongoing county-wide socioeconomic assessments and contingency planning efforts. This paper summarizes key research implications of such research as applied to Lincoln County, Nevada. Implications for other rural counties are discussed in light of the research findings.

  14. The Health Impact Assessment (HIA) Resource and Tool Compilation: A Comprehensive Toolkit for New and Experienced HIA Practitioners in the U.S.

    EPA Science Inventory

    Health Impact Assessment (HIA) is a relatively new and rapidly emerging field in the U.S. An inventory of available HIA resources and tools was conducted, with a primary focus on resources developed in the U.S. The resources and tools available to HIA practitioners in the conduct...

  15. The bioavailability and adverse impacts of lead and decabromodiphenyl ether on soil microbial activities.

    PubMed

    Chen, Lei; Zhang, Wei; Zhang, Rong; Lin, Kuangfei; He, Lei; Wu, Liqun

    2015-08-01

    Lead (Pb) and decabromodiphenyl ether (BDE209) are the main pollutants at electronic waste (e-waste) recycling sites (EWRSs), and their potential toxic effects on soil organisms have received extensive attention. However, the impact on soil microorganisms of joint exposure to the two chemicals remains almost unknown. Therefore, indoor incubation tests were performed to explore the adverse impacts of Pb and BDE209 on soil microbial activities and chemical transformation for the first time. The results have demonstrated that BDE209 was barely degraded in all treated groups, indicating that the presence of Pb hardly affected BDE209 dissipation. The fractions analysis according to Tessier suggested that Pb gradually transformed towards more stable fractions in the slightly alkaline soil, thus reducing the bioavailability of Pb. Additionally, increased Pb doses caused significantly higher bioavailability (p < 0.05), and the same trend was clearly observed after simultaneous exposure to BDE209. Generally, single Pb or BDE209 exposure markedly inhibited (p < 0.05 or 0.01) soil microbial biomass C (C mic), while soil basal respiration (SBR) indicated the opposite response trend (inhibition or stimulation for BDE209 or Pb alone, respectively). Compared to the controls, Pb dramatically (p < 0.01) facilitated soil metabolic quotient (qCO2) during the incubation period. After joint exposure to Pb and BDE209, C mic generally declined with increasing exposure concentration, following certain dose-response relationships. However, SBR and qCO2 were highly significantly stimulated (p < 0.01), and more doses of Pb and BDE209 resulted in higher values. The results of these observations have provided a basic understanding of the potential ecological risk of Pb and BDE209 in soil at EWRSs.

  16. Associations of adverse childhood experiences with depression and alcohol abuse among Korean college students.

    PubMed

    Kim, Yeon Ha

    2017-05-01

    This study investigated adverse childhood experiences of Korean college students and the impact such experiences have on students' depression and alcohol abuse. Using an online questionnaire, 939 college students were surveyed regarding their adverse childhood experiences, depressive symptoms and alcohol use habits. About half of the participants claimed to have experienced at least one adversity in their childhood. Eight percent of participants reported experiencing four or more categories of adversity. The correlations between adverse childhood experiences and depressive symptoms, alcohol abusive behaviors, and the comorbid condition of the two outcomes were significant when students' gender, geographical regions, maternal and paternal education, and family incomes were adjusted. Graded associations of cumulated adverse childhood experiences with the outcome variables were evident. These findings strengthen the link between child maltreatment and adult public health issues carrying socioeconomic burdens, two matters that have not been extensively studied in Korean contexts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Arms trade and its impact on global health.

    PubMed

    Mahmudi-Azer, Salahaddin

    2006-01-01

    The most obvious adverse impact of the arms trade on health is loss of life and maiming from the use of weapons in conflicts. Wealthy countries suffer damage to their health and human services when considerable resources are diverted to military expenditure. However, the relative impact of military expenditures and conflict on third world countries is much greater, and often devastating, by depriving a significant portion of the population of essential food, medicine, shelter, education, and economic opportunities. Further, the physical and psychological damage inflicted specifically on children is debilitating - through loss of (or separation from) families, loss of education, destruction of homes, exposure to murder and other violence, sexual abuse, abduction, torture, slavery, and forcible conscription as soldiers. This article outlines the socio-economic impact of the global arms trade in general and the damage done to human health and the environment, specifically.

  18. The prevalence and impact of antimicrobial allergies and adverse drug reactions at an Australian tertiary centre.

    PubMed

    Trubiano, Jason A; Cairns, Kelly A; Evans, Jacqui A; Ding, Amally; Nguyen, Tuan; Dooley, Michael J; Cheng, Allen C

    2015-12-16

    The prevalence and impact of antimicrobial "allergy" labels and Adverse Drug Reactions (ADRs) on antibiotic usage and antimicrobial stewardship initiatives is ill defined. We sought to examine the rate of antimicrobial "allergy labels" at our tertiary referral centre and impacts on antimicrobial usage and appropriateness. Two inpatient antimicrobial prevalence surveys were conducted over a 1-week period in November 2013 and 2014 as part of the prospective National Antimicrobial Prescribing Survey (NAPS). Post survey, patients recorded in the NAPS database were assigned to two groups based upon recorded antimicrobial "allergy label" and ADR: (i) Antimicrobial Allergy/ADR (AA) or (ii) No Antimicrobial Allergy/ADR (NAA). Antimicrobial usage and antimicrobial appropriateness were compared between AA and NAA groups. From 509 identified patients the prevalence of an antimicrobial allergy or ADR was 25 %. The prevalence of "allergy labels"/ADR was 10 % (51/509) for penicillin V/G, 5 % (24/509) cephalosporins, 4 % (22/509) trimethroprim-sulfamethoxazole and 3 % (17/509) aminopenicillins. One thousand and seventy antimicrobials were prescribed during the study periods, the median antimicrobial duration was longer in the AA versus NAA group (6 days vs. 4 days; p = 0.018), and proportion of inappropriate antimicrobial prescribing higher in the AA group compared with NAA (29 %; 35/120 vs. 23 %; 86/367, p = 0.22). Oral antimicrobial administration was higher in the NAA than AA group (60 %; 177/297 vs. 46 %; 356/793, p = 0.0001). The proportion of patients that received a β-lactam was lower in the AA versus NAA group (60 % vs. 79 %, p = 0.0001). In an Australian tertiary referral centre an antimicrobial "allergy" or ADR label was found to significantly impacted on rate of oral antimicrobial administration, beta-lactam usage, antimicrobial duration and antimicrobial appropriateness.

  19. Expanding Approaches for Understanding Impact: Integrating Technology, Curriculum, and Open Educational Resources in Science Education

    ERIC Educational Resources Information Center

    Ye, Lei; Recker, Mimi; Walker, Andrew; Leary, Heather; Yuan, Min

    2015-01-01

    This article reports results from a scale-up study of the impact of a software tool designed to support teachers in the digital learning era. This tool, the Curriculum Customization Service (CCS), enables teachers to access open educational resources from multiple providers, customize them for classroom instruction, and share them with other…

  20. Automated Detection of Surgical Adverse Events from Retrospective Clinical Data

    ERIC Educational Resources Information Center

    Hu, Zhen

    2017-01-01

    The Detection of surgical adverse events has become increasingly important with the growing demand for quality improvement and public health surveillance with surgery. Event reporting is one of the key steps in determining the impact of postoperative complications from a variety of perspectives and is an integral component of improving…

  1. Detailed Assessments of Childhood AdversityEnhance Prediction of Central Obesity Independent of Gender, Race, Adult Psychosocial Risk and Health Behaviors

    PubMed Central

    Davis, Cynthia R.; Dearing, Eric; Usher, Nicole; Trifiletti, Sarah; Zaichenko, Lesya; Ollen, Elizabeth; Brinkoetter, Mary T.; Crowell-Doom, Cindy; Joung, Kyoung; Park, Kyung Hee; Mantzoros, Christos S.; Crowell, Judith A.

    2017-01-01

    Objective This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of “modifiable” risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities X severity X chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity. Materials/Methods 210 Black/African Americans and White/European Americans, mean age = 45.8; ±3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist-hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise). Results Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI. Conclusions Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning. PMID:24211017

  2. Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.

    PubMed

    Davis, Cynthia R; Dearing, Eric; Usher, Nicole; Trifiletti, Sarah; Zaichenko, Lesya; Ollen, Elizabeth; Brinkoetter, Mary T; Crowell-Doom, Cindy; Joung, Kyoung; Park, Kyung Hee; Mantzoros, Christos S; Crowell, Judith A

    2014-02-01

    This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of "modifiable" risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities × severity × chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity. 210 Black/African Americans and White/European Americans, mean age=45.8; ±3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist-hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise). Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI. Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning. © 2013.

  3. 78 FR 5834 - Notice of Intent To Prepare a Supplemental Environmental Impact Statement and Resource Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCON04000 L16100000.DP0000] Notice of Intent To Prepare a Supplemental Environmental Impact Statement and Resource Management Plan Amendment for the Roan Plateau, CO AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Intent...

  4. 78 FR 12347 - Notice of Availability of the Proposed Resource Management Plan and Final Environmental Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... Historic trails. The four alternatives were: Alternative A: Continues existing management practices (no... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLWYR05000 L16100000.DQ0000 LXSS04 K0000] Notice of Availability of the Proposed Resource Management Plan and Final Environmental Impact Statement...

  5. The adverse effects of International Monetary Fund programs on the health and education workforce.

    PubMed

    Marphatia, Akanksha A

    2010-01-01

    Decades of underinvestment in public sectors and in teachers and health workers have adversely affected the health and educational outcomes of women. This is partly explained by a general lack of resources. However, the amount a country can spend on social sectors, including teachers and health workers, is also determined by its macroeconomic framework, which is set in agreement with the International Monetary Fund. There is now ample evidence of how IMF-imposed wage ceilings have constrained the ability of governments to hire adequate numbers of trained professionals and increase investment in social sectors. Though the IMF has recently removed wage ceilings from its basket of conditions, little change has taken place to ensure that women are better supported by macroeconomic policies or, at the least, are less adversely affected. Thus far, the IMF's neoliberal policies have either ignored gender concerns or instrumentalized equity, health, and education to support economic development. Unless macroeconomic policies are more flexible and deliberately take into account the different needs of women and men, social outcomes will continue to be poor and inequitable. Governments must pursue alternative, feminist policies that put the goals of social equity at the center of macroeconomic policy. These policies can facilitate increased investment in education and health care, which are vital measures for achieving gender equality and providing both women and men with the skills and training needed to soften the impact of the current economic crisis.

  6. Mitigating Aviation Communication and Satellite Orbit Operations Surprises from Adverse Space Weather

    NASA Technical Reports Server (NTRS)

    Tobiska, W. Kent

    2008-01-01

    Adverse space weather affects operational activities in aviation and satellite systems. For example, large solar flares create highly variable enhanced neutral atmosphere and ionosphere electron density regions. These regions impact aviation communication frequencies as well as precision orbit determination. The natural space environment, with its dynamic space weather variability, is additionally changed by human activity. The increase in orbital debris in low Earth orbit (LEO), combined with lower atmosphere CO2 that rises into the lower thermosphere and causes increased cooling that results in increased debris lifetime, adds to the environmental hazards of navigating in near-Earth space. This is at a time when commercial space endeavors are posed to begin more missions to LEO during the rise of the solar activity cycle toward the next maximum (2012). For satellite and aviation operators, adverse space weather results in greater expenses for orbit management, more communication outages or aviation and ground-based high frequency radio used, and an inability to effectively plan missions or service customers with space-based communication, imagery, and data transferal during time-critical activities. Examples of some revenue-impacting conditions and solutions for mitigating adverse space weather are offered.

  7. Preference and Priority in Federal Funding: Aligning Federal Resources to Maximize Program Investment Efficiency and Impacts in Communities

    EPA Pesticide Factsheets

    This page contains the document, Preference and Priority in Federal Funding: Aligning Federal Resources to Maximize Program Investment Efficiency and Impacts in Communities - Lessons from EPA’s Brownfields Program.

  8. Cultural Resource Investigations for the Resumption of Transient Testing of Nuclear Fuels and Material at the Idaho National Laboratory

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pace, Brenda R.; Williams, Julie B.

    2013-11-01

    historic properties is consistent with original missions related to nuclear reactor testing and is expected to result in no adverse effects to their historic significance. Cultural resource investigations also involved communication with representatives from the Shoshone-Bannock Tribes to characterize cultural resources of potential tribal concern. This report provides a summary of the cultural resources inventoried and assessed within the defined areas of potential effect for the resumption of transient testing at the INL. Based on these analyses, proposed activities would have no adverse effects on historic properties within the APEs that have been defined. Other archaeological resources and cultural resources of potential concern to the Shoshone-Bannock Tribes and others that are located near the APEs are also discussed with regard to potential indirect impacts. The report concludes with general recommendations for measures to reduce impacts to all identified resources.« less

  9. Attachment-Related Regulatory Processes Moderate the Impact of Adverse Childhood Experiences on Stress Reaction in Borderline Personality Disorder.

    PubMed

    Ehrenthal, Johannes C; Levy, Kenneth N; Scott, Lori N; Granger, Douglas A

    2018-01-01

    In this study, the authors explored whether attachment insecurity moderates the effects of adverse childhood experiences on stress reactivity in the context of borderline personality disorder (BPD). Participants were 113 women (39 with BPD, 15 with some BPD criteria present, 59 without any BPD symptoms) who participated in the Trier Social Stress Test. Saliva samples were collected before and after the stressor and assayed for salivary alpha-amylase (sAA) and cortisol. Adverse childhood experiences were measured using the Childhood Trauma Questionnaire, and attachment by the Experiences in Close Relationships-Revised questionnaire. Results revealed that attachment avoidance and a combination of more adverse childhood experiences and attachment insecurity resulted in higher sAA levels and differences in reactivity to the stressor. Interactions between attachment anxiety and adverse childhood experiences were related to blunted cortisol reactivity. The results suggest that the influence of adverse childhood experiences on stress regulation in BPD may be moderated by attachment-related regulatory processes.

  10. The reasons for Chinese nursing staff to report adverse events: a questionnaire survey.

    PubMed

    Hong, Su; Li, QiuJie

    2017-04-01

    To investigate the impact of nurses' perception of patient safety culture and adverse event reporting, and demographic factors on adverse event reporting in Chinese hospitals. Accurate and timely adverse event reporting is integral in promoting patient safety and professional learning around the incident. In a cross-sectional survey, a sample of 919 nurses completed a structured questionnaire composed of two validated instruments measuring nurses' perception of patient safety culture and adverse event reporting. Associations between the variables were examined using multiple linear regression analysis. The positive response rates of five dimensions of the Patient Safety Culture Assessment Scale varied from 47.55% to 80.62%. The accuracy rate of Adverse Event Reporting Perception Scale was 63.16%. Five hundred and thirty-one (58.03%) nurses did not report adverse event in past 12 months. Six variables were found to be associated with nurses' adverse event reporting: total work experience (P = 0.003), overall patient safety culture score (P < 0.001), safety climate (P < 0.001), teamwork climate (P < 0.001), overall the adverse event reporting perception scale score (P = 0.003) and importance or reporting (P = 0.002). The results confirmed that improvements in the patient safety culture and nurses' perception of adverse event reporting were related to an increase in voluntary adverse event reporting. The knowledge of adverse event reporting should be integrated into the patient safety curriculum. Interventions that target a specific domain are necessary to improve the safety culture. © 2017 John Wiley & Sons Ltd.

  11. Modernization of the International Volcanic Ash Website - a global resource for ashfall preparedness and impact guidance.

    NASA Astrophysics Data System (ADS)

    Wallace, K.; Leonard, G.; Stewart, C.; Wilson, T. M.; Randall, M.; Stovall, W. K.

    2015-12-01

    The internationally collaborative volcanic ash website (http://volcanoes.usgs.gov/ash/) has been an important global information resource for ashfall preparedness and impact guidance since 2004. Recent volcanic ashfalls with significant local, regional, and global impacts highlighted the need to improve the website to make it more accessible and pertinent to users worldwide. Recently, the Volcanic Ash Impacts Working Group (Cities and Volcanoes Commission of IAVCEI) redesigned and modernized the website. Improvements include 1) a database-driven back end, 2) reorganized menu navigation, 3) language translation, 4) increased downloadable content, 5) addition of ash-impact case studies, 7) expanded and updated references , 8) an image database, and 9) inclusion of cooperating organization's logos. The database-driven platform makes the website more dynamic and efficient to operate and update. New menus provide information about specific impact topics (buildings, transportation, power, health, agriculture, water and waste water, equipment and communications, clean up) and updated content has been added throughout all topics. A new "for scientists" menu includes information on ash collection and analysis. Website translation using Google translate will significantly increase user base. Printable resources (e.g. checklists, pamphlets, posters) provide information to people without Internet access. Ash impact studies are used to improve mitigation measures during future eruptions, and links to case studies will assist communities' preparation and response plans. The Case Studies menu is intended to be a living topic area, growing as new case studies are published. A database of all images from the website allows users to access larger resolution images and additional descriptive details. Logos clarify linkages among key contributors and assure users that the site is authoritative and science-based.

  12. Daily Living Resources

    MedlinePlus

    ... PPMD. Click here to review PPMD’s policy on corporate support . Daily Living Resources PPMD Resource Fair Participants ... About PPMD ❯ Mission & Impact Staff & Board News History Finance & Operations Partners Media Contact us Get Involved ❯ Donate ...

  13. PFIESTERIA PISCICIDA IMPACTS

    EPA Science Inventory

    Recent evidence suggests that the estuarine dinofageflate, Pfiesteria piscicida, may release a toxin(s) which kills fish and adversely affects human health in laboratory and environmental settings. The potential for Pfresferia-like organisms to adversely impact estuarine ecosys...

  14. The Impact of Environmental Resource Learning Applied to Geometry in Education for Power and Citizenship

    ERIC Educational Resources Information Center

    Morales, Roosevelt Barros; Guerra, Mara Cabanilla; Barros, Carlos; Froment, Sunny Bores

    2018-01-01

    This article is based on education for power and citizenship and related educational and social problems, where the axis of the issue is the environmental resources applied to learning geometry. These have a great impact on the teaching process, as it is currently considered that education should be interactive with respect to the environment. In…

  15. The Impact of Web Based Resource Material on Learning Outcome in Open Distance Higher Education

    ERIC Educational Resources Information Center

    Masrur, Rehana

    2010-01-01

    One of the most powerful educational option in open and distance education is web-based learning. A blended (hybrid) course combines traditional face to face and web-based learning approaches in an educational environment that is nonspecific as to time and place. The study reported here investigated the impact of web based resource material…

  16. Historical changes in the major fish resources of the Great Lakes

    USGS Publications Warehouse

    Hartman, Wilbur L.; Evans, Marlene S.

    1988-01-01

    My purpose here is to review historic changes in the major fish resources of the five Great Lakes, and to identify the cause or causes for those changes. In some instances it will be clear that intensive fishing was the primary cause of change; in other instances it will be nearly as clear that predation by the sea lamprey played a significant if not dominant role in change; and in still others it will be clear (or at least circumstantial) that exotic species other than the sea lamprey have been implicated. The exotics that have invaded or been accidentally or purposefully released into the Great Lakes system have not only adversely affected indigenous fishes, but some have developed into new and valuable resources. However, when it comes to degradation of water quality and of critical habitat, the linkages to changes in fish populations are neither clear-cut nor quantifiable — their impacts were generally far more subtle and difficult to detect, but not necessarily of less importance. Inasmuch as a comprehensive review of all changes in fishery resources, water quality, and habitat conditions in the Great Lakes would be encyclopedic, I confine discussion here to prime examples related to the most historically important fish resources. One of the values of the approach used in this manuscript is the collation in a single-source document of the conclusions reached by many scientists on reasons for changes in the fish resources across the Great Lakes basin.

  17. Cross-ecosystem impacts of stream pollution reduce resource and contaminant flux to riparian food webs

    USGS Publications Warehouse

    Kraus, Johanna M.; Schmidt, Travis S.; Walters, David; Wanty, Richard B.; Zuellig, Robert E.; Wolf, Ruth E.

    2014-01-01

    The effects of aquatic contaminants are propagated across ecosystem boundaries by aquatic insects that export resources and contaminants to terrestrial food webs; however, the mechanisms driving these effects are poorly understood. We examined how emergence, contaminant concentration, and total contaminant flux by adult aquatic insects changed over a gradient of bioavailable metals in streams and how these changes affected riparian web-building spiders. Insect emergence decreased 97% over the metal gradient, whereas metal concentrations in adult insects changed relatively little. As a result, total metal exported by insects (flux) was lowest at the most contaminated streams, declining 96% among sites. Spiders were affected by the decrease in prey biomass, but not by metal exposure or metal flux to land in aquatic prey. Aquatic insects are increasingly thought to increase exposure of terrestrial consumers to aquatic contaminants, but stream metals reduce contaminant flux to riparian consumers by strongly impacting the resource linkage. Our results demonstrate the importance of understanding the contaminant-specific effects of aquatic pollutants on adult insect emergence and contaminant accumulation in adults to predict impacts on terrestrial food webs.

  18. Childhood adversity increases the risk of onward transmission from perinatal HIV-infected adolescents and youth in South Africa.

    PubMed

    Kidman, Rachel; Nachman, Sharon; Dietrich, Janan; Liberty, Afaaf; Violari, Avy

    2018-05-01

    Repeated exposure to childhood adversity (abuse, neglect and other traumas experienced before age 18) can have lifelong impacts on health. For HIV-infected adolescents and youth, such impacts may include onward transmission of HIV. To evaluate this possibility, the current study measured the burden of childhood adversity and its influence on risky health behaviors among perinatally-infected adolescents and youth. We surveyed 250 perinatally-infected adolescents and youth (13-24 years) receiving care in Soweto, South Africa. Both male and female participants reported on childhood adversity (using the ACE-IQ), sexual behavior, and psychosocial state. Viral load was also abstracted from their charts. We used logistic regressions to test the association between cumulative adversity and behavioral outcomes. Half the sample reported eight or more adversities. Overall, 72% experienced emotional abuse, 59% experienced physical abuse, 34% experienced sexual abuse, 82% witnessed domestic violence, and 91% saw someone being attacked in their community. A clear gradient emerged between cumulative adversities and behavioral risk. Having experienced one additional childhood adversity raised the odds of risky sexual behavior by almost 30% (OR 1.27, 95% CI 1.09-1.48). Viral suppression was poor overall (31% had viral loads >400 copies/ml), but was not related to adversity. Adversity showed a robust relationship to depression and substance abuse. Childhood adversity is common, influences the current health of HIV-positive adolescents and youth, and puts their sexual partners at risk for HIV infection. Greater primary prevention of childhood adversity and increased access to support services (e.g., mental health) could reduce risk taking among HIV-positive adolescents and youth. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Kenya's health workforce information system: a model of impact on strategic human resources policy, planning and management.

    PubMed

    Waters, Keith P; Zuber, Alexandra; Willy, Rankesh M; Kiriinya, Rose N; Waudo, Agnes N; Oluoch, Tom; Kimani, Francis M; Riley, Patricia L

    2013-09-01

    Countries worldwide are challenged by health worker shortages, skill mix imbalances, and maldistribution. Human resources information systems (HRIS) are used to monitor and address these health workforce issues, but global understanding of such systems is minimal and baseline information regarding their scope and capability is practically non-existent. The Kenya Health Workforce Information System (KHWIS) has been identified as a promising example of a functioning HRIS. The objective of this paper is to document the impact of KHWIS data on human resources policy, planning and management. Sources for this study included semi-structured interviews with senior officials at Kenya's Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation (MOPHS), the Department of Nursing within MOMS, the Nursing Council of Kenya, Kenya Medical Practitioners and Dentists Board, Kenya's Clinical Officers Council, and Kenya Medical Laboratory Technicians and Technologists Board. Additionally, quantitative data were extracted from KHWIS databases to supplement the interviews. Health sector policy documents were retrieved from MOMS and MOPHS websites, and reviewed to assess whether they documented any changes to policy and practice as having been impacted by KHWIS data. Interviews with Kenyan government and regulatory officials cited health workforce data provided by KHWIS influenced policy, regulation, and management. Policy changes include extension of Kenya's age of mandatory civil service retirement from 55 to 60 years. Data retrieved from KHWIS document increased relicensing of professional nurses, midwives, medical practitioners and dentists, and interviewees reported this improved compliance raised professional regulatory body revenues. The review of Government records revealed few references to KHWIS; however, documentation specifically cited the KHWIS as having improved the availability of human resources for health information regarding workforce planning

  20. Effect of monthly vitamin D3 supplementation in healthy adults on adverse effects of earthquakes: randomised controlled trial

    PubMed Central

    Florkowski, Christopher M; Chambers, Stephen T; Priest, Patricia C; Stewart, Alistair W; Jennings, Lance C; Livesey, John H; Camargo, Carlos A; Scragg, Robert; Murdoch, David R

    2014-01-01

    Objective To determine whether supplementation with vitamin D improves resilience to the adverse effects of earthquakes. Design Opportunistic addition to an established randomised double blind placebo controlled trial. Setting Christchurch, New Zealand, where a prolonged series of catastrophic earthquakes beginning on 4 September 2010 occurred, which caused widespread destruction, fatalities, and extensive psychological damage. Participants 322 healthy adults (241 women; 81 men) aged 18-67 who were already participating in the vitamin D and acute respiratory infections study (VIDARIS) between February 2010 and November 2011. Intervention Participants were randomised to receive an oral dose of either 200 000 IU vitamin D3 monthly for two months then 100 000 IU monthly (n=161) or placebo (n=161) for a total of 18 months. Main outcome measure This is a post hoc analysis from the previously published VIDARIS trial. The primary endpoint in the current analysis was the self reported effects and overall adverse impact of the Christchurch earthquakes as assessed by questionnaire four months after the most destructive earthquake on 22 February 2011, which was used as the index event. The secondary end point was the number of “psychological” adverse events that participants reported at their usual monthly appointments as part of the original VIDARIS trial. Results 308 participants completed the earthquake impact questionnaire (n=152 in the vitamin D group and 156 in the placebo group). There was no significant difference in the number of self reported adverse effects between those receiving vitamin D supplementation and those receiving placebo. There was also no difference in the overall adverse impact score between treatment groups (χ2 P=0.44). The exception was that those in the vitamin D group experienced more adverse effects on family relationships (22% v 13%; χ2 P=0.03). The number of psychological adverse events—such as fatigue, stress, anxiety, and insomnia

  1. Effect of monthly vitamin D3 supplementation in healthy adults on adverse effects of earthquakes: randomised controlled trial.

    PubMed

    Slow, Sandy; Florkowski, Christopher M; Chambers, Stephen T; Priest, Patricia C; Stewart, Alistair W; Jennings, Lance C; Livesey, John H; Camargo, Carlos A; Scragg, Robert; Murdoch, David R

    2014-12-15

    To determine whether supplementation with vitamin D improves resilience to the adverse effects of earthquakes. Opportunistic addition to an established randomised double blind placebo controlled trial. Christchurch, New Zealand, where a prolonged series of catastrophic earthquakes beginning on 4 September 2010 occurred, which caused widespread destruction, fatalities, and extensive psychological damage. 322 healthy adults (241 women; 81 men) aged 18-67 who were already participating in the vitamin D and acute respiratory infections study (VIDARIS) between February 2010 and November 2011. Participants were randomised to receive an oral dose of either 200,000 IU vitamin D3 monthly for two months then 100,000 IU monthly (n=161) or placebo (n=161) for a total of 18 months. This is a post hoc analysis from the previously published VIDARIS trial. The primary endpoint in the current analysis was the self reported effects and overall adverse impact of the Christchurch earthquakes as assessed by questionnaire four months after the most destructive earthquake on 22 February 2011, which was used as the index event. The secondary end point was the number of "psychological" adverse events that participants reported at their usual monthly appointments as part of the original VIDARIS trial. 308 participants completed the earthquake impact questionnaire (n=152 in the vitamin D group and 156 in the placebo group). There was no significant difference in the number of self reported adverse effects between those receiving vitamin D supplementation and those receiving placebo. There was also no difference in the overall adverse impact score between treatment groups (χ(2) P=0.44). The exception was that those in the vitamin D group experienced more adverse effects on family relationships (22% v 13%; χ(2) P=0.03). The number of psychological adverse events-such as fatigue, stress, anxiety, and insomnia-that participants reported at their usual monthly appointments was significantly

  2. Incidence and economic burden of suspected adverse events and adverse event monitoring during AF therapy.

    PubMed

    Kim, M H; Lin, J; Hussein, M; Battleman, D

    2009-12-01

    Rhythm- and rate-control therapies are an essential part of atrial fibrillation (AF) management; however, the use of existing agents is often limited by the occurrence of adverse events. The aim of this study was to evaluate suspected adverse events and adverse event monitoring, and associated medical costs, in patients receiving AF rhythm-control and/or rate-control therapy. This retrospective cohort study used claims data from the Integrated Healthcare Information Systems National Managed Care Benchmark Database from 2002-2006. Patients hospitalized for AF (primary diagnosis), and who had at least 365 days' enrollment before and after the initial (index) AF hospitalization, were included in the analysis. Suspected AF therapy-related adverse events and function tests for adverse event monitoring were identified according to pre-specified diagnosis codes/procedures, and examined over the 12 months following discharge from the index hospitalization. Events/function tests had to have occurred within 90 days of a claim for AF therapy to be considered a suspected adverse event/adverse event monitoring. Of 4174 AF patients meeting the study criteria, 3323 received AF drugs; 428 received rhythm-control only (12.9%), 2130 rate-control only (64.1%), and 765 combined rhythm/rate-control therapy (23.0%). Overall, 50.1% of treated patients had a suspected adverse event and/or function test for adverse event monitoring (45.5% with rate-control, 53.5% with rhythm-control, and 61.2% with combined rhythm/rate-control). Suspected cardiovascular adverse events were the most common events (occurring in 36.1% of patients), followed by pulmonary (6.1%), and endocrine events (5.9%). Overall, suspected adverse events/function tests were associated with mean annual per-patient costs of $3089 ($1750 with rhythm-control, $2041 with rate control, and $6755 with combined rhythm/rate-control). As a retrospective analysis, the study is subject to potential selection bias, while its reliance on

  3. Reducing Adverse Childhood Experiences (ACE) by Building Community Capacity: A Summary of Washington Family Policy Council Research Findings

    PubMed Central

    Hall, Judy; Porter, Laura; Longhi, Dario; Becker-Green, Jody; Dreyfus, Susan

    2012-01-01

    Community capacity for organization and collaboration has been shown to be a powerful tool for improving the health and well-being of communities. Since 1994 the Washington State Family Policy Council has supported the development of community capacity in 42 community public health and safety networks. Community networks bring local communities together to restructure natural supports and local resources to meet the needs of families and children, and increase cross-system coordination and flexible funding streams to improve local services and policy. In this study, researchers sought to demonstrate the strong impact of the community networks’ capacity to interrupt health and social problems. Findings suggest that community networks reduce health and safety problems for the entire community population. Further, community networks with high community capacity reduced adverse childhood experiences (ACE) in young adults ages 18–34. PMID:22970785

  4. Quantitative Adverse Outcome Pathways and Their ...

    EPA Pesticide Factsheets

    A quantitative adverse outcome pathway (qAOP) consists of one or more biologically based, computational models describing key event relationships linking a molecular initiating event (MIE) to an adverse outcome. A qAOP provides quantitative, dose–response, and time-course predictions that can support regulatory decision-making. Herein we describe several facets of qAOPs, including (a) motivation for development, (b) technical considerations, (c) evaluation of confidence, and (d) potential applications. The qAOP used as an illustrative example for these points describes the linkage between inhibition of cytochrome P450 19A aromatase (the MIE) and population-level decreases in the fathead minnow (FHM; Pimephales promelas). The qAOP consists of three linked computational models for the following: (a) the hypothalamic-pitutitary-gonadal axis in female FHMs, where aromatase inhibition decreases the conversion of testosterone to 17β-estradiol (E2), thereby reducing E2-dependent vitellogenin (VTG; egg yolk protein precursor) synthesis, (b) VTG-dependent egg development and spawning (fecundity), and (c) fecundity-dependent population trajectory. While development of the example qAOP was based on experiments with FHMs exposed to the aromatase inhibitor fadrozole, we also show how a toxic equivalence (TEQ) calculation allows use of the qAOP to predict effects of another, untested aromatase inhibitor, iprodione. While qAOP development can be resource-intensive, the quan

  5. Accelerating Adverse Outcome Pathway (AOP) development ...

    EPA Pesticide Factsheets

    The Adverse Outcome Pathway (AOP) framework is increasingly being adopted as a tool for organizing and summarizing the mechanistic information connecting molecular perturbations by environmental stressors with adverse outcomes relevant for ecological and human health outcomes. However, the conventional process for assembly of these AOPs is time and resource intensive, and has been a rate limiting step for AOP use and development. Therefore computational approaches to accelerate the process need to be developed. We previously developed a method for generating computationally predicted AOPs (cpAOPs) by association mining and integration of data from publicly available databases. In this work, a cpAOP network of ~21,000 associations was established between 105 phenotypes from TG-GATEs rat liver data from different time points (including microarray, pathological effects and clinical chemistry data), 994 REACTOME pathways, 688 High-throughput assays from ToxCast and 194 chemicals. A second network of 128,536 associations was generated by connecting 255 biological target genes from ToxCast to 4,980 diseases from CTD using either HT screening activity from ToxCast for 286 chemicals or CTD gene expression changes in response to 2,330 chemicals. Both networks were separately evaluated through manual extraction of disease-specific cpAOPs and comparison with expert curation of the relevant literature. By employing data integration strategies that involve the weighting of n

  6. Impact of human resource management practices on nursing home performance.

    PubMed

    Rondeau, K V; Wagar, T H

    2001-08-01

    Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain

  7. Combating adverse selection in secondary PC markets.

    PubMed

    Hickey, Stewart W; Fitzpatrick, Colin

    2008-04-15

    Adverse selection is a significant contributor to market failure in secondary personal computer (PC) markets. Signaling can act as a potential solution to adverse selection and facilitate superior remarketing of second-hand PCs. Signaling is a means whereby usage information can be utilized to enhance consumer perception of both value and utility of used PCs and, therefore, promote lifetime extension for these systems. This can help mitigate a large portion of the environmental impact associated with PC system manufacture. In this paper, the computer buying and selling behavior of consumers is characterized via a survey of 270 Irish residential users. Results confirm the existence of adverse selection in the Irish market with 76% of potential buyers being unwilling to purchase and 45% of potential vendors being unwilling to sell a used PC. The so-called "closet affect" is also apparent with 78% of users storing their PC after use has ceased. Results also indicate that consumers place a higher emphasis on specifications when considering a second-hand purchase. This contradicts their application needs which are predominantly Internet and word-processing/spreadsheet/presentation applications, 88% and 60% respectively. Finally, a market solution utilizing self monitoring and reporting technology (SMART) sensors for the purpose of real time usage monitoring is proposed, that can change consumer attitudes with regard to second-hand computer equipment.

  8. Adverse Outcome Pathway (AOP) Network Development for ...

    EPA Pesticide Factsheets

    Adverse outcome pathways (AOPs) are descriptive biological sequences that start from a molecular initiating event (MIE) and end with an adverse health outcome. AOPs provide biological context for high throughput chemical testing and further prioritize environmental health risk research. According to the Organization for Economic Co-operation and Development guidelines, AOPs are pathways with one MIE anchored to an adverse outcome (AO) by key events (KEs) and key event relationships (KERs). However, this approach does not always capture the cumulative impacts of multiple MIEs on the AO. For example, hepatic lipid flux due to chemical-induced toxicity initiates from multiple ligand-activated receptors and signaling pathways that cascade across biology to converge upon a common fatty liver (FL, also known as steatosis) outcome. To capture this complexity, a top-down strategy was used to develop a FL AOP network (AOPnet). Literature was queried based on the terms steatosis, fatty liver, cirrhosis, and hepatocellular carcinoma. Search results were analyzed for physiological and pathophysiological organ level, cellular and molecular processes, as well as pathway intermediates, to identify potential KEs and MIEs that are key for hepatic lipid metabolism, maintenance, and dysregulation. The analysis identified four apical KE nodes (hepatic fatty acid uptake, de novo fatty acid and lipid synthesis, fatty acid oxidation, and lipid efflux) juxtaposed to the FL AO. The apic

  9. Optimizing Resources for Trustworthiness and Scientific Impact of Domain Repositories

    NASA Astrophysics Data System (ADS)

    Lehnert, K.

    2017-12-01

    Domain repositories, i.e. data archives tied to specific scientific communities, are widely recognized and trusted by their user communities for ensuring a high level of data quality, enhancing data value, access, and reuse through a unique combination of disciplinary and digital curation expertise. Their data services are guided by the practices and values of the specific community they serve and designed to support the advancement of their science. Domain repositories need to meet user expectations for scientific utility in order to be successful, but they also need to fulfill the requirements for trustworthy repository services to be acknowledged by scientists, funders, and publishers as a reliable facility that curates and preserves data following international standards. Domain repositories therefore need to carefully plan and balance investments to optimize the scientific impact of their data services and user satisfaction on the one hand, while maintaining a reliable and robust operation of the repository infrastructure on the other hand. Staying abreast of evolving repository standards to certify as a trustworthy repository and conducting a regular self-assessment and certification alone requires resources that compete with the demands for improving data holdings or usability of systems. The Interdisciplinary Earth Data Alliance (IEDA), a data facility funded by the US National Science Foundation, operates repositories for geochemical, marine Geoscience, and Antarctic research data, while also maintaining data products (global syntheses) and data visualization and analysis tools that are of high value for the science community and have demonstrated considerable scientific impact. Balancing the investments in the growth and utility of the syntheses with resources required for certifcation of IEDA's repository services has been challenging, and a major self-assessment effort has been difficult to accommodate. IEDA is exploring a partnership model to share

  10. Statin-Associated Muscle-Related Adverse Effects: A Case Series of 354 Patients

    PubMed Central

    Cham, Stephanie; Evans, Marcella A.; Denenberg, Julie O.; Golomb, Beatrice A.

    2016-01-01

    Study Objective To characterize the properties and natural history of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin)-associated muscle-related adverse effects (MAEs). Design Patient-targeted postmarketing adverse-effect surveillance approach coupling survey design with an open-ended narrative. Setting University-affiliated health care system. Subjects Three hundred fifty-four patients (age range 34–86 yrs) who self-reported muscle-related problems associated with statin therapy. Measurements and Main Results Patients with perceived statin-associated MAEs completed a survey assessing statin drugs and dosages; characteristics of the MAEs; time course of onset, resolution, or recurrence; and impact on quality of life (QOL). Cases were assessed for putative drug adverse-effect causality by using the Naranjo adverse drug reaction probability scale criteria and were evaluated for inclusion in groups for which mortality benefit with statins has been shown. Patients reported muscle pain (93%), fatigue (88%), and weakness (85%). Three hundred patients (85%) met literature criteria for probable or definite drug adverse-effect causality. Ninety-four percent of atorvastatin usages (240/255) generated MAEs versus 61% of lovastatin usages (38/62, p<0.0001). Higher potency statins reproduced MAEs in 100% of 39 rechallenges versus 73% (29/40) with lower potency rechallenges (p<0.01). Time course of onset after statin initiation varied (median 14 wks); some MAEs occurred after long-term symptom-free use. Recurrence with rechallenge had a significantly shorter latency to onset (median 2 wks). The MAEs adversely affected all assessed functional and QOL domains. Most patients with probable or definite MAEs were in categories for which available randomized controlled trial evidence shows no trend to all-cause mortality benefit with statin therapy. Conclusion This study complements available information on the properties and natural history of statin

  11. Statin-associated muscle-related adverse effects: a case series of 354 patients.

    PubMed

    Cham, Stephanie; Evans, Marcella A; Denenberg, Julie O; Golomb, Beatrice A

    2010-06-01

    To characterize the properties and natural history of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin)-associated muscle-related adverse effects (MAEs). Patient-targeted postmarketing adverse-effect surveillance approach coupling survey design with an open-ended narrative. University-affiliated health care system. Three hundred fifty-four patients (age range 34-86 yrs) who self-reported muscle-related problems associated with statin therapy. Patients with perceived statin-associated MAEs completed a survey assessing statin drugs and dosages; characteristics of the MAEs; time course of onset, resolution, or recurrence; and impact on quality of life (QOL). Cases were assessed for putative drug adverse-effect causality by using the Naranjo adverse drug reaction probability scale criteria and were evaluated for inclusion in groups for which mortality benefit with statins has been shown. Patients reported muscle pain (93%), fatigue (88%), and weakness (85%). Three hundred patients (85%) met literature criteria for probable or definite drug adverse-effect causality. Ninety-four percent of atorvastatin usages (240/255) generated MAEs versus 61% of lovastatin usages (38/62, p<0.0001). Higher potency statins reproduced MAEs in 100% of 39 rechallenges versus 73% (29/40) with lower potency rechallenges (p<0.01). Time course of onset after statin initiation varied (median 14 wks); some MAEs occurred after long-term symptom-free use. Recurrence with rechallenge had a significantly shorter latency to onset (median 2 wks). The MAEs adversely affected all assessed functional and QOL domains. Most patients with probable or definite MAEs were in categories for which available randomized controlled trial evidence shows no trend to all-cause mortality benefit with statin therapy. This study complements available information on the properties and natural history of statin-associated MAEs, affirming dose dependence and strong QOL impact. The data indicating a dose

  12. Promoting Resilience: Breaking the Intergenerational Cycle of Adverse Childhood Experiences.

    PubMed

    Woods-Jaeger, Briana A; Cho, Bridget; Sexton, Chris C; Slagel, Lauren; Goggin, Kathy

    2018-02-01

    Adverse childhood experiences (ACEs), including trauma exposure, parent mental health problems, and family dysfunction, put children at risk for disrupted brain development and increased risk for later health problems and mortality. These negative effects may be prevented by resilience promoting environments that include protective caregiving relationships. We sought to understand (1) parents' experiences of ACEs, (2) the perceived impact on parenting, (3) protective factors that buffer ACEs potential negative impact, and (4) supports and services that can reduce the number and severity of ACEs and promote resilience among children exposed to early adversity. We conducted in-depth qualitative interviews with 11 low-income, urban parents of young children who had experienced ACEs. Interviews were analyzed for emergent themes and shared with parents from the community to ensure relevance and proper interpretation. Themes from these interviews describe the potential intergenerational cycle of ACEs and key factors that can break that cycle, including parent aspirations to make children's lives better and parent nurturance and support. Parents' suggestions for intervention are also presented. Our findings illuminate protective factors and family strengths that are important to build upon when developing and implementing interventions to promote resilience among parents and children exposed to early adversity. This study benefits from highly ecologically valid data obtained from low-socioeconomic status, racial/ethnic minority parents through one-on-one in-depth interviews and interpreted with the aid of community stakeholders through a community-based participatory research approach.

  13. Biomarkers in Natural Fish Populations Indicate Adverse Biological Effects of Offshore Oil Production

    PubMed Central

    Balk, Lennart; Hylland, Ketil; Hansson, Tomas; Berntssen, Marc H. G.; Beyer, Jonny; Jonsson, Grete; Melbye, Alf; Grung, Merete; Torstensen, Bente E.; Børseth, Jan Fredrik; Skarphedinsdottir, Halldora; Klungsøyr, Jarle

    2011-01-01

    Background Despite the growing awareness of the necessity of a sustainable development, the global economy continues to depend largely on the consumption of non-renewable energy resources. One such energy resource is fossil oil extracted from the seabed at offshore oil platforms. This type of oil production causes continuous environmental pollution from drilling waste, discharge of large amounts of produced water, and accidental spills. Methods and principal findings Samples from natural populations of haddock (Melanogrammus aeglefinus) and Atlantic cod (Gadus morhua) in two North Sea areas with extensive oil production were investigated. Exposure to and uptake of polycyclic aromatic hydrocarbons (PAHs) were demonstrated, and biomarker analyses revealed adverse biological effects, including induction of biotransformation enzymes, oxidative stress, altered fatty acid composition, and genotoxicity. Genotoxicity was reflected by a hepatic DNA adduct pattern typical for exposure to a mixture of PAHs. Control material was collected from a North Sea area without oil production and from remote Icelandic waters. The difference between the two control areas indicates significant background pollution in the North Sea. Conclusion It is most remarkable to obtain biomarker responses in natural fish populations in the open sea that are similar to the biomarker responses in fish from highly polluted areas close to a point source. Risk assessment of various threats to the marine fish populations in the North Sea, such as overfishing, global warming, and eutrophication, should also take into account the ecologically relevant impact of offshore oil production. PMID:21625421

  14. Biomarkers in natural fish populations indicate adverse biological effects of offshore oil production.

    PubMed

    Balk, Lennart; Hylland, Ketil; Hansson, Tomas; Berntssen, Marc H G; Beyer, Jonny; Jonsson, Grete; Melbye, Alf; Grung, Merete; Torstensen, Bente E; Børseth, Jan Fredrik; Skarphedinsdottir, Halldora; Klungsøyr, Jarle

    2011-01-01

    Despite the growing awareness of the necessity of a sustainable development, the global economy continues to depend largely on the consumption of non-renewable energy resources. One such energy resource is fossil oil extracted from the seabed at offshore oil platforms. This type of oil production causes continuous environmental pollution from drilling waste, discharge of large amounts of produced water, and accidental spills. Samples from natural populations of haddock (Melanogrammus aeglefinus) and Atlantic cod (Gadus morhua) in two North Sea areas with extensive oil production were investigated. Exposure to and uptake of polycyclic aromatic hydrocarbons (PAHs) were demonstrated, and biomarker analyses revealed adverse biological effects, including induction of biotransformation enzymes, oxidative stress, altered fatty acid composition, and genotoxicity. Genotoxicity was reflected by a hepatic DNA adduct pattern typical for exposure to a mixture of PAHs. Control material was collected from a North Sea area without oil production and from remote Icelandic waters. The difference between the two control areas indicates significant background pollution in the North Sea. It is most remarkable to obtain biomarker responses in natural fish populations in the open sea that are similar to the biomarker responses in fish from highly polluted areas close to a point source. Risk assessment of various threats to the marine fish populations in the North Sea, such as overfishing, global warming, and eutrophication, should also take into account the ecologically relevant impact of offshore oil production.

  15. Weight of evidence evaluation of a network of adverse ...

    EPA Pesticide Factsheets

    Ongoing honey bee colony losses are of significant international concern because of the essential role these insects play in pollinating many high nutrient crops, such as fruits, vegetables, and nuts. Both chemical and non-chemical stressors have been implicated as possible contributors to colony failure, however, the potential role(s) of commonly-used neonicotinoid insecticides has emerged as particularly concerning. Neonicotinoids act on the nicotinic acetylcholine receptors (nAChRs) in the central nervous system to eliminate target pest insects. However, mounting evidence indicates that these neonicotinoids also may adversely affect beneficial pollinators, such as the honey bee, via impairments on learning and memory, and ultimately foraging success. The specific mechanisms linking activation of the nAChR to adverse effects on learning and memory are uncertain. Additionally, clear connections between observed impacts on individual bees and colony level effects are lacking. The objective of this review was to develop adverse outcome pathways (AOPs) as a means to evaluate the biological plausibility and empirical evidence supporting (or refuting) the linkage between activation of the physiological target site, the nAChR, and colony level consequences. Development of AOPs has led to the identification of research gaps which, for example, may be of high priority in understanding how perturbation of pathways involved in neurotransmission can adversely affect norm

  16. The EPA's Study on the Potential Impacts of Hydraulic Fracturing on Drinking Water Resources

    NASA Astrophysics Data System (ADS)

    Burden, Susan

    2013-03-01

    Natural gas plays a key role in our nation's clean energy future. The United States has vast reserves of natural gas that are commercially viable as a result of advances in horizontal drilling and hydraulic fracturing technologies, which enable greater access to gas in rock formations deep underground. These advances have spurred a significant increase in the production of both natural gas and oil across the country. However, as the use of hydraulic fracturing has increased, so have concerns about its potential human health and environmental impacts, especially for drinking water. In response to public concern, the US Congress requested that the US Environmental Protection Agency (EPA) conduct scientific research to examine the relationship between hydraulic fracturing and drinking water resources. In 2011, the EPA began research to assess the potential impacts of hydraulic fracturing on drinking water resources, if any, and to identify the driving factors that may affect the severity and frequency of such impacts. The study is organized around the five stages of the hydraulic fracturing water cycle, from water acquisition through the mixing of chemicals and the injection of fracturing fluid to post-fracturing treatment and/or disposal of wastewater. EPA scientists are using a transdisciplinary research approach involving laboratory studies, computer modeling, toxicity assessments, and case studies to answer research questions associated with each stage of the water cycle. This talk will provide an overview of the EPA's study, including a description of the hydraulic fracturing water cycle and a summary of the ongoing research projects.

  17. Measuring Impact of U.S. DOE Geothermal Technologies Office Funding: Considerations for Development of a Geothermal Resource Reporting Metric

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Young, Katherine R.; Wall, Anna M.; Dobson, Patrick F.

    This paper reviews existing methodologies and reporting codes used to describe extracted energy resources such as coal and oil and describes a comparable proposed methodology to describe geothermal resources. The goal is to provide the U.S. Department of Energy's (DOE) Geothermal Technologies Office (GTO) with a consistent and comprehensible means of assessing the impacts of its funding programs. This framework will allow for GTO to assess the effectiveness of research, development, and deployment (RD&D) funding, prioritize funding requests, and demonstrate the value of RD&D programs to the U.S. Congress. Standards and reporting codes used in other countries and energy sectorsmore » provide guidance to inform development of a geothermal methodology, but industry feedback and our analysis suggest that the existing models have drawbacks that should be addressed. In order to formulate a comprehensive metric for use by GTO, we analyzed existing resource assessments and reporting methodologies for the geothermal, mining, and oil and gas industries, and we sought input from industry, investors, academia, national labs, and other government agencies. Using this background research as a guide, we describe a methodology for assessing and reporting on GTO funding according to resource knowledge and resource grade (or quality). This methodology would allow GTO to target funding or measure impact by progression of projects or geological potential for development.« less

  18. Adverse childhood experiences and disability in U.S. adults.

    PubMed

    Schüssler-Fiorenza Rose, Sophia Miryam; Xie, Dawei; Stineman, Margaret

    2014-08-01

    dysfunction and self-reported disability in adulthood, even after adjusting for potentially mediating health conditions. Greater clinician, researcher, and policymaker awareness of the impact of childhood adversity on disability is crucial to help those affected by childhood adversity lead more functional lives. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  19. Adverse conditions at the workplace are associated with increased suicide risk.

    PubMed

    Baumert, Jens; Schneider, Barbara; Lukaschek, Karoline; Emeny, Rebecca T; Meisinger, Christa; Erazo, Natalia; Dragano, Nico; Ladwig, Karl-Heinz

    2014-10-01

    The present study addressed potential harms of a negative working environment for employed subjects. The main aim was to evaluate if adverse working conditions and job strain are related to an increase in suicide mortality. The study population consisted of 6817 participants drawn from the MONICA/KORA Augsburg, Germany, surveys conducted in 1984-1995, being employed at baseline examination and followed up on average for 12.6 years. Adverse working conditions were assessed by an instrument of 16 items about chronobiological, physical and psychosocial conditions at the workplace, job strain was assessed as defined by Karasek. Suicide risks were estimated by Cox regression adjusted for suicide-related risk factors. A number of 28 suicide cases were observed within follow-up. High levels of adversity in chronobiological/physical working conditions significantly increased the risk for suicide mortality (HR 3.28, 95% CI 1.43-7.54) compared to low/intermediate levels in a model adjusted for age, sex and survey (p value 0.005). Additional adjustment for living alone, low educational level, smoking, high alcohol consumption, obesity and depressed mood attenuated this effect (HR 2.73) but significance remained (p value 0.022). Adverse psychosocial working conditions and job strain, in contrast, had no impact on subsequent suicide mortality risk (p values > 0.200). A negative working environment concerning chronobiological or physical conditions at the workplace had an unfavourable impact on suicide mortality risk, even after controlling for relevant suicide-related risk factors. Employer interventions aimed to improve workplace conditions might be considered as a suitable means to prevent suicides among employees. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Evaluating the impact of health resource reconstruction on improving spatial accessibility of tuberculosis care.

    PubMed

    Izumi, K; Kawatsu, L; Ohkado, A; Uchimura, K; Kato, S

    2016-11-01

    In Japan, a decline in tuberculosis (TB) notification rates and shortening of duration of hospitalisation have led to a drastic decrease in the number of hospital beds for TB patients (TB beds), causing severe undersupply in certain regions. To assess the current status of spatial access to TB beds in Japan and evaluate the potential impact of health resource reconstruction in mitigating undersupply of TB beds. A cross-sectional study was conducted whereby a two-step floating catchment area (2SFCA) method was used to calculate an 'accessibility score' to evaluate spatial accessibility of TB beds in the regions classified by four levels of urbanisation. The impact of introducing 'potential TB beds' was assessed via the changes in the proportion of undersupplied regions and TB patients notified from undersupplied regions. Undersupplied regions were characterised by 'very low', 'low' and 'moderate' level of urbanisation. By introducing 'potential TB beds', the proportion of both undersupplied regions and TB patients could be significantly reduced, especially in less urbanised regions. Our results may be used to guide future decision-making over resource allocation of TB care in Japan. The 2SFCA method may be applied to other countries using appropriate demand and supply variables.

  1. Practitioner Review: Diagnosing childhood resilience--a systemic approach to the diagnosis of adaptation in adverse social and physical ecologies.

    PubMed

    Ungar, Michael

    2015-01-01

    With growing interest in resilience among mental health care providers globally, there is a need for a simple way to consider the complex interactions that predict adaptive coping when there is exposure to high levels of adversity such as family violence, mental illness of a child or caregiver, natural disasters, social marginalization, or political conflict. This article presents diagnostic criteria for assessing childhood resilience in a way that is sensitive to the systemic factors that influence a child's wellbeing. The most important characteristics of children who cope well under adversity and avoid problems like depression, PTSD, and delinquency are highlighted. A multidimensional assessment of resilience is presented that examines, first, the severity, chronicity, ecological level, children's attributions of causality, and cultural and contextual relevance of experiences of adversity. Second, promotive and protective factors related to resilience are assessed with sensitivity to the differential impact these have on outcomes depending on a child's level of exposure to adversity. These factors include individual qualities like temperament, personality, and cognitions, as well as contextual dimensions of positive functioning related to the available and accessibility of resources, their strategic use, positive reinforcement by a child's significant others, and the adaptive capacity of the environment itself. Third, an assessment of resilience includes temporal and cultural factors that increase or decrease the influence of protective factors. A decision tree for the diagnosis of resilience is presented, followed by a case study and diagnosis of a 15-year-old boy who required treatment for a number of mental health challenges. The diagnostic criteria for assessing resilience and its application to clinical practice demonstrate the potential usefulness of a systemic approach to understanding resilience among child populations. © 2014 Association for Child and

  2. The Associations Between Air Pollution and Adverse Pregnancy Outcomes in China.

    PubMed

    Tan, Yafei; Yang, Rong; Zhao, Jinzhu; Cao, Zhongqiang; Chen, Yawen; Zhang, Bin

    2017-01-01

    Research on the potential impact of air pollution on the human's health has increased rapidly in recent years. Several studies have suggested that exposure to air pollutants during period of pregnancy which is a crucial time point of mother-fetus development may have long-term and serious impact on adverse pregnancy outcomes. There is lack of review to evaluate the existed epidemiologic evidence on the associations between air pollutants and adverse pregnancy outcomes in China, so we conducted a review to explore the current epidemiological evidence on the effects of air pollutants to pregnancy outcomes and possible mechanisms during the pregnancy process. We used keywords to systematically search all the English and Chinese literatures on studies that were conducted in China. Exposure to air pollutants during pregnancy had shown there were harmful effects for different birth outcomes: preterm birth, low birth weight, stillbirth, birth defects, infertility, and macrosomia fetus. Results on the effects of air pollutants on adverse pregnancy outcomes are small and inconsistent because they vary in their design and methodology. The existed available evidence is compatible with either a small negative effect of air pollutants on pregnancy outcomes or with no effect; therefore, further studies are needed to confirm and quantify the possible associations and potential biologic mechanisms between air pollutants and pregnancy outcomes.

  3. The impact of gestational diabetes and hypothyroidism on the third-trimester ultrasound parameters and in adverse perinatal outcomes: a retrospective cohort study.

    PubMed

    Peixoto, Alberto Borges; Caldas, Taciana Mara Rodrigues da Cunha; Santos, Raisa Oliveira; Lopes, Karina Souza; Martins, Wellington P; Araujo Júnior, Edward

    2016-11-01

    To assess the impact of gestational diabetes and hypothyroidism on the third-trimester ultrasound parameters and in adverse perinatal outcomes. We performed a retrospective cohort study with 817 singleton pregnant women between 26w0d and 37w6d of gestation which were divided in four groups: 56 gestational diabetes mellitus (GDM), 63 hypothyroidism, 14 GDM + hypothyroidism, and 684 controls. The following ultrasound parameters were assessed: mean uterine artery pulsatility index (PI), umbilical artery PI, middle cerebral artery PI, single deepest pocket (SDP) and cerebroplacental ratio (CPR). Adverse perinatal outcomes were the following: low birth weight, macrosomia, and Agar score at 1st min <7. These four groups were compared using the Kruskall-Wallis and χ(2) tests. Pregnant women from GDM showed higher weight (p < 0.001), BMI (p < 0.001), SDP (p < 0.001) and newborns with higher birth weight (p = 0.008) and macrosomia (p = 0.02) than other groups. Comparing with control, hypothyroidism showed higher SDP (p < 0.05). Pregnant women with GDM showed higher risk of macrosomic newborns than other three groups. Both pregnant women with GDM and hypothyroidism showed higher SDP than normal pregnancies.

  4. The impacts of climate change on water resources and agriculture in China.

    PubMed

    Piao, Shilong; Ciais, Philippe; Huang, Yao; Shen, Zehao; Peng, Shushi; Li, Junsheng; Zhou, Liping; Liu, Hongyan; Ma, Yuecun; Ding, Yihui; Friedlingstein, Pierre; Liu, Chunzhen; Tan, Kun; Yu, Yongqiang; Zhang, Tianyi; Fang, Jingyun

    2010-09-02

    China is the world's most populous country and a major emitter of greenhouse gases. Consequently, much research has focused on China's influence on climate change but somewhat less has been written about the impact of climate change on China. China experienced explosive economic growth in recent decades, but with only 7% of the world's arable land available to feed 22% of the world's population, China's economy may be vulnerable to climate change itself. We find, however, that notwithstanding the clear warming that has occurred in China in recent decades, current understanding does not allow a clear assessment of the impact of anthropogenic climate change on China's water resources and agriculture and therefore China's ability to feed its people. To reach a more definitive conclusion, future work must improve regional climate simulations-especially of precipitation-and develop a better understanding of the managed and unmanaged responses of crops to changes in climate, diseases, pests and atmospheric constituents.

  5. [Adverse effects of oxcarbazepine].

    PubMed

    Fang, Shu; Gong, Zhi-Cheng

    2015-04-01

    Oxcarbazepine is a new antiepileptic drug. The results of clinical trials suggest that oxcarbazepine is well tolerated and has less drug interactions. It is being used more and more widely in clinical practice, but its adverse effects should not be ignored. The most common adverse effects of oxcarbazepine are usually related to the central nervous system and digestive system, including fatigue, drowsiness, diplopia, dizziness, nausea and vomit. The common skin adverse reaction is rash. Long-term use of oxcarbazepine may also cause hyponatremia. This article reviews the literature from China and overseas about the adverse effets of oxcarbazepine over the last 10 years in order to find information about rational clinical use of oxcarbazepine.

  6. The scale-dependent impact of wolf predation risk on resource selection by three sympatric ungulates.

    PubMed

    Kittle, Andrew M; Fryxell, John M; Desy, Glenn E; Hamr, Joe

    2008-08-01

    Resource selection is a fundamental ecological process impacting population dynamics and ecosystem structure. Understanding which factors drive selection is vital for effective species- and landscape-level management. We used resource selection probability functions (RSPFs) to study the influence of two forms of wolf (Canis lupus) predation risk, snow conditions and habitat variables on white-tailed deer (Odocoileus virginianus), elk (Cervus elaphus) and moose (Alces alces) resource selection in central Ontario's mixed forest French River-Burwash ecosystem. Direct predation risk was defined as the frequency of a predator's occurrence across the landscape and indirect predation risk as landscape features associated with a higher risk of predation. Models were developed for two winters, each at two spatial scales, using a combination of GIS-derived and ground-measured data. Ungulate presence was determined from snow track transects in 64 16- and 128 1-km(2) resource units, and direct predation risk from GPS radio collar locations of four adjacent wolf packs. Ungulates did not select resources based on the avoidance of areas of direct predation risk at any scale, and instead exhibited selection patterns that tradeoff predation risk minimization with forage and/or mobility requirements. Elk did not avoid indirect predation risk, while both deer and moose exhibited inconsistent responses to this risk. Direct predation risk was more important to models than indirect predation risk but overall, abiotic topographical factors were most influential. These results indicate that wolf predation risk does not limit ungulate habitat use at the scales investigated and that responses to spatial sources of predation risk are complex, incorporating a variety of anti-predator behaviours. Moose resource selection was influenced less by snow conditions than cover type, particularly selection for dense forest, whereas deer showed the opposite pattern. Temporal and spatial scale

  7. Anxiety Adversely Impacts Response to Cognitive Behavioral Therapy in Children with Chronic Pain.

    PubMed

    Cunningham, Natoshia Raishevich; Jagpal, Anjana; Tran, Susan T; Kashikar-Zuck, Susmita; Goldschneider, Kenneth R; Coghill, Robert C; Lynch-Jordan, Anne M

    2016-04-01

    To evaluate whether clinical anxiety in children presenting to a pediatric pain management center is associated with a poorer treatment response for those who completed pain-focused cognitive behavioral therapy (CBT). The total sample consisted of 175 children, 40 of whom completed CBT for chronic pain. The Screen for Child Anxiety Related Emotional Disorders was completed at initial evaluation and outcome measures (average pain intensity and the Functional Disability Inventory) were collected during the initial evaluation and at the end of CBT. Group differences in outcomes were examined following CBT. The role of anxiety in CBT initiation and completion was also explored. Presence of clinical anxiety was associated with greater initiation and/or completion of pain-focused CBT but also a poorer treatment response. Specifically, the group with subclinical anxiety exhibited a substantial reduction in pain intensity, and the group with clinical anxiety exhibited a more limited response to treatment (F [1, 36] = 13.68 P < .01). A similar effect was observed for Functional Disability Inventory, such that the group with clinical anxiety had a significantly smaller response to treatment (F [1, 38] = 4.33 P < .05). The difference in pain and disability between groups following CBT suggest moderate effects (Cohen d = 0.77 and 0.78, respectively). Although youths with clinical anxiety are more likely to start and/or complete pain-focused CBT, anxiety has an adverse impact on CBT treatment response in children with chronic pain. Identification of patients with anxiety and use of tailored behavioral interventions may improve clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Tourism impacts of Three Mile Island and other adverse events: Implications for Lincoln County and other rural counties bisected by radioactive wastes intended for Yucca Mountain

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Himmelberger, J.J.; Ogneva-Himmelberger, Y.A.; Baughman, M.

    Whether the proposed Yucca Mountain nuclear waste repository system will adversely impact tourism in southern Nevada is an open question of particular importance to visitor-oriented rural counties bisected by planned waste transportation corridors (highway or rail). As part of one such county`s repository impact assessment program, tourism implications of Three Mile Island (TMI) and other major hazard events have been revisited to inform ongoing county-wide socioeconomic assessments and contingency planning efforts. This paper summarizes key research implications of such research as applied to Lincoln County, Nevada. Implications for other rural counties are discussed in light of the research findings. 29more » refs., 3 figs., 1 tab.« less

  9. The relationship between childhood adversity and food insecurity: 'It's like a bird nesting in your head'.

    PubMed

    Chilton, Mariana; Knowles, Molly; Rabinowich, Jenny; Arnold, Kimberly T

    2015-10-01

    Adverse childhood experiences, including abuse, neglect and household instability, affect lifelong health and economic potential. The present study investigates how adverse childhood experiences are associated with food insecurity by exploring caregivers' perceptions of the impact of their childhood adversity on educational attainment, employment and mental health. Semi-structured audio-recorded in-person interviews that included (i) quantitative measures of maternal and child health, adverse childhood experiences (range: 0-10) and food security using the US Household Food Security Survey Module; and (ii) qualitative audio-recorded investigations of experiences with abuse, neglect, violence and hunger over participants' lifetimes. Households in Philadelphia, PA, USA. Thirty-one mothers of children <4 years old who reported low or very low household food security. Twenty-one caregivers (68 %) reported four or more adverse childhood experiences, and this severity was significantly associated with reports of very low food security (Fisher's exact P=0·021). Mothers reporting emotional and physical abuse were more likely to report very low food security (Fisher's exact P=0·032). Qualitatively, participants described the impact of childhood adverse experiences with emotional and physical abuse/neglect, and household substance abuse, on their emotional health, school performance and ability to maintain employment. In turn, these experiences negatively affected their ability to protect their children from food insecurity. The associations between mothers' adverse experiences in childhood and reports of current household food security should inspire researchers, advocates and policy makers to comprehensively address family hardship through greater attention to the emotional health of caregivers. Programmes meant to address nutritional deprivation and financial hardship should include trauma-informed approaches that integrate behavioural interventions.

  10. Cumulative exergy extraction from the natural environment (CEENE): a comprehensive life cycle impact assessment method for resource accounting.

    PubMed

    Dewulf, J; Bösch, M E; De Meester, B; Van der Vorst, G; Van Langenhove, H; Hellweg, S; Huijbregts, M A J

    2007-12-15

    The objective of the paper is to establish a comprehensive resource-based life cycle impact assessment (LCIA) method which is scientifically sound and that enables to assess all kinds of resources that are deprived from the natural ecosystem, all quantified on one single scale, free of weighting factors. The method is based on the exergy concept. Consistent exergy data on fossils, nuclear and metal ores, minerals, air, water, land occupation, and renewable energy sources were elaborated, with well defined system boundaries. Based on these data, the method quantifies the exergy "taken away" from natural ecosystems, and is thus called the cumulative exergy extraction from the natural environment (CEENE). The acquired data set was coupled with a state-of-the art life cycle inventory database, ecoinvent. In this way, the method is able to quantitatively distinguish eight categories of resources withdrawn from the natural environment: renewable resources, fossil fuels, nuclear energy, metal ores, minerals, water resources, land resources, and atmospheric resources. Third, the CEENE method is illustrated for a number of products that are available in ecoinvent, and results are compared with common resource oriented LCIA methods. The application to the materials in the ecoinvent database showed that fossil resources and land use are of particular importance with regard to the total CEENE score, although the other resource categories may also be significant.

  11. The introduction of syphilis point of care tests in resource limited settings.

    PubMed

    Marks, Michael; Mabey, David Cw

    2017-04-01

    Syphilis remains an important and preventable cause of stillbirth and neonatal mortality. About 1 million women with active syphilis become pregnant each year. Without treatment, 25% of them will deliver a stillborn baby and 33% a low birth weight baby with an increased chance of dying in the first month of life. Adverse pregnancy outcomes due to syphilis can be prevented by screening pregnant women, and treating those who test positive with a single dose of penicillin before 28 weeks' gestation. Areas covered: This manuscript covers the impact of syphilis on pregnancy outcome, the diagnosis of syphilis, with a special focus on point of care (POC) tests, and challenges to the introduction of POC tests, and their potential impact on the control and prevention of syphilis in resource limited settings. Expert commentary: POC tests for syphilis are available which meet the ASSURED criteria, and could make syphilis screening accessible to all women anywhere in the world who attend an antenatal clinic. High quality dual POC tests for HIV and syphilis could ensure that well-funded programmes for the prevention of mother to child transmission of HIV can contribute towards increased coverage of antenatal syphilis screening, and prevent more than 300,000 adverse pregnancy outcomes due to syphilis annually. Alongside investment to increase availability of syphilis POC tests, operational research is needed to understand how best to improve screening of pregnant women and to translate test availability into improved pregnancy outcomes.

  12. Impact of scabies in resource-poor communities.

    PubMed

    Heukelbach, Jorg; Mazigo, Humphrey D; Ugbomoiko, Uade S

    2013-04-01

    Features of endemic scabies are specific in resource-poor and underprivileged communities, with implications for control measures on the community level. In this review, these special aspects are addressed. Scabies is endemic in many resource-poor communities, with a prevalence of 20% and higher. Transmission is influenced by social attitudes, migration, access to healthcare services, housing conditions, hygiene conditions, and crowding. Endemic scabies occurs with severe infestations, complications, and sequels, mainly in children. Sleep loss as a result of scabies-related itching is common. Complications include secondary infections by group A streptococci and acute poststreptococcal glomerulonephritis. Shame, restriction of leisure activities, and stigmatization are common. Treatment of scabies includes a variety of topical compounds, but control on the community level is not an easy task. As ivermectin kills a variety of other parasites, this oral drug is increasingly used for mass treatment. Intervention should address socioemotional aspects using an integrated approach with professionals from different areas, and the community. Scabies is a neglected disease and needs to be perceived as an important public health problem causing morbidity in many resource-poor communities. Future work on epidemiology, clinical aspects, transmission dynamics, socioeconomic aspects, and sustainable control in resource-poor communities is needed.

  13. Modelling the resource implications and budget impact of managing cow milk allergy in Australia.

    PubMed

    Guest, J F; Nagy, E

    2009-02-01

    To estimate the resource implications and budget impact of current clinical practice for managing cow milk allergy (CMA) in Australia, from the perspective of the publicly funded healthcare system. A decision model was constructed using published clinical outcomes and clinician-derived resource utilisation estimates. The model was used to estimate the expected 6-monthly levels of healthcare resource use and corresponding costs attributable to managing 6150 new CMA sufferers following referral to a specialist. The expected 6-monthly costs of managing 6150 newly-diagnosed infants with CMA following referral to a specialist was an estimated (Australian dollars, AU$) AU$6.5 million at 2006/07 prices. Clinical nutrition preparations were found to be the primary cost driver accounting for 62% of the total 6-monthly cost and clinician visits were the secondary cost driver accounting for up to a further 28% of the total 6-monthly cost. Sensitivity analysis showed there would be fewer visits to hospital-based paediatric gastroenterologists and paediatric immunologists/allergists if all newly-diagnosed patients were prescribed an amino acid formula (AAF) following referral to a specialist, instead of being managed according to current practice. CMA imposes a substantial burden on the publicly funded healthcare system in Australia. However, using an AAF as the initial treatment for CMA can potentially release limited hospital resources for alternative use within the paediatric healthcare system.

  14. Ventilator-associated respiratory infection in a resource-restricted setting: impact and etiology.

    PubMed

    Phu, Vu Dinh; Nadjm, Behzad; Duy, Nguyen Hoang Anh; Co, Dao Xuan; Mai, Nguyen Thi Hoang; Trinh, Dao Tuyet; Campbell, James; Khiem, Dong Phu; Quang, Tran Ngoc; Loan, Huynh Thi; Binh, Ha Son; Dinh, Quynh-Dao; Thuy, Duong Bich; Lan, Huong Nguyen Phu; Ha, Nguyen Hong; Bonell, Ana; Larsson, Mattias; Hoan, Hoang Minh; Tuan, Đang Quoc; Hanberger, Hakan; Minh, Hoang Nguyen Van; Yen, Lam Minh; Van Hao, Nguyen; Binh, Nguyen Gia; Chau, Nguyen Van Vinh; Van Kinh, Nguyen; Thwaites, Guy E; Wertheim, Heiman F; van Doorn, H Rogier; Thwaites, C Louise

    2017-01-01

    Ventilator-associated respiratory infection (VARI) is a significant problem in resource-restricted intensive care units (ICUs), but differences in casemix and etiology means VARI in resource-restricted ICUs may be different from that found in resource-rich units. Data from these settings are vital to plan preventative interventions and assess their cost-effectiveness, but few are available. We conducted a prospective observational study in four Vietnamese ICUs to assess the incidence and impact of VARI. Patients ≥ 16 years old and expected to be mechanically ventilated > 48 h were enrolled in the study and followed daily for 28 days following ICU admission. Four hundred fifty eligible patients were enrolled over 24 months, and after exclusions, 374 patients' data were analyzed. A total of 92/374 cases of VARI (21.7/1000 ventilator days) were diagnosed; 37 (9.9%) of these met ventilator-associated pneumonia (VAP) criteria (8.7/1000 ventilator days). Patients with any VARI, VAP, or VARI without VAP experienced increased hospital and ICU stay, ICU cost, and antibiotic use ( p  < 0.01 for all). This was also true for all VARI ( p  < 0.01 for all) with/without tetanus. There was no increased risk of in-hospital death in patients with VARI compared to those without (VAP HR 1.58, 95% CI 0.75-3.33, p  = 0.23; VARI without VAP HR 0.40, 95% CI 0.14-1.17, p  = 0.09). In patients with positive endotracheal aspirate cultures, most VARI was caused by Gram-negative organisms; the most frequent were Acinetobacter baumannii (32/73, 43.8%) Klebsiella pneumoniae (26/73, 35.6%), and Pseudomonas aeruginosa (24/73, 32.9%). 40/68 (58.8%) patients with positive cultures for these had carbapenem-resistant isolates. Patients with carbapenem-resistant VARI had significantly greater ICU costs than patients with carbapenem-susceptible isolates (6053 USD (IQR 3806-7824) vs 3131 USD (IQR 2108-7551), p  = 0.04) and after correction for adequacy of initial antibiotics

  15. Assessment of climate change impacts on groundwater resources: the case study of Veneto and Friuli plain in Italy

    NASA Astrophysics Data System (ADS)

    Critto, Andrea; Pasini, Sara; Torresan, Silvia; Rizzi, Jonathan; Zabeo, Alex; Marcomini, Antonio

    2013-04-01

    Climate change will have different impacts on water resources and water-dependent services worldwide. In particular, climate-related risks for groundwater and related ecosystems pose great concern to scientists and water authorities involved in the protection of these valuable resources. Research is needed to better understand how climate change will impact groundwater resources in specific regions and places and to develop predictive tools for their sustainable management, copying with the envisaged effects of global climate change and the key principles of EU water policy. Within the European project Life+ TRUST (Tool for Regional-scale assessment of groundwater Storage improvement in adaptation to climaTe change), a Regional Risk Assessment (RRA) methodology was developed in order to identify impacts from climate change on groundwater and associated ecosystems (e.g. surface waters, agricultural areas, natural environments) and to rank areas and receptors at risk in the high and middle Veneto and Friuli Plain (Italy). Based on an integrated analysis of impacts, vulnerability and risks linked to climate change at the regional scale, a RRA framework complying with the Sources-Pathway-Receptor-Consequence (SPRC) approach was defined. Relevant impacts on groundwater and surface waters (i.e. groundwater level variations, changes in nitrate infiltration processes, changes in water availability for irrigation) were selected and analyzed through hazard scenario, exposure, susceptibility and risk assessment. The RRA methodology used hazard scenarios constructed through global and high resolution models simulations for the 2071-2100 period, according with IPCC A1B emission scenario in order to produce useful indications for future risk prioritization and to support the addressing of adaptation measures, primarily Managed Artificial Recharge (MAR) techniques. Relevant outcomes from the described RRA application highlighted that potential climate change impacts will occur

  16. Potential environmental impacts of light-emitting diodes (LEDs): metallic resources, toxicity, and hazardous waste classification.

    PubMed

    Lim, Seong-Rin; Kang, Daniel; Ogunseitan, Oladele A; Schoenung, Julie M

    2011-01-01

    Light-emitting diodes (LEDs) are advertised as environmentally friendly because they are energy efficient and mercury-free. This study aimed to determine if LEDs engender other forms of environmental and human health impacts, and to characterize variation across different LEDs based on color and intensity. The objectives are as follows: (i) to use standardized leachability tests to examine whether LEDs are to be categorized as hazardous waste under existing United States federal and California state regulations; and (ii) to use material life cycle impact and hazard assessment methods to evaluate resource depletion and toxicity potentials of LEDs based on their metallic constituents. According to federal standards, LEDs are not hazardous except for low-intensity red LEDs, which leached Pb at levels exceeding regulatory limits (186 mg/L; regulatory limit: 5). However, according to California regulations, excessive levels of copper (up to 3892 mg/kg; limit: 2500), Pb (up to 8103 mg/kg; limit: 1000), nickel (up to 4797 mg/kg; limit: 2000), or silver (up to 721 mg/kg; limit: 500) render all except low-intensity yellow LEDs hazardous. The environmental burden associated with resource depletion potentials derives primarily from gold and silver, whereas the burden from toxicity potentials is associated primarily with arsenic, copper, nickel, lead, iron, and silver. Establishing benchmark levels of these substances can help manufacturers implement design for environment through informed materials substitution, can motivate recyclers and waste management teams to recognize resource value and occupational hazards, and can inform policymakers who establish waste management policies for LEDs.

  17. The costs associated with adverse event procedures for an international HIV clinical trial determined by activity-based costing.

    PubMed

    Chou, Victoria B; Omer, Saad B; Hussain, Hamidah; Mugasha, Christine; Musisi, Maria; Mmiro, Francis; Musoke, Philippa; Jackson, J Brooks; Guay, Laura A

    2007-12-01

    To determine costs for adverse event (AE) procedures for a large HIV perinatal trial by analyzing actual resource consumption using activity-based costing (ABC) in an international research setting. The AE system for an ongoing clinical trial in Uganda was evaluated using ABC techniques to determine costs from the perspective of the study. Resources were organized into cost categories (eg, personnel, patient care expenses, laboratory testing, equipment). Cost drivers were quantified, and unit cost per AE was calculated. A subset of time and motion studies was performed prospectively to observe clinic personnel time required for AE identification. In 18 months, there were 9028 AEs, with 970 (11%) reported as serious adverse events. Unit cost per AE was $101.97. Overall, AE-related costs represented 32% ($920,581 of $2,834,692) of all study expenses. Personnel ($79.30) and patient care ($11.96) contributed the greatest proportion of component costs. Reported AEs were predominantly nonserious (mild or moderate severity) and unrelated to study drug(s) delivery. Intensive identification and management of AEs to conduct clinical trials ethically and protect human subjects require expenditure of substantial human and financial resources. Better understanding of these resource requirements should improve planning and funding of international HIV-related clinical trials.

  18. Differences between Drug-Induced and Contrast Media-Induced Adverse Reactions Based on Spontaneously Reported Adverse Drug Reactions.

    PubMed

    Ryu, JiHyeon; Lee, HeeYoung; Suh, JinUk; Yang, MyungSuk; Kang, WonKu; Kim, EunYoung

    2015-01-01

    We analyzed differences between spontaneously reported drug-induced (not including contrast media) and contrast media-induced adverse reactions. Adverse drug reactions reported by an in-hospital pharmacovigilance center (St. Mary's teaching hospital, Daejeon, Korea) from 2010-2012 were classified as drug-induced or contrast media-induced. Clinical patterns, frequency, causality, severity, Schumock and Thornton's preventability, and type A/B reactions were recorded. The trends among causality tools measuring drug and contrast-induced adverse reactions were analyzed. Of 1,335 reports, 636 drug-induced and contrast media-induced adverse reactions were identified. The prevalence of spontaneously reported adverse drug reaction-related admissions revealed a suspected adverse drug reaction-reporting rate of 20.9/100,000 (inpatient, 0.021%) and 3.9/100,000 (outpatients, 0.004%). The most common adverse drug reaction-associated drug classes included nervous system agents and anti-infectives. Dermatological and gastrointestinal adverse drug reactions were most frequently and similarly reported between drug and contrast media-induced adverse reactions. Compared to contrast media-induced adverse reactions, drug-induced adverse reactions were milder, more likely to be preventable (9.8% vs. 1.1%, p < 0.001), and more likely to be type A reactions (73.5% vs. 18.8%, p < 0.001). Females were over-represented among drug-induced adverse reactions (68.1%, p < 0.001) but not among contrast media-induced adverse reactions (56.6%, p = 0.066). Causality patterns differed between the two adverse reaction classes. The World Health Organization-Uppsala Monitoring Centre causality evaluation and Naranjo algorithm results significantly differed from those of the Korean algorithm version II (p < 0.001). We found differences in sex, preventability, severity, and type A/B reactions between spontaneously reported drug and contrast media-induced adverse reactions. The World Health Organization

  19. Differences between Drug-Induced and Contrast Media-Induced Adverse Reactions Based on Spontaneously Reported Adverse Drug Reactions

    PubMed Central

    Suh, JinUk; Yang, MyungSuk; Kang, WonKu; Kim, EunYoung

    2015-01-01

    Objective We analyzed differences between spontaneously reported drug-induced (not including contrast media) and contrast media-induced adverse reactions. Methods Adverse drug reactions reported by an in-hospital pharmacovigilance center (St. Mary’s teaching hospital, Daejeon, Korea) from 2010–2012 were classified as drug-induced or contrast media-induced. Clinical patterns, frequency, causality, severity, Schumock and Thornton’s preventability, and type A/B reactions were recorded. The trends among causality tools measuring drug and contrast-induced adverse reactions were analyzed. Results Of 1,335 reports, 636 drug-induced and contrast media-induced adverse reactions were identified. The prevalence of spontaneously reported adverse drug reaction-related admissions revealed a suspected adverse drug reaction-reporting rate of 20.9/100,000 (inpatient, 0.021%) and 3.9/100,000 (outpatients, 0.004%). The most common adverse drug reaction-associated drug classes included nervous system agents and anti-infectives. Dermatological and gastrointestinal adverse drug reactions were most frequently and similarly reported between drug and contrast media-induced adverse reactions. Compared to contrast media-induced adverse reactions, drug-induced adverse reactions were milder, more likely to be preventable (9.8% vs. 1.1%, p < 0.001), and more likely to be type A reactions (73.5% vs. 18.8%, p < 0.001). Females were over-represented among drug-induced adverse reactions (68.1%, p < 0.001) but not among contrast media-induced adverse reactions (56.6%, p = 0.066). Causality patterns differed between the two adverse reaction classes. The World Health Organization–Uppsala Monitoring Centre causality evaluation and Naranjo algorithm results significantly differed from those of the Korean algorithm version II (p < 0.001). Conclusions We found differences in sex, preventability, severity, and type A/B reactions between spontaneously reported drug and contrast media-induced adverse

  20. Identifying Impacts of Hydropower Regulation on Salmonid Habitats to Guide River Restoration for Existing Schemes and Mitigate Adverse Effects of Future Developments

    NASA Astrophysics Data System (ADS)

    Buddendorf, B.; Geris, J.; Malcolm, I.; Wilkinson, M.; Soulsby, C.

    2015-12-01

    A decrease in longitudinal connectivity in riverine ecosystems resulting from the construction of transverse barriers has been identified as a major threat to biodiversity. For example, Atlantic Salmon (Salmo salar) have a seasonal variety of hydraulic habitat requirements for their different life stages. However, hydropower impoundments impact the spatial and temporal connectivity of natural habitat along many salmon rivers in ways that are not fully understood. Yet, these changes may affect the sustainability of habitat at local and regional scales and so ultimately the conservation of the species. Research is therefore needed both to aid the restoration and management of rivers impacted by previous hydropower development and guide new schemes to mitigate potentially adverse effects. To this end we assessed the effects of hydropower development on the flow related habitat conditions for different salmon life stages in Scottish rivers at different spatial scales. We used GIS techniques to map the changes in structural connectivity at regional scales, applying a weighting for habitat quality. Next, we used hydrological models to simulate past and present hydrologic conditions that in turn drive reach-scale hydraulic models to assess the impacts of regulation on habitat suitability in both space and time. Preliminary results indicate that: 1) impacts on connectivity depend on the location of the barrier within the river network; 2) multiple smaller barriers may have a potentially lower impact than a single larger barrier; 3) there is a relationship between habitat and connectivity where losing less but more suitable habitat potentially has a disproportionally large impact; 4) the impact of flow regulation can lead to a deterioration of habitat quality, though the effects are spatially variable and the extent of the impact depends on salmon life stage. This work can form a basis for using natural processes to perform targeted and cost-effective restoration of rivers.

  1. Projected wood energy impact on US forest wood resources

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Skog, K.E.

    1993-12-31

    The USDA Forest Service has developed long-term projections of wood energy use as part of a 1993 assessment of demand for and supply of resources from forest and range lands in the United States. To assess the impact of wood energy demand on timber resources, a market equilibrium model based on linear programming was developed to project residential, industrial, commercial, and utility wood energy use from various wood energy sources: roundwood from various land sources, primary wood products mill residue, other wood residue, and black liquor. Baseline projections are driven by projected price of fossil fuels compared to price ofmore » wood fuels and the projected increase in total energy use in various end uses. Wood energy use is projected to increase from 2.67 quad in 1986 to 3.5 quad in 2030 and 3.7 quad in 2040. This is less than the DOE National Energy Strategy projection of 5.5 quad in 2030. Wood energy from forest sources (roundwood) is projected to increase from 3.1 billion (10{sup 9}) ft{sup 3} in 1986 to 4.4. billion ft{sup 3} in 2030 and 4.8 billion ft{sup 3} in 2040 (88, 124 and 136 million m{sup 3}, respectively). This rate of increase of roundwood use for fuel -- 0.8 percent per year -- is virtually the same as the projected increase rate for roundwood for pulpwood. Pulpwood roundwood is projected to increase from 4.2 billion ft{sup 3} in 1986 to 6.0 billion ft{sup 3} in 2030 and 6.4 billion ft{sup 3} in 2040 (119, 170 and 183 million m{sup 3}, respectively).« less

  2. [Changes of menstruation patterns and adverse effects during the treatment of LNG-IUS for symptomatic adenomyosis].

    PubMed

    Li, L; Leng, J H; Zhang, J J; Jia, S Z; Li, X Y; Shi, J H; Dai, Y; Zhang, J R; Li, T; Xu, X X; Liu, Z Z; You, S S; Chang, X Y; Lang, J H

    2016-09-25

    Objective: To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system(LNG-IUS)for symptomatic adenomyosis in a prospective cohort study. Methods: From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients' parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results: Totally 1 100 cases met inclusion criteria, with median age 36 years(range 20-44 years), median follow-up 35 months(range 1 -108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383)and 29.6%(82/277)patients achieved amenorrhea respectively( P <0.01). Total and subclassification of adverse effects decreased significantly( P <0.01). Within 12 months and >12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status(all P > 0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions: During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened

  3. Too Much of a Good Thing? Psychosocial Resources, Gendered Racism, and Suicidal Ideation Among Low-SES African American Women.

    PubMed

    Perry, Brea L; Pullen, Erin; Oser, Carrie B

    2012-12-01

    Very few studies have examined predictors of suicidal ideation among African American women. Consequently, we have a poor understanding of the combinations of culturally-specific experiences and psychosocial processes that may constitute risk and protective factors for suicide in this population. Drawing on theories of social inequality, medical sociology, and the stress process, we explore the adverse impact of gendered racism experiences and potential moderating factors in a sample of 204 predominantly low-SES African American women. We find that African American women's risk for suicidal ideation is linked to stressors occurring as a function of their distinct social location at the intersection of gender and race. In addition, we find that gendered racism has no effect on suicidal ideation among women with moderate levels of well-being, self-esteem, and active coping, but has a strong adverse influence in those with high and low levels of psychosocial resources.

  4. Enhanced prefrontal-amygdala connectivity following childhood adversity as a protective mechanism against internalizing in adolescence.

    PubMed

    Herringa, Ryan J; Burghy, Cory A; Stodola, Diane E; Fox, Michelle E; Davidson, Richard J; Essex, Marilyn J

    2016-07-01

    Much research has focused on the deleterious neurobiological effects of childhood adversity that may underlie internalizing disorders. While most youth show emotional adaptation following adversity, the corresponding neural mechanisms remain poorly understood. In this longitudinal community study, we examined the associations among childhood family adversity, adolescent internalizing symptoms, and their interaction on regional brain activation and amygdala/hippocampus functional connectivity during emotion processing in 132 adolescents. Consistent with prior work, childhood adversity predicted heightened amygdala reactivity to negative, but not positive, images in adolescence. However, amygdala reactivity was not related to internalizing symptoms. Furthermore, childhood adversity predicted increased fronto-amygdala connectivity to negative, but not positive, images, yet only in lower internalizing adolescents. Childhood adversity also predicted increased fronto-hippocampal connectivity to negative images, but was not moderated by internalizing. These findings were unrelated to adolescence adversity or externalizing symptoms, suggesting specificity to childhood adversity and adolescent internalizing. Together, these findings suggest that adaptation to childhood adversity is associated with augmentation of fronto-subcortical circuits specifically for negative emotional stimuli. Conversely, insufficient enhancement of fronto-amygdala connectivity, with increasing amygdala reactivity, may represent a neural signature of vulnerability for internalizing by late adolescence. These findings implicate early childhood as a critical period in determining the brain's adaptation to adversity, and suggest that even normative adverse experiences can have significant impact on neurodevelopment and functioning. These results offer potential neural mechanisms of adaptation and vulnerability which could be used in the prediction of risk for psychopathology following childhood

  5. Impact of Friedreich’s Ataxia on health-care resource utilization in the United Kingdom and Germany

    PubMed Central

    2013-01-01

    Background Friedreich’s Ataxia (FRDA) is a neurodegenerative disorder that causes progressive damage to the central and peripheral nervous systems having a significant impact upon quality of life. With little information in the literature, cross-sectional observational studies were conducted in the UK and Germany to collect data on resource use and the burden of the disease on individuals and their caregivers. Methods Cross-sectional observational studies were conducted in the UK and Germany to estimate the burden of FRDA on individuals and on the respective healthcare systems. A total of 75 individuals in the UK and 28 in Germany were recruited to the study. Participants in both countries were asked to complete a Patient and Caregiver Information Form (PCIF), regarding access to, and use of, healthcare resources, and the impact FRDA has on their lifestyle. In Germany, doctors were asked to complete a Patient Record Form (PRF). Analyses of annual direct and indirect resource utilization were conducted for both countries while costs were calculated for the UK only. These figures were compared to the costs associated with Parkinson’s disease; one of the most common neurodegenerative conditions and the one most similar in terms of disease progression. Results The results showed that the annual burden of FRDA is significant and falls on the health and social care sectors, on society, on caregivers and on the individuals themselves. In the UK FRDA had a total annual cost per person of between £11,818 and £18,774 depending on whether the cost of long-term unemployment was included. Typically the largest component of direct costs is associated with professional care. Given the high proportion of children and young adults recruited and the long disease duration, (typically 40-50 years for FRDA, compared with 20 years for Parkinson’s disease), these figures may underestimate the true burden of the disease. Conclusion It is hoped that these estimates of resource

  6. Impacts of making sense of adversity on depression, posttraumatic stress disorder, and posttraumatic growth among a sample of mainly newly diagnosed HIV-positive Chinese young homosexual men: the mediating role of resilience.

    PubMed

    Yu, Nancy Xiaonan; Chen, Lihua; Ye, Zhi; Li, Xiaoming; Lin, Danhua

    2017-01-01

    The experience of HIV, as a life-transforming event, might produce both negative and positive outcomes. Guided by the stress appraisal model, the present study investigated the hypothesized pathways in predicting symptomatology and posttraumatic growth (PTG) in a sample of Chinese male patients with HIV (PHIV) who were mainly newly diagnosed, young, and homosexual. In this cross-sectional study, 141 Chinese male PHIV (87.2% of them were homosexual) completed measures of making negative/positive sense of adversity, resilience, depression, posttraumatic stress disorder (PTSD), and PTG. The path analysis results showed that making negative sense of adversity was associated with depression and PTSD, partially mediated by low levels of resilience, whereas making positive sense of adversity was associated with PTG, partially mediated by resilience. The results suggest that negative and positive outcomes of trauma are impacted by making negative and positive sense of adversity, respectively, via two separate pathways, both mediated by resilience. Our findings contribute to an understanding of the cognitive process of symptomatology and PTG in the HIV context. Theoretical considerations, clinical implications, and future directions are discussed.

  7. Adverse childhood experiences in children with autism spectrum disorder.

    PubMed

    Hoover, Daniel W; Kaufman, Joan

    2018-03-01

    Recent years have shown an uptick in studies assessing bullying and other adverse childhood experiences (ACEs) in children with autism spectrum disorder (ASD). This article reviews extant findings, and points to gaps in the literature. Children with ASD are bullied by peers at a rate three to four times that of nondisabled peers with negative impacts on academic functioning and mental health symptoms, including increased risk for suicidality. Children with ASD are also at enhanced risk for other ACES, particularly parental divorce and income insufficiency, and as observed in the general population, children with ASD who experience an increased number of ACES are at elevated risk for comorbid psychiatric and medical health problems. Children with ASD with an elevated number of ACES also experience a delay in ASD diagnosis and treatment initiation. There is no evidence of increased risk of child maltreatment within the ASD population. As bullying and other adverse experiences are common and associated with deleterious outcomes in children with ASD, there is a need for additional research on intervention strategies to prevent and mitigate the impact of these experiences. Ongoing work on the assessment of trauma experiences and PTSD symptoms in children on the spectrum is also needed.

  8. Impact of Hydrologic Variability on Ecosystem Dynamics and the Sustainable Use of Soil and Water Resources

    NASA Astrophysics Data System (ADS)

    Porporato, A. M.

    2013-05-01

    We discuss the key processes by which hydrologic variability affects the probabilistic structure of soil moisture dynamics in water-controlled ecosystems. These in turn impact biogeochemical cycling and ecosystem structure through plant productivity and biodiversity as well as nitrogen availability and soil conditions. Once the long-term probabilistic structure of these processes is quantified, the results become useful to understand the impact of climatic changes and human activities on ecosystem services, and can be used to find optimal strategies of water and soil resources management under unpredictable hydro-climatic fluctuations. Particular applications regard soil salinization, phytoremediation and optimal stochastic irrigation.

  9. Impacts of warming revealed by linking resource growth rates with consumer functional responses.

    PubMed

    West, Derek C; Post, David M

    2016-05-01

    Warming global temperatures are driving changes in species distributions, growth and timing, but much uncertainty remains regarding how climate change will alter species interactions. Consumer-Resource interactions in particular can be strongly impacted by changes to the relative performance of interacting species. While consumers generally gain an advantage over their resources with increasing temperatures, nonlinearities can change this relation near temperature extremes. We use an experimental approach to determine how temperature changes between 5 and 30 °C will alter the growth of the algae Scenedesmus obliquus and the functional responses of the small-bodied Daphnia ambigua and the larger Daphnia pulicaria. The impact of warming generally followed expectations, making both Daphnia species more effective grazers, with the increase in feeding rates outpacing the increases in algal growth rate. At the extremes of our temperature range, however, warming resulted in a decrease in Daphnia grazing effectiveness. Between 25 and 30 °C, both species of Daphnia experienced a precipitous drop in feeding rates, while algal growth rates remained high, increasing the likelihood of algal blooms in warming summer temperatures. Daphnia pulicaria performed significantly better at cold temperatures than D. ambigua, but by 20 °C, there was no significant difference between the two species, and at 25 °C, D. ambigua outperformed D. pulicaria. Warming summer temperatures will favour the smaller D. ambigua, but only over a narrow temperature range, and warming beyond 25 °C could open D. ambigua to invasion from tropical species. By fitting our results to temperature-dependent functions, we develop a temperature- and density-dependent model, which produces a metric of grazing effectiveness, quantifying the grazer density necessary to halt algal growth. This approach should prove useful for tracking the transient dynamics of other density-dependent consumer-resource

  10. Integrating Technology, Curriculum, and Online Resources: A Multilevel Model Study of Impacts on Science Teachers and Students

    ERIC Educational Resources Information Center

    Ye, Lei

    2013-01-01

    This scale-up study investigated the impact of a teacher technology tool (Curriculum Customization Service, CCS), curriculum, and online resources on earth science teachers' attitudes, beliefs, and practices and on students' achievement and engagement with science learning. Participants included 73 teachers and over 2,000 ninth-grade students…

  11. Individual differences in early adolescents' latent trait cortisol: Interaction of early adversity and 5-HTTLPR.

    PubMed

    Chen, Frances R; Stroud, Catherine B; Vrshek-Schallhorn, Suzanne; Doane, Leah D; Granger, Douglas A

    2017-10-01

    The present study aimed to examine the interaction of 5-HTTLPR and early adversity on trait-like levels of cortisol. A community sample of 117 early adolescent girls (M age=12.39years) provided DNA samples for 5-HTTLPR genotyping, and saliva samples for assessing cortisol 3 times a day (waking, 30min post-waking, and bedtime) over a three-day period. Latent trait cortisol (LTC) was modeled using the first 2 samples of each day. Early adversity was assessed with objective contextual stress interviews with adolescents and their mothers. A significant 5-HTTLPR×early adversity interaction indicated that greater early adversity was associated with lower LTC levels, but only among individuals with either L/L or S/L genotype. Findings suggest that serotonergic genetic variation may influence the impact of early adversity on individual differences in HPA-axis regulation. Future research should explore whether this interaction contributes to the development of psychopathology through HPA axis functioning. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Pathways towards risk: syndemic conditions mediate the effect of adversity on HIV risk behaviors among young men who have sex with men (YMSM).

    PubMed

    Herrick, Amy; Stall, Ron; Egan, James; Schrager, Sheree; Kipke, Michele

    2014-10-01

    Research shows that young men who have sex with men (YMSM) engage in higher rates of health risk behaviors and experience higher rates of negative health outcomes than their peers. The purpose of this study is to determine if the effects of adversity on HIV risk are mediated by syndemics (co-occurring health problems). Participants were 470 ethnically diverse YMSM ages 18 to 24 recruited between 2005 and 2006 and surveyed every 6 months for 24 months. Regression analyses examined the impact of adversity on syndemics (emotional distress, substance use, and problematic alcohol use) and the effects of both adversity and syndemics on HIV risk behaviors over time. Gay-related discrimination and victimization-among other adversity variables-were significantly associated with syndemics and condomless sex (CS). Syndemics mediated the effects of adversity on CS in all models. Adverse events impact HIV risk taking among YMSM through syndemics. These findings suggest that prevention programs aimed at reducing adversity may reduce both the synergistic effect of multiple psychosocial health problems and HIV risk taking.

  13. Environmental impacts of utility-scale solar energy

    USGS Publications Warehouse

    Hernandez, R.R.; Easter, S.B.; Murphy-Mariscal, M. L.; Maestre, F.T.; Tavassoli, M.; Allen, E.B.; Barrows, C.W.; Belnap, J.; Ochoa-Hueso, R.; Ravi, S.; Allen, M.F.

    2014-01-01

    Renewable energy is a promising alternative to fossil fuel-based energy, but its development can require a complex set of environmental tradeoffs. A recent increase in solar energy systems, especially large, centralized installations, underscores the urgency of understanding their environmental interactions. Synthesizing literature across numerous disciplines, we review direct and indirect environmental impacts – both beneficial and adverse – of utility-scale solar energy (USSE) development, including impacts on biodiversity, land-use and land-cover change, soils, water resources, and human health. Additionally, we review feedbacks between USSE infrastructure and land-atmosphere interactions and the potential for USSE systems to mitigate climate change. Several characteristics and development strategies of USSE systems have low environmental impacts relative to other energy systems, including other renewables. We show opportunities to increase USSE environmental co-benefits, the permitting and regulatory constraints and opportunities of USSE, and highlight future research directions to better understand the nexus between USSE and the environment. Increasing the environmental compatibility of USSE systems will maximize the efficacy of this key renewable energy source in mitigating climatic and global environmental change.

  14. Understanding and Promoting Resilience in the Context of Adverse Childhood Experiences

    ERIC Educational Resources Information Center

    Sciaraffa, Mary A.; Zeanah, Paula D.; Zeanah, Charles H.

    2018-01-01

    Brain development in the early years is especially susceptible to toxic stress caused by adverse childhood experiences (ACEs). According to epigenetics research, toxic stress has the capacity to physically change a child's brain and be hardwired into the child's biology via genes in the DNA. The compelling nature of the impact of early adversity…

  15. The impact of changes in work stressors and coping resources on the risk of new-onset suicide ideation among Chinese petroleum industry workers.

    PubMed

    Xiao, Jing; Guan, Suzhen; Ge, Hua; Tao, Ning; Zhang, Yanxia; Jiang, Yu; Ning, Li; Liu, Jiwen; Lian, Yulong

    2017-05-01

    Little is known about the relationship between changing psychosocial work conditions and suicidality. We examined whether or not changed work stressors and coping resources increase the risk of new-onset suicidal ideation. A total of 1384 workers from the Occupational Health Study of Petroleum Industry Workers were included in this study. A baseline evaluation of work-related stress and coping resources was followed by a final evaluation after 2 years. The changes in task stressors and coping resources were measured using the Occupation Stress Inventory-Revised Edition, and changes in job control and organizational stressors were evaluated using the Instrument for Stress-Related Job Analysis (v. 6.0). Increased task stressors (RR = 2.87, 95% CI = 1.48, 6.15) and decreased coping resources (RR = 2.53, 95% CI = 1.31, 5.34) were associated with an elevated risk of new-onset suicidal ideation incidence. Effect magnitudes were higher than known suicidal risk factors. The main risk factors were increased role overload, increased role insufficiency, increased accident risk, and decreased recreation. Decreased coping resources also increased the negative effect of task stressors on new-onset suicidal ideation. However, increased coping resources did not decrease the effect. These findings demonstrate that changes in work stressors and coping resources have a strong influence on new-onset suicidal ideation, highlighting the importance of preventive measures against adverse psychosocial work conditions and reduced coping resources for workplace suicide behavior prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Prevalence and detection of neuropsychiatric adverse effects during hepatitis C treatment.

    PubMed

    Masip, Montserrat; Tuneu, Laura; Pagès, Neus; Torras, Xavier; Gallego, Adolfo; Guardiola, Josep Maria; Faus, María José; Mangues, Maria Antònia

    2015-12-01

    Current treatment combinations for chronic hepatitis C virus infection still include pegylated interferon and ribavirin despite the new therapeutic options available. Interferon-based treatments are associated with a high incidence of adverse effects. Central nervous system events are among the most frequent adverse drug reactions and their influence on treatment adherence and effectiveness is controversial. The aim of the study was to evaluate neuropsychiatric adverse effects of interferon-based treatment for chronic hepatitis C in standard multidisciplinary clinical practice. Risk factors for these adverse effects and their impact on adherence and sustained viral response were also evaluated. Setting Ambulatory care pharmacy in coordination with the liver unit and the infectious diseases unit at a 650-bed tertiary university hospital. We included all consecutive patients with chronic hepatitis C who completed treatment with pegylated interferon and ribavirin between 2005 and 2013. All patients underwent a multidisciplinary follow-up during treatment. Neuropsychiatric adverse effects were evaluated in relation to severity, management and outcome. The presence of anxiety and depression was evaluated by means of specific tests. A total of 717 treatments in 679 patients were included. During treatment, we detected 1679 neuropsychiatric adverse effects in 618 patients (86.2 %), generating 1737 clinical interventions. Fifty-seven (3.3 %) neuropsychiatric adverse effects were severe and 2 (0.1 %) were life-threatening (suicidal attempts). Most neuropsychiatric adverse effects (1555 events, 92.6 %) resolved without sequelae. Psychiatric medication was required in 289 patients (40.3 %). Sustained viral response was achieved in 400 cases (55.8 %) and was associated with adherence (OR = 1.942, 95 % CI = 1.235-3.052, p = 0.004). A multivariate analysis did not show any relationship between neuropsychiatric adverse effects and treatment adherence or sustained viral response

  17. U.S. Global Climate Change Impacts Report, Overview of Sectors

    NASA Astrophysics Data System (ADS)

    Wuebbles, D.

    2009-12-01

    The assessment of the Global Climate Change Impacts in the United States includes analyses of the potential climate change impacts by sector, including water resources, energy supply and use, transportation, agriculture, ecosystems, human health and society. The resulting findings for the climate change impacts on these sectors are discussed in this presentation, with the effects on water resources discussed separately. Major findings include: Widespread climate-related impacts are occurring now and are expected to increase. Climate changes are already affecting water, energy, transportation, agriculture, ecosystems, and health. These impacts are different from region to region and will grow under projected climate change. Crop and livestock production will be increasingly challenged. Agriculture is considered one of the sectors most adaptable to changes in climate. However, increased heat, pests, water stress, diseases, and weather extremes will pose adaptation challenges for crop and livestock production. Coastal areas are at increasing risk from sea-level rise and storm surge. Sea-level rise and storm surge place many U.S. coastal areas at increasing risk. Energy and transportation infrastructure and other property in coastal areas are very likely to be adversely affected. Threats to human health will increase. Health impacts of climate change are related to heat stress, waterborne diseases, poor air quality, extreme weather events, and diseases transmitted by insects and rodents. Robust public health infrastructure can reduce the potential for negative impacts. Climate change will interact with many social and environmental stresses. Climate change will combine with pollution, population growth, overuse of resources, urbanization, and other social, economic, and environmental stresses to create larger impacts than from any of these factors alone. Thresholds will be crossed, leading to large changes in climate and ecosystems. There are a variety of thresholds in

  18. Comparing Methods for Estimating Direct Costs of Adverse Drug Events.

    PubMed

    Gyllensten, Hanna; Jönsson, Anna K; Hakkarainen, Katja M; Svensson, Staffan; Hägg, Staffan; Rehnberg, Clas

    2017-12-01

    To estimate how direct health care costs resulting from adverse drug events (ADEs) and cost distribution are affected by methodological decisions regarding identification of ADEs, assigning relevant resource use to ADEs, and estimating costs for the assigned resources. ADEs were identified from medical records and diagnostic codes for a random sample of 4970 Swedish adults during a 3-month study period in 2008 and were assessed for causality. Results were compared for five cost evaluation methods, including different methods for identifying ADEs, assigning resource use to ADEs, and for estimating costs for the assigned resources (resource use method, proportion of registered cost method, unit cost method, diagnostic code method, and main diagnosis method). Different levels of causality for ADEs and ADEs' contribution to health care resource use were considered. Using the five methods, the maximum estimated overall direct health care costs resulting from ADEs ranged from Sk10,000 (Sk = Swedish krona; ~€1,500 in 2016 values) using the diagnostic code method to more than Sk3,000,000 (~€414,000) using the unit cost method in our study population. The most conservative definitions for ADEs' contribution to health care resource use and the causality of ADEs resulted in average costs per patient ranging from Sk0 using the diagnostic code method to Sk4066 (~€500) using the unit cost method. The estimated costs resulting from ADEs varied considerably depending on the methodological choices. The results indicate that costs for ADEs need to be identified through medical record review and by using detailed unit cost data. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Alaska Department of Natural Resources

    Science.gov Websites

    Department of Natural Resources logo Department of Natural Resources Office of Project Management & Restoration Coastal Impact Assistance Program Natural Resources / Office of Project Management & ; Permitting Welcome to the Office of Project Management & Permitting Large Project Coordination The

  20. Inadequate Preoperative Team Briefings Lead to More Intraoperative Adverse Events.

    PubMed

    Phadnis, Joideep; Templeton-Ward, Oliver

    2018-06-01

    Implementation of the World Health Organization checklists has reduced major surgical complications and errors; however, the impact of preoperative briefings on intraoperative adverse events has not been assessed. A prospective case-control study assessing the association between preoperative briefings and minor, potentially major, and major adverse intraoperative events was performed in 2 phases. Phase 1 involved prospective data collection for all trauma and orthopedic lists during a 2-week period. Changes were implemented as a result of the findings, and after this, the study was repeated (phase 2) to assess for the effect of the changes made to the practice. Forty-one lists were audited during phase 1 and 47 lists were audited during phase 2 of the study. Adequate preoperative briefings were performed in 10 (24%) of 41 lists in phase 1. There was a significant association between the occurrences of intraoperative adverse events (n = 37) when a briefing was not performed (P = < 0.01) and when a briefing was performed incompletely (P = 0.01). In phase 2, after staff reeducation and policy change, briefings were found to be adequate in 38 (81%) of 47 lists with the occurrence of only 3 adverse events. Team familiarity also improved significantly as a result of better preoperative briefings (P = 0.02). Inadequate preoperative briefings are associated with an increase in minor adverse events and are detrimental to team familiarity. On the basis of our findings, we recommend that all surgical units perform preoperative briefings thoroughly to minimize these factors.

  1. Cognitive behavioural anger management intervention for people with intellectual disabilities: costs of intervention and impact on health and social care resource use.

    PubMed

    Felce, D; Cohen, D; Willner, P; Rose, J; Kroese, B; Rose, N; Shead, J; Jahoda, A; MacMahon, P; Lammie, C; Stimpson, A; Woodgate, C; Gillespie, D; Townson, J; Nuttall, J; Hood, K

    2015-01-01

    Anger and aggression among adults with intellectual disability (ID) are associated with a range of adverse consequences for their well-being and that of their family or staff carers. The aims were to evaluate the effectiveness of an anger management intervention for adults with mild to moderate ID and to evaluate the costs of the intervention and its impact on health and social care resource use. This paper is concerned with the latter aim. A cluster-randomised controlled trial was conducted involving day services for adults with ID in Scotland, England and Wales. Incremental costs of delivering the intervention and its impact on subsequent total health and social care package costs were calculated. Full data comparing costs between baseline and follow-up 10 months later were collected for 67 participants in the intervention arm and 62 participants in the control arm. Cost differences between the groups at follow-up, adjusted for baseline levels, were calculated using non-parametric bootstrapping controlling for clustering. The mean hourly excess cost of intervention over treatment as usual was £12.34. A mean adjusted cost difference of £22.46 per person per week in favour of the intervention group was found but this was not statistically significant. The baseline-adjusted cost difference at follow-up would result in a fairly immediate compensation for the excess costs of intervention, provided the difference is not a statistical artefact. Further research is needed to clarify the extent to which it might represent a real saving in service support costs. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  2. Impact of Information Technology, Clinical Resource Constraints, and Patient-Centered Practice Characteristics on Quality of Care.

    PubMed

    Baek, JongDeuk; Seidman, Robert L

    2015-01-01

    Factors in the practice environment, such as health information technology (IT) infrastructure, availability of other clinical resources, and financial incentives, may influence whether practices are able to successfully implement the patient-centered medical home (PCMH) model and realize its benefits. This study investigates the impacts of those PCMH-related elements on primary care physicians' perception of quality of care. A multiple logistic regression model was estimated using the 2004 to 2005 CTS Physician Survey, a national sample of salaried primary care physicians (n = 1733). The patient-centered practice environment and availability of clinical resources increased physicians' perceived quality of care. Although IT use for clinical information access did enhance physicians' ability to provide high quality of care, a similar positive impact of IT use was not found for e-prescribing or the exchange of clinical patient information. Lack of resources was negatively associated with physician perception of quality of care. Since health IT is an important foundation of PCMH, patient-centered practices are more likely to have health IT in place to support care delivery. However, despite its potential to enhance delivery of primary care, simply making health IT available does not necessarily translate into physicians' perceptions that it enhances the quality of care they provide. It is critical for health-care managers and policy makers to ensure that primary care physicians fully recognize and embrace the use of new technology to improve both the quality of care provided and the patient outcomes.

  3. Impact of hurricanes storm surges on the groundwater resources

    USGS Publications Warehouse

    Van Biersel, T. P.; Carlson, D.A.; Milner, L.R.

    2007-01-01

    Ocean surges onto coastal lowlands caused by tropical and extra tropical storms, tsunamis, and sea level rise affect all coastal lowlands and present a threat to drinking water resources of many coastal residents. In 2005, two such storms, Hurricanes Katrina and Rita struck the Gulf Coast of the US. Since September 2005, water samples have been collected from water wells impacted by the hurricanes' storm surges along the north shore of Lake Pontchartrain in southeastern Louisiana. The private and public water wells tested were submerged by 0.6-4.5 m of surging saltwater for several hours. The wells' casing and/or the associated plumbing were severely damaged. Water samples were collected to determine if storm surge water inundated the well casing and, if so, its effect on water quality within the shallow aquifers of the Southern Hills Aquifer System. In addition, the samples were used to determine if the impact on water quality may have long-term implication for public health. Laboratory testing for several indicator parameters (Ca/Mg, Cl/Si, chloride, boron, specific conductance and bacteria) indicates that surge water entered water wells' casing and the screened aquifer. Analysis of the groundwater shows a decrease in the Ca/Mg ratio right after the storm and then a return toward pre-Katrina values. Chloride concentrations were elevated right after Katrina and Rita, and then decreased downward toward pre-Katrina values. From September 2005 to June 2006, the wells showed improvement in all the saltwater intrusion indicators. ?? 2007 Springer-Verlag.

  4. OAE: The Ontology of Adverse Events.

    PubMed

    He, Yongqun; Sarntivijai, Sirarat; Lin, Yu; Xiang, Zuoshuang; Guo, Abra; Zhang, Shelley; Jagannathan, Desikan; Toldo, Luca; Tao, Cui; Smith, Barry

    2014-01-01

    A medical intervention is a medical procedure or application intended to relieve or prevent illness or injury. Examples of medical interventions include vaccination and drug administration. After a medical intervention, adverse events (AEs) may occur which lie outside the intended consequences of the intervention. The representation and analysis of AEs are critical to the improvement of public health. The Ontology of Adverse Events (OAE), previously named Adverse Event Ontology (AEO), is a community-driven ontology developed to standardize and integrate data relating to AEs arising subsequent to medical interventions, as well as to support computer-assisted reasoning. OAE has over 3,000 terms with unique identifiers, including terms imported from existing ontologies and more than 1,800 OAE-specific terms. In OAE, the term 'adverse event' denotes a pathological bodily process in a patient that occurs after a medical intervention. Causal adverse events are defined by OAE as those events that are causal consequences of a medical intervention. OAE represents various adverse events based on patient anatomic regions and clinical outcomes, including symptoms, signs, and abnormal processes. OAE has been used in the analysis of several different sorts of vaccine and drug adverse event data. For example, using the data extracted from the Vaccine Adverse Event Reporting System (VAERS), OAE was used to analyse vaccine adverse events associated with the administrations of different types of influenza vaccines. OAE has also been used to represent and classify the vaccine adverse events cited in package inserts of FDA-licensed human vaccines in the USA. OAE is a biomedical ontology that logically defines and classifies various adverse events occurring after medical interventions. OAE has successfully been applied in several adverse event studies. The OAE ontological framework provides a platform for systematic representation and analysis of adverse events and of the factors (e

  5. IDAAPM: integrated database of ADMET and adverse effects of predictive modeling based on FDA approved drug data.

    PubMed

    Legehar, Ashenafi; Xhaard, Henri; Ghemtio, Leo

    2016-01-01

    The disposition of a pharmaceutical compound within an organism, i.e. its Absorption, Distribution, Metabolism, Excretion, Toxicity (ADMET) properties and adverse effects, critically affects late stage failure of drug candidates and has led to the withdrawal of approved drugs. Computational methods are effective approaches to reduce the number of safety issues by analyzing possible links between chemical structures and ADMET or adverse effects, but this is limited by the size, quality, and heterogeneity of the data available from individual sources. Thus, large, clean and integrated databases of approved drug data, associated with fast and efficient predictive tools are desirable early in the drug discovery process. We have built a relational database (IDAAPM) to integrate available approved drug data such as drug approval information, ADMET and adverse effects, chemical structures and molecular descriptors, targets, bioactivity and related references. The database has been coupled with a searchable web interface and modern data analytics platform (KNIME) to allow data access, data transformation, initial analysis and further predictive modeling. Data were extracted from FDA resources and supplemented from other publicly available databases. Currently, the database contains information regarding about 19,226 FDA approval applications for 31,815 products (small molecules and biologics) with their approval history, 2505 active ingredients, together with as many ADMET properties, 1629 molecular structures, 2.5 million adverse effects and 36,963 experimental drug-target bioactivity data. IDAAPM is a unique resource that, in a single relational database, provides detailed information on FDA approved drugs including their ADMET properties and adverse effects, the corresponding targets with bioactivity data, coupled with a data analytics platform. It can be used to perform basic to complex drug-target ADMET or adverse effects analysis and predictive modeling. IDAAPM is

  6. Aging and selective engagement: the moderating impact of motivation on older adults' resource utilization.

    PubMed

    Hess, Thomas M; Germain, Cassandra M; Swaim, Elizabeth L; Osowski, Nicole L

    2009-06-01

    Two studies were conducted to examine age differences in the impact of motivation in a social cognitive task. We tested the hypothesis that aging is associated with an increase in the selective engagement of cognitive resources in support of performance. Different-aged adults read descriptions of 2 people in order to determine which was better suited for a particular job. These descriptions contained behaviors that were either consistent or inconsistent with the job, and participants performed the task under conditions of high versus low accountability. Examination of memory for behavioral information revealed that accountability disproportionately affected older adults' performance, with the locus of this effect being in conscious recollection processes. This supports the aforementioned selective engagement hypothesis by demonstrating that the differential impact of the motivational manipulation was based in deliberative memory processes.

  7. Utilizing an Innovative Evaluation Model To Assess Impacts of Training Adult Educators on Reaching Limited Resource Audiences.

    ERIC Educational Resources Information Center

    Safrit, R. Dale; And Others

    An interagency conference, Reading Families and Youth Who Have Limited Resources, was held in September 1992. Over a 2-day period, 186 adult educators and human service professionals participated in 27 different workshops. An innovative evaluation model was developed to assess the impacts of conference participation on reaching audiences who have…

  8. Racial disparities in the impact of chronic pruritus: A cross-sectional study on quality of life and resource utilization in United States veterans.

    PubMed

    Shaw, Fiona M; Luk, Kevin Man Hin; Chen, Kuang-Ho; Wrenn, Glenda; Chen, Suephy C

    2017-07-01

    Chronic pruritus has a lifetime prevalence of up to 26% in the worldwide population. Research has shown that the incidence and quality of life (QoL) impact of chronic pruritus varies by race. We sought to explore the effects of race on specific pruritus-related QoL factors and resource utilization. We performed a cross-sectional, national telephone survey of 6000 US veterans randomly sampled from the Veterans Hospital Patient Database. We administered surveys to assess QoL impact and resource utilization of chronic pruritus. Nonwhites overall reported higher levels of burning and scarring with their pruritus. African Americans had a significantly greater emotional impact and use of special soaps, lotions, and clothes. African Americans were also more likely to visit their primary care provider for pruritus (P = .03), yet had similar numbers of specialty care visits. Because our sample was drawn from a veteran population, generalizability may be limited. The data indicate a racial disparity in specific QoL impact and resource utilization from pruritus. These findings merit further exploration into explanations, such as access, communication, trust of the medical system, and biologic differences. Published by Elsevier Inc.

  9. Draft Environmental Impact Statement for the Ulysses Mission (Tier 2)

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This Draft Environmental Impact Statement (DEIS) addresses the environmental impacts which may be caused by the preparation and operation of the Ulysses spacecraft, including its planned launch on the Space Transportation System (STS) Shuttle and the alternative of canceling further work on the mission. The launch configuration will use the STS/Inertial Upper Stage (IUS)/Payload Assist Module-Special(PAM-S) combination. The Tier 1 EIS included a delay alternative which considered the Titan 4 launch vehicle as an alternative booster stage for launch in 1991 or later. However, the U.S. Air Force, which procures the Titan 4 for NASA, could not provide a Titan 4 vehicle for the 1991 launch opportunity because of high priority Department of Defense requirements. The only expected environmental effects of the proposed action are associated with normal Shuttle launch operations. These impacts are limited largely to the near-field at the launch pad, except for temporary stratospheric ozone effects during launch and occasional sonic boom effects near the landing site. These effects have been judged insufficient to preclude Shuttle launches. In the event of (1) an accident during launch, or (2) reentry of the spacecraft from earth orbit, there are potential adverse health and environmental effects associated with the possible release of plutonium dioxide from the spacecraft's radioisotope thermoelectric generators (RTG). The potential effects considered in this EIS include risks of air and water quality impacts, local land area contamination, adverse health and safety impacts, the disturbance of biotic resources, impacts on wetland areas or areas containing historical sites, and socioeconomic impacts. Intensive analysis of the possible accidents associated with the proposed action are underway and preliminary results indicate small health or environmental risks. The results of a Final Safety Analysis Report will be available for inclusion into the final EIS.

  10. Childhood adversity and insomnia in adolescence.

    PubMed

    Wang, Yan; Raffeld, Miriam R; Slopen, Natalie; Hale, Lauren; Dunn, Erin C

    2016-05-01

    The study aims to evaluate the association between exposure to childhood adversity and insomnia, with an emphasis on the role of adversity type, timing, and accumulation (i.e., the number of specific types of adversities the child reported being exposed to). Our analytic sample comprised 9582 adolescents from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative population-based sample. We examined the association between 18 different types of retrospectively reported adversities (capturing interpersonal violence, accidents and injuries, social network or witnessing events, and other adverse events) and risk of self-reported past-year insomnia. We also examined whether the age at first exposure to adversity was associated with the risk of insomnia, and whether exposure to a greater number of different types of adversities (ie, accumulation) conferred an elevated risk of insomnia. In addition, we performed a sensitivity analysis excluding adolescents with a past-year diagnosis of major depression, dysthymia, post-traumatic stress disorder (PTSD), or generalized anxiety disorder. Almost one-third of adolescents reported insomnia, with a higher prevalence among girls and those from racial/ethnic minority groups. Adolescents exposed to at least one childhood adversity of any type (59.41%) were more likely than their nonexposed peers to experience insomnia (across adversities, prevalence ratios (PRs) ranged from 1.31 to 1.89). Risk of insomnia differed based on the age at first exposure to adversity as well as the type of adversity. Adolescents exposed to a greater number of different types of adversities had a higher risk of insomnia compared to those experiencing fewer adversities. These results were similar, by and large, to those obtained after excluding adolescents with at least one of the four past-year psychiatric disorders. Exposure to adversity confers an elevated risk of insomnia. This association varied by type

  11. Impact of Biotechnology on Libraries and Educational Resources.

    ERIC Educational Resources Information Center

    Adams, Mignon; And Others

    1990-01-01

    As biotechnology continues to influence significantly the environment of pharmacy educators, it brings pharmacy librarians opportunity for changes in many sectors, notably the profession of librarianship, the nature of information resources, and delivery of information services. More human, financial, and material resources will be needed to…

  12. The long reach of early adversity: Parenting, stress, and neural pathways to antisocial behavior in adulthood.

    PubMed

    Gard, Arianna M; Waller, Rebecca; Shaw, Daniel S; Forbes, Erika E; Hariri, Ahmad R; Hyde, Luke W

    2017-10-01

    Early life adversities including harsh parenting, maternal depression, neighborhood deprivation, and low family economic resources are more prevalent in low-income urban environments and are potent predictors of psychopathology, including, for boys, antisocial behavior (AB). However, little research has examined how these stressful experiences alter later neural function. Moreover, identifying genetic markers of greater susceptibility to adversity is critical to understanding biopsychosocial pathways from early adversity to later psychopathology. Within a sample of 310 low-income boys followed from age 1.5 to 20, multimethod assessments of adversities were examined at age 2 and age 12. At age 20, amygdala reactivity to emotional facial expressions was assessed using fMRI, and symptoms of Antisocial Personality Disorder were assessed via structured clinical interview. Genetic variability in cortisol signaling ( CRHR1 ) was examined as a moderator of pathways to amygdala reactivity. Observed parenting and neighborhood deprivation at age 2 each uniquely predicted amygdala reactivity to emotional faces at age 20 over and above other adversities measured at multiple developmental periods. Harsher parenting and greater neighborhood deprivation in toddlerhood predicted clinically-significant symptoms of AB via less amygdala reactivity to fearful facial expressions and this pathway was moderated by genetic variation in CRHR1 . These results elucidate a pathway linking early adversity to less amygdala reactivity to social signals of interpersonal distress 18 years later, which in turn increased risk for serious AB. Moreover, these findings suggest a genetic marker of youth more susceptible to adversity.

  13. Resource factors for mental health resilience in early childhood: An analysis with multiple methodologies

    PubMed Central

    2013-01-01

    Background Given that relatively little is known about the development of resilience in early childhood, this longitudinal study aimed to identify preschool resource factors associated with young children’s mental health resilience to family adversity. Methods A community sample of 474 young Australian children was assessed in preschool (mean age 4.59 years, 49% male), and again two years later after their transition into formal schooling. At each assessment, standard questionnaires were used to obtain ratings from both parents and teachers about the quality of children’s relationships with parents and teachers, children’s self-concept and self-control, mental health (Strengths and Difficulties Questionnaire), and family adversities (including stressful life events and socioeconomic disadvantage). Results Greater exposure to cumulative family adversities was associated with both greater teacher- and parent-reported child mental health difficulties two years later. Multiple methodologies for operationalizing resilience were used to identify resources associated with resilient mental health outcomes. Higher quality child–parent and child-teacher relationships, and greater child self-concept and self-control were associated with resilient mental health outcomes. With the exception of child-teacher relationships, these resources were also prospective antecedents of subsequent resilient mental health outcomes in children with no pre-existing mental health difficulties. Child–parent relationships and child self-concept generally had promotive effects, being equally beneficial for children facing both low- and high-adversity. Child self-control demonstrated a small protective effect on teacher-reported outcomes, with greater self-control conferring greater protection to children under conditions of high-adversity. Conclusions Findings suggest that early intervention and prevention strategies that focus on fostering child-adult relationship quality, self

  14. Resource factors for mental health resilience in early childhood: An analysis with multiple methodologies.

    PubMed

    Miller-Lewis, Lauren R; Searle, Amelia K; Sawyer, Michael G; Baghurst, Peter A; Hedley, Darren

    2013-02-22

    Given that relatively little is known about the development of resilience in early childhood, this longitudinal study aimed to identify preschool resource factors associated with young children's mental health resilience to family adversity. A community sample of 474 young Australian children was assessed in preschool (mean age 4.59 years, 49% male), and again two years later after their transition into formal schooling. At each assessment, standard questionnaires were used to obtain ratings from both parents and teachers about the quality of children's relationships with parents and teachers, children's self-concept and self-control, mental health (Strengths and Difficulties Questionnaire), and family adversities (including stressful life events and socioeconomic disadvantage). Greater exposure to cumulative family adversities was associated with both greater teacher- and parent-reported child mental health difficulties two years later. Multiple methodologies for operationalizing resilience were used to identify resources associated with resilient mental health outcomes. Higher quality child-parent and child-teacher relationships, and greater child self-concept and self-control were associated with resilient mental health outcomes. With the exception of child-teacher relationships, these resources were also prospective antecedents of subsequent resilient mental health outcomes in children with no pre-existing mental health difficulties. Child-parent relationships and child self-concept generally had promotive effects, being equally beneficial for children facing both low- and high-adversity. Child self-control demonstrated a small protective effect on teacher-reported outcomes, with greater self-control conferring greater protection to children under conditions of high-adversity. Findings suggest that early intervention and prevention strategies that focus on fostering child-adult relationship quality, self-concept, and self-control in young children may help

  15. Adverse Outcome Pathways – Organizing Toxicological ...

    EPA Pesticide Factsheets

    The number of chemicals for which environmental regulatory decisions are required far exceeds the current capacity for toxicity testing. High throughput screening (HTS) commonly used for drug discovery has the potential to increase this capacity. The adverse outcome pathway (AOP) concept has emerged as a natural framework for connecting high throughput toxicity testing (HTT) results to potential impacts on humans and wildlife populations. An AOP consists of two main components that describe the biological mechanisms driving toxicity. Key events represent biological processes essential for causing the adverse outcome that are also measurable experimentally. Key event relationships capture the biological processes connecting the key events. Evidence documented for each KER based on measurements of the KEs can provide the confidence needed for extrapolating HTT from early key events to overt toxicity represented by later key events based on the AOP. The IPCS mode of action (MOA) framework incorporates information required for making a chemical-specific toxicity determination. Given the close relationship between the AOP and MOA frameworks, it is possible to assemble an MOA by incorporating HTT results, chemical properties including absorption, distribution, metabolism, and excretion (ADME), and an AOP describing the biological basis of toxicity thereby streamlining the process. While current applications focus on the assessment of risk for environmental chemicals,

  16. Health shocks adversely impact participation in the labour force in a working age population: a longitudinal analysis.

    PubMed

    Carter, Kristie N; Gunasekara, Fiona Imlach; Blakely, Tony; Richardson, Ken

    2013-06-01

    It is well understood that health affects labour force participation (LFP). However, much of the published research has been on older (retiring age) populations and using subjective health measures. This paper aims to assess the impact of an objective measure of 'health shock' (cancer registration or hospitalisation) on LFP in a working age population using longitudinal panel study data and fixed effect regression analyses. Seven waves of data from 2002-09 from the longitudinal Survey of Family, Income and Employment (SoFIE) were used, including working aged individuals who consented to have their survey information linked to health records (n=6,780). Fixed effect conditional logistic regression was used to model the impact of health shocks (hospitalisation or cancer registration) in the previous year on labour force participation at date of annual interview. Models were stratified by gender, age group (25-39 years, 40-54 years) and gender by age group. A health shock was associated with a significantly increased risk of subsequent non-participation in the labour force (odds ratio 1.54, 95%CI 1.30-1.82). Although interactions of age, sex and age by sex with health shock were not statistically significant, the association was largest in younger men and women. Using an objective measure of health, we have shown that a health shock adversely affects subsequent labour force participation. There are a number of policy and practice implications relating to support for working age people who have hospitalisations. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  17. Distribution of selected healthcare resources for influenza pandemic response in Cambodia

    PubMed Central

    2013-01-01

    Introduction Human influenza infection poses a serious public health threat in Cambodia, a country at risk for the emergence and spread of novel influenza viruses with pandemic potential. Prior pandemics demonstrated the adverse impact of influenza on poor communities in developing countries. Investigation of healthcare resource distribution can inform decisions regarding resource mobilization and investment for pandemic mitigation. Methods A health facility survey performed across Cambodia obtained data on availability of healthcare resources important for pandemic influenza response. Focusing on five key resources considered most necessary for treating severe influenza (inpatient beds, doctors, nurses, oseltamivir, and ventilators), resource distributions were analyzed at the Operational District (OD) and Province levels, refining data analysis from earlier studies. Resources were stratified by respondent type (hospital vs. District Health Office [DHO]). A summary index of distribution inequality was calculated using the Gini coefficient. Indices for local spatial autocorrelation were measured at the OD level using geographical information system (GIS) analysis. Finally, a potential link between socioeconomic status and resource distribution was explored by mapping resource densities against poverty rates. Results Gini coefficient calculation revealed variable inequality in distribution of the five key resources at the Province and OD levels. A greater percentage of the population resides in areas of relative under-supply (28.5%) than over-supply (21.3%). Areas with more resources per capita showed significant clustering in central Cambodia while areas with fewer resources clustered in the northern and western provinces. Hospital-based inpatient beds, doctors, and nurses were most heavily concentrated in areas of the country with the lowest poverty rates; however, beds and nurses in Non-Hospital Medical Facilities (NHMF) showed increasing concentrations at higher

  18. Distribution of selected healthcare resources for influenza pandemic response in Cambodia.

    PubMed

    Schwanke Khilji, Sara U; Rudge, James W; Drake, Tom; Chavez, Irwin; Borin, Khieu; Touch, Sok; Coker, Richard

    2013-10-04

    Human influenza infection poses a serious public health threat in Cambodia, a country at risk for the emergence and spread of novel influenza viruses with pandemic potential. Prior pandemics demonstrated the adverse impact of influenza on poor communities in developing countries. Investigation of healthcare resource distribution can inform decisions regarding resource mobilization and investment for pandemic mitigation. A health facility survey performed across Cambodia obtained data on availability of healthcare resources important for pandemic influenza response. Focusing on five key resources considered most necessary for treating severe influenza (inpatient beds, doctors, nurses, oseltamivir, and ventilators), resource distributions were analyzed at the Operational District (OD) and Province levels, refining data analysis from earlier studies. Resources were stratified by respondent type (hospital vs. District Health Office [DHO]). A summary index of distribution inequality was calculated using the Gini coefficient. Indices for local spatial autocorrelation were measured at the OD level using geographical information system (GIS) analysis. Finally, a potential link between socioeconomic status and resource distribution was explored by mapping resource densities against poverty rates. Gini coefficient calculation revealed variable inequality in distribution of the five key resources at the Province and OD levels. A greater percentage of the population resides in areas of relative under-supply (28.5%) than over-supply (21.3%). Areas with more resources per capita showed significant clustering in central Cambodia while areas with fewer resources clustered in the northern and western provinces. Hospital-based inpatient beds, doctors, and nurses were most heavily concentrated in areas of the country with the lowest poverty rates; however, beds and nurses in Non-Hospital Medical Facilities (NHMF) showed increasing concentrations at higher levels of poverty. There is

  19. World energy resources

    NASA Astrophysics Data System (ADS)

    Clerici, A.; Alimonti, G.

    2015-08-01

    As energy is the main "fuel" for social and economic development and since energy-related activities have significant environmental impacts, it is important for decision-makers to have access to reliable and accurate data in an user-friendly format. The World Energy Council (WEC) has for decades been a pioneer in the field of energy resources and every three years publishes its flagship report Survey of Energy Resources. A commented analysis in the light of latest data summarized in such a report, World Energy Resources (WER) 2013, is presented together with the evolution of the world energy resources over the last twenty years.

  20. Advancing Medication Safety: Establishing a National Action Plan for Adverse Drug Event Prevention.

    PubMed

    Harris, Yael; Hu, Dale J; Lee, Christine; Mistry, Mishale; York, Andrew; Johnson, Tisha K

    2015-08-01

    Adverse drug events (ADEs) are important contributors to preventable morbidity and mortality, comprising one third of all hospital adverse events. In response to growing evidence detailing the high prevalence of ADEs, particularly among vulnerable older adults, Congress requested that the Secretary of the Department of Health and Human Services (HHS) convene a Federal Interagency Steering Committee to establish a National Action Plan to focus on ADE prevention. In August 2014, the Office of Disease Prevention and Health Promotion released the final version of the National Action Plan for Adverse Drug Event Prevention. The Action Plan directly supports the goals of the HHS Strategic Plan and the Patient Protection and Affordable Care Act by providing guidance on tracking and preventing ADEs, as well as describing evidence-based tools and resources to enhance medication safety. ADE ACTION PLAN CONTENT: The Federal Interagency Steering Committee focused the Action Plan on ADEs that are clinically significant, account for the greatest number of measurable harms as identified by using existing surveillance tools, and are largely preventable. As such, the decision was made to target three medication classes: anticoagulants, diabetes agents (insulin and oral hypoglycemic agents), and opioids. The Action Plan is organized around four key areas: surveillance; evidence-based prevention; payment, policy incentives, and oversight; and research opportunities to advance medication safety. One measure of the ADE Action Plan's success will be the wider dissemination of information and educational resources to providers and patients (or consumers) regarding the risks associated with medications. Future Action Plan iterations are likely to consider other high-priority medication classes and update the recommendations.

  1. Impact of Local Resources on Hospitalization Patterns of Medicare Beneficiaries and Propensity to Travel outside Local Markets

    ERIC Educational Resources Information Center

    Basu, Jayasree; Mobley, Lee R.

    2010-01-01

    Purpose: To examine how local health care resources impact travel patterns of patients age 65 and older across the rural urban continuum. Methods: Information on inpatient hospital discharges was drawn from complete 2004 hospital discharge files from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for New York,…

  2. Preparation for workplace adversity: Student narratives as a stimulus for learning.

    PubMed

    Hanson, Julie; McAllister, Margaret

    2017-07-01

    Nursing students are not always well prepared for the kind of adverse events they may experience in the workplace and yet it seems apparent that future students could benefit from learning about such experiences so that they can be avoided, or their impact minimised. This research aimed to identify nursing students' experiences of adversity, collaborate with students to discern important lessons for future students in their experiences, and make recommendations for other educators on how to use these adversity stories as lessons. Seven Australian nursing students were interviewed using critical incident technique consisting of 7 questions. This paper focuses on the responses to the questions: "Does this story's message have a place in the curriculum?" and "How would you teach this lesson?" Data were analysed using critical discourse analysis. Four recurring discourses emerged including: power relationships are a two-way street; learn from mistakes to prevent mistakes; begin cultural consciousness-raising in first year, first semester; and become critically self-aware. Narratives derived from original stories of adversity may be a valuable source of learning about the realities of the workplace but to benefit fully, educators need to assist students to notice and analyse embedded messages. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Exploring adverse parent-child relationships from the perspective of convicted child murderers: A South African qualitative study.

    PubMed

    Dekel, Bianca; Abrahams, Naeemah; Andipatin, Michelle

    2018-01-01

    Child homicide is the most extreme form of violence against children. Within South Africa, children face the highest risk of homicide by parents/caregivers. It is suggested that prolonged exposure to adverse relationships with one's own parents may be linked to committing child homicide as it may lead to psychological damage and disturb neurological functioning. This paper explores the adverse parent-child relationships of 22 men and women incarcerated for the murder of either a biological child, a stepchild or a child in their care and draws on 49 in-depth interviews with these participants. We illustrate that traumatic parent-child experiences in the form of absent parents, neglect and abuse have a profound impact on establishing unhealthy attachment styles and emphasize the importance of early adverse parent-child bonds in setting the tone for future bonds as adults. The pathway to adopting an adverse attachment with one's own child is argued to be influenced by these early traumatic emotional experiences within the home. This study highlights the need to acknowledge the impact that adverse parent-child experiences have on the formation of violent forms of parental behavior. It is imperative to reduce children's emotional vulnerabilities by implementing strategies to strengthen current parenting practices, to promote the development of less violent parent-child relationships and to work towards resolving parents' experiences of trauma in reducing child homicide.

  4. Disassembly factories for electrical and electronic products to recover resources in product and material cycles.

    PubMed

    Basdere, Bahadir; Seliger, Guenther

    2003-12-01

    Cycle economy as a paradigm for industry in the 21st century depends on the economical and ecological treatment of limited resources. The objective is to achieve more use with fewer resources to increase the use-productivity of these resources. The European Union, aware of the adverse environmental impacts associated with electrical and electronic consumer goods in particular, has passed legislation regulating their appropriate end-of-life treatment. Adaptation processes, including essential disassembly and re-assembly operations, contribute significantly toward the economical fulfillment of these new legal requirements. Typically, the disassembly of used products is characterized by a high rate of manual operations, wide variety of product types, and unknown product properties. To cope with such demands, life cycle units or product accompanying information systems, are being developed and used for acquiring data about a specific product throughout its life cycle to aid in determining the level of product deterioration. Modular disassembly processes and tools have been developed and realized to enable the handling of multiple productvariants. They are being implemented in prototypical hybrid disassembly systemsfor large- and small-size electrical and electronic consumer goods.

  5. Impacts of Using Distributed Energy Resources to Reduce Peak Loads in Vermont

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ruth, Mark F.; Lunacek, Monte S.; Jones, Birk

    To help the United States develop a modern electricity grid that provides reliable power from multiple resources as well as resiliency under extreme conditions, the U.S. Department of Energy (DOE) is leading the Grid Modernization Initiative (GMI) to help shape the future of the nation's grid. Under the GMI, DOE funded the Vermont Regional Initiative project to provide the technical support and analysis to utilities that need to mitigate possible impacts of increasing renewable generation required by statewide goals. Advanced control of distributed energy resources (DER) can both support higher penetrations of renewable energy by balancing controllable loads to windmore » and photovoltaic (PV) solar generation and reduce peak demand by shedding noncritical loads. This work focuses on the latter. This document reports on an experiment that evaluated and quantified the potential benefits and impacts of reducing the peak load through demand response (DR) using centrally controllable electric water heaters (EWHs) and batteries on two Green Mountain Power (GMP) feeders. The experiment simulated various hypothetical scenarios that varied the number of controllable EWHs, the amount of distributed PV systems, and the number of distributed residential batteries. The control schemes were designed with several objectives. For the first objective, the primary simulations focused on reducing the load during the independent system operator (ISO) peak when capacity charges were the primary concern. The second objective was to mitigate DR rebound to avoid new peak loads and high ramp rates. The final objective was to minimize customers' discomfort, which is defined by the lack of hot water when it is needed. We performed the simulations using the National Renewable Energy Laboratory's (NREL's) Integrated Energy System Model (IESM) because it can simulate both electric power distribution feeder and appliance end use performance and it includes the ability to simulate multiple

  6. Big concerns with small projects: Evaluating the socio-ecological impacts of small hydropower projects in India.

    PubMed

    Jumani, Suman; Rao, Shishir; Machado, Siddarth; Prakash, Anup

    2017-05-01

    Although Small Hydropower Projects (SHPs) are encouraged as sources of clean and green energy, there is a paucity of research examining their socio-ecological impacts. We assessed the perceived socio-ecological impacts of 4 SHPs within the Western Ghats in India by conducting semi-structured interviews with local respondents. Primary interview data were sequentially validated with secondary data, and respondent perceptions were subsequently compared against the expected baseline of assured impacts. We evaluated the level of awareness about SHPs, their perceived socio-economic impacts, influence on resource access and impacts on human-elephant interactions. The general level of awareness about SHPs was low, and assurances of local electricity and employment generation remained largely unfulfilled. Additionally most respondents faced numerous unanticipated adverse impacts. We found a strong relationship between SHP construction and increasing levels of human-elephant conflict. Based on the disparity between assured and actual social impacts, we suggest that policies regarding SHPs be suitably revised.

  7. Who uses foodbanks and why? Exploring the impact of financial strain and adverse life events on food insecurity.

    PubMed

    Prayogo, E; Chater, A; Chapman, S; Barker, M; Rahmawati, N; Waterfall, T; Grimble, G

    2017-11-14

    Rising use of foodbanks highlights food insecurity in the UK. Adverse life events (e.g. unemployment, benefit delays or sanctions) and financial strains are thought to be the drivers of foodbank use. This research aimed to explore who uses foodbanks, and factors associated with increased food insecurity. We surveyed those seeking help from front line crisis providers from foodbanks (N = 270) and a comparison group from Advice Centres (ACs) (N = 245) in relation to demographics, adverse life events, financial strain and household food security. About 55.9% of foodbank users were women and the majority were in receipt of benefits (64.8%). Benefit delays (31.9%), changes (11.1%) and low income (19.6%) were the most common reasons given for referral. Compared to AC users, there were more foodbank users who were single men without children, unemployed, currently homeless, experiencing more financial strain and adverse life events (P = 0.001). Food insecurity was high in both populations, and more severe if they also reported financial strain and adverse life events. Benefit-related problems appear to be a key reason for foodbank referral. By comparison with other disadvantaged groups, foodbank users experienced more financial strain, adverse life events, both increased the severity of food insecurity. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  8. Resource Recovery. Redefining the 3 Rs. Reduce...Reuse...Recycle. Resources in Technology.

    ERIC Educational Resources Information Center

    Technology Teacher, 1991

    1991-01-01

    Discusses the problems of waste disposal, recycling, and resource recovery. Includes information on the social and cultural impact, the three classes of resource recovery (reuse, direct recycling, and indirect recycling), and specific products (paper, glass, plastics, metals, and so on). Includes a student quiz and possible outcomes. (JOW)

  9. Characterizing "Adversity" of Pathology Findings in ...

    EPA Pesticide Factsheets

    The identification of adverse health effects has a central role in the development and risk/safety assessment of chemical entities and pharmaceuticals. There is currently a need for better alignment in the toxicologic pathology community regarding how nonclinical adversity is determined and characterized. The European Society of Toxicologic Pathology (ESTP) therefore coordinated a workshop in June 2015 to review available definitions of adversity, weigh determining and qualifying factors of adversity based on case examples, and recommend a practical approach to define and characterize adversity in toxicology reports. The international group of expert pathologists and toxicologists emphasized that a holistic, weight-of-evidence, case-specific approach should be followed for each adversity assessment. It was recommended that nonclinical adversity should typically be determined at a morphological level (most often the organ) in the pathology report and should refer specifically to the test species. Final adversity calls, integration of target pharmacology/pathway information, and consideration of human translation should generally be made in toxicology overview reports. Differences in interpretation and implications of adversity calls between (agro)chemical and pharmaceutical industries and among world regions were highlighted. The results of this workshop should serve a valuable prerequisite for future organ- or lesion-specific workshops planned by the ESTP. This

  10. H2@Scale Resource and Market Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ruth, Mark

    This presentation overviews progress to date on the H2@Scale resource and market analysis work. The work finds, for example, that hydrogen demand of 60 MMT/yr is possible when transportation and industry are considered; resources are available to meet that demand; using renewable resources would reduce emissions and fossil use by over 15%; further impacts are possible when considering synergistic benefits; additional analysis is underway to improve understanding of potential markets and synergistic impacts; and further analysis will be necessary to estimate impacts due to spatial characteristics, feedback effects in the economy, and inertia characteristics.

  11. Modeling life course pathways from adverse childhood experiences to adult mental health.

    PubMed

    Jones, Tiffany M; Nurius, Paula; Song, Chiho; Fleming, Christopher M

    2018-06-01

    Although the association between adverse childhood experiences (ACEs) and adult mental health is becoming well established, less is known about the complex and multiple pathways through which ACEs exert their influence. Growing evidence suggests that adversity early in life conveys not only early impacts, but also augments risk of stress-related life course cascades that continue to undermine health. The present study aims to test pathways of stress proliferation and stress embodiment processes linking ACEs to mental health impairment in adulthood. Data are from the 2011 Behavioral Risk Factor Surveillance Survey, a representative sample of Washington State adults ages 18 and over (N = 14,001). Structural equation modeling allowed for testing of direct and indirect effects from ACEs though low income status, experiences of adversity in adulthood, and social support. The model demonstrated that adult low income, social support and adult adversity are in fact conduits through which ACEs exert their influence on mental health impairment in adulthood. Significant indirect pathways through these variables supported hypotheses that the effect of ACEs is carried through these variables. This is among the first models that demonstrates multiple stress-related life course pathways through which early life adversity compromises adult mental health. Discussion elaborates multiple service system opportunities for intervention in early and later life to interrupt direct and indirect pathways of ACE effects. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. The Impact of Resources on Women's Strategies for Coping with Work-Home Conflict: Does Sociocultural Context Matter?

    ERIC Educational Resources Information Center

    Kulik, Liat

    2012-01-01

    The study examined differences in the impact of resources on strategies for coping with work-home conflict (WHC) among Jewish (n = 59) and Muslim Arab (n = 87) women from dual-earner families in Israel. A distinction was made between three main types of coping strategies: taking initiative, help seeking (active strategies), and redefinition (a…

  13. Final environmental impact statement for the Galileo Mission (Tier 2)

    NASA Technical Reports Server (NTRS)

    1989-01-01

    This Final Environmental Impact Statement (FEIS) addresses the proposed action of completing the preparation and operation of the Galileo spacecraft, including its planned launch on the Space Transportation System (STS) Shuttle in October 1989, and the alternative of canceling further work on the mission. The only expected environmental effects of the proposed action are associated with normal launch vehicle operation, and are treated in published National Environmental Policy Act (NEPA) documents on the Shuttle (NASA 1978) and the Kennedy Space Center (NASA 1979), and in the KSC Environmental Resources Document (NASA 1986) and the Galileo Tier 1 EIS (NASA 1988a). The environmental impacts of a normal launch were deemed insufficient to preclude Shuttle operations. Environmental impacts may also result from launch or mission accidents that could release plutonium fuel used in the Galileo power system. Intensive analysis of the possible accidents associated with the proposed action reveal small health or environmental risks. There are no environmental impacts in the no-action alternative. The remote possibility of environmental impacts of the proposed action must be weighed against the large adverse fiscal and programmatic impacts inherent in the no-action alternative.

  14. Environmental impact of geopressure - geothermal cogeneration facility on wetland resources and socioeconomic characteristics in Louisiana Gulf Coast region. Final report, October 10, 1983-September 31, 1984

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Smalley, A.M.; Saleh, F.M.S.; Fontenot, M.

    1984-08-01

    Baseline data relevant to air quality are presented. The following are also included: geology and resource assessment, design well prospects in southwestern Louisiana, water quality monitoring, chemical analysis subsidence, microseismicity, geopressure-geothermal subsidence modeling, models of compaction and subsidence, sampling handling and preparation, brine chemistry, wetland resources, socioeconomic characteristics, impacts on wetlands, salinity, toxic metals, non-metal toxicants, temperature, subsidence, and socioeconomic impacts. (MHR)

  15. Wave resource variability: Impacts on wave power supply over regional to international scales

    NASA Astrophysics Data System (ADS)

    Smith, Helen; Fairley, Iain; Robertson, Bryson; Abusara, Mohammad; Masters, Ian

    2017-04-01

    The intermittent, irregular and variable nature of the wave energy resource has implications for the supply of wave-generated electricity into the grid. Intermittency of renewable power may lead to frequency and voltage fluctuations in the transmission and distribution networks. A matching supply of electricity must be planned to meet the predicted demand, leading to a need for gas-fired and back-up generating plants to supplement intermittent supplies, and potentially limiting the integration of intermittent power into the grid. Issues relating to resource intermittency and their mitigation through the development of spatially separated sites have been widely researched in the wind industry, but have received little attention to date in the less mature wave industry. This study analyses the wave resource over three different spatial scales to investigate the potential impacts of the temporal and spatial resource variability on the grid supply. The primary focus is the Southwest UK, a region already home to multiple existing and proposed wave energy test sites. Concurrent wave buoy data from six locations, supported by SWAN wave model hindcast data, are analysed to assess the correlation of the resource across the region and the variation in wave power with direction. Power matrices for theoretical nearshore and offshore devices are used to calculate the maximum step change in generated power across the region as the number of deployment sites is increased. The step change analysis is also applied across national and international spatial scales using output from the European Centre for Medium-range Weather Forecasting (ECMWF) ERA-Interim hindcast model. It is found that the deployment of multiple wave energy sites, whether on a regional, national or international scale, results in both a reduction in step changes in power and reduced times of zero generation, leading to an overall smoothing of the wave-generated electrical power. This has implications for the

  16. Too Much of a Good Thing? Psychosocial Resources, Gendered Racism, and Suicidal Ideation Among Low-SES African American Women

    PubMed Central

    Perry, Brea L.; Pullen, Erin; Oser, Carrie B.

    2012-01-01

    Very few studies have examined predictors of suicidal ideation among African American women. Consequently, we have a poor understanding of the combinations of culturally-specific experiences and psychosocial processes that may constitute risk and protective factors for suicide in this population. Drawing on theories of social inequality, medical sociology, and the stress process, we explore the adverse impact of gendered racism experiences and potential moderating factors in a sample of 204 predominantly low-SES African American women. We find that African American women’s risk for suicidal ideation is linked to stressors occurring as a function of their distinct social location at the intersection of gender and race. In addition, we find that gendered racism has no effect on suicidal ideation among women with moderate levels of well-being, self-esteem, and active coping, but has a strong adverse influence in those with high and low levels of psychosocial resources. PMID:23565018

  17. Intimate partner violence adversely impacts health over 16 years and across generations: A longitudinal cohort study.

    PubMed

    Loxton, Deborah; Dolja-Gore, Xenia; Anderson, Amy E; Townsend, Natalie

    2017-01-01

    To determine the impact of intimate partner violence on women's mental and physical health over a 16 year period and across three generations. Participants were from the Australian Longitudinal study on Women's Health, a broadly representative national sample of women comprised of three birth cohorts 1973-78, 1946-51 and 1921-26 who were randomly selected from the Australian Medicare (i.e. national health insurer) database in 1996 to participate in the longitudinal health and wellbeing survey. Since baseline, six waves of survey data have been collected. Women from each cohort who had returned all six surveys and had a baseline measure (Survey 1) for intimate partner violence were eligible for the current study. The main outcome of interest was women's physical and mental health, measured using the Medical Outcome Study Short-Form (SF-36). The experience of intimate partner violence was measured using the survey item 'Have you ever been in a violent relationship with a partner/spouse?' Sociodemographic information was also collected. For all cohorts, women who had lived with intimate partner violence were more likely to report poorer mental health, physical function and general health, and higher levels of bodily pain. Some generational differences existed. Younger women showed a reduction in health associated with the onset of intimate partner violence, which was not apparent for women in the older two groups. In addition, the physical health differences between women born 1921-26 who had and had not experienced intimate partner violence tapered off overtime, whereas these differences remained constant for women born 1973-78 and 1946-51. Despite generational differences, intimate partner violence adversely impacted on mental and physical health over the 16 year study period and across generations.

  18. Adverse Childhood Experiences, the Medical Home, and Child Well-Being.

    PubMed

    Balistreri, Kelly Stamper

    2015-11-01

    To examine the relationship between adverse childhood experiences (ACE), access to a medical home and a global measure of well-being among children ages 6-17 using the 2011-2012 National Survey of Children's Health. Multivariate linear regressions assessed the associations between each adverse experience and an index of child well-being with and without the impact of other events. The number of ACE was summed for each respondent and the analyses were repeated with the cumulative score as a continuous variable. The cumulative model was repeated with the addition of an interaction term between ACE score and medical home access. All analyses were conducted separately for children ages 6-11 and adolescents 12-17. Over half (53 %) of US children ages 6-17 have experienced some adverse experience during childhood. Over a quarter (28 %) has experienced at least two adverse experiences, while 15 % have experienced three or more hardships. Results suggest that the accumulation of ACE reduces well-being in children. The associations remained significant after controlling for gender, race/ethnicity, age, parental education, special health condition, and medical home access. Medical home access was consistently associated with higher levels of child well-being and was a significant moderator of the relationship between the total ACE and child well-being among children ages 6-11. Children with ACE exposure and access to a medical home have higher levels of well-being than comparable children without access to a medical home. Children exposed to adverse experiences have measurably lower levels of well-being, although younger children with access to a medical home are protected at increasing exposure.

  19. The association between cumulative adversity and mental health: considering dose and primary focus of adversity.

    PubMed

    Keinan, Giora; Shrira, Amit; Shmotkin, Dov

    2012-09-01

    The study addressed the dose-response model in the association of cumulative adversity with mental health. Data of 1,725 participants aged 50+ were drawn from the Israeli component of the Survey of Health, Ageing, and Retirement in Europe. Measures included an inventory of potentially traumatic events, distress (lifetime depression, depressive symptoms), and well-being (quality of life, optimism/hope). The maximal effect of cumulative trauma emerged in the contrast between 0-2 and 3+ events, where the higher number of events related to higher distress but also to higher well-being. While self-oriented adversity revealed no, or negative, association with well-being, other-oriented adversity revealed a positive association. The study suggests an experiential dose of cumulative adversity leading to a co-activation of distress and well-being. The source of this co-activation seems to be other-oriented adversity.

  20. Influence of three common calibration metrics on the diagnosis of climate change impacts on water resources

    NASA Astrophysics Data System (ADS)

    Seiller, G.; Roy, R.; Anctil, F.

    2017-04-01

    Uncertainties associated to the evaluation of the impacts of climate change on water resources are broad, from multiple sources, and lead to diagnoses sometimes difficult to interpret. Quantification of these uncertainties is a key element to yield confidence in the analyses and to provide water managers with valuable information. This work specifically evaluates the influence of hydrological modeling calibration metrics on future water resources projections, on thirty-seven watersheds in the Province of Québec, Canada. Twelve lumped hydrologic models, representing a wide range of operational options, are calibrated with three common objective functions derived from the Nash-Sutcliffe efficiency. The hydrologic models are forced with climate simulations corresponding to two RCP, twenty-nine GCM from CMIP5 (Coupled Model Intercomparison Project phase 5) and two post-treatment techniques, leading to future projections in the 2041-2070 period. Results show that the diagnosis of the impacts of climate change on water resources are quite affected by the hydrologic models selection and calibration metrics. Indeed, for the four selected hydrological indicators, dedicated to water management, parameters from the three objective functions can provide different interpretations in terms of absolute and relative changes, as well as projected changes direction and climatic ensemble consensus. The GR4J model and a multimodel approach offer the best modeling options, based on calibration performance and robustness. Overall, these results illustrate the need to provide water managers with detailed information on relative changes analysis, but also absolute change values, especially for hydrological indicators acting as security policy thresholds.