The impact of forest structure and light utilization on carbon cycling in tropical forests

NASA Astrophysics Data System (ADS)

Morton, D. C.; Longo, M.; Leitold, V.; Keller, M. M.

2015-12-01

Light competition is a fundamental organizing principle of forest ecosystems, and interactions between forest structure and light availability provide an important constraint on forest productivity. Tropical forests maintain a dense, multi-layered canopy, based in part on abundant diffuse light reaching the forest understory. Climate-driven changes in light availability, such as more direct illumination during drought conditions, therefore alter the potential productivity of forest ecosystems during such events. Here, we used multi-temporal airborne lidar data over a range of Amazon forest conditions to explore the influence of forest structure on gross primary productivity (GPP). Our analysis combined lidar-based observations of canopy illumination and turnover in the Ecosystem Demography model (ED, version 2.2). The ED model was updated to specifically account for regional differences in canopy and understory illumination using lidar-derived measures of canopy light environments. Model simulations considered the influence of forest structure on GPP over seasonal to decadal time scales, including feedbacks from differential productivity between illuminated and shaded canopy trees on mortality rates and forest composition. Finally, we constructed simple scenarios with varying diffuse and direct illumination to evaluate the potential for novel plant-climate interactions under scenarios of climate change. Collectively, the lidar observations and model simulations underscore the need to account for spatial heterogeneity in the vertical structure of tropical forests to constrain estimates of tropical forest productivity under current and future climate conditions.

Integrating invasive grasses into carbon cycle projections: Cogongrass spread in southern pine forests

NASA Astrophysics Data System (ADS)

McCabe, T. D.; Flory, S. L.; Wiesner, S.; Dietze, M.

2017-12-01

Forested ecosystems are currently being disrupted by invasive species. One example is the invasive grass Imperata cylindrica (cogongrass), which is widespread in southeastern US pine forests. Pines forests dominate the forest cover of the southeast, and contribute to making the Southeast the United States' largest carbon sink. Cogongrass decreases the colonization of loblolly pine fine roots. If cogongrass continues to invade,this sink could be jeopardized. However, the effects of cogongrass invasion on carbon sequestration are largely unknown. We have projected the effects of elevated CO2 and changing climate on future cogongrass invasion. To test how pine stands are affected by cogongrass, cogongrass invasions were modeled using the Ecosystem Demography 2 (ED2) model, and parameterized using the Predictive Ecosystem Analyzer (PEcAn). ED2 takes into account local meteorological data, stand populations and succession, disturbance, and geochemical pools. PEcAn is a workflow that uses Bayesian sensitivity analyses and variance decomposition to quantify the uncertainty that each parameter contributes to overall model uncertainty. ED2 was run for four NEON and Ameriflux sites in the Southeast from the earliest available census of the site into 2010. These model results were compared to site measures to test for model accuracy and bias. To project the effect of elevated CO2 on cogongrass invasions, ED was run from 2006-2100 at four sites under four separate scenarios: 1) RPC4.5 CO2 and climate, 2) RPC4.5 climate only, with constant CO2 concentrations, 3) RPC4.5 Elevated CO2 only, with climate randomly selected from 2006-2026, 4) Present Day, made from randomly selected measures of CO2 and radiation from 2006-2026. Each scenario was run three times; once with cogongrass absent, once with a low cogongrass abundance, and once with a high cogongrass abundance. Model results suggest that many relevant parameters have high uncertainty due to lack of measurement. Further field work quantifying the carbon cycle, particularly belowground processes and respiration, could help constrain parameter uncertainty.

Improving predictions of carbon fluxes in the tropics undre climatic changes using ED2

NASA Astrophysics Data System (ADS)

Feng, X.; Uriarte, M.

2016-12-01

Tropical forests play a critical role in the exchange of carbon between land and atmosphere, highlighting the urgency of understanding the effects of climate change on these ecosystems. The most optimistic predictions of climate models indicate that global mean temperatures will increase by up to 2 0C with some tropical regions experiencing extreme heat. Drought and heat-induced tree mortality will accelerate the release of carbon to the atmosphere creating a positive feedback that greatly exacerbates global warming. Thus, under a warmer and drier climate, tropical forests may become net sources, rather than sinks, of carbon. Earth system models have not reached a consensus on the magnitude and direction of climate change impacts on tropical forests, calling into question the reliability of their predictions. Thus, there is an immediate need to improve the representation of tropical forests in earth system models to make robust predictions. The goal of our study is to quantify the responses of tropical forests to climate variability and improve the predictive capacity of terrestrial ecosystem models. We have collected species-specific physiological and functional trait data from 144 tree species in a Puerto Rican rainforest to parameterize the Ecosystem Demography model (ED2). The large amount of data generated by this research will lead to better validation and lowering the uncertainty in future model predictions. To best represent the forest landscape in ED2, all the trees have been assigned to three plant functional types (PFTs): early, mid, and late successional species. Trait data for each PFT were synthesized in a Bayesian meta-analytical model and posterior distributions of traits were used to parameterize the ED2 model. Model predictions show that biomass production of late successional PFT (118.89 ton/ha) was consistently higher than mid (71.33 ton/ha) and early (13.21 ton/ha) PFTs. However, mid successional PFT had the highest contributions to NPP for the modeled period. Tropical forest biomass reduces by 30% under future drought scenario turning the tropics into carbon sources. Ensemble runs were conducted to construct error estimates around model forecasts, to compare modeled and observed aboveground biomass, and to identify which processes and tree species need further study.

Taking off the training wheels: the properties of a dynamic vegetation model without climate envelopes

DOE PAGES

Fisher, R. A.; Muszala, S.; Verteinstein, M.; ...

2015-04-29

We describe an implementation of the Ecosystem Demography (ED) concept in the Community Land Model. The structure of CLM(ED) and the physiological and structural modifications applied to the CLM are presented. A major motivation of this development is to allow the prediction of biome boundaries directly from plant physiological traits via their competitive interactions. Here we investigate the performance of the model for an example biome boundary in Eastern North America. We explore the sensitivity of the predicted biome boundaries and ecosystem properties to the variation of leaf properties determined by the parameter space defined by the GLOPNET global leafmore » trait database. Further, we investigate the impact of four sequential alterations to the structural assumptions in the model governing the relative carbon economy of deciduous and evergreen plants. The default assumption is that the costs and benefits of deciduous vs. evergreen leaf strategies, in terms of carbon assimilation and expenditure, can reproduce the geographical structure of biome boundaries and ecosystem functioning. We find some support for this assumption, but only under particular combinations of model traits and structural assumptions. Many questions remain regarding the preferred methods for deployment of plant trait information in land surface models. In some cases, plant traits might best be closely linked with each other, but we also find support for direct linkages to environmental conditions. We advocate for intensified study of the costs and benefits of plant life history strategies in different environments, and for the increased use of parametric and structural ensembles in the development and analysis of complex vegetation models.« less

Taking off the training wheels: the properties of a dynamic vegetation model without climate envelopes

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

Fisher, R. A.; Muszala, S.; Verteinstein, M.

We describe an implementation of the Ecosystem Demography (ED) concept in the Community Land Model. The structure of CLM(ED) and the physiological and structural modifications applied to the CLM are presented. A major motivation of this development is to allow the prediction of biome boundaries directly from plant physiological traits via their competitive interactions. Here we investigate the performance of the model for an example biome boundary in Eastern North America. We explore the sensitivity of the predicted biome boundaries and ecosystem properties to the variation of leaf properties determined by the parameter space defined by the GLOPNET global leafmore » trait database. Further, we investigate the impact of four sequential alterations to the structural assumptions in the model governing the relative carbon economy of deciduous and evergreen plants. The default assumption is that the costs and benefits of deciduous vs. evergreen leaf strategies, in terms of carbon assimilation and expenditure, can reproduce the geographical structure of biome boundaries and ecosystem functioning. We find some support for this assumption, but only under particular combinations of model traits and structural assumptions. Many questions remain regarding the preferred methods for deployment of plant trait information in land surface models. In some cases, plant traits might best be closely linked with each other, but we also find support for direct linkages to environmental conditions. We advocate for intensified study of the costs and benefits of plant life history strategies in different environments, and for the increased use of parametric and structural ensembles in the development and analysis of complex vegetation models.« less

Predicting ecosystem dynamics at regional scales: an evaluation of a terrestrial biosphere model for the forests of northeastern North America.

PubMed

Medvigy, David; Moorcroft, Paul R

2012-01-19

Terrestrial biosphere models are important tools for diagnosing both the current state of the terrestrial carbon cycle and forecasting terrestrial ecosystem responses to global change. While there are a number of ongoing assessments of the short-term predictive capabilities of terrestrial biosphere models using flux-tower measurements, to date there have been relatively few assessments of their ability to predict longer term, decadal-scale biomass dynamics. Here, we present the results of a regional-scale evaluation of the Ecosystem Demography version 2 (ED2)-structured terrestrial biosphere model, evaluating the model's predictions against forest inventory measurements for the northeast USA and Quebec from 1985 to 1995. Simulations were conducted using a default parametrization, which used parameter values from the literature, and a constrained model parametrization, which had been developed by constraining the model's predictions against 2 years of measurements from a single site, Harvard Forest (42.5° N, 72.1° W). The analysis shows that the constrained model parametrization offered marked improvements over the default model formulation, capturing large-scale variation in patterns of biomass dynamics despite marked differences in climate forcing, land-use history and species-composition across the region. These results imply that data-constrained parametrizations of structured biosphere models such as ED2 can be successfully used for regional-scale ecosystem prediction and forecasting. We also assess the model's ability to capture sub-grid scale heterogeneity in the dynamics of biomass growth and mortality of different sizes and types of trees, and then discuss the implications of these analyses for further reducing the remaining biases in the model's predictions.

Constraining predictions of tundra permafrost and vegetation through model-data feedbacks and data-assimilation

NASA Astrophysics Data System (ADS)

Davidson, C. D.; Dietze, M.

2011-12-01

Arctic climate is warming at a rate disproportionate to the rest of the world, and recent interest has emerged in using terrestrial biosphere models to understand and predict the response of tundra ecosystems to such warming. Of particular interest are the potential feedbacks between permafrost melting, plant community dynamics, and biogeochemical cycles. Here, we report on efforts to calibrate and validate version 2 of the Ecosystem Demography model (ED2) for the Alaskan tundra and on the use of model analyses to motivate targeted field measurements. ED2 is a terrestrial biosphere model unique in its ability to scale physiological and plant community dynamics to regional levels. We began by assessing the ability of ED2's land surface model to capture permafrost thermodynamics and hydrology. Simulations at Barrow and Toolik Lake, Alaska bore several incongruities with observed data, with soil temperatures significantly higher and soil moisture lower than observed. Modifications were made to increase the soil column depth and to simulate the effect of wind compaction on snow density, and in turn, the insulation of winter soils. In addition to these changes, a new soil class was created to represent unique characteristics within the organic horizon of tundra soils. Together these changes significantly improved permafrost dynamics without substantially altering dynamics in the temperate region. To capture tundra vegetation dynamics, tundra species were classified into three plant functional types (graminoid, deciduous shrub, evergreen shrub). ED2 was then iteratively calibrated for the tundra using the Predictive Ecosystem Analyzer (PEcAn), a scientific workflow and ecoinformatics toolbox developed to aid model parameterization and analysis. Initial parameter estimates were derived from a formal Bayesian meta-analysis of compiled plant trait data. Sensitivity analyses and variance decomposition demonstrated that model uncertainties were driven by the minimum temperature at which photosynthesis could occur and the allocation of resources to different plant tissues. Based on these findings a targeted field campaign was conducted at the Toolik LTER. Temperature response curves for the top 12 most common species found significant carbon assimilation at leaf temperatures below 0 C for most species. Individual-level plant harvests across six different vegetation classes were used to construct leaf, stem, and root allometries, while individual-level plant growth and plot-level biomass data were incorporated using Bayesian data-assimilation techniques. Model parameters were further constrained by also assimilating eddy-covariance data on carbon and moisture fluxes from the Atquasuk and Barrow Ameriflux towers. Finally, ED2 was validated against long-term plot measurements at Toolik and flux data from Ivotuk and Happy Valley. Projections at each site were made using an ensemble approach in order to propagate model uncertainties. Ongoing work is now focused on regional-scale validation against remotely sensed data and on coupling the ED2 model to the ALFRESCO landscape fire model.

Use and toxicity of traditional and complementary medicine among patients seeking care at an emergency department of a teaching hospital in Malaysia.

PubMed

Jatau, Abubakar Ibrahim; Aung, Myat Moe Thwe; Kamauzaman, Tuan Hairulnizam Tuan; Ab Rahman, Ab Fatah

2018-05-01

Traditional and Complementary Medicines (TCM) are widely used worldwide, and many of them have the potential to cause toxicity, interaction with conventional medications and non-adherence to prescribed medications due to patients' preference for the TCM use. However, information regarding their use among patients seeking care at emergency departments (ED) of a healthcare facility is limited. The study aimed to evaluate the TCM use among patients attending the ED of a teaching hospital in Malaysia. A sub-analysis of data from a prevalence study of medication-related visits among patients at the ED of Hospital Universiti Sains Malaysia was conducted. The study took place over a period of six weeks from December 2014 to January 2015 involving 434 eligible patients. Data on demography, conventional medication, and TCM uses were collected from patient interview and the medical folders. Among this cohort, 66 patients (15.2%, 95%CI 12.0, 19.0) reported concurrent TCM use. Sixteen (24.2%) of the TCM users were using more than one (1) type of TCM, and 17 (25.8%) came to the ED for medication-related reasons. Traditional Malay Medicine (TMM) was the most frequently used TCM by the patients. Five patients (7.6%) sought treatment at the ED for medical problems related to use of TCM. Patients seeking medical care at the ED may be currently using TCM. ED-physicians should be aware of these therapies and should always ask patients about the TCM use. Copyright © 2018 Elsevier Ltd. All rights reserved.

Modeling the influence of leaf demography on remotely sensed data using DART and PROSPECT-D

NASA Astrophysics Data System (ADS)

Feret, J. B.; Grau, E.; Barbier, N.; Berveiller, D.; Chave, J.; Durrieu, S.; Gastellu-Etchegorry, J. P.; Hmimina, G.; Lefèvre-Fonollosa, M. J.; Proisy, C.; Soudani, K.; Vincent, G.

2016-12-01

The seasonality of Amazon forest productivity and photosynthetic activity has recently been investigated under a new perspective by a series of publications. The debate about possible factors explaining this seasonality is vivid, and the possibility of several hypotheses has been tested, including canopy phenology and leaf demography, and changes in illumination geometry combined with the complex 3D structure of the canopy. A manifold of measurements and techniques have been used to test these hypotheses, including field observations of leaf demography from ground measured litterfall and phenocam, airborne and satellite remote sensing and 3 dimensional radiative transfer modeling. Our study explores the relative influence of leaf demography and illumination geometry on remotely sensed data. To achieve this, we take advantage of the latest advances in the domain of physical modeling at both leaf and canopy scale. The leaf optical properties model PROSPECT-D was used to model leaf optical properties at various growth stages based on field observations and theoretical leaf biochemical composition during its development and senescence. The 3-dimensional radiative transfer model DART was used to simulate various levels of complexity of canopy covers, from a turbid layer to complex canopy derived from airborne LiDAR acquisitions. Data for leaf demography and ontogeny taken from recent publications was used and integrated into canopy simulations corresponding to year-long observations. Data acquisitions were performed in the frame of the HyperTropik project, funded by CNES, Our results focus on analyzing the influence of separated and combined factors such as illumination geometry, leaf biochemistry and leaf demography on various spectral attributes, including Enhanced vegetation index and hyperspectral metrics.

Potential for Woody Bioenergy Crops Grown on Marginal Lands in the US Midwest to Reduce Carbon Emissions

NASA Astrophysics Data System (ADS)

Sahajpal, R.; Hurtt, G. C.; Fisk, J. P.; Izaurralde, R. C.; Zhang, X.

2012-12-01

While cellulosic biofuels are widely considered to be a low carbon energy source for the future, a comprehensive assessment of the environmental sustainability of existing and future biofuel systems is needed to assess their utility in meeting US energy and food needs without exacerbating environmental harm. To assess the carbon emission reduction potential of cellulosic biofuels, we need to identify lands that are initially not storing large quantities of carbon in soil and vegetation but are capable of producing abundant biomass with limited management inputs, and accurately model forest production rates and associated input requirements. Here we present modeled results for carbon emission reduction potential and cellulosic ethanol production of woody bioenergy crops replacing existing native prairie vegetation grown on marginal lands in the US Midwest. Marginal lands are selected based on soil properties describing use limitation, and are extracted from the SSURGO (Soil Survey Geographic) database. Yield estimates for existing native prairie vegetation on marginal lands modeled using the process-based field-scale model EPIC (Environmental Policy Integrated Climate) amount to ~ 6.7±2.0 Mg ha-1. To model woody bioenergy crops, the individual-based terrestrial ecosystem model ED (Ecosystem Demography) is initialized with the soil organic carbon stocks estimated at the end of the EPIC simulation. Four woody bioenergy crops: willow, southern pine, eucalyptus and poplar are parameterized in ED. Sensitivity analysis of model parameters and drivers is conducted to explore the range of carbon emission reduction possible with variation in woody bioenergy crop types, spatial and temporal resolution. We hypothesize that growing cellulosic crops on these marginal lands can provide significant water quality, biodiversity and GHG emissions mitigation benefits, without accruing additional carbon costs from the displacement of food and feed production.

Geography, population, demography, socioeconomic, anthropometry, and environmental status in the MAL-ED cohort and case-control study Sites in Fortaleza, Ceará, Brazil.

PubMed

Lima, Aldo A M; Oriá, Reinaldo B; Soares, Alberto M; Filho, José Q; de Sousa, Francisco; Abreu, Cláudia B; Bindá, Alexandre; Lima, Ila; Quetz, Josiane; Moraes, Milena; Maciel, Bruna; Costa, Hilda; Leite, Alvaro M; Lima, Noélia L; Mota, Francisco S; Di Moura, Alessandra; Scharf, Rebecca; Barrett, Leah; Guerrant, Richard L

2014-11-01

The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort in the study's Fortaleza, Brazil, catchment area has a population of approximately 82 300 inhabitants. Most of the households (87%) have access to clean water, 98% have electricity, and 69% have access to improved toilet/sanitation. Most childbirths occur at the hospital, and the under-5 mortality rate is 20 per 1000 live births. The MAL-ED case-control study population, identified through the Institute for the Promotion of Nutrition and Human Development (IPREDE), serves 600 000 inhabitants from areas totaling about 42% of the city of Fortaleza. IPREDE receives referrals from throughout the state of Ceará for infant nutrition, and provides services including teaching activities and the training of graduate students and health professionals, while supporting research projects on child nutrition and health. In this article, we describe the geographic, demographic, socioeconomic, anthropometric, and environmental status of the MAL-ED cohort and case-control study populations in Fortaleza, Brazil. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Partitioning CO 2 fluxes with isotopologue measurements and modeling to understand mechanisms of forest carbon sequestration

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

Saleska, Scott; Davidson, Eric; Finzi, Adrien

This project combines automated in situ observations of the isotopologues of CO 2 with root observations, novel experimental manipulations of below ground processes, and isotope-enabled ecosystem modeling to investigate mechanisms of below- vs. above ground carbon sequestration at the Harvard Forest Environmental Measurements Site (EMS). The proposed objectives, which have now been largely accomplished, include: (A) Partitioning of net ecosystem CO2 exchange (NEE) into photosynthesis and respiration using long-term continuous observations of the isotopic composition of NEE, and analysis of their dynamics; (B) Investigation of the influence of vegetation phenology on the timing and magnitude of carbon allocated below groundmore » using measurements of root growth and indices of below ground autotrophic vs. heterotrophic respiration (via trenched plots andisotope measurements); (C) Testing whether plant allocation of carbon below ground stimulates the microbial decomposition of soil organic matter, using in situ rhizosphere simulation experiments wherein realistic quantities of artificial isotopically-labeled exudates are released into the soil; and (D) Synthesis and interpretation of the above data using the Ecosystem Demography Model 2 (ED2).« less

Partitioning CO 2 fluxes with isotopologue measurements and modeling to understand mechanisms of forest carbon sequestration

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

Davidson, Eric A.; Saleska, Scott; Savage, Kathleen

1. Project Summary and Objectives This project combines automated in situ observations of the isotopologues of CO 2 with root observations, novel experimental manipulations of belowground processes, and isotope-enabled ecosystem modeling to investigate mechanisms of below- vs. aboveground carbon sequestration at the Harvard Forest Environmental Measurements Site (EMS). The proposed objectives, which have now been largely accomplished, include: A. Partitioning of net ecosystem CO 2 exchange (NEE) into photosynthesis and respiration using long-term continuous observations of the isotopic composition of NEE, and analysis of their dynamics ; B. Investigation of the influence of vegetation phenology on the timing and magnitudemore » of carbon allocated belowground using measurements of root growth and indices of belowground autotrophic vs. heterotrophic respiration (via trenched plots and isotope measurements); C. Testing whether plant allocation of carbon belowground stimulates the microbial decomposition of soil organic matter, using in situ rhizosphere simulation experiments wherein realistic quantities of artificial isotopically-labeled exudates are released into the soil; and D. Synthesis and interpretation of the above data using the Ecosystem Demography Model 2 (ED2).« less

A multi-model assessment of terrestrial biosphere model data needs

NASA Astrophysics Data System (ADS)

Gardella, A.; Cowdery, E.; De Kauwe, M. G.; Desai, A. R.; Duveneck, M.; Fer, I.; Fisher, R.; Knox, R. G.; Kooper, R.; LeBauer, D.; McCabe, T.; Minunno, F.; Raiho, A.; Serbin, S.; Shiklomanov, A. N.; Thomas, A.; Walker, A.; Dietze, M.

2017-12-01

Terrestrial biosphere models provide us with the means to simulate the impacts of climate change and their uncertainties. Going beyond direct observation and experimentation, models synthesize our current understanding of ecosystem processes and can give us insight on data needed to constrain model parameters. In previous work, we leveraged the Predictive Ecosystem Analyzer (PEcAn) to assess the contribution of different parameters to the uncertainty of the Ecosystem Demography model v2 (ED) model outputs across various North American biomes (Dietze et al., JGR-G, 2014). While this analysis identified key research priorities, the extent to which these priorities were model- and/or biome-specific was unclear. Furthermore, because the analysis only studied one model, we were unable to comment on the effect of variability in model structure to overall predictive uncertainty. Here, we expand this analysis to all biomes globally and a wide sample of models that vary in complexity: BioCro, CABLE, CLM, DALEC, ED2, FATES, G'DAY, JULES, LANDIS, LINKAGES, LPJ-GUESS, MAESPA, PRELES, SDGVM, SIPNET, and TEM. Prior to performing uncertainty analyses, model parameter uncertainties were assessed by assimilating all available trait data from the combination of the BETYdb and TRY trait databases, using an updated multivariate version of PEcAn's Hierarchical Bayesian meta-analysis. Next, sensitivity analyses were performed for all models across a range of sites globally to assess sensitivities for a range of different outputs (GPP, ET, SH, Ra, NPP, Rh, NEE, LAI) at multiple time scales from the sub-annual to the decadal. Finally, parameter uncertainties and model sensitivities were combined to evaluate the fractional contribution of each parameter to the predictive uncertainty for a specific variable at a specific site and timescale. Facilitated by PEcAn's automated workflows, this analysis represents the broadest assessment of the sensitivities and uncertainties in terrestrial models to date, and provides a comprehensive roadmap for constraining model uncertainties through model development and data collection.

Structured models of infectious disease: inference with discrete data

PubMed Central

Metcalf, C.J.E.; Lessler, J.; Klepac, P.; Morice, A.; Grenfell, B.T.; Bjørnstad, O.N.

2014-01-01

The usage of structured population models can make substantial contributions to public health, particularly for infections where clinical outcomes vary over age. There are three theoretical challenges in implementing such analyses: i) developing an appropriate framework that models both demographic and epidemiological transitions; ii) parameterizing the framework, where parameters may be based on data ranging from the biological course of infection, basic patterns of human demography, specific characteristics of population growth, and details of vaccination regimes implemented; and iii) evaluating public health strategies in the face of changing human demography. We illustrate the general approach by developing a model of rubella in Costa Rica. The demographic profile of this infection is a crucial aspect of its public health impact, and we use a transient perturbation analysis to explore the impact of changing human demography on immunization strategies implemented. PMID:22178687

Improving predictions of tropical forest response to climate change through integration of field studies and ecosystem modeling.

PubMed

Feng, Xiaohui; Uriarte, María; González, Grizelle; Reed, Sasha; Thompson, Jill; Zimmerman, Jess K; Murphy, Lora

2018-01-01

Tropical forests play a critical role in carbon and water cycles at a global scale. Rapid climate change is anticipated in tropical regions over the coming decades and, under a warmer and drier climate, tropical forests are likely to be net sources of carbon rather than sinks. However, our understanding of tropical forest response and feedback to climate change is very limited. Efforts to model climate change impacts on carbon fluxes in tropical forests have not reached a consensus. Here, we use the Ecosystem Demography model (ED2) to predict carbon fluxes of a Puerto Rican tropical forest under realistic climate change scenarios. We parameterized ED2 with species-specific tree physiological data using the Predictive Ecosystem Analyzer workflow and projected the fate of this ecosystem under five future climate scenarios. The model successfully captured interannual variability in the dynamics of this tropical forest. Model predictions closely followed observed values across a wide range of metrics including aboveground biomass, tree diameter growth, tree size class distributions, and leaf area index. Under a future warming and drying climate scenario, the model predicted reductions in carbon storage and tree growth, together with large shifts in forest community composition and structure. Such rapid changes in climate led the forest to transition from a sink to a source of carbon. Growth respiration and root allocation parameters were responsible for the highest fraction of predictive uncertainty in modeled biomass, highlighting the need to target these processes in future data collection. Our study is the first effort to rely on Bayesian model calibration and synthesis to elucidate the key physiological parameters that drive uncertainty in tropical forests responses to climatic change. We propose a new path forward for model-data synthesis that can substantially reduce uncertainty in our ability to model tropical forest responses to future climate. © 2017 John Wiley & Sons Ltd.

Improving predictions of tropical forest response to climate change through integration of field studies and ecosystem modeling

USGS Publications Warehouse

Feng, Xiaohui; Uriarte, María; González, Grizelle; Reed, Sasha C.; Thompson, Jill; Zimmerman, Jess K.; Murphy, Lora

2018-01-01

Tropical forests play a critical role in carbon and water cycles at a global scale. Rapid climate change is anticipated in tropical regions over the coming decades and, under a warmer and drier climate, tropical forests are likely to be net sources of carbon rather than sinks. However, our understanding of tropical forest response and feedback to climate change is very limited. Efforts to model climate change impacts on carbon fluxes in tropical forests have not reached a consensus. Here we use the Ecosystem Demography model (ED2) to predict carbon fluxes of a Puerto Rican tropical forest under realistic climate change scenarios. We parameterized ED2 with species-specific tree physiological data using the Predictive Ecosystem Analyzer workflow and projected the fate of this ecosystem under five future climate scenarios. The model successfully captured inter-annual variability in the dynamics of this tropical forest. Model predictions closely followed observed values across a wide range of metrics including above-ground biomass, tree diameter growth, tree size class distributions, and leaf area index. Under a future warming and drying climate scenario, the model predicted reductions in carbon storage and tree growth, together with large shifts in forest community composition and structure. Such rapid changes in climate led the forest to transition from a sink to a source of carbon. Growth respiration and root allocation parameters were responsible for the highest fraction of predictive uncertainty in modeled biomass, highlighting the need to target these processes in future data collection. Our study is the first effort to rely on Bayesian model calibration and synthesis to elucidate the key physiological parameters that drive uncertainty in tropical forests responses to climatic change. We propose a new path forward for model-data synthesis that can substantially reduce uncertainty in our ability to model tropical forest responses to future climate.

Annual and spatial variation in shoot demography associated with masting in Betula grossa: comparison between mature trees and saplings

PubMed Central

Ishihara, Masae Iwamoto; Kikuzawa, Kihachiro

2009-01-01

Backgrounds and Aims Shoot demography affects the growth of the tree crown and the number of leaves on a tree. Masting may cause inter-annual and spatial variation in shoot demography of mature trees, which may in turn affect the resource budget of the tree. The aim of this study was to evaluate the effect of masting on the temporal and spatial variations in shoot demography of mature Betula grossa. Methods The shoot demography was analysed in the upper and lower parts of the tree crown in mature trees and saplings over 7 years. Mature trees and saplings were compared to differentiate the effect of masting from the effect of exogenous environment on shoot demography. The fate of different shoot types (reproductive, vegetative, short, long), shoot length and leaf area were investigated by monitoring and by retrospective survey using morphological markers on branches. The effects of year and branch position on demographic parameters were evaluated. Key Results Shoot increase rate, production of long shoots, bud mortality, length of long shoots and leaf area of a branch fluctuated periodically from year to year in mature trees over 7 years, in which two masting events occurred. Branches within a crown showed synchronized annual variation, and the extent of fluctuation was larger in the upper branches than the lower branches. Vegetative shoots varied in their bud differentiation each year and contributed to the dynamic shoot demography as much as did reproductive shoots, suggesting physiological integration in shoot demography through hormonal regulation and resource allocation. Conclusions Masting caused periodic annual variation in shoot demography of the mature trees and the effect was spatially variable within a tree crown. Since masting is a common phenomenon among tree species, annual variation in shoot demography and leaf area should be incorporated into resource allocation models of mature masting trees. PMID:19734164

Mathematical demography of spotted owls in the Pacific Northwest

Treesearch

B.R. Noon; C.M. Biles

1990-01-01

We examined the mathematical demography of northern spotted owls (Strix occidentalis caurina) using simple deterministic population models. Our goals were to gain insights into the life history strategy, to determine demographic attributes most affecting changes in population size, and to provide guidelines for effective management of spotted owl...

Model-data assimilation of multiple phenological observations to constrain and predict leaf area index.

PubMed

Viskari, Toni; Hardiman, Brady; Desai, Ankur R; Dietze, Michael C

2015-03-01

Our limited ability to accurately simulate leaf phenology is a leading source of uncertainty in models of ecosystem carbon cycling. We evaluate if continuously updating canopy state variables with observations is beneficial for predicting phenological events. We employed ensemble adjustment Kalman filter (EAKF) to update predictions of leaf area index (LAI) and leaf extension using tower-based photosynthetically active radiation (PAR) and moderate resolution imaging spectrometer (MODIS) data for 2002-2005 at Willow Creek, Wisconsin, USA, a mature, even-aged, northern hardwood, deciduous forest. The ecosystem demography model version 2 (ED2) was used as the prediction model, forced by offline climate data. EAKF successfully incorporated information from both the observations and model predictions weighted by their respective uncertainties. The resulting. estimate reproduced the observed leaf phenological cycle in the spring and the fall better than a parametric model prediction. These results indicate that during spring the observations contribute most in determining the correct bud-burst date, after which the model performs well, but accurately modeling fall leaf senesce requires continuous model updating from observations. While the predicted net ecosystem exchange (NEE) of CO2 precedes tower observations and unassimilated model predictions in the spring, overall the prediction follows observed NEE better than the model alone. Our results show state data assimilation successfully simulates the evolution of plant leaf phenology and improves model predictions of forest NEE.

Seasonal productivity and nest survival of Golden-cheeked Warblers vary with forest type and edge density

Treesearch

Rebecca G. Peak; Frank R., III Thompson

2014-01-01

Knowledge of the demography and habitat requirements of the endangered Golden-cheeked Warbler (Setophaga chrysoparia) is needed for its recovery, including measures of productivity instead of reproductive indices. We report on breeding phenology and demography, calculate model-based estimates of nest survival and seasonal productivity and evaluate...

Mosquito population dynamics from cellular automata-based simulation

NASA Astrophysics Data System (ADS)

Syafarina, Inna; Sadikin, Rifki; Nuraini, Nuning

2016-02-01

In this paper we present an innovative model for simulating mosquito-vector population dynamics. The simulation consist of two stages: demography and dispersal dynamics. For demography simulation, we follow the existing model for modeling a mosquito life cycles. Moreover, we use cellular automata-based model for simulating dispersal of the vector. In simulation, each individual vector is able to move to other grid based on a random walk. Our model is also capable to represent immunity factor for each grid. We simulate the model to evaluate its correctness. Based on the simulations, we can conclude that our model is correct. However, our model need to be improved to find a realistic parameters to match real data.

A Study of the U.S. Capacity to Address Tropical Disease Problems

DTIC Science & Technology

1986-04-01

TROPICAL DISEASE SPECIALISTS. ............... 3-1 DEMOGRAPHY .. ....................... 3-4 Size of the Work Force .. .................. 3-5 Age...tropical disease research experience. This is an increasingly important talent pool. - 3-4 - DEMOGRAPHY Data on the number of tropical disease specialists...lines pioneered in the agricultural field in the institutions supported by the Consultative Group for International Agricultural Research. That model

Scaling Forest Management Practices in Earth System Models: Case Study of Southeast and Pacific Northwest Forests

NASA Astrophysics Data System (ADS)

Pourmokhtarian, A.; Becknell, J. M.; Hall, J.; Desai, A. R.; Boring, L. R.; Duffy, P.; Staudhammer, C. L.; Starr, G.; Dietze, M.

2014-12-01

A wide array of human-induced disturbances can alter the structure and function of forests, including climate change, disturbance and management. While there have been numerous studies on climate change impacts on forests, interactions of management with changing climate and natural disturbance are poorly studied. Forecasts of the range of plausible responses of forests to climate change and management are need for informed decision making on new management approaches under changing climate, as well as adaptation strategies for coming decades. Terrestrial biosphere models (TBMs) provide an excellent opportunity to investigate and assess simultaneous responses of terrestrial ecosystems to climatic perturbations and management across multiple spatio-temporal scales, but currently do not represent a wide array of management activities known to impact carbon, water, surface energy fluxes, and biodiversity. The Ecosystem Demography model 2 (ED2) incorporates non-linear impacts of fine-scale (~10-1 km) heterogeneity in ecosystem structure both horizontally and vertically at a plant level. Therefore it is an ideal candidate to incorporate different forest management practices and test various hypotheses under changing climate and across various spatial scales. The management practices that we implemented were: clear-cut, conversion, planting, partial harvest, low intensity fire, restoration, salvage, and herbicide. The results were validated against observed data across 8 different sites in the U.S. Southeast (Duke Forest, Joseph Jones Ecological Research Center, North Carolina Loblolly Pine, and Ordway-Swisher Biological Station) and Pacific Northwest (Metolius Research Natural Area, H.J. Andrews Experimental Forest, Wind River Field Station, and Mount Rainier National Park). These sites differ in regards to climate, vegetation, soil, and historical land disturbance as well as management approaches. Results showed that different management practices could successfully and realistically be implemented in the ED2 model at a site level. Moreover, sensitivity analyses determined the most important processes at different spatial scales, and also those which could be ignored while minimizing overall error.

Influence of local demography on asymptotic and transient dynamics of a yellow-bellied marmot metapopulation.

PubMed

Ozgul, Arpat; Oli, Madan K; Armitage, Kenneth B; Blumstein, Daniel T; Van Vuren, Dirk H

2009-04-01

Despite recent advances in biodemography and metapopulation ecology, we still have limited understanding of how local demographic parameters influence short- and long-term metapopulation dynamics. We used long-term data from 17 local populations, along with the recently developed methods of matrix metapopulation modeling and transient sensitivity analysis, to investigate the influence of local demography on long-term (asymptotic) versus short-term (transient) dynamics of a yellow-bellied marmot metapopulation in Colorado. Both long- and short-term dynamics depended primarily on a few colony sites and were highly sensitive to changes in demography at these sites, particularly in survival of reproductive adult females. Interestingly, the relative importance of sites differed between long- and short-term dynamics; the spatial structure and local population sizes, while insignificant for asymptotic dynamics, were influential on transient dynamics. However, considering the spatial structure was uninformative about the relative influence of local demography on metapopulation dynamics. The vital rates that were the most influential on local dynamics were also the most influential on both long- and short-term metapopulation dynamics. Our results show that an explicit consideration of local demography is essential for a complete understanding of the dynamics and persistence of spatially structured populations.

Modeling multiple resource limitation in tropical dry forests

NASA Astrophysics Data System (ADS)

Medvigy, D.; Xu, X.; Zarakas, C.

2015-12-01

Tropical dry forests (TDFs) are characterized by a long dry season when little rain falls. At the same time, many neotropical soils are highly weathered and relatively nutrient poor. Because TDFs are often subject to both water and nutrient constraints, the question of how they will respond to environmental perturbations is both complex and highly interesting. Models, our basic tools for projecting ecosystem responses to global change, can be used to address this question. However, few models have been specifically parameterized for TDFs. Here, we present a new version of the Ecosystem Demography 2 (ED2) model that includes a new parameterization of TDFs. In particular, we focus on the model's framework for representing limitation by multiple resources (carbon, water, nitrogen, and phosphorus). Plant functional types are represented in terms of a dichotomy between "acquisitive" and "conservative" resource acquisition strategies. Depending on their resource acquisition strategy and basic stoichiometry, plants can dynamically adjust their allocation to organs (leaves, stem, roots), symbionts (e.g. N2-fixing bacteria), and mycorrhizal fungi. Several case studies are used to investigate how resource acquisition strategies affect ecosystem responses to environmental perturbations. Results are described in terms of the basic setting (e.g., rich vs. poor soils; longer vs. shorter dry season), and well as the type and magnitude of environmental perturbation (e.g., changes in precipitation or temperature; changes in nitrogen deposition). Implications for ecosystem structure and functioning are discussed.

Impact of Climate Variability on Forest Dynamics in Eastern Amazon: the Role of Large-Scale Droughts, Local Droughts, and Other Disturbances

NASA Astrophysics Data System (ADS)

Longo, M.; Hayek, M.; Alves, L. F.; Bonal, D.; Camargo, P. B.; Restrepo-Coupe, N.; Fitzjarrald, D. R.; Knox, R. G.; Saleska, S. R.; da Silva, R.; Stark, S.; Tapajos, R.; Wiedemann, K. T.; Moorcroft, P. R.; Wofsy, S. C.

2012-12-01

Droughts in the Amazon - especially in the southern and eastern regions - are likely to become more frequent and severe with climate change, potentially resulting in significant losses of biomass. Therefore, understanding the ecosystem response to past events, such as the major Amazonian drought of 2005, is fundamental to forecast the ecosystem resilience to extreme droughts in case they become more frequent. In this study we evaluate whether and how large-scale droughts affected the forest dynamics both in terms of productivity and in mortality, and what is the relative contribution of other factors, such as windthrow and smaller local droughts, to explain the observed dynamics. We focus on two sites in Eastern Amazon: Tapajos National Forest near Santarem, Brazil (S67), and Guyaflux tower at Paracou Field Station in French Guiana (GYF). We analyzed site-level observations from eddy flux towers, biometric measurements, and simulated the environment with the Ecosystem Demography Model, version 2 (ED2). This model has the advantage to represent the forest structure in size and functional type, and also biophysical processes within and above canopy, making comparisons with observations more direct. Preliminary results indicate that while the large-scale 2005 drought influenced productivity at both sites, local droughts and windthrow had also a significant contribution to the variation in productivity and mortality rates. Mortality in S67 increased significantly between 2005 and 2007, and was slightly higher in GYF between 2006 and 2008. In both cases, however, higher incidence of uprooted and broken trees suggests a significant contribution from windthrow to mortality. In S67, preliminary simulations using ED2 indicate that water stress reduced productivity during a local but severe drought at the end of 2006, followed by an increase in mortality particularly among trees with diameter at breast height less than 35 cm and early successional trees. In GYF, both ED2 and observations show decline in productivity late in the 2008 dry season, which was longer and drier than average, although the impact on mortality was negligible.

Demographic variations in HIV testing history among emergency department patients: implications for HIV screening in US emergency departments

PubMed Central

Merchant, Roland C; Catanzaro, Bethany M; Seage, George R; Mayer, Kenneth H; Clark, Melissa A; DeGruttola, Victor G; Becker, Bruce M

2011-01-01

Objective To determine the proportion of emergency department (ED) patients who have been tested for human immunodeficiency virus (HIV) infection and assess if patient history of HIV testing varies according to patient demographic characteristics. Design From July 2005–July 2006, a random sample of 18–55-year-old English-speaking patients being treated for sub-critical injury or illness at a northeastern US ED were interviewed on their history of HIV testing. Logistic regression models were created to compare patients by their history of being tested for HIV according to their demography. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results Of 2107 patients surveyed who were not known to be HIV-infected, the median age was 32 years; 54% were male, 71% were white, and 45% were single/never married; 49% had private health-care insurance and 45% had never been tested for HIV. Of the 946 never previously tested for HIV, 56.1% did not consider themselves at risk for HIV. In multivariable logistic regression analyses, those less likely to have been HIV tested were male (OR: 1.32 [1.37–2.73]), white (OR: 1.93 [1.37–2.73]), married (OR: 1.53 [1.12–2.08]), and had private health-care insurance (OR: 2.10 [1.69–2.61]). There was a U-shaped relationship between age and history of being tested for HIV; younger and older patients were less likely to have been tested. History of HIV testing and years of formal education were not related. Conclusion Almost half of ED patients surveyed had never been tested for HIV. Certain demographic groups are being missed though HIV diagnostic testing and screening programmes in other settings. These groups could potentially be reached through universal screening. PMID:19564517

The Dependencies of Ecosystem Pattern, Structure, and Dynamics on Climate, Climate Variability, and Climate Change

NASA Astrophysics Data System (ADS)

Flanagan, S.; Hurtt, G. C.; Fisk, J. P.; Rourke, O.

2012-12-01

A robust understanding of the sensitivity of the pattern, structure, and dynamics of ecosystems to climate, climate variability, and climate change is needed to predict ecosystem responses to current and projected climate change. We present results of a study designed to first quantify the sensitivity of ecosystems to climate through the use of climate and ecosystem data, and then use the results to test the sensitivity of the climate data in a state-of the art ecosystem model. A database of available ecosystem characteristics such as mean canopy height, above ground biomass, and basal area was constructed from sources like the National Biomass and Carbon Dataset (NBCD). The ecosystem characteristics were then paired by latitude and longitude with the corresponding climate characteristics temperature, precipitation, photosynthetically active radiation (PAR) and dew point that were retrieved from the North American Regional Reanalysis (NARR). The average yearly and seasonal means of the climate data, and their associated maximum and minimum values, over the 1979-2010 time frame provided by NARR were constructed and paired with the ecosystem data. The compiled results provide natural patterns of vegetation structure and distribution with regard to climate data. An advanced ecosystem model, the Ecosystem Demography model (ED), was then modified to allow yearly alterations to its mechanistic climate lookup table and used to predict the sensitivities of ecosystem pattern, structure, and dynamics to climate data. The combined ecosystem structure and climate data results were compared to ED's output to check the validity of the model. After verification, climate change scenarios such as those used in the last IPCC were run and future forest structure changes due to climate sensitivities were identified. The results of this study can be used to both quantify and test key relationships for next generation models. The sensitivity of ecosystem characteristics to climate data shown in the database construction and by the model reinforces the need for high-resolution datasets and stresses the importance of understanding and incorporating climate change scenarios into earth system models.

Genetic demographic networks: Mathematical model and applications.

PubMed

Kimmel, Marek; Wojdyła, Tomasz

2016-10-01

Recent improvement in the quality of genetic data obtained from extinct human populations and their ancestors encourages searching for answers to basic questions regarding human population history. The most common and successful are model-based approaches, in which genetic data are compared to the data obtained from the assumed demography model. Using such approach, it is possible to either validate or adjust assumed demography. Model fit to data can be obtained based on reverse-time coalescent simulations or forward-time simulations. In this paper we introduce a computational method based on mathematical equation that allows obtaining joint distributions of pairs of individuals under a specified demography model, each of them characterized by a genetic variant at a chosen locus. The two individuals are randomly sampled from either the same or two different populations. The model assumes three types of demographic events (split, merge and migration). Populations evolve according to the time-continuous Moran model with drift and Markov-process mutation. This latter process is described by the Lyapunov-type equation introduced by O'Brien and generalized in our previous works. Application of this equation constitutes an original contribution. In the result section of the paper we present sample applications of our model to both simulated and literature-based demographies. Among other we include a study of the Slavs-Balts-Finns genetic relationship, in which we model split and migrations between the Balts and Slavs. We also include another example that involves the migration rates between farmers and hunters-gatherers, based on modern and ancient DNA samples. This latter process was previously studied using coalescent simulations. Our results are in general agreement with the previous method, which provides validation of our approach. Although our model is not an alternative to simulation methods in the practical sense, it provides an algorithm to compute pairwise distributions of alleles, in the case of haploid non-recombining loci such as mitochondrial and Y-chromosome loci in humans. Copyright © 2016 Elsevier Inc. All rights reserved.

Household demography and early childhood mortality in a rice-farming village in Northern Laos.

PubMed

Tomita, Shinsuke; Parker, Daniel M; Jennings, Julia A; Wood, James

2015-01-01

This paper extends Alexandr Chayanov's model of changing household demography (specifically the ratio of food consumers to food producers) and its influence on agricultural behavior so that it includes possible adverse effects of a rising ratio on nutritional status and early childhood mortality within the household. We apply the model to 35 years' worth of longitudinal demographic and economic data collected in the irrigated-rice growing village of Na Savang in northern Laos. When appropriate controls are included for other household variables, unobserved inter-household heterogeneity, and changes in local conditions and national policy over the study period, the analysis suggests that a unit increase in the household's consumer/producer ratio induces something like a nine-fold increase in the risk of death among household members aged less than five years. Monte Carlo simulation studies suggest that this may be an over-estimate but also that the effect is probably real and likely to be an important factor in household demography. At the very least, the results suggest that Chayanov's model still has theoretical relevance and deserves to be revived.

Household Demography and Early Childhood Mortality in a Rice-Farming Village in Northern Laos

PubMed Central

Tomita, Shinsuke; Parker, Daniel M.; Jennings, Julia A.; Wood, James

2015-01-01

This paper extends Alexandr Chayanov’s model of changing household demography (specifically the ratio of food consumers to food producers) and its influence on agricultural behavior so that it includes possible adverse effects of a rising ratio on nutritional status and early childhood mortality within the household. We apply the model to 35 years’ worth of longitudinal demographic and economic data collected in the irrigated-rice growing village of Na Savang in northern Laos. When appropriate controls are included for other household variables, unobserved inter-household heterogeneity, and changes in local conditions and national policy over the study period, the analysis suggests that a unit increase in the household’s consumer/producer ratio induces something like a nine-fold increase in the risk of death among household members aged less than five years. Monte Carlo simulation studies suggest that this may be an over-estimate but also that the effect is probably real and likely to be an important factor in household demography. At the very least, the results suggest that Chayanov’s model still has theoretical relevance and deserves to be revived. PMID:25775467

Beyond the climate envelope: using trait filtering models to predict biome boundaries from plant physiology.

NASA Astrophysics Data System (ADS)

Fisher, R.; Hoffmann, W. A.; Muszala, S.

2014-12-01

The introduction of second-generation dynamic vegetation models - which simulate the distribution of light resources between plant types along the vertical canopy profile, and therefore facilitate the representation of plant competition explicitly - is a large increase in the complexity and fidelity with which the terrestrial biosphere is abstracted into Earth System Models. In this new class of model, biome boundaries are predicted as the emergent properties of plant physiology, and are therefore sensitive to the high-dimensional parameterizations of plant functional traits. These new approaches offer the facility to quantitatively test ecophysiological hypotheses of plant distribution at large scales, a field which remains surprisingly under-developed. Here we describe experiments conducted with the Community Land Model Ecosystem Demography component, CLM(ED), in which we reduce the complexity of the problem by testing how individual plant functional trait changes to control the location of biome boundaries between functional types. Specifically, we investigate which physiological trade-offs determine the boundary between frequently burned savanna and forest biomes, and attempt to distinguish how each strategic life-history trade-off (carbon storage, bark investment, re-sprouting strategy) contributes towards the maintenance of sharp geographical gradients between fire adapted and typically inflammable closed canopy ecosystems. This study forms part of the planning for a model-inspired fire manipulation experiment at the cerrado-forest boundary in South-Eastern Brazil, and the results will be used to guide future data-collection and analysis strategies.

Incorporating variability in simulations of seasonally forced phenology using integral projection models

DOE PAGES

Goodsman, Devin W.; Aukema, Brian H.; McDowell, Nate G.; ...

2017-11-26

Phenology models are becoming increasingly important tools to accurately predict how climate change will impact the life histories of organisms. We propose a class of integral projection phenology models derived from stochastic individual-based models of insect development and demography. Our derivation, which is based on the rate summation concept, produces integral projection models that capture the effect of phenotypic rate variability on insect phenology, but which are typically more computationally frugal than equivalent individual-based phenology models. We demonstrate our approach using a temperature-dependent model of the demography of the mountain pine beetle (Dendroctonus ponderosae Hopkins), an insect that kills maturemore » pine trees. This work illustrates how a wide range of stochastic phenology models can be reformulated as integral projection models. Due to their computational efficiency, these integral projection models are suitable for deployment in large-scale simulations, such as studies of altered pest distributions under climate change.« less

Incorporating variability in simulations of seasonally forced phenology using integral projection models

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

Goodsman, Devin W.; Aukema, Brian H.; McDowell, Nate G.

Phenology models are becoming increasingly important tools to accurately predict how climate change will impact the life histories of organisms. We propose a class of integral projection phenology models derived from stochastic individual-based models of insect development and demography. Our derivation, which is based on the rate summation concept, produces integral projection models that capture the effect of phenotypic rate variability on insect phenology, but which are typically more computationally frugal than equivalent individual-based phenology models. We demonstrate our approach using a temperature-dependent model of the demography of the mountain pine beetle (Dendroctonus ponderosae Hopkins), an insect that kills maturemore » pine trees. This work illustrates how a wide range of stochastic phenology models can be reformulated as integral projection models. Due to their computational efficiency, these integral projection models are suitable for deployment in large-scale simulations, such as studies of altered pest distributions under climate change.« less

Proposal of a short-form version of the Brazilian Food Insecurity Scale

PubMed Central

dos Santos, Leonardo Pozza; Lindemann, Ivana Loraine; Motta, Janaína Vieira dos Santos; Mintem, Gicele; Bender, Eliana; Gigante, Denise Petrucci

2014-01-01

OBJECTIVE To propose a short version of the Brazilian Food Insecurity Scale. METHODS Two samples were used to test the results obtained in the analyses in two distinct scenarios. One of the studies was composed of 230 low income families from Pelotas, RS, Southern Brazil, and the other was composed of 15,575 women, whose data were obtained from the 2006 National Survey on Demography and Health. Two models were tested, the first containing seven questions, and the second, the five questions that were considered the most relevant ones in the concordance analysis. The models were compared to the Brazilian Food Insecurity Scale, and the sensitivity, specificity and accuracy parameters were calculated, as well as the kappa agreement test. RESULTS Comparing the prevalence of food insecurity between the Brazilian Food Insecurity Scale and the two models, the differences were around 2 percentage points. In the sensitivity analysis, the short version of seven questions obtained 97.8% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively, while specificity was 100% in both studies. The five-question model showed similar results (sensitivity of 95.7% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively). In the Pelotas sample, the kappa test of the seven-question version totaled 97.0% and that of the five-question version, 95.0%. In the National Survey on Demography and Health sample, the two models presented a 99.0% kappa. CONCLUSIONS We suggest that the model with five questions should be used as the short version of the Brazilian Food Insecurity Scale, as its results were similar to the original scale with a lower number of questions. This version needs to be administered to other populations in Brazil in order to allow for the adequate assessment of the validity parameters. PMID:25372169

Measured and modeled evidence for a two-fold increase in water use efficiency at an old-growth forest site in the Pacific Northwest

NASA Astrophysics Data System (ADS)

Jiang, Y.; Rastogi, B.; Kim, J. B.; Voelker, S.; Meinzer, F. C.; Still, C. J.

2017-12-01

Water use efficiency (WUE), the ratio of carbon uptake to transpiration, has been widely recognized as an important measure of carbon and water cycling in plants, and is used to track forest ecosystem responses to climate change and rising atmospheric CO2concentrations. In this study we used eddy covariance measurement data and Ecosystem Demography model (ED2) simulations to explore the patterns and physiological and biophysical controls of WUE at Wind River Experimental Forest, an old-growth coniferous forest in the Pacific Northwest. We characterized how observed and simulated WUE vary between wet and dry years, and explored the drivers of the differences in WUE between the wet and dry years. Through this explorative process, we evaluated the utility of various ways that WUE have been computed in literature. Measurement-based and simulated WUE at the old-growth forest increased over twofold from 1998 to 2015. The primary driver of this trend is a decreasing trend in evapotranspiration (ET). There were significant inter-annual variations. For example, during drought years, higher air temperature drove increases in early season ET, thereby depleting soil water and decreasing GPP. Lower GPP in turn resulted in lower WUE. This mechanism might drive changes in future carbon and water budgets under warming climate. Our evaluation of multiple WUE metrics demonstrates that each metric has a distinct sensitivity to climate anomalies, but also indicates a robust increasing trend of WUE. Statistical (multiple linear regression) and machine learning (Random Forest) analyses of flux measurements indicated that atmospheric CO2 concentration, air temperature and radiation were the most important predictors of WUE at monthly, daily and half-hourly time scale, respectively. In contrast, WUE mechanism was stable across all time scales in ED2 simulations: vapor pressure deficit was consistently the most important predictor of WUE at the monthly, daily and half-hourly time scales.

Assessing model sensitivity and uncertainty across multiple Free-Air CO2 Enrichment experiments.

NASA Astrophysics Data System (ADS)

Cowdery, E.; Dietze, M.

2015-12-01

As atmospheric levels of carbon dioxide levels continue to increase, it is critical that terrestrial ecosystem models can accurately predict ecological responses to the changing environment. Current predictions of net primary productivity (NPP) in response to elevated atmospheric CO2 concentrations are highly variable and contain a considerable amount of uncertainty. It is necessary that we understand which factors are driving this uncertainty. The Free-Air CO2 Enrichment (FACE) experiments have equipped us with a rich data source that can be used to calibrate and validate these model predictions. To identify and evaluate the assumptions causing inter-model differences we performed model sensitivity and uncertainty analysis across ambient and elevated CO2 treatments using the Data Assimilation Linked Ecosystem Carbon (DALEC) model and the Ecosystem Demography Model (ED2), two process-based models ranging from low to high complexity respectively. These modeled process responses were compared to experimental data from the Kennedy Space Center Open Top Chamber Experiment, the Nevada Desert Free Air CO2 Enrichment Facility, the Rhinelander FACE experiment, the Wyoming Prairie Heating and CO2 Enrichment Experiment, the Duke Forest Face experiment and the Oak Ridge Experiment on CO2 Enrichment. By leveraging data access proxy and data tilling services provided by the BrownDog data curation project alongside analysis modules available in the Predictive Ecosystem Analyzer (PEcAn), we produced automated, repeatable benchmarking workflows that are generalized to incorporate different sites and ecological models. Combining the observed patterns of uncertainty between the two models with results of the recent FACE-model data synthesis project (FACE-MDS) can help identify which processes need further study and additional data constraints. These findings can be used to inform future experimental design and in turn can provide informative starting point for data assimilation.

Variability of Phenology and Fluxes of Water and Carbon with Observed and Simulated Soil Moisture in the Ent Terrestrial Biosphere Model (Ent TBM Version 1.0.1.0.0)

NASA Technical Reports Server (NTRS)

Kim, Y.; Moorcroft, P. R.; Aleinov, Igor; Puma, M. J.; Kiang, N. Y.

2015-01-01

The Ent Terrestrial Biosphere Model (Ent TBM) is a mixed-canopy dynamic global vegetation model developed specifically for coupling with land surface hydrology and general circulation models (GCMs). This study describes the leaf phenology submodel implemented in the Ent TBM version 1.0.1.0.0 coupled to the carbon allocation scheme of the Ecosystem Demography (ED) model. The phenology submodel adopts a combination of responses to temperature (growing degree days and frost hardening), soil moisture (linearity of stress with relative saturation) and radiation (light length). Growth of leaves, sapwood, fine roots, stem wood and coarse roots is updated on a daily basis. We evaluate the performance in reproducing observed leaf seasonal growth as well as water and carbon fluxes for four plant functional types at five Fluxnet sites, with both observed and prognostic hydrology, and observed and prognostic seasonal leaf area index. The phenology submodel is able to capture the timing and magnitude of leaf-out and senescence for temperate broadleaf deciduous forest (Harvard Forest and Morgan- Monroe State Forest, US), C3 annual grassland (Vaira Ranch, US) and California oak savanna (Tonzi Ranch, US). For evergreen needleleaf forest (Hyytiäla, Finland), the phenology submodel captures the effect of frost hardening of photosynthetic capacity on seasonal fluxes and leaf area. We address the importance of customizing parameter sets of vegetation soil moisture stress response to the particular land surface hydrology scheme. We identify model deficiencies that reveal important dynamics and parameter needs.

Variability of phenology and fluxes of water and carbon with observed and simulated soil moisture in the Ent Terrestrial Biosphere Model (Ent TBM version 1.0.1.0.0)

NASA Astrophysics Data System (ADS)

Kim, Y.; Moorcroft, P. R.; Aleinov, I.; Puma, M. J.; Kiang, N. Y.

2015-12-01

The Ent Terrestrial Biosphere Model (Ent TBM) is a mixed-canopy dynamic global vegetation model developed specifically for coupling with land surface hydrology and general circulation models (GCMs). This study describes the leaf phenology submodel implemented in the Ent TBM version 1.0.1.0.0 coupled to the carbon allocation scheme of the Ecosystem Demography (ED) model. The phenology submodel adopts a combination of responses to temperature (growing degree days and frost hardening), soil moisture (linearity of stress with relative saturation) and radiation (light length). Growth of leaves, sapwood, fine roots, stem wood and coarse roots is updated on a daily basis. We evaluate the performance in reproducing observed leaf seasonal growth as well as water and carbon fluxes for four plant functional types at five Fluxnet sites, with both observed and prognostic hydrology, and observed and prognostic seasonal leaf area index. The phenology submodel is able to capture the timing and magnitude of leaf-out and senescence for temperate broadleaf deciduous forest (Harvard Forest and Morgan-Monroe State Forest, US), C3 annual grassland (Vaira Ranch, US) and California oak savanna (Tonzi Ranch, US). For evergreen needleleaf forest (Hyytiäla, Finland), the phenology submodel captures the effect of frost hardening of photosynthetic capacity on seasonal fluxes and leaf area. We address the importance of customizing parameter sets of vegetation soil moisture stress response to the particular land surface hydrology scheme. We identify model deficiencies that reveal important dynamics and parameter needs.

Bayesian demography 250 years after Bayes

PubMed Central

Bijak, Jakub; Bryant, John

2016-01-01

Bayesian statistics offers an alternative to classical (frequentist) statistics. It is distinguished by its use of probability distributions to describe uncertain quantities, which leads to elegant solutions to many difficult statistical problems. Although Bayesian demography, like Bayesian statistics more generally, is around 250 years old, only recently has it begun to flourish. The aim of this paper is to review the achievements of Bayesian demography, address some misconceptions, and make the case for wider use of Bayesian methods in population studies. We focus on three applications: demographic forecasts, limited data, and highly structured or complex models. The key advantages of Bayesian methods are the ability to integrate information from multiple sources and to describe uncertainty coherently. Bayesian methods also allow for including additional (prior) information next to the data sample. As such, Bayesian approaches are complementary to many traditional methods, which can be productively re-expressed in Bayesian terms. PMID:26902889

Incorporating variability in simulations of seasonally forced phenology using integral projection models

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

Goodsman, Devin W.; Aukema, Brian H.; McDowell, Nate G.

Phenology models are becoming increasingly important tools to accurately predict how climate change will impact the life histories of organisms. We propose a class of integral projection phenology models derived from stochastic individual-based models of insect development and demography.Our derivation, which is based on the rate-summation concept, produces integral projection models that capture the effect of phenotypic rate variability on insect phenology, but which are typically more computationally frugal than equivalent individual-based phenology models. We demonstrate our approach using a temperature-dependent model of the demography of the mountain pine beetle (Dendroctonus ponderosae Hopkins), an insect that kills mature pine trees.more » This work illustrates how a wide range of stochastic phenology models can be reformulated as integral projection models. Due to their computational efficiency, these integral projection models are suitable for deployment in large-scale simulations, such as studies of altered pest distributions under climate change.« less

Regional Energy Deployment System (ReEDS) | Energy Analysis | NREL

Science.gov Websites

System Model The Regional Energy Deployment System (ReEDS) model helps the U.S. Department of model. Visualize Future Capacity Expansion of Renewable Energy Watch this video of the ReEDS model audio. Model Documentation ReEDS Model Documentation: Version 2016 ReEDS Map with Numbered Regions

Culture and Demography: From Reluctant Bedfellows to Committed Partners

PubMed Central

Bachrach, Christine A.

2015-01-01

Demography and culture have had a long but ambivalent relationship. Cultural influences are widely recognized as important for demographic outcomes, but are often “backgrounded” in demographic research. I argue that progress towards a more successful integration is feasible and suggest a network model of culture as a potential tool. The network model bridges both traditional (holistic and institutional) and contemporary (tool kit) models of culture used in the social sciences and offers a simple vocabulary for the diverse set of cultural concepts such as attitudes, beliefs and norms, and quantitative measures of how culture is organized. The proposed model conceptualizes culture as a nested network of meanings which are represented by schemas that range in complexity from simple concepts to multifaceted cultural models. I illustrate the potential value of a model using accounts of the cultural changes underpinning the transformation of marriage in the U.S. and point to developments in the social, cognitive and computational sciences that could facilitate the application of the model in empirical demographic research. PMID:24338643

Culture and demography: from reluctant bedfellows to committed partners.

PubMed

Bachrach, Christine A

2014-02-01

Demography and culture have had a long but ambivalent relationship. Cultural influences are widely recognized as important for demographic outcomes but are often "backgrounded" in demographic research. I argue that progress toward a more successful integration is feasible and suggest a network model of culture as a potential tool. The network model bridges both traditional (holistic and institutional) and contemporary (tool kit) models of culture used in the social sciences and offers a simple vocabulary for a diverse set of cultural concepts, such as attitudes, beliefs, and norms, as well as quantitative measures of how culture is organized. The proposed model conceptualizes culture as a nested network of meanings represented by schemas that range in complexity from simple concepts to multifaceted cultural models. I illustrate the potential value of a model using accounts of the cultural changes underpinning the transformation of marriage in the United States and point to developments in the social, cognitive, and computational sciences that could facilitate the application of the model in empirical demographic research.

A stand-alone tree demography and landscape structure module for Earth system models: integration with global forest data

NASA Astrophysics Data System (ADS)

Haverd, V.; Smith, B.; Nieradzik, L. P.; Briggs, P. R.

2014-02-01

Poorly constrained rates of biomass turnover are a key limitation of Earth system models (ESM). In light of this, we recently proposed a new approach encoded in a model called Populations-Order-Physiology (POP), for the simulation of woody ecosystem stand dynamics, demography and disturbance-mediated heterogeneity. POP is suitable for continental to global applications and designed for coupling to the terrestrial ecosystem component of any ESM. POP bridges the gap between first generation Dynamic Vegetation Models (DVMs) with simple large-area parameterisations of woody biomass (typically used in current ESMs) and complex second generation DVMs, that explicitly simulate demographic processes and landscape heterogeneity of forests. The key simplification in the POP approach, compared with second-generation DVMs, is to compute physiological processes such as assimilation at grid-scale (with CABLE or a similar land surface model), but to partition the grid-scale biomass increment among age classes defined at sub grid-scale, each subject to its own dynamics. POP was successfully demonstrated along a savanna transect in northern Australia, replicating the effects of strong rainfall and fire disturbance gradients on observed stand productivity and structure. Here, we extend the application of POP to a range of forest types around the globe, employing paired observations of stem biomass and density from forest inventory data to calibrate model parameters governing stand demography and biomass evolution. The calibrated POP model is then coupled to the CABLE land surface model and the combined model (CABLE-POP) is evaluated against leaf-stem allometry observations from forest stands ranging in age from 3 to 200 yr. Results indicate that simulated biomass pools conform well with observed allometry. We conclude that POP represents a preferable alternative to large-area parameterisations of woody biomass turnover, typically used in current ESMs.

Remote sensing in support of high-resolution terrestrial carbon monitoring and modeling

NASA Astrophysics Data System (ADS)

Hurtt, G. C.; Zhao, M.; Dubayah, R.; Huang, C.; Swatantran, A.; ONeil-Dunne, J.; Johnson, K. D.; Birdsey, R.; Fisk, J.; Flanagan, S.; Sahajpal, R.; Huang, W.; Tang, H.; Armstrong, A. H.

2014-12-01

As part of its Phase 1 Carbon Monitoring System (CMS) activities, NASA initiated a Local-Scale Biomass Pilot study. The goals of the pilot study were to develop protocols for fusing high-resolution remotely sensed observations with field data, provide accurate validation test areas for the continental-scale biomass product, and demonstrate efficacy for prognostic terrestrial ecosystem modeling. In Phase 2, this effort was expanded to the state scale. Here, we present results of this activity focusing on the use of remote sensing in high-resolution ecosystem modeling. The Ecosystem Demography (ED) model was implemented at 90 m spatial resolution for the entire state of Maryland. We rasterized soil depth and soil texture data from SSURGO. For hourly meteorological data, we spatially interpolated 32-km 3-hourly NARR into 1-km hourly and further corrected them at monthly level using PRISM data. NLCD data were used to mask sand, seashore, and wetland. High-resolution 1 m forest/non-forest mapping was used to define forest fraction of 90 m cells. Three alternative strategies were evaluated for initialization of forest structure using high-resolution lidar, and the model was used to calculate statewide estimates of forest biomass, carbon sequestration potential, time to reach sequestration potential, and sensitivity to future forest growth and disturbance rates, all at 90 m resolution. To our knowledge, no dynamic ecosystem model has been run at such high spatial resolution over such large areas utilizing remote sensing and validated as extensively. There are over 3 million 90 m land cells in Maryland, greater than 43 times the ~73,000 half-degree cells in a state-of-the-art global land model.

Exploring eco-hydrological consequences of the Amazonian ecosystems under climate and land-use changes in the 21st century

NASA Astrophysics Data System (ADS)

Zhang, K.; Castanho, A. D.; Moghim, S.; Bras, R. L.; Coe, M. T.; Costa, M. H.; Levine, N. M.; Longo, M.; McKnight, S.; Wang, J.; Moorcroft, P. R.

2012-12-01

Deforestation and drought have imposed regional-scale perturbations onto Amazonian ecosystems and are predicted to cause larger negative impacts on the Amazonian ecosystems and associated regional carbon dynamics in the 21st century. However, global climate models (GCMs) vary greatly in their projections of future climate change in Amazonia, giving rise to uncertainty in the expected fate of the Amazon over the coming century. In this study, we explore the possible eco-hydrological consequences of the Amazonian ecosystems under projected climate and land-use changes in the 21st century using two state-of-the-art terrestrial ecosystem models—Ecosystem Demography Model 2.1(ED2.1) and Integrated Biosphere Simulator model (IBIS)—driven by three representative, bias-corrected climate projections from three IPCC GCMs (NCARPCM1, NCARCCSM3 and HadCM3), coupled with two land-use change scenarios (a business-as-usual and a strict governance scenario). We also analyze the relative roles of climate change, CO2 fertilization, land-use change and fire in driving the projected composition and structure of the Amazonian ecosystems. Our results show that CO2 fertilization enhances vegetation productivity and above-ground biomass (AGB) in the region, while land-use change and fire cause AGB loss and the replacement of forests by the savanna-like vegetation. The impacts of climate change depend strongly on the direction and severity of projected precipitation changes in the region. In particular, when intensified water stress is superimposed on unregulated deforestation, both ecosystem models predict large-scale dieback of Amazonian rainforests.

Leaf ontogeny and demography explain photosynthetic seasonality in Amazon evergreen forests

NASA Astrophysics Data System (ADS)

Wu, J.; Albert, L.; Lopes, A. P.; Restrepo-Coupe, N.; Hayek, M.; Wiedemann, K. T.; Guan, K.; Stark, S. C.; Prohaska, N.; Tavares, J. V.; Marostica, S. F.; Kobayashi, H.; Ferreira, M. L.; Campos, K.; Silva, R. D.; Brando, P. M.; Dye, D. G.; Huxman, T. E.; Huete, A. R.; Nelson, B. W.; Saleska, S. R.

2015-12-01

Photosynthetic seasonality couples the evolutionary ecology of plant leaves to large-scale rhythms of carbon and water exchanges that are important feedbacks to climate. However, the extent, magnitude, and controls on photosynthetic seasonality of carbon-rich tropical forests are poorly resolved, controversial in the remote sensing literature, and inadequately represented in most earth system models. Here we show that ecosystem-scale phenology (measured by photosynthetic capacity), rather than environmental seasonality, is the primary driver of photosynthetic seasonality at four Amazon evergreen forests spanning gradients in rainfall seasonality, forest composition, and flux seasonality. We further demonstrate that leaf ontogeny and demography explain most of this ecosystem phenology at two central Amazon evergreen forests, using a simple leaf-cohort canopy model that integrates eddy covariance-derived CO2 fluxes, novel near-surface camera-detected leaf phenology, and ground observations of litterfall and leaf physiology. The coordination of new leaf growth and old leaf divestment (litterfall) during the dry season shifts canopy composition towards younger leaves with higher photosynthetic efficiency, driving large seasonal increases (~27%) in ecosystem photosynthetic capacity. Leaf ontogeny and demography thus reconciles disparate observations of forest seasonality from leaves to eddy flux towers to satellites. Strategic incorporation of such whole-plant coordination processes as phenology and ontogeny will improve ecological, evolutionary and earth system theories describing tropical forests structure and function, allowing more accurate representation of forest dynamics and feedbacks to climate in earth system models.

Using HexSim to link demography and genetics in animal and plant simulations

EPA Science Inventory

Simulation models are essential for understanding the effects of land management practices and environmental drivers, including landscape change, shape population genetic structure and persistence probabilities. The emerging field of eco-evolutionary modeling is beginning to dev...

Demographically-Based Evaluation of Genomic Regions under Selection in Domestic Dogs

PubMed Central

Freedman, Adam H.; Schweizer, Rena M.; Ortega-Del Vecchyo, Diego; Han, Eunjung; Davis, Brian W.; Gronau, Ilan; Silva, Pedro M.; Galaverni, Marco; Fan, Zhenxin; Marx, Peter; Lorente-Galdos, Belen; Ramirez, Oscar; Hormozdiari, Farhad; Alkan, Can; Vilà, Carles; Squire, Kevin; Geffen, Eli; Kusak, Josip; Boyko, Adam R.; Parker, Heidi G.; Lee, Clarence; Tadigotla, Vasisht; Siepel, Adam; Bustamante, Carlos D.; Harkins, Timothy T.; Nelson, Stanley F.; Marques-Bonet, Tomas; Ostrander, Elaine A.; Wayne, Robert K.; Novembre, John

2016-01-01

Controlling for background demographic effects is important for accurately identifying loci that have recently undergone positive selection. To date, the effects of demography have not yet been explicitly considered when identifying loci under selection during dog domestication. To investigate positive selection on the dog lineage early in the domestication, we examined patterns of polymorphism in six canid genomes that were previously used to infer a demographic model of dog domestication. Using an inferred demographic model, we computed false discovery rates (FDR) and identified 349 outlier regions consistent with positive selection at a low FDR. The signals in the top 100 regions were frequently centered on candidate genes related to brain function and behavior, including LHFPL3, CADM2, GRIK3, SH3GL2, MBP, PDE7B, NTAN1, and GLRA1. These regions contained significant enrichments in behavioral ontology categories. The 3rd top hit, CCRN4L, plays a major role in lipid metabolism, that is supported by additional metabolism related candidates revealed in our scan, including SCP2D1 and PDXC1. Comparing our method to an empirical outlier approach that does not directly account for demography, we found only modest overlaps between the two methods, with 60% of empirical outliers having no overlap with our demography-based outlier detection approach. Demography-aware approaches have lower-rates of false discovery. Our top candidates for selection, in addition to expanding the set of neurobehavioral candidate genes, include genes related to lipid metabolism, suggesting a dietary target of selection that was important during the period when proto-dogs hunted and fed alongside hunter-gatherers. PMID:26943675

Demography and Environment Earth: Teacher Edition.

ERIC Educational Resources Information Center

McCrea, Lester C.; And Others

This document is one in a series of instructional materials on population education developed for the Baltimore public schools. The unit, designed for elementary grades 5 and 6, focuses on demography and human factors and consequences. The first part of the resource unit presents basic information, methodology, and understandings of demography and…

Demography and You: Teacher Edition.

ERIC Educational Resources Information Center

McCrea, Lester C.; And Others

This teacher's guide is the grades 7-9 unit for population education developed for the Baltimore public schools. This mini-demography course covers various factors of population growth and change. The activities of the unit focus on seven major concepts: (1) demography provides information for understanding population growth, trends, and changes;…

Altered resource availability and the population dynamics of tree species in Amazonian secondary forests.

PubMed

Fortini, Lucas Berio; Bruna, Emilio M; Zarin, Daniel J; Vasconcelos, Steel S; Miranda, Izildinha S

2010-04-01

Despite research demonstrating that water and nutrient availability exert strong effects on multiple ecosystem processes in tropical forests, little is known about the effect of these factors on the demography and population dynamics of tropical trees. Over the course of 5 years, we monitored two common Amazonian secondary forest species-Lacistema pubescens and Myrcia sylvatica-in dry-season irrigation, litter-removal and control plots. We then evaluated the effects of altered water and nutrient availability on population demography and dynamics using matrix models and life table response experiments. Our results show that despite prolonged experimental manipulation of water and nutrient availability, there were nearly no consistent and unidirectional treatment effects on the demography of either species. The patterns and significance of observed treatment effects were largely dependent on cross-year variability not related to rainfall patterns, and disappeared once we pooled data across years. Furthermore, most of these transient treatment effects had little effect on population growth rates. Our results suggest that despite major experimental manipulations of water and nutrient availability-factors considered critical to the ecology of tropical pioneer tree species-autogenic light limitation appears to be the primary regulator of tree demography at early/mid successional stages. Indeed, the effects of light availability may completely override those of other factors thought to influence the successional development of Amazonian secondary forests.

About Regional Energy Deployment System Model-ReEDS | Regional Energy

Science.gov Websites

Deployment System Model | Energy Analysis | NREL About Regional Energy Deployment System Model -ReEDS About Regional Energy Deployment System Model-ReEDS The Regional Energy Deployment System (ReEDS ) is a long-term, capacity-expansion model for the deployment of electric power generation technologies

The Economic Demography of Mass Poverty.

ERIC Educational Resources Information Center

Abegaz, Berhanu, Ed.

1986-01-01

The four papers in this volume discuss various facets of the poverty-demography interaction: the rationale for the desired family size of the poor, the problems of attaining such size, the effect of family size/structure on household economy, and the future well-being of the children of the poor. "Mass Poverty, Demography, and Development…

Demography of Honors: The Census of U.S. Honors Programs and Colleges

ERIC Educational Resources Information Center

Scott, Richard I.; Smith, Patricia J.; Cognard-Black, Andrew J.

2017-01-01

Beginning in 2013 and spanning four research articles, we have implemented an empirical analysis protocol for honors education that is rooted in demography (Scott; Scott and Smith; Smith and Scott "Growth"; Smith and Scott, "Demography"). The goal of this protocol is to describe the structure and distribution of the honors…

USSR Report, Life Sciences, Biomedical and Behavioral Sciences

DTIC Science & Technology

1985-02-19

BIBLIOGRAPHY 1. Demografiya vrachebnykh kadrov i potrebnost’ v poslediplomnom ikh obuchenii [ Demography of Physician Personnel and Need for Their...chief of Demography Department^ Scientific Research Institute of the USSR Central Statistical Administration/ /Text/ A sampling sociodemographic...statisticians and social hygienists in studying the pressing problems of demography and social hygiene. COPYRIGH: "Zdravookhraneniye Rössiyskoy

Coalescent Processes with Skewed Offspring Distributions and Nonequilibrium Demography.

PubMed

Matuszewski, Sebastian; Hildebrandt, Marcel E; Achaz, Guillaume; Jensen, Jeffrey D

2018-01-01

Nonequilibrium demography impacts coalescent genealogies leaving detectable, well-studied signatures of variation. However, similar genomic footprints are also expected under models of large reproductive skew, posing a serious problem when trying to make inference. Furthermore, current approaches consider only one of the two processes at a time, neglecting any genomic signal that could arise from their simultaneous effects, preventing the possibility of jointly inferring parameters relating to both offspring distribution and population history. Here, we develop an extended Moran model with exponential population growth, and demonstrate that the underlying ancestral process converges to a time-inhomogeneous psi-coalescent. However, by applying a nonlinear change of time scale-analogous to the Kingman coalescent-we find that the ancestral process can be rescaled to its time-homogeneous analog, allowing the process to be simulated quickly and efficiently. Furthermore, we derive analytical expressions for the expected site-frequency spectrum under the time-inhomogeneous psi-coalescent, and develop an approximate-likelihood framework for the joint estimation of the coalescent and growth parameters. By means of extensive simulation, we demonstrate that both can be estimated accurately from whole-genome data. In addition, not accounting for demography can lead to serious biases in the inferred coalescent model, with broad implications for genomic studies ranging from ecology to conservation biology. Finally, we use our method to analyze sequence data from Japanese sardine populations, and find evidence of high variation in individual reproductive success, but few signs of a recent demographic expansion. Copyright © 2018 by the Genetics Society of America.

Abstracts and program proceedings of the 1994 meeting of the International Society for Ecological Modelling North American Chapter

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

Kercher, J.R.

1994-06-01

This document contains information about the 1994 meeting of the International Society for Ecological Modelling North American Chapter. The topics discussed include: extinction risk assessment modelling, ecological risk analysis of uranium mining, impacts of pesticides, demography, habitats, atmospheric deposition, and climate change.

Effects of sample size on estimates of population growth rates calculated with matrix models.

PubMed

Fiske, Ian J; Bruna, Emilio M; Bolker, Benjamin M

2008-08-28

Matrix models are widely used to study the dynamics and demography of populations. An important but overlooked issue is how the number of individuals sampled influences estimates of the population growth rate (lambda) calculated with matrix models. Even unbiased estimates of vital rates do not ensure unbiased estimates of lambda-Jensen's Inequality implies that even when the estimates of the vital rates are accurate, small sample sizes lead to biased estimates of lambda due to increased sampling variance. We investigated if sampling variability and the distribution of sampling effort among size classes lead to biases in estimates of lambda. Using data from a long-term field study of plant demography, we simulated the effects of sampling variance by drawing vital rates and calculating lambda for increasingly larger populations drawn from a total population of 3842 plants. We then compared these estimates of lambda with those based on the entire population and calculated the resulting bias. Finally, we conducted a review of the literature to determine the sample sizes typically used when parameterizing matrix models used to study plant demography. We found significant bias at small sample sizes when survival was low (survival = 0.5), and that sampling with a more-realistic inverse J-shaped population structure exacerbated this bias. However our simulations also demonstrate that these biases rapidly become negligible with increasing sample sizes or as survival increases. For many of the sample sizes used in demographic studies, matrix models are probably robust to the biases resulting from sampling variance of vital rates. However, this conclusion may depend on the structure of populations or the distribution of sampling effort in ways that are unexplored. We suggest more intensive sampling of populations when individual survival is low and greater sampling of stages with high elasticities.

Experts correctly describe demography associated with historical decline of the endangered Indiana bat, but not recent period of stationarity

USGS Publications Warehouse

Thogmartin, Wayne E.; Sanders-Reed, Carol A.; Szymanski, Jennifer; Pruitt, Lori; Runge, Michael C.

2017-01-01

Demographic characteristics of bats are often insufficiently described for modeling populations. In data poor situations, experts are often relied upon for characterizing ecological systems. In concert with the development of a matrix model describing Indiana bat (Myotis sodalis) demography, we elicited estimates for parameterizing this model from 12 experts. We conducted this elicitation in two stages, requesting expert values for 12 demographic rates. These rates were adult and juvenile seasonal (winter, summer, fall) survival rates, pup survival in fall, and propensity and success at breeding. Experts were most in agreement about adult fall survival (3% Coefficient of Variation) and least in agreement about propensity of juveniles to breed (37% CV). The experts showed greater concordance for adult ( mean CV, adult = 6.2%) than for juvenile parameters ( mean CV, juvenile = 16.4%), and slightly more agreement for survival (mean CV, survival = 9.8%) compared to reproductive rates ( mean CV, reproduction = 15.1%). However, survival and reproduction were negatively and positively biased, respectively, relative to a stationary dynamic. Despite the species exhibiting near stationary dynamics for two decades prior to the onset of a potential extinction-causing agent, white-nose syndrome, expert estimates indicated a population decline of -11% per year (95% CI = -2%, -20%); quasi-extinction was predicted within a century ( mean = 61 years to QE, range = 32, 97) by 10 of the 12 experts. Were we to use these expert estimates in our modeling efforts, we would have errantly trained our models to a rapidly declining demography asymptomatic of recent demographic behavior. While experts are sometimes the only source of information, a clear understanding of the temporal and spatial context of the information being elicited is necessary to guard against wayward predictions.

Middle Rio Grande Cooperative Water Model

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

Tidwell, Vince; Passell, Howard

2005-11-01

This is computer simulation model built in a commercial modeling product Called Studio Expert, developed by Powersim, Inc. The simulation model is built in a system dynamics environment, allowing the simulation of the interaction among multiple systems that are all changing over time. The model focuses on hydrology, ecology, demography, and economy of the Middle Rio Grande, with Water as the unifying feature.

A stand-alone tree demography and landscape structure module for Earth system models: integration with inventory data from temperate and boreal forests

NASA Astrophysics Data System (ADS)

Haverd, V.; Smith, B.; Nieradzik, L. P.; Briggs, P. R.

2014-08-01

Poorly constrained rates of biomass turnover are a key limitation of Earth system models (ESMs). In light of this, we recently proposed a new approach encoded in a model called Populations-Order-Physiology (POP), for the simulation of woody ecosystem stand dynamics, demography and disturbance-mediated heterogeneity. POP is suitable for continental to global applications and designed for coupling to the terrestrial ecosystem component of any ESM. POP bridges the gap between first-generation dynamic vegetation models (DVMs) with simple large-area parameterisations of woody biomass (typically used in current ESMs) and complex second-generation DVMs that explicitly simulate demographic processes and landscape heterogeneity of forests. The key simplification in the POP approach, compared with second-generation DVMs, is to compute physiological processes such as assimilation at grid-scale (with CABLE (Community Atmosphere Biosphere Land Exchange) or a similar land surface model), but to partition the grid-scale biomass increment among age classes defined at sub-grid-scale, each subject to its own dynamics. POP was successfully demonstrated along a savanna transect in northern Australia, replicating the effects of strong rainfall and fire disturbance gradients on observed stand productivity and structure. Here, we extend the application of POP to wide-ranging temporal and boreal forests, employing paired observations of stem biomass and density from forest inventory data to calibrate model parameters governing stand demography and biomass evolution. The calibrated POP model is then coupled to the CABLE land surface model, and the combined model (CABLE-POP) is evaluated against leaf-stem allometry observations from forest stands ranging in age from 3 to 200 year. Results indicate that simulated biomass pools conform well with observed allometry. We conclude that POP represents an ecologically plausible and efficient alternative to large-area parameterisations of woody biomass turnover, typically used in current ESMs.

Deep Learning for Population Genetic Inference.

PubMed

Sheehan, Sara; Song, Yun S

2016-03-01

Given genomic variation data from multiple individuals, computing the likelihood of complex population genetic models is often infeasible. To circumvent this problem, we introduce a novel likelihood-free inference framework by applying deep learning, a powerful modern technique in machine learning. Deep learning makes use of multilayer neural networks to learn a feature-based function from the input (e.g., hundreds of correlated summary statistics of data) to the output (e.g., population genetic parameters of interest). We demonstrate that deep learning can be effectively employed for population genetic inference and learning informative features of data. As a concrete application, we focus on the challenging problem of jointly inferring natural selection and demography (in the form of a population size change history). Our method is able to separate the global nature of demography from the local nature of selection, without sequential steps for these two factors. Studying demography and selection jointly is motivated by Drosophila, where pervasive selection confounds demographic analysis. We apply our method to 197 African Drosophila melanogaster genomes from Zambia to infer both their overall demography, and regions of their genome under selection. We find many regions of the genome that have experienced hard sweeps, and fewer under selection on standing variation (soft sweep) or balancing selection. Interestingly, we find that soft sweeps and balancing selection occur more frequently closer to the centromere of each chromosome. In addition, our demographic inference suggests that previously estimated bottlenecks for African Drosophila melanogaster are too extreme.

Deep Learning for Population Genetic Inference

PubMed Central

Sheehan, Sara; Song, Yun S.

2016-01-01

Given genomic variation data from multiple individuals, computing the likelihood of complex population genetic models is often infeasible. To circumvent this problem, we introduce a novel likelihood-free inference framework by applying deep learning, a powerful modern technique in machine learning. Deep learning makes use of multilayer neural networks to learn a feature-based function from the input (e.g., hundreds of correlated summary statistics of data) to the output (e.g., population genetic parameters of interest). We demonstrate that deep learning can be effectively employed for population genetic inference and learning informative features of data. As a concrete application, we focus on the challenging problem of jointly inferring natural selection and demography (in the form of a population size change history). Our method is able to separate the global nature of demography from the local nature of selection, without sequential steps for these two factors. Studying demography and selection jointly is motivated by Drosophila, where pervasive selection confounds demographic analysis. We apply our method to 197 African Drosophila melanogaster genomes from Zambia to infer both their overall demography, and regions of their genome under selection. We find many regions of the genome that have experienced hard sweeps, and fewer under selection on standing variation (soft sweep) or balancing selection. Interestingly, we find that soft sweeps and balancing selection occur more frequently closer to the centromere of each chromosome. In addition, our demographic inference suggests that previously estimated bottlenecks for African Drosophila melanogaster are too extreme. PMID:27018908

Human Cognition and Performance.

DTIC Science & Technology

1985-05-01

implications. In D. LaBerge & S. J. Samuels (Eds.), Basic processes in reading: Perception and comprehesion. Hillsdale, NJ: Eribaum. Anderson, J. A...Also pub- lished individually as follows: Some observations on mental models, in D. Gentner and A. Stevens (Eds.), Mental models, Hillsdale, NJ: Erlbaum...A. Stevens (Eds.), Mental Models. Hillsdale, NJ: Erlbaunm. Norman, D.A. (1983). Theories and models in cognitive psychology. In E. Douclkin (Ed

Eating disorders and non-suicidal self-injury: Structural equation modelling of a conceptual model.

PubMed

Vieira, Ana Isabel; Machado, Bárbara C; Moreira, Célia S; Machado, Paulo P P; Brandão, Isabel; Roma-Torres, António; Gonçalves, Sónia

2018-06-14

Evidence suggests several risk factors for both eating disorders (ED) and nonsuicidal self-injury (NSSI), but the relationships between these factors are not well understood. Considering our previous work and a conceptual model, this cross-sectional study aimed to assess the relationships among distal and proximal factors for the presence of NSSI in ED. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. Structural equation modelling revealed that both distal and proximal factors were related to the presence of NSSI in ED, disclosing a mediating role of the proximal factors. Stressful life events mediated the relationship between childhood sexual abuse, peer aggression, and both ED and NSSI. Childhood physical abuse was related to ED and NSSI via substance use, negative self-evaluation, and suicide attempts. Findings provided support for the conceptual model and highlight the possible mechanisms by which psychosocial factors may lead to ED and NSSI. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

A comparison of multivariate and univariate time series approaches to modelling and forecasting emergency department demand in Western Australia.

PubMed

Aboagye-Sarfo, Patrick; Mai, Qun; Sanfilippo, Frank M; Preen, David B; Stewart, Louise M; Fatovich, Daniel M

2015-10-01

To develop multivariate vector-ARMA (VARMA) forecast models for predicting emergency department (ED) demand in Western Australia (WA) and compare them to the benchmark univariate autoregressive moving average (ARMA) and Winters' models. Seven-year monthly WA state-wide public hospital ED presentation data from 2006/07 to 2012/13 were modelled. Graphical and VARMA modelling methods were used for descriptive analysis and model fitting. The VARMA models were compared to the benchmark univariate ARMA and Winters' models to determine their accuracy to predict ED demand. The best models were evaluated by using error correction methods for accuracy. Descriptive analysis of all the dependent variables showed an increasing pattern of ED use with seasonal trends over time. The VARMA models provided a more precise and accurate forecast with smaller confidence intervals and better measures of accuracy in predicting ED demand in WA than the ARMA and Winters' method. VARMA models are a reliable forecasting method to predict ED demand for strategic planning and resource allocation. While the ARMA models are a closely competing alternative, they under-estimated future ED demand. Copyright © 2015 Elsevier Inc. All rights reserved.

Demography-based adaptive network model reproduces the spatial organization of human linguistic groups

NASA Astrophysics Data System (ADS)

Capitán, José A.; Manrubia, Susanna

2015-12-01

The distribution of human linguistic groups presents a number of interesting and nontrivial patterns. The distributions of the number of speakers per language and the area each group covers follow log-normal distributions, while population and area fulfill an allometric relationship. The topology of networks of spatial contacts between different linguistic groups has been recently characterized, showing atypical properties of the degree distribution and clustering, among others. Human demography, spatial conflicts, and the construction of networks of contacts between linguistic groups are mutually dependent processes. Here we introduce an adaptive network model that takes all of them into account and successfully reproduces, using only four model parameters, not only those features of linguistic groups already described in the literature, but also correlations between demographic and topological properties uncovered in this work. Besides their relevance when modeling and understanding processes related to human biogeography, our adaptive network model admits a number of generalizations that broaden its scope and make it suitable to represent interactions between agents based on population dynamics and competition for space.

Demography-based adaptive network model reproduces the spatial organization of human linguistic groups.

PubMed

Capitán, José A; Manrubia, Susanna

2015-12-01

The distribution of human linguistic groups presents a number of interesting and nontrivial patterns. The distributions of the number of speakers per language and the area each group covers follow log-normal distributions, while population and area fulfill an allometric relationship. The topology of networks of spatial contacts between different linguistic groups has been recently characterized, showing atypical properties of the degree distribution and clustering, among others. Human demography, spatial conflicts, and the construction of networks of contacts between linguistic groups are mutually dependent processes. Here we introduce an adaptive network model that takes all of them into account and successfully reproduces, using only four model parameters, not only those features of linguistic groups already described in the literature, but also correlations between demographic and topological properties uncovered in this work. Besides their relevance when modeling and understanding processes related to human biogeography, our adaptive network model admits a number of generalizations that broaden its scope and make it suitable to represent interactions between agents based on population dynamics and competition for space.

Population size does not explain past changes in cultural complexity.

PubMed

Vaesen, Krist; Collard, Mark; Cosgrove, Richard; Roebroeks, Wil

2016-04-19

Demography is increasingly being invoked to account for features of the archaeological record, such as the technological conservatism of the Lower and Middle Pleistocene, the Middle to Upper Paleolithic transition, and cultural loss in Holocene Tasmania. Such explanations are commonly justified in relation to population dynamic models developed by Henrich [Henrich J (2004)Am Antiq69:197-214] and Powell et al. [Powell A, et al. (2009)Science324(5932):1298-1301], which appear to demonstrate that population size is the crucial determinant of cultural complexity. Here, we show that these models fail in two important respects. First, they only support a relationship between demography and culture in implausible conditions. Second, their predictions conflict with the available archaeological and ethnographic evidence. We conclude that new theoretical and empirical research is required to identify the factors that drove the changes in cultural complexity that are documented by the archaeological record.

Population size does not explain past changes in cultural complexity

PubMed Central

Vaesen, Krist; Collard, Mark; Cosgrove, Richard; Roebroeks, Wil

2016-01-01

Demography is increasingly being invoked to account for features of the archaeological record, such as the technological conservatism of the Lower and Middle Pleistocene, the Middle to Upper Paleolithic transition, and cultural loss in Holocene Tasmania. Such explanations are commonly justified in relation to population dynamic models developed by Henrich [Henrich J (2004) Am Antiq 69:197–214] and Powell et al. [Powell A, et al. (2009) Science 324(5932):1298–1301], which appear to demonstrate that population size is the crucial determinant of cultural complexity. Here, we show that these models fail in two important respects. First, they only support a relationship between demography and culture in implausible conditions. Second, their predictions conflict with the available archaeological and ethnographic evidence. We conclude that new theoretical and empirical research is required to identify the factors that drove the changes in cultural complexity that are documented by the archaeological record. PMID:27044082

From leaf longevity to canopy seasonality: a carbon optimality phenology model for tropical evergreen forests

NASA Astrophysics Data System (ADS)

Xu, X.; Medvigy, D.; Wu, J.; Wright, S. J.; Kitajima, K.; Pacala, S. W.

2016-12-01

Tropical evergreen forests play a key role in the global carbon, water and energy cycles. Despite apparent evergreenness, this biome shows strong seasonality in leaf litter and photosynthesis. Recent studies have suggested that this seasonality is not directly related to environmental variability but is dominated by seasonal changes of leaf development and senescence. Meanwhile, current terrestrial biosphere models (TBMs) can not capture this pattern because leaf life cycle is highly underrepresented. One challenge to model this leaf life cycle is the remarkable diversity in leaf longevity, ranging from several weeks to multiple years. Ecologists have proposed models where leaf longevity is regarded as a strategy to optimize carbon gain. However previous optimality models can not be readily integrated into TBMs because (i) there are still large biases in predicted leaf longevity and (ii) it is never tested whether the carbon optimality model can capture the observed seasonality in leaf demography and canopy photosynthesis. In this study, we develop a new carbon optimality model for leaf demography. The novelty of our approach is two-fold. First, we incorporate a mechanistic photosynthesis model that can better estimate leaf carbon gain. Second, we consider the interspecific variations in leaf senescence rate, which strongly influence the modelled optimal carbon gain. We test our model with a leaf trait database for Panamanian evergreen forests. Then, we apply the model at seasonal scale and compare simulated seasonality of leaf litter and canopy photosynthesis with in-situ observations from several Amazonian forest sites. We find that (i) compared with original optimality model, the regression slope between observed and predicted leaf longevity increases from 0.15 to 1.04 in our new model and (ii) that our new model can capture the observed seasonal variations of leaf demography and canopy photosynthesis. Our results suggest that the phenology in tropical evergreen forests might result from plant adaptation to optimize canopy carbon gain. Finally, this proposed trait-driven prognostic phenology model could potentially be incorporated into next generation TBMs to improve simulation of carbon and water fluxes in the tropics.

Tree demography suggests multiple directions and drivers for species range shifts in mountains of Northeastern United States.

PubMed

Wason, Jay W; Dovciak, Martin

2017-08-01

Climate change is expected to lead to upslope shifts in tree species distributions, but the evidence is mixed partly due to land-use effects and individualistic species responses to climate. We examined how individual tree species demography varies along elevational climatic gradients across four states in the northeastern United States to determine whether species elevational distributions and their potential upslope (or downslope) shifts were controlled by climate, land-use legacies (past logging), or soils. We characterized tree demography, microclimate, land-use legacies, and soils at 83 sites stratified by elevation (~500 to ~1200 m above sea level) across 12 mountains containing the transition from northern hardwood to spruce-fir forests. We modeled elevational distributions of tree species saplings and adults using logistic regression to test whether sapling distributions suggest ongoing species range expansion upslope (or contraction downslope) relative to adults, and we used linear mixed models to determine the extent to which climate, land use, and soil variables explain these distributions. Tree demography varied with elevation by species, suggesting a potential upslope shift only for American beech, downslope shifts for red spruce (more so in cool regions) and sugar maple, and no change with elevation for balsam fir. While soils had relatively minor effects, climate was the dominant predictor for most species and more so for saplings than adults of red spruce, sugar maple, yellow birch, cordate birch, and striped maple. On the other hand, logging legacies were positively associated with American beech, sugar maple, and yellow birch, and negatively with red spruce and balsam fir - generally more so for adults than saplings. All species exhibited individualistic rather than synchronous demographic responses to climate and land use, and the return of red spruce to lower elevations where past logging originally benefited northern hardwood species indicates that land use may mask species range shifts caused by changing climate. © 2016 John Wiley & Sons Ltd.

Economic comparison of reproductive programs for dairy herds using estrus detection, timed artificial insemination, or a combination.

PubMed

Galvão, K N; Federico, P; De Vries, A; Schuenemann, G M

2013-04-01

The objective of this study was to compare the economic outcome of reproductive programs using estrus detection (ED), timed artificial insemination (TAI), or a combination of both (TAI-ED) using a stochastic dynamic Monte-Carlo simulation model. Programs evaluated were (1) ED only; (2) TAI: Presynch-Ovsynch for first AI, and Ovsynch for resynchronization of open cows at 32 d after AI; (3) TAI-ED: Presynch-Ovsynch for first AI, but cows underwent ED and AI after first AI, and cows diagnosed open 32 d after AI were resynchronized using Ovsynch. Evaluated were the effect of ED rate (40 vs. 60%; ED40 or ED60), accuracy of estrus detection (85 vs. 95%), compliance with the timed AI protocol (85 vs. 95%), and milk price ($0.33 vs. 0.44/kg). Conception rate to first service was set at 33.9% and then decreased by 2.6% for every subsequent service. Abortion was set at 11.3%. Cows were not AI after 366 d in milk, and open cows were culled after 450 d in milk. Culled cows were immediately replaced. Herd size was maintained at 1,000 cows, and the model accounted for all incomes and costs. Simulation was performed until steady state was reached (3,000 d), and then average daily values for the subsequent 2,000 d were used to calculate profit/cow per year. Net daily value was calculated by subtracting the costs (replacement, feeding, breeding, and other costs) from the daily income (milk sales, cow sales, and calf sales). The ED40 models resulted in greater profits than the TAI-85 model but lower profits than the TAI-95 model. Both ED60 models resulted in greater profits than the TAI-95 model. Combining TAI and ED increased profits within each level of accuracy or compliance. Adding TAI to ED would increase overall profit/cow per year by $46.8 to $74.7 with 40% ED, and by $8.9 to $30.5 with 60% ED. Adding ED to TAI would increase profit/cow per year by $64.2 to $99.4 with 85% compliance and by $31.8 to $59.7 with 95% compliance. Although combining TAI and ED increased profits within each level of accuracy or compliance, when evaluated separately, ED60 with 95% accuracy or TAI with 95% compliance were as profitable as or more profitable than TAI-ED with low ED, accuracy, or compliance. Therefore, producers can improve their profits by combining TAI and ED as reproductive management; however, if a herd can achieve high ED with high accuracy or have high compliance with injections, using only ED or TAI might be more profitable than trying to do both. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

ALM-FATES: Using dynamic vegetation and demography to capture changes in forest carbon cycling and competition at the global scale

NASA Astrophysics Data System (ADS)

Holm, J. A.; Knox, R. G.; Koven, C.; Riley, W. J.; Bisht, G.; Fisher, R.; Christoffersen, B. O.; Dietze, M.; Chambers, J. Q.

2017-12-01

The inclusion of dynamic vegetation demography in Earth System Models (ESMs) has been identified as a critical step in moving ESMs towards more realistic representations of plant ecology and the processes that govern climatically important fluxes of carbon, energy, and water. Successful application of dynamic vegetation models, and process-based approaches to simulate plant demography, succession, and response to disturbances without climate envelopes at the global scale is a challenging endeavor. We integrated demographic processes using the Functionally-Assembled Terrestrial Ecosystem Simulator (FATES) in the newly developed ACME Land Model (ALM). We then use an ALM-FATES globally gridded simulation for the first time to investigate plant functional type (PFT) distributions and dynamic turnover rates. Initial global simulations successfully include six interacting and competing PFTs (ranging from tropical to boreal, evergreen, deciduous, needleleaf and broadleaf); including more PFTs is planned. Global maps of net primary productivity, leaf area index, and total vegetation biomass by ALM-FATES matched patterns and values when compared to CLM4.5-BGC and MODIS estimates. We also present techniques for PFT parameterization based on the Predictive Ecosystem Analyzer (PEcAn), field based turnover rates, improved PFT groupings based on trait-tradeoffs, and improved representation of multiple canopy positions. Finally, we applied the improved ALM-FATES model at a central Amazon tropical and western U.S. temperate sites and demonstrate improvements in predicted PFT size- and age-structure and regional distribution. Results from the Amazon tropical site investigate the ability and magnitude of a tropical forest to act as a carbon sink by 2100 with a doubling of CO2, while results from the temperate sites investigate the response of forest mortality with increasing droughts.

Demography and population dynamics of the mouse opossum (Thylamys elegans) in semi-arid Chile: seasonality, feedback structure and climate.

PubMed Central

Lima, M.; Stenseth, N. C.; Yoccoz, N. G.; Jaksic, F. M.

2001-01-01

Here we present, to the authors' knowledge for the very first time for a small marsupial, a thorough analysis of the demography and population dynamics of the mouse opossum (Thylamys elegans) in western South America. We test the relative importance of feedback structure and climatic factors (rainfall and the Southern Oscillation Index) in explaining the temporal variation in the demography of the mouse opossum. The demographic information was incorporated into a stage-structured population dynamics model and the model's predictions were compared with observed patterns. The mouse opossum's capture rates showed seasonal (within-year) and between-year variability, with individuals having higher capture rates during late summer and autumn and lower capture rates during winter and spring. There was also a strong between-year effect on capture probabilities. The reproductive (the fraction of reproductively active individuals) and recruitment rates showed a clear seasonal and a between-year pattern of variation with the peak of reproductive activity occuring during winter and early spring. In addition, the fraction of reproductive individuals was positively related to annual rainfall, while population density and annual rainfall positively influenced the recruitment rate. The survival rates were negatively related to annual rainfall. The average finite population growth rate during the study period was estimated to be 1.011 +/- 0.0019 from capture-recapture estimates. While the annual growth rate estimated from the seasonal linear matrix models was 1.026, the subadult and adult survival and maturation rates represent between 54% (winter) and 81% (summer) of the impact on the annual growth rate. PMID:11571053

Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change.

PubMed

Burkett, Ellen; Martin-Khan, Melinda G; Scott, Justin; Samanta, Mayukh; Gray, Leonard C

2017-07-01

Objectives The aim of the present study was to describe trends in and age and gender distributions of presentations of older people to Australian emergency departments (EDs) from July 2006 to June 2011, and to develop ED utilisation projections to 2050. Methods A retrospective analysis of data collected in the National Non-admitted Patient Emergency Department Care Database was undertaken to assess trends in ED presentations. Three standard Australian Bureau of Statistics population growth models, with and without adjustment for current trends in ED presentation growth and effects of climate change, were examined with projections of ED presentations across three age groups (0-64, 65-84 and ≥85 years) to 2050. Results From 2006-07 to 2010-11, ED presentations increased by 12.63%, whereas the Australian population over this time increased by only 7.26%. Rates of presentation per head of population were greatest among those aged ≥85 years. Projections of ED presentations to 2050 revealed that overall ED presentations are forecast to increase markedly, with the rate of increase being most marked for older people. Conclusion Growth in Australian ED presentations from 2006-07 to 2010-11 was greater than that expected from population growth alone. The predicted changes in demand for ED care will only be able to be optimally managed if Australian health policy, ED funding instruments and ED models of care are adjusted to take into account the specific care and resource needs of older people. What is known about the topic? Rapid population aging is anticipated over coming decades. International studies and specific local-level Australian studies have demonstrated significant growth in ED presentations. There have been no prior national-level Australian studies of ED presentation trends by age group. What does this paper add? The present study examined national ED presentation trends from July 2006 to June 2011, with specific emphasis on trends in presentation by age group. ED presentation growth was found to exceed population growth in all age groups. The rate of ED presentations per head of population was highest among those aged ≥85 years. ED utilisation projections to 2050, using standard Australian Bureau of Statistics population modelling, with and without adjustment for current ED growth, were developed. The projections demonstrated linear growth in ED presentation for those aged 0-84 years, with growth in ED presentations of the ≥85 year age group demonstrating marked acceleration after 2030. What are the implications for practitioners? Growth in ED presentations exceeding population growth suggests that current models of acute health care delivery require review to ensure that optimal care is delivered in the most fiscally efficient manner. Trends in presentation of older people emphasise the imperative for ED workforce planning and education in care of this complex patient cohort, and the requirement to review funding models to incentivise investment in ED avoidance and substitutive care models targeting older people.

Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

PubMed

McManus, Moira C; Cramer, Robert J; Boshier, Maureen; Akpinar-Elci, Muge; Van Lunen, Bonnie

2018-01-13

Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. 'Other' ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.

The influences of CO2 fertilization and land use change on the total aboveground biomass in Amazonian tropical forest

NASA Astrophysics Data System (ADS)

Castanho, A. D.; Zhang, K.; Coe, M. T.; Costa, M. H.; Moorcroft, P. R.

2012-12-01

Field observations from undisturbed old-growth Amazonian forest plots have recently reported on the temporal variation of many of the physical and chemical characteristics such as: physiological properties of leaves, above ground live biomass, above ground productivity, mortality and turnover rates. However, although this variation has been measured, it is still not well understood what mechanisms control the observed temporal variability. The observed changes in time are believed to be a result of a combination of increasing atmospheric CO2 concentration, climate variability, recovery from natural disturbance (drought, wind blow, flood), and increase of nutrient availability. The time and spatial variability of the fertilization effect of CO2 on above ground biomass will be explored in more detail in this work. A precise understanding of the CO2 effect on the vegetation is essential for an accurate prediction of the future response of the forest to climate change. To address this issue we simultaneously explore the effects of climate variability, historical CO2 and land-use change on total biomass and productivity using two different Dynamic Global Vegetation Models (DGVM). We use the Integrated Biosphere Simulator (IBIS) and the Ecosystem Demography Model 2.1 (ED2.1). Using land use changes database from 1700 - 2008 we reconstruct the total carbon balance in the Amazonian forest in space and time and present how the models predict the forest as carbon sink or source and explore why the model and field data diverge from each other. From 1970 to 2005 the Amazonian forest has been exposed to an increase of approximately 50 ppm in the atmospheric CO2 concentration. Preliminary analyses with the IBIS and ED2.1 dynamic vegetation model shows the CO2 fertilization effect could account for an increase in above ground biomass of 0.03 and 0.04 kg-C/m2/yr on average for the Amazon basin, respectively. The annual biomass change varies temporally and spatially from about 0.01 - 0.08 Kg-C/m2/yr, indicating a significant combined effect of the physical environment and climatological variability. The change in biomass due to CO2 fertilization in this study is comparable to the lower limit of the change that has been observed in the field (0.04 - 0.085 kg-C/m2/yr), which suggests that other factors must also be considered to explain the total amount of biomass change observed in the field.

Demand for resident hunting in the southeastern United States

Treesearch

Neelam Poudyal; Seong Hoon Cho; J. Michael Bowker

2008-01-01

We modeled hunting demand among resident hunters in the Southeastern United States. Our model revealed that future hunting demand will likely decline in this region. Population growth in the region will increase demand but structural change in the region's demography (e.g., "browning" and "aging "), along with declining forestland access will...

The devil is in the dispersers: Predictions of landscape connectivity change with demography

Treesearch

Nicholas B. Elliot; Samuel A. Cushman; David W. Macdonald; Andrew J. Loveridge

2014-01-01

Concern about the effects of habitat fragmentation has led to increasing interest in dispersal and connectivity modelling. Most modern techniques for connectivity modelling have resistance surfaces as their foundation. However, resistance surfaces for animal movement are frequently estimated without considering dispersal, despite being the principal natural mechanism...

How does variation in rainfall affect simulated tropical tree mortality, functional diversity and coexistence?

NASA Astrophysics Data System (ADS)

Powell, T.; Kueppers, L. M.; Koven, C.; Johnson, D. J.; Faybishenko, B.; McDowell, N. G.; Chambers, J. Q.

2016-12-01

Land surface models that include demographic and plant hydrodynamic processes are promising tools for characterizing how different drought scenarios may affect carbon cycling of tropical forests. The Ecosystem Demography (ED2) model, now formulated with such features, was used to evaluate how different drought scenarios affect mortality patterns, functional diversity and coexistence of four plant functional types (PFTs) of tropical trees at Barro Colorado Island (BCI), Panama. The four PFTs simulated were early- versus late-successional groups subdivided into drought-tolerant versus -intolerant groups. The hydrodynamic formulation enables the four PFTs to compete mechanistically along two largely orthogonal resource gradients of water and light. The model simulations produced considerable differences in the aboveground biomass response to contrasting drying scenarios that included longer dry seasons, El Nino related droughts, and drier dry seasons. The emergent mortality dynamics reflect the physiological trade-off between water-use and carbon fixation formulated by the hydrodynamic regulation over stomatal conductance. During dry periods, the model predicts increased mortality rates of pioneer trees compared to generalists and drought-intolerant trees compared to -tolerant trees. The model also predicts that surviving cohorts in the smallest size classes of drought-intolerant trees are occasionally primed for release from competition following acute droughts. Observations at BCI showed increased mortality rates for large trees (i.e. >30 cm dbh) during the 1982 El Nino drought, but not subsequent El Nino related droughts. The causes of the elevated mortality rates are explored with the model. Coexistence of four plant functional types in the model is highly sensitive to the parameterization of stem hydraulic conductivity; but, surprisingly not very sensitive to shifts in rainfall patterns. These results demonstrate (a) that plant hydrodynamics are critical for simulating dynamic mortality patterns between drought-tolerant and -intolerant PFTs in order to increase representation of functional diversity in land surface models, and (b) that more demographic, plant hydraulic and deeper soil moisture observations are required to constrain hydrodynamic parameter selection.

Work and Family: An Annotated Bibliography

DTIC Science & Technology

1984-01-01

8217 with the rest of society. t..- _ 81. Collver, 0. A. Women’s work participation and fertility in metropolitan are’as. Demography , 1968, 5, 55-60. This...In the United States. Demography , 1979, 16, 177-197. The central concept of microeconomic theories of fertility is opportunity cost-the product of...Convenience of work and the job constraint of children. Demography , 1975,1 12, 245-258. This paper investigates whether convenient working conditions reduce

Gendered Authorship and Demographic Research: An Analysis of 50 Years of Demography.

PubMed

Krapf, Sandra; Kreyenfeld, Michaela; Wolf, Katharina

2016-08-01

Demography, the official journal of the Population Association of America, has been given the highest rating among demographic journals by the Social Sciences Citation Index (SSCI). Our aim here is to investigate the development of research subfields and female authorship in Demography over the last 50 years. We find that female authorship in Demography has risen considerably since the 1980s and that currently a woman is about as likely as a man to be the sole or the first author of a paper published in the journal. However, we find some differences by subfield. Women seem to be overrepresented in the "family and household" research subfield but underrepresented in the "mortality and health" and "data and methods" categories.

Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

PubMed

Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

2014-09-01

Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data statistically improve the performance of predicting ILI-related ED visits in Douglas County, and this result can be generalized to other communities. Timely and accurate estimates of ED volume during the influenza season, as well as during pandemic outbreaks, can help hospitals plan their ED resources accordingly and lower their costs by optimizing supplies and staffing and can improve service quality by decreasing ED wait times and overcrowding. Copyright © 2014 Elsevier Inc. All rights reserved.

Beyond Population and Environment: Household Life Cycle Demography and Land Use Allocation among Small Farm Colonists in the Amazon

NASA Technical Reports Server (NTRS)

Perz, Stephen G.; Walker, Robert T.; Caldas, Marcellus M.

2006-01-01

Most research featuring demographic factors in environmental change has focused on processes operating at the level of national or global populations. This paper focuses on household-level demographic life cycles among colonists in the Amazon, and evaluates the impacts on land use allocation. The analysis goes beyond prior research by including a broader suite of demographic variables, and by simultaneously assessing their impacts on multiple land uses with different economic and ecological implications. We estimate a system of structural equations that accounts for endogeneity among land uses, and the findings indicate stronger demographic effects than previous work. These findings bear implications for modeling land use, and the place of demography in environmental research.

Leaf development and demography explain photosynthetic seasonality in Amazon evergreen forests

USGS Publications Warehouse

Wu, Jin; Albert, Lauren; Lopes, Aline; Restrepo-Coupe, Natalia; Hayek, Matthew; Wiedemann, Kenia T.; Guan, Kaiyu; Stark, Scott C.; Christoffersen, Bradley; Prohaska, Neill; Tavares, Julia V.; Marostica, Suelen; Kobayashi, Hideki; Ferreira, Maurocio L.; Campos, Kleber Silva; da Silva, Rodrigo; Brando, Paulo M.; Dye, Dennis G.; Huxman, Travis E.; Huete, Alfredo; Nelson, Bruce; Saleska, Scott

2016-01-01

In evergreen tropical forests, the extent, magnitude, and controls on photosynthetic seasonality are poorly resolved and inadequately represented in Earth system models. Combining camera observations with ecosystem carbon dioxide fluxes at forests across rainfall gradients in Amazônia, we show that aggregate canopy phenology, not seasonality of climate drivers, is the primary cause of photosynthetic seasonality in these forests. Specifically, synchronization of new leaf growth with dry season litterfall shifts canopy composition toward younger, more light-use efficient leaves, explaining large seasonal increases (~27%) in ecosystem photosynthesis. Coordinated leaf development and demography thus reconcile seemingly disparate observations at different scales and indicate that accounting for leaf-level phenology is critical for accurately simulating ecosystem-scale responses to climate change.

A new social-family model for eating disorders: A European multicentre project using a case-control design.

PubMed

Krug, Isabel; Fuller-Tyszkiewicz, Matthew; Anderluh, Marija; Bellodi, Laura; Bagnoli, Silvia; Collier, David; Fernandez-Aranda, Fernando; Karwautz, Andreas; Mitchell, Sarah; Nacmias, Benedetta; Ricca, Valdo; Sorbi, Sandro; Tchanuria, Kate; Wagner, Gudrun; Treasure, Janet; Micali, Nadia

2015-12-01

To examine a new socio-family risk model of Eating Disorders (EDs) using path-analyses. The sample comprised 1264 (ED patients = 653; Healthy Controls = 611) participants, recruited into a multicentre European project. Socio-family factors assessed included: perceived maternal and parental parenting styles, family, peer and media influences, and body dissatisfaction. Two types of path-analyses were run to assess the socio-family model: 1.) a multinomial logistic path-model including ED sub-types [Anorexia Nervosa-Restrictive (AN-R), AN-Binge-Purging (AN-BP), Bulimia Nervosa (BN) and EDNOS)] as the key polychotomous categorical outcome and 2.) a path-model assessing whether the socio-family model differed across ED sub-types and healthy controls using body dissatisfaction as the outcome variable. The first path-analyses suggested that family and media (but not peers) were directly and indirectly associated (through body dissatisfaction) with all ED sub-types. There was a weak effect of perceived parenting directly on ED sub-types and indirectly through family influences and body dissatisfaction. For the second path-analyses, the socio-family model varied substantially across ED sub-types. Family and media influences were related to body dissatisfaction in the EDNOS and control sample, whereas perceived abusive parenting was related to AN-BP and BN. This is the first study providing support for this new socio-family model, which differed across ED sub-types. This suggests that prevention and early intervention might need to be tailored to diagnosis-specific ED profiles. Copyright © 2015 Elsevier Ltd. All rights reserved.

Don't panic--prepare: towards crisis-aware models of emergency department operations.

PubMed

Ceglowski, Red; Churilov, Leonid; Wasserheil, Jeff

2005-12-01

The existing models of Emergency Department (ED) operations that are based on the "flow-shop" management logic do not provide adequate decision support in dealing with the ED overcrowding crises. A conceptually different crisis-aware approach to ED modelling and operational decision support is introduced in this paper. It is based on Perrow's theory of "normal accidents" and calls for recognizing the inevitable nature of ED overcrowding crises within current health system setup. Managing the crisis before it happens--a standard approach in crisis management area--should become an integral part of ED operations management. The potential implications of adopting such a crisis-aware perspective for health services research and ED management are outlined.

Development of emergency department load relief area--gauging benefits in empirical terms.

PubMed

Rasheed, Farrukh; Lee, Young Hoon; Kim, Seung Ho; Park, In Cheol

2012-12-01

The primary goal of this investigation was to develop a simulation model to evaluate the various internal and external factors affecting patient flow and crowding in the emergency department (ED). In addition, a few recommendations are proposed to reconfigure the patient flow to improve ED capacity while maintaining service quality. In this research, we present a simulation study conducted in the ED at the "S Hospital" located in Seoul. Based on patient flow data and process analysis, a simulation model of patient throughput in the ED has been developed. We evaluated simulations of diverting the specific patient load in the light of our proposed recommendations to a separately managed area named as the ED load relief area (ED-LRA) and analyzing potential effects on overall length of stay (LOS) and waiting time (WT). What-if analyses have been proposed to identify key issues and investigate the improvements as per our proposed recommendations. The simulation results suggest that specific patient load diversion is needed to ensure desired outcomes. With the diversion of specific patient load to ED-LRA, there is a reduction of 40.60% in mean LOS and 42.5% in WT with improved resource utilization. As a result, opening of an ED-LRA is justified. Real-world systems are often too intricate for analytical models and often too expensive to trial with directly. Simulation models allow the modeling of this intricacy and enable experimentation to make inferences about how the actual system might perform. Our simulation study modeled that diverting the specific patient load to ED-LRA produced an improvement in overall ED's LOS and WT.

Projecting future impacts of hurricanes on the carbon balance of eastern U.S. forests

NASA Astrophysics Data System (ADS)

Fisk, J. P.; Hurtt, G. C.; Chambers, J. Q.; Zeng, H.; Dolan, K.; Flanagan, S.; Rourke, O.; Negron Juarez, R. I.

2011-12-01

In U.S. Atlantic coastal areas, hurricanes are a principal agent of catastrophic wind damage, with dramatic impacts on the structure and functioning of forests. Substantial recent progress has been made to estimate the biomass loss and resulting carbon emissions caused by hurricanes impacting the U.S. Additionally, efforts to evaluate the net effects of hurricanes on the regional carbon balance have demonstrated the importance of viewing large disturbance events in the broader context of recovery from a mosaic of past events. Viewed over sufficiently long time scales and large spatial scales, regrowth from previous storms may largely offset new emissions; however, changes in number, strength or spatial distribution of extreme disturbance events will result in changes to the equilibrium state of the ecosystem and have the potential to result in a lasting carbon source or sink. Many recent studies have linked climate change to changes in the frequency and intensity of hurricanes. In this study, we use a mechanistic ecosystem model, the Ecosystem Demography (ED) model, driven by scenarios of future hurricane activity based on historic activity and future climate projections, to evaluate how changes in hurricane frequency, intensity and spatial distribution could affect regional carbon storage and flux over the coming century. We find a non-linear response where increased storm activity reduces standing biomass stocks reducing the impacts of future events. This effect is highly dependent on the spatial pattern and repeat interval of future hurricane activity. Developing this kind of predictive modeling capability that tracks disturbance events and recovery is key to our understanding and ability to predict the carbon balance of forests.

Attitudes of Major Soviet Nationalities. Volume IV. Central Asia. Kazakhstan, Kirgizistan, Turkmenistan, Uzbekistan, Tadzhikistan.

DTIC Science & Technology

1973-06-01

attitudes. IV. Demography Although Uzbekistan is somewhat smaller in area than neighboring Turkmenistan, it has nearly six times the population--close...Uzbekistan - Demography - 2 Table A.2. National Composition of Uzbek SSR 19 26a 19 39b 1959 c 1 970c T number % number % number % number % Total . Uzbek...Mullyadzbanov, Narodo naseleniye Ilzbekskoi SSR (Tashkent, 1967): 177. c Pravda Vostoka (April 28), 1971: 2. 4 Uzbekistan - Demography - 3 the extraordinary

SPATIALLY AUTOCORRELATED DEMOGRAPHY AND INTERPOND MIGRATION IN THE CALIFORNIA TIGER SALAMANDER (AMBYSTOME CALIFORNIENSE)

EPA Science Inventory

We investigated the metapopulation structure of the California tiger salamander (Ambystoma californiense) using a combination of indirect and direct methods to evaluate two key requirements of modern metapopulation models: 1) that patches support somewhat independent populations ...

DEMOGRAPHY AND VIABILITY ANALYSES OF A DIAMONDBACK TERRAPIN POPULATION

EPA Science Inventory

The diamondback terrapin Malaclemys terrapin is a long-lived species with special management requirements, but quantitative analyses to support management are lacking. I analyzed mark-recapture data and constructed an age-classified matrix population model to determine the status...

Evolutionary demography and the population history of the European early Neolithic.

PubMed

Shennan, Stephen

2009-04-01

In this paper I propose that evolutionary demography and associated theory from human behavioral ecology provide a strong basis for explaining the available evidence for the patterns observed in the first agricultural settlement of Europe in the 7th-5th millennium cal. BC, linking together a variety of what have previously been disconnected observations and casting doubt on some long-standing existing models. An outline of relevant aspects of life history theory, which provides the foundation for understanding demography, is followed by a review of large-scale demographic patterns in the early Neolithic, which point to rapid population increase and a process of demic diffusion. More localized socioeconomic and demographic patterns suggesting rapid expansion to local carrying capacities and an associated growth of inequality in the earliest farming communities of central Europe (the Linear Pottery Culture, or LBK) are then outlined and shown to correspond to predictions of spatial population ecology and reproductive skew theory. Existing models of why it took so long for farming to spread to northern and northwest Europe, which explain the spread in terms of the gradual disruption of hunter-gatherer ways of life, are then questioned in light of evidence for population collapse at the end of the LBK. Finally, some broader implications of the study are presented, including the suggestion that the pattern of an initial agricultural boom followed by a bust may be relevant in other parts of the world.

Water Operations Technical Support Program: Techniques for Evaluating Aquatic Habitats in Rivers, Streams, and Reservoirs. Proceedings of a Workshop Held in Vicksburg, Mississippi on 8-10 August 1989.

DTIC Science & Technology

1991-08-01

cohorts). The abundance of individuals greater than 20 mm SL and the complexity of size demography indicated longevity of 2 to 3 years for a substantial...Richard Kasul ......... ......................... . 86 DATA ANALYSIS AND INTERPRETATION ...... ................... 93 Measurement of Size Demography ...Experi- ment Station, Vicksburg, MS. Miller, A. C., and Payne, B. S. 1988. "The Need for Quantitative Sampling to Characterize Size Demography and Density

ED leadership competency matrix: an administrative management tool.

PubMed

Propp, Douglas A; Glickman, Seth; Uehara, Dennis T

2003-10-01

A successful ED relies on its leaders to master and demonstrate core competencies to be effective in the many arenas in which they interact and are responsible. A unique matrix model for the assessment of an ED leadership's key administrative skill sets is presented. The model incorporates capabilities related to the individual's cognitive aptitude, experience, acquired technical skills, behavioral characteristics, as well as the ability to manage relationships effectively. Based on the personnel inventory using the matrix, focused evaluation, development, and recruitment of ED key leaders occurs. This dynamic tool has provided a unique perspective for the evaluation and enhancement of overall ED leadership performance. It is hoped that incorporation of such a model will similarly improve the accomplishments of EDs at other institutions.

An empirical/theoretical model with dimensionless numbers to predict the performance of electrodialysis systems on the basis of operating conditions.

PubMed

Karimi, Leila; Ghassemi, Abbas

2016-07-01

Among the different technologies developed for desalination, the electrodialysis/electrodialysis reversal (ED/EDR) process is one of the most promising for treating brackish water with low salinity when there is high risk of scaling. Multiple researchers have investigated ED/EDR to optimize the process, determine the effects of operating parameters, and develop theoretical/empirical models. Previously published empirical/theoretical models have evaluated the effect of the hydraulic conditions of the ED/EDR on the limiting current density using dimensionless numbers. The reason for previous studies' emphasis on limiting current density is twofold: 1) to maximize ion removal, most ED/EDR systems are operated close to limiting current conditions if there is not a scaling potential in the concentrate chamber due to a high concentration of less-soluble salts; and 2) for modeling the ED/EDR system with dimensionless numbers, it is more accurate and convenient to use limiting current density, where the boundary layer's characteristics are known at constant electrical conditions. To improve knowledge of ED/EDR systems, ED/EDR models should be also developed for the Ohmic region, where operation reduces energy consumption, facilitates targeted ion removal, and prolongs membrane life compared to limiting current conditions. In this paper, theoretical/empirical models were developed for ED/EDR performance in a wide range of operating conditions. The presented ion removal and selectivity models were developed for the removal of monovalent ions and divalent ions utilizing the dominant dimensionless numbers obtained from laboratory scale electrodialysis experiments. At any system scale, these models can predict ED/EDR performance in terms of monovalent and divalent ion removal. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determinants of Dentists' Geographic Distribution.

ERIC Educational Resources Information Center

Beazoglou, Tryfon J.; And Others

1992-01-01

A model for explaining the geographic distribution of dentists' practice locations is presented and applied to particular market areas in Connecticut. Results show geographic distribution is significantly related to a few key variables, including demography, disposable income, and housing prices. Implications for helping students make practice…

Integrating Paleodistribution Models and Phylogeography in the Grass-Cutting Ant Acromyrmex striatus (Hymenoptera: Formicidae) in Southern Lowlands of South America

PubMed Central

Cristiano, Maykon Passos; Clemes Cardoso, Danon; Fernandes-Salomão, Tânia Maria; Heinze, Jürgen

2016-01-01

Past climate changes often have influenced the present distribution and intraspecific genetic diversity of organisms. The objective of this study was to investigate the phylogeography and historical demography of populations of Acromyrmex striatus (Roger, 1863), a leaf-cutting ant species restricted to the open plains of South America. Additionally, we modeled the distribution of this species to predict its contemporary and historic habitat. From the partial sequences of the mitochondrial gene cytochrome oxidase I of 128 A. striatus workers from 38 locations we estimated genetic diversity and inferred historical demography, divergence time, and population structure. The potential distribution areas of A. striatus for current and quaternary weather conditions were modeled using the maximum entropy algorithm. We identified a total of 58 haplotypes, divided into five main haplogroups. The analysis of molecular variance (AMOVA) revealed that the largest proportion of genetic variation is found among the groups of populations. Paleodistribution models suggest that the potential habitat of A. striatus may have decreased during the Last Interglacial Period (LIG) and expanded during the Last Maximum Glacial (LGM). Overall, the past potential distribution recovered by the model comprises the current potential distribution of the species. The general structuring pattern observed was consistent with isolation by distance, suggesting a balance between gene flow and drift. Analysis of historical demography showed that populations of A. striatus had remained constant throughout its evolutionary history. Although fluctuations in the area of their potential historic habitat occurred during quaternary climate changes, populations of A. striatus are strongly structured geographically. However, explicit barriers to gene flow have not been identified. These findings closely match those in Mycetophylax simplex, another ant species that in some areas occurs in sympatry with A. striatus. Ecophysiological traits of this species and isolation by distance may together have shaped the phylogeographic pattern. PMID:26734939

Litter decomposition, N2-fixer abundance, and microbial dynamics govern tropical dry forest recovery to land use change

NASA Astrophysics Data System (ADS)

Trierweiler, A.; Powers, J. S.; Xu, X.; Gei, M. G.; Medvigy, D.

2017-12-01

As one of the most threatened tropical biomes, Seasonal Dry Tropical Forests (TDF) have undergone extensive land-use change. However, some areas are undergoing recovery into secondary forests. Despite their broad distribution (42% of tropical forests), they are under-studied compared to wet tropical forests and our understanding of their biogeochemical cycling and belowground processes are limited. Here, we use models along with field measurements to improve our understanding of nutrient cycling and limitation in secondary TDFs. We ask (1) Is there modeling evidence that tropical dry forests can become nutrient limited? (2) What are the most important mechanisms employed to avoid nutrient limitation? (3) How might climate change alter biogeochemical cycling and nutrient limitation in recovering TDF? We use a new version of the Ecosystem Demography (ED2) model that has been recently parameterized for TDFs and incorporates a range of plant functional groups (including deciduousness and N2-fixation) and multiple resource constraints (carbon, nitrogen, phosphorus, and water). In the model, plants then can dynamically adjust their carbon allocation and nutrient acquisition strategies using N2-fixing bacteria and mycorrhizal fungi according to the nutrient limitation status. We ran the model for a nutrient gradient of field sites in Costa Rica and explored the sensitivity of nutrient limitation to key mechanisms including litter respiration, N resorption, N2-fixation, and overflow respiration. Future runs will evaluate how CO2 and climate change affect recovering TDFs. We found increasing nutrient limitation across the nutrient gradient of sites. Nitrogen limitation dominated the nutrient limitation signal. In the model, forest litter accumulation was negatively correlated with site fertility in Costa Rican forests. Our sensitivity analyses indicate that N2-fixer abundance, decomposition rates, and adding more explicit microbial dynamics are key factors in overcoming this limitation. These insights improve our understanding of how TDFs function and are especially relevant to the management of recovering secondary TDFs by highlighting potential bottlenecks in the recovery process.

A casemix model for estimating the impact of hospital access block on the emergency department.

PubMed

Stuart, Peter

2004-06-01

To determine the ED activity and costs resulting from access block. A casemix model (AWOOS) was developed to measure activity due to access block. Using data from four hospitals between 1998 and 2002, ED activity was measured using the urgency and disposition group (UDG) casemix model and the AWOOS model with the purpose of determining the change in ED activity due to access block. Whilst the mean length of stay in ED (admitted patients) increased by 93% between 1998 and 2002, mean UDG activity increased by 0.63% compared to a mean increase in AWOOS activity of 24.5%. The 23.9% difference between UDG and AWOOS activity represents the (unmeasured) increase in ED activity and costs for the period 1998-2002 resulting from access block. The UDG system significantly underestimates the activity in EDs experiencing marked access block.

Smoothing inpatient discharges decreases emergency department congestion: a system dynamics simulation model.

PubMed

Wong, Hannah J; Wu, Robert C; Caesar, Michael; Abrams, Howard; Morra, Dante

2010-08-01

Timely access to emergency patient care is an important quality and efficiency issue. Reduced discharges of inpatients at weekends are a reality to many hospitals and may reduce hospital efficiency and contribute to emergency department (ED) congestion. To evaluate the daily number of ED beds occupied by inpatients after evenly distributing inpatient discharges over the course of the week using a computer simulation model. Simulation modelling study from an academic care hospital in Toronto, Canada. Daily historical data from the general internal medicine (GIM) department between 15 January and 15 December for two years, 2005 and 2006, were used for model building and validation, respectively. There was good agreement between model simulations and historical data for both ED and ward censuses and their respective lengths of stay (LOS), with the greatest difference being +7.8% for GIM ward LOS (model: 9.3 days vs historical: 8.7 days). When discharges were smoothed across the 7 days, the number of ED beds occupied by GIM patients decreased by approximately 27-57% while ED LOS decreased 7-14 hours. The model also demonstrated that patients occupying hospital beds who no longer require acute care have a considerable impact on ED and ward beds. Smoothing out inpatient discharges over the course of a week had a positive effect on decreasing the number of ED beds occupied by inpatients. Despite the particular challenges associated with weekend discharges, simulation experiments suggest that discharges evenly spread across the week may significantly reduce bed requirements and ED LOS.

Dedication increases productivity: an analysis of the implementation of a dedicated medical team in the emergency department.

PubMed

Ramos, Pedro; Paiva, José Artur

2017-12-01

In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED. Our study assesses the effect of an intervention in a large academic hospital ED in Portugal in 2002, and it is the first to test the hypothesis that implementing a dedicated team of doctors with EM expertise increases the productivity and reduces costs in the ED, maintaining the quality of care provided to patients. A pre-post design was used for comparing the change on the organisational model of delivering care in our medical ED. All emergency medical admissions were tracked in 2002 (classic model with 12-h shift in the ED) and 2005/2006 (dedicated team with full-time EM physicians), and productivity, costs with medical human resources and quality of care measures were compared. We found that medical productivity (number of patients treated per hour of medical work) increased dramatically after the creation of the dedicated team (X 2 KW = 31.135; N = 36; p < 0.001) and costs with ED medical work reduced both in regular hours and overtime. Moreover, hospitalisation rates decreased and the length of stay in the ED increased significantly after the creation of the dedicated team. Implementing a dedicated team of doctors increased the medical productivity and reduced costs in our ED. Our findings have straightforward implication for Portuguese policymakers aiming at reducing hospital costs while coping with increased ED demand.

Process modeling of emergency department patient flow: effect of patient length of stay on ED diversion.

PubMed

Kolker, Alexander

2008-10-01

A discreet event simulation methodology has been used to establish a quantitative relationship between Emergency Department (ED) performance characteristics, such as percent of time on ambulance diversion and the number of patients in queue in the waiting room, and the upper limits of patient length of stay (LOS). A simulation process model of ED patient flow has been developed that took into account a significant difference between LOS distributions of patients discharged home and patients admitted into the hospital. Using simulation model it has been identified that ED diversion could be negligible (less than approximately 0.5%) if patients discharged home stay in ED not more than 5 h, and patients admitted into the hospital stay in ED not more than 6 h Using full factorial design of experiments with two factors and the model's predicted percent diversion as a response function, other combinations of LOS upper limits have been determined that would result in low ED percent diversion as well. It has also been determined that if the number of patients exceeds 11 in queue in ED waiting room then the diversion percent is rapidly increasing.

Demography and Public Health Emergency Preparedness: Making the Connection

PubMed Central

Katz, Rebecca

2009-01-01

The tools and techniques of population sciences are extremely relevant to the discipline of public health emergency preparedness: protecting and securing the population’s health requires information about that population. While related fields such as security studies have successfully integrated demographic tools into their research and literature, the theoretical and practical connection between the methods of demography and the practice of public health emergency preparedness is weak. This article suggests the need to further the interdisciplinary use of demography by examining the need for a systematic use of population science techniques in public health emergency preparedness. Ultimately, we demonstrate how public health emergency preparedness can incorporate demography to develop more effective preparedness plans. Important policy implications emerge: demographers and preparedness experts need to collaborate more formally in order to facilitate community resilience and mitigate the consequences of public health emergencies. PMID:20694030

High Selection Pressure Promotes Increase in Cumulative Adaptive Culture

PubMed Central

Vegvari, Carolin; Foley, Robert A.

2014-01-01

The evolution of cumulative adaptive culture has received widespread interest in recent years, especially the factors promoting its occurrence. Current evolutionary models suggest that an increase in population size may lead to an increase in cultural complexity via a higher rate of cultural transmission and innovation. However, relatively little attention has been paid to the role of natural selection in the evolution of cultural complexity. Here we use an agent-based simulation model to demonstrate that high selection pressure in the form of resource pressure promotes the accumulation of adaptive culture in spite of small population sizes and high innovation costs. We argue that the interaction of demography and selection is important, and that neither can be considered in isolation. We predict that an increase in cultural complexity is most likely to occur under conditions of population pressure relative to resource availability. Our model may help to explain why culture change can occur without major environmental change. We suggest that understanding the interaction between shifting selective pressures and demography is essential for explaining the evolution of cultural complexity. PMID:24489724

Invasive plant species and the new bioeconomy

USDA-ARS?s Scientific Manuscript database

Simulation models of management effects on weed demography and the experience of successful organic and low-external-input farmers point in the same direction: long-term weed management success depends on diversified strategies that attack multiple weed life stages. In an era of declining research b...

A generalized model for estimating the energy density of invertebrates

USGS Publications Warehouse

James, Daniel A.; Csargo, Isak J.; Von Eschen, Aaron; Thul, Megan D.; Baker, James M.; Hayer, Cari-Ann; Howell, Jessica; Krause, Jacob; Letvin, Alex; Chipps, Steven R.

2012-01-01

Invertebrate energy density (ED) values are traditionally measured using bomb calorimetry. However, many researchers rely on a few published literature sources to obtain ED values because of time and sampling constraints on measuring ED with bomb calorimetry. Literature values often do not account for spatial or temporal variability associated with invertebrate ED. Thus, these values can be unreliable for use in models and other ecological applications. We evaluated the generality of the relationship between invertebrate ED and proportion of dry-to-wet mass (pDM). We then developed and tested a regression model to predict ED from pDM based on a taxonomically, spatially, and temporally diverse sample of invertebrates representing 28 orders in aquatic (freshwater, estuarine, and marine) and terrestrial (temperate and arid) habitats from 4 continents and 2 oceans. Samples included invertebrates collected in all seasons over the last 19 y. Evaluation of these data revealed a significant relationship between ED and pDM (r2  =  0.96, p < 0.0001), where ED (as J/g wet mass) was estimated from pDM as ED  =  22,960pDM − 174.2. Model evaluation showed that nearly all (98.8%) of the variability between observed and predicted values for invertebrate ED could be attributed to residual error in the model. Regression of observed on predicted values revealed that the 97.5% joint confidence region included the intercept of 0 (−103.0 ± 707.9) and slope of 1 (1.01 ± 0.12). Use of this model requires that only dry and wet mass measurements be obtained, resulting in significant time, sample size, and cost savings compared to traditional bomb calorimetry approaches. This model should prove useful for a wide range of ecological studies because it is unaffected by taxonomic, seasonal, or spatial variability.

System Level Health Disparities in California Emergency Departments: Minorities and Medicaid Patients are at Higher Risk of Losing Their EDs

PubMed Central

Hsia, Renee Y.; Srebotnjak, Tanja; Kanzaria, Hemal K.; McCulloch, Charles; Auerbach, Andrew D.

2015-01-01

Study Objective Emergency Department (ED) closures threaten community access to emergency services, but few data exist to describe factors associated with closure. We evaluated factors associated with ED closure in California and sought to determine if hospitals serving more vulnerable populations have a higher rate of ED closure. Methods Retrospective cohort study of California hospital EDs between 1998 and 2008, using hospital and patient level data from the California Office of Statewide Planning and Development (OSHPD), as well as OSHPD Patient Discharge Data. We examined the effects of hospital and patient factors on the hospital's likelihood of ED closure using Cox proportional hazards models. Results In 4,411 hospital-years of observation, 29 of 401 (7.2%) EDs closed. In a model adjusted for total ED visits, hospital discharges, trauma center and teaching status, ownership, operating margin, and urbanicity, hospitals with more black patients (OR 1.41 per increase in proportion of blacks by 0.1, 95% CI 1.16-1.72) and Medi-Cal recipients (OR 1.17 per increase in proportion insured by Medi-Cal by 0.1, 95% CI 1.02-1.34) had higher odds for ED closure, as did for-profit institutions (OR 1.65, 95% CI 1.13-2.41). Conclusion The population served by EDs and hospitals’ profit model are associated with ED closure. Whether our findings are a manifestation of poorer reimbursement in at-risk EDs is unclear. PMID:22093435

Political demography: Powerful trends under-attended by demographic science.

PubMed

Teitelbaum, Michael S

2015-01-01

The interconnections between politics and the dramatic demographic changes under way around the world have been neglected by the two research disciplines that could contribute most to their understanding: demography and political science. Instead, this area of 'political demography' has largely been ceded to political activists, pundits, and journalists, leading often to exaggerated or garbled interpretation. The terrain includes some of the most politically sensitive and contested issues: alleged demographically determined shifts in the international balance of power; low fertility, population decline, and demographic ageing; international migration; change in national identity; and compositional shifts in politically sensitive social categories and human rights. Meanwhile many governments and non-governmental actors have actively pursued varieties of 'strategic demography', deploying fertility, mortality, or migration as instruments of domestic or international policy. Political scientists and demographers could and should use their knowledge and analytic techniques to improve understanding and to moderate excessive claims and fears on these topics.

Critical Watersheds: Climate Change, Tipping Points, and Energy-Water Impacts

NASA Astrophysics Data System (ADS)

Middleton, R. S.; Brown, M.; Coon, E.; Linn, R.; McDowell, N. G.; Painter, S. L.; Xu, C.

2014-12-01

Climate change, extreme climate events, and climate-induced disturbances will have a substantial and detrimental impact on terrestrial ecosystems. How ecosystems respond to these impacts will, in turn, have a significant effect on the quantity, quality, and timing of water supply for energy security, agriculture, industry, and municipal use. As a community, we lack sufficient quantitative and mechanistic understanding of the complex interplay between climate extremes (e.g., drought, floods), ecosystem dynamics (e.g., vegetation succession), and disruptive events (e.g., wildfire) to assess ecosystem vulnerabilities and to design mitigation strategies that minimize or prevent catastrophic ecosystem impacts. Through a combination of experimental and observational science and modeling, we are developing a unique multi-physics ecohydrologic framework for understanding and quantifying feedbacks between novel climate and extremes, surface and subsurface hydrology, ecosystem dynamics, and disruptive events in critical watersheds. The simulation capability integrates and advances coupled surface-subsurface hydrology from the Advanced Terrestrial Simulator (ATS), dynamic vegetation succession from the Ecosystem Demography (ED) model, and QUICFIRE, a novel wildfire behavior model developed from the FIRETEC platform. These advances are expected to make extensive contributions to the literature and to earth system modeling. The framework is designed to predict, quantify, and mitigate the impacts of climate change on vulnerable watersheds, with a focus on the US Mountain West and the energy-water nexus. This emerging capability is used to identify tipping points in watershed ecosystems, quantify impacts on downstream users, and formally evaluate mitigation efforts including forest (e.g., thinning, prescribed burns) and watershed (e.g., slope stabilization). The framework is being trained, validated, and demonstrated using field observations and remote data collections in the Valles Caldera National Preserve, including pre- and post-wildfire and infestation observations. Ultimately, the framework will be applied to the upper Colorado River basin. Here, we present an overview of the framework development strategy and latest field and modeling results.

Demography of invasive black and pale swallow-wort populations in New York

USDA-ARS?s Scientific Manuscript database

Vincetoxicum nigrum (Black Swallow-wort) and Vincetoxicum rossicum (Pale Swallow-wort) are perennial twining vines introduced from Europe. Both species have become invasive in northeastern North America in a variety of habitats. To develop parameters for a population model for evaluating potential b...

Dynamical systems in economics

NASA Astrophysics Data System (ADS)

Stanojević, Jelena; Kukić, Katarina

2018-01-01

In last few decades much attention is given to explain complex behaviour of very large systems, such as weather, economy, biology and demography. In this paper we give short overview of basic notions in the field of dynamical systems which are relevant for understanding complex nature of some economic models.

Predicting Appropriate Admission of Bronchiolitis Patients in the Emergency Department: Rationale and Methods.

PubMed

Luo, Gang; Stone, Bryan L; Johnson, Michael D; Nkoy, Flory L

2016-03-07

In young children, bronchiolitis is the most common illness resulting in hospitalization. For children less than age 2, bronchiolitis incurs an annual total inpatient cost of $1.73 billion. Each year in the United States, 287,000 emergency department (ED) visits occur because of bronchiolitis, with a hospital admission rate of 32%-40%. Due to a lack of evidence and objective criteria for managing bronchiolitis, ED disposition decisions (hospital admission or discharge to home) are often made subjectively, resulting in significant practice variation. Studies reviewing admission need suggest that up to 29% of admissions from the ED are unnecessary. About 6% of ED discharges for bronchiolitis result in ED returns with admission. These inappropriate dispositions waste limited health care resources, increase patient and parental distress, expose patients to iatrogenic risks, and worsen outcomes. Existing clinical guidelines for bronchiolitis offer limited improvement in patient outcomes. Methodological shortcomings include that the guidelines provide no specific thresholds for ED decisions to admit or to discharge, have an insufficient level of detail, and do not account for differences in patient and illness characteristics including co-morbidities. Predictive models are frequently used to complement clinical guidelines, reduce practice variation, and improve clinicians' decision making. Used in real time, predictive models can present objective criteria supported by historical data for an individualized disease management plan and guide admission decisions. However, existing predictive models for ED patients with bronchiolitis have limitations, including low accuracy and the assumption that the actual ED disposition decision was appropriate. To date, no operational definition of appropriate admission exists. No model has been built based on appropriate admissions, which include both actual admissions that were necessary and actual ED discharges that were unsafe. The goal of this study is to develop a predictive model to guide appropriate hospital admission for ED patients with bronchiolitis. This study will: (1) develop an operational definition of appropriate hospital admission for ED patients with bronchiolitis, (2) develop and test the accuracy of a new model to predict appropriate hospital admission for an ED patient with bronchiolitis, and (3) conduct simulations to estimate the impact of using the model on bronchiolitis outcomes. We are currently extracting administrative and clinical data from the enterprise data warehouse of an integrated health care system. Our goal is to finish this study by the end of 2019. This study will produce a new predictive model that can be operationalized to guide and improve disposition decisions for ED patients with bronchiolitis. Broad use of the model would reduce iatrogenic risk, patient and parental distress, health care use, and costs and improve outcomes for bronchiolitis patients.

A multivariate time series approach to modeling and forecasting demand in the emergency department.

PubMed

Jones, Spencer S; Evans, R Scott; Allen, Todd L; Thomas, Alun; Haug, Peter J; Welch, Shari J; Snow, Gregory L

2009-02-01

The goals of this investigation were to study the temporal relationships between the demands for key resources in the emergency department (ED) and the inpatient hospital, and to develop multivariate forecasting models. Hourly data were collected from three diverse hospitals for the year 2006. Descriptive analysis and model fitting were carried out using graphical and multivariate time series methods. Multivariate models were compared to a univariate benchmark model in terms of their ability to provide out-of-sample forecasts of ED census and the demands for diagnostic resources. Descriptive analyses revealed little temporal interaction between the demand for inpatient resources and the demand for ED resources at the facilities considered. Multivariate models provided more accurate forecasts of ED census and of the demands for diagnostic resources. Our results suggest that multivariate time series models can be used to reliably forecast ED patient census; however, forecasts of the demands for diagnostic resources were not sufficiently reliable to be useful in the clinical setting.

Predicting frequent emergency department visits among children with asthma using EHR data.

PubMed

Das, Lala T; Abramson, Erika L; Stone, Anne E; Kondrich, Janienne E; Kern, Lisa M; Grinspan, Zachary M

2017-07-01

For children with asthma, emergency department (ED) visits are common, expensive, and often avoidable. Though several factors are associated with ED use (demographics, comorbidities, insurance, medications), its predictability using electronic health record (EHR) data is understudied. We used a retrospective cohort study design and EHR data from one center to examine the relationship of patient factors in 1 year (2013) and the likelihood of frequent ED use (≥2 visits) in the following year (2014), using bivariate and multivariable statistics. We applied and compared several machine-learning algorithms to predict frequent ED use, then selected a model based on accuracy, parsimony, and interpretability. We identified 2691 children. In bivariate analyses, future frequent ED use was associated with demographics, co-morbidities, insurance status, medication history, and use of healthcare resources. Machine learning algorithms had very good AUC (area under the curve) values [0.66-0.87], though fair PPV (positive predictive value) [48-70%] and poor sensitivity [16-27%]. Our final multivariable logistic regression model contained two variables: insurance status and prior ED use. For publicly insured patients, the odds of frequent ED use were 3.1 [2.2-4.5] times that of privately insured patients. Publicly insured patients with 4+ ED visits and privately insured patients with 6+ ED visits in a year had ≥50% probability of frequent ED use the following year. The model had an AUC of 0.86, PPV of 56%, and sensitivity of 23%. Among children with asthma, prior frequent ED use and insurance status strongly predict future ED use. © 2017 Wiley Periodicals, Inc.

Estimating the waiting time of multi-priority emergency patients with downstream blocking.

PubMed

Lin, Di; Patrick, Jonathan; Labeau, Fabrice

2014-03-01

To characterize the coupling effect between patient flow to access the emergency department (ED) and that to access the inpatient unit (IU), we develop a model with two connected queues: one upstream queue for the patient flow to access the ED and one downstream queue for the patient flow to access the IU. Building on this patient flow model, we employ queueing theory to estimate the average waiting time across patients. Using priority specific wait time targets, we further estimate the necessary number of ED and IU resources. Finally, we investigate how an alternative way of accessing ED (Fast Track) impacts the average waiting time of patients as well as the necessary number of ED/IU resources. This model as well as the analysis on patient flow can help the designer or manager of a hospital make decisions on the allocation of ED/IU resources in a hospital.

Antecedents of eating disorders and muscle dysmorphia in a non-clinical sample.

PubMed

Lamanna, J; Grieve, F G; Derryberry, W Pitt; Hakman, M; McClure, A

2010-01-01

Muscle Dysmorphia (MD) has recently been conceptualized as the male form of Eating Disorders (ED); although, it is not currently classified as an ED. The current study compares etiological models of MD symptomatology and ED symptomatology. It was hypothesized that sociocultural influences on appearance (SIA) would predict body dissatisfaction (BD), and that this relationship would be mediated by self-esteem (SE) and perfectionism (P); that BD would predict negative affect (NA); and that NA would predict MD and ED symptomatology. Two-hundred-forty-seven female and 101 male college students at a midsouth university completed the study. All participants completed measures assessing each of the constructs, and multiple regression analyses were conducted to test each model's fit. In both models, most predictor paths were significant. These results suggest similarity in symptomatology and etiological models between ED and MD.

Demography and the Evolution of Educational Inequality.

ERIC Educational Resources Information Center

Mare, Robert D.

The combined effects of differential fertility, differential mortality, and intergenerational educational mobility on the distribution of educational attainment in the United States were studied for women in the past half century. A simple model for the reproduction of educational hierarchies was used that takes these factors, plus age structure…

Regional analyses of labor markets and demography: a model based Norwegian example.

PubMed

Stambol, L S; Stolen, N M; Avitsland, T

1998-01-01

The authors discuss the regional REGARD model, developed by Statistics Norway to analyze the regional implications of macroeconomic development of employment, labor force, and unemployment. "In building the model, empirical analyses of regional producer behavior in manufacturing industries have been performed, and the relation between labor market development and regional migration has been investigated. Apart from providing a short description of the REGARD model, this article demonstrates the functioning of the model, and presents some results of an application." excerpt

78 FR 67103 - Request for Nominations of Members To Serve on the Census Scientific Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... analysis, survey methodology, geospatial analysis, econometrics, cognitive psychology, and computer science... following disciplines: demography, economics, geography, psychology, statistics, survey methodology, social... expertise in such areas as demography, economics, geography, psychology, statistics, survey methodology...

77 FR 1454 - Request for Nominations of Members To Serve on the Census Scientific Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-10

..., statistical analysis, survey methodology, geospatial analysis, econometrics, cognitive psychology, and... following disciplines: Demography, economics, geography, psychology, statistics, survey methodology, social... technical expertise in such areas as demography, economics, geography, psychology, statistics, survey...

Out-of-hours primary care. Implications of organisation on costs

PubMed Central

van Uden, Caro JT; Ament, Andre JHA; Voss, Gemma BWE; Wesseling, Geertjan; Winkens, Ron AG; van Schayck, Onno CP; Crebolder, Harry FJM

2006-01-01

Background To perform out-of-hours primary care, Dutch general practitioners (GPs) have organised themselves in large-scale GP cooperatives. Roughly, two models of out-of-hours care can be distinguished; GP cooperatives working separate from the hospital emergency department (ED) and GP cooperatives integrated with the hospital ED. Research has shown differences in care utilisation between these two models; a significant shift in the integrated model from utilisation of ED care to primary care. These differences may have implications on costs, however, until now this has not been investigated. This study was performed to provide insight in costs of these two different models of out-of-hours care. Methods Annual reports of two GP cooperatives (one separate from and one integrated with a hospital emergency department) in 2003 were analysed on costs and use of out-of-hours care. Costs were calculated per capita. Comparisons were made between the two cooperatives. In addition, a comparison was made between the costs of the hospital ED of the integrated model before and after the set up of the GP cooperative were analysed. Results Costs per capita of the GP cooperative in the integrated model were slightly higher than in the separate model (ε 11.47 and ε 10.54 respectively). Differences were mainly caused by personnel and other costs, including transportation, interest, cleaning, computers and overhead. Despite a significant reduction in patients utilising ED care as a result of the introduction of the GP cooperative integrated within the ED, the costs of the ED remained the same. Conclusion The study results show that the costs of primary care appear to be more dependent on the size of the population the cooperative covers than on the way the GP cooperative is organised, i.e. separated versus integrated. In addition, despite the substantial reduction of patients, locating the GP cooperative at the same site as the ED was found to have little effect on costs of the ED. Sharing more facilities and personnel between the ED and the GP cooperative may improve cost-efficiency. PMID:16674814

Out-of-hours primary care. Implications of organisation on costs.

PubMed

van Uden, Caro J T; Ament, Andre J H A; Voss, Gemma B W E; Wesseling, Geertjan; Winkens, Ron A G; van Schayck, Onno C P; Crebolder, Harry F J M

2006-05-04

To perform out-of-hours primary care, Dutch general practitioners (GPs) have organised themselves in large-scale GP cooperatives. Roughly, two models of out-of-hours care can be distinguished; GP cooperatives working separate from the hospital emergency department (ED) and GP cooperatives integrated with the hospital ED. Research has shown differences in care utilisation between these two models; a significant shift in the integrated model from utilisation of ED care to primary care. These differences may have implications on costs, however, until now this has not been investigated. This study was performed to provide insight in costs of these two different models of out-of-hours care. Annual reports of two GP cooperatives (one separate from and one integrated with a hospital emergency department) in 2003 were analysed on costs and use of out-of-hours care. Costs were calculated per capita. Comparisons were made between the two cooperatives. In addition, a comparison was made between the costs of the hospital ED of the integrated model before and after the set up of the GP cooperative were analysed. Costs per capita of the GP cooperative in the integrated model were slightly higher than in the separate model (epsilon 11.47 and epsilon 10.54 respectively). Differences were mainly caused by personnel and other costs, including transportation, interest, cleaning, computers and overhead. Despite a significant reduction in patients utilising ED care as a result of the introduction of the GP cooperative integrated within the ED, the costs of the ED remained the same. The study results show that the costs of primary care appear to be more dependent on the size of the population the cooperative covers than on the way the GP cooperative is organised, i.e. separated versus integrated. In addition, despite the substantial reduction of patients, locating the GP cooperative at the same site as the ED was found to have little effect on costs of the ED. Sharing more facilities and personnel between the ED and the GP cooperative may improve cost-efficiency.

Five easy equations for patient flow through an emergency department.

PubMed

Madsen, Thomas Lill; Kofoed-Enevoldsen, Allan

2011-10-01

Queue models are effective tools for framing management decisions and Danish hospitals could benefit from awareness of such models. Currently, as emergency departments (ED) are under reorganization, we deem it timely to empirically investigate the applicability of the standard "M/M/1" queue model in order to document its relevance. We compared actual versus theoretical distributions of hourly patient flow from 27,000 patient cases seen at Frederiksberg Hospital's ED. Formulating equations for arrivals and capacity, we wrote and tested a five equation simulation model. The Poisson distribution fitted arrivals with an hour-of-the-day specific parameter. Treatment times exceeding 15 minutes were well-described by an exponential distribution. The ED can be modelled as a black box with an hourly capacity that can be estimated either as admissions per hour when the ED operates full hilt Poisson distribution or from the linear dependency of waiting times on queue number. The results show that our ED capacity is surprisingly constant despite variations in staffing. These findings led to the formulation of a model giving a compact framework for assessing the behaviour of the ED under different assumptions about opening hours, capacity and workload. The M/M/1 almost perfectly fits our. Thus modeling and simulations have contributed to the management process. not relevant. not relevant.

Do dynamic global vegetation models capture the seasonality of carbon fluxes in the Amazon basin? A data-model intercomparison

DOE PAGES

Restrepo-Coupe, Natalia; Levine, Naomi M.; Christoffersen, Bradley O.; ...

2016-08-29

To predict forest response to long-term climate change with high confidence requires that dynamic global vegetation models (DGVMs) be successfully tested against ecosystem response to short-term variations in environmental drivers, including regular seasonal patterns. Here, we used an integrated dataset from four forests in the Brasil flux network, spanning a range of dry-season intensities and lengths, to determine how well four state-of-the-art models (IBIS, ED2, JULES, and CLM3.5) simulated the seasonality of carbon exchanges in Amazonian tropical forests. We found that most DGVMs poorly represented the annual cycle of gross primary productivity (GPP), of photosynthetic capacity (Pc), and of othermore » fluxes and pools. Models simulated consistent dry-season declines in GPP in the equatorial Amazon (Manaus K34, Santarem K67, and Caxiuanã CAX); a contrast to observed GPP increases. Model simulated dry-season GPP reductions were driven by an external environmental factor, ‘soil water stress’ and consequently by a constant or decreasing photosynthetic infrastructure (Pc), while observed dry-season GPP resulted from a combination of internal biological (leaf-flush and abscission and increased Pc) and environmental (incoming radiation) causes. Moreover, we found models generally overestimated observed seasonal net ecosystem exchange (NEE) and respiration (Re) at equatorial locations. In contrast, a southern Amazon forest (Jarú RJA) exhibited dry-season declines in GPP and Re consistent with most DGVMs simulations. While water limitation was represented in models and the primary driver of seasonal photosynthesis in southern Amazonia, changes in internal biophysical processes, light-harvesting adaptations (e.g., variations in leaf area index (LAI) and increasing leaf-level assimilation rate related to leaf demography), and allocation lags between leaf and wood, dominated equatorial Amazon carbon flux dynamics and were deficient or absent from current model formulations. In conclusion, correctly simulating flux seasonality at tropical forests requires a greater understanding and the incorporation of internal biophysical mechanisms in future model developments.« less

Do dynamic global vegetation models capture the seasonality of carbon fluxes in the Amazon basin? A data-model intercomparison

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

Restrepo-Coupe, Natalia; Levine, Naomi M.; Christoffersen, Bradley O.

To predict forest response to long-term climate change with high confidence requires that dynamic global vegetation models (DGVMs) be successfully tested against ecosystem response to short-term variations in environmental drivers, including regular seasonal patterns. Here, we used an integrated dataset from four forests in the Brasil flux network, spanning a range of dry-season intensities and lengths, to determine how well four state-of-the-art models (IBIS, ED2, JULES, and CLM3.5) simulated the seasonality of carbon exchanges in Amazonian tropical forests. We found that most DGVMs poorly represented the annual cycle of gross primary productivity (GPP), of photosynthetic capacity (Pc), and of othermore » fluxes and pools. Models simulated consistent dry-season declines in GPP in the equatorial Amazon (Manaus K34, Santarem K67, and Caxiuanã CAX); a contrast to observed GPP increases. Model simulated dry-season GPP reductions were driven by an external environmental factor, ‘soil water stress’ and consequently by a constant or decreasing photosynthetic infrastructure (Pc), while observed dry-season GPP resulted from a combination of internal biological (leaf-flush and abscission and increased Pc) and environmental (incoming radiation) causes. Moreover, we found models generally overestimated observed seasonal net ecosystem exchange (NEE) and respiration (Re) at equatorial locations. In contrast, a southern Amazon forest (Jarú RJA) exhibited dry-season declines in GPP and Re consistent with most DGVMs simulations. While water limitation was represented in models and the primary driver of seasonal photosynthesis in southern Amazonia, changes in internal biophysical processes, light-harvesting adaptations (e.g., variations in leaf area index (LAI) and increasing leaf-level assimilation rate related to leaf demography), and allocation lags between leaf and wood, dominated equatorial Amazon carbon flux dynamics and were deficient or absent from current model formulations. In conclusion, correctly simulating flux seasonality at tropical forests requires a greater understanding and the incorporation of internal biophysical mechanisms in future model developments.« less

Teaching Demography to Undergraduates: A Pedagogical Dilemma.

ERIC Educational Resources Information Center

Abowitz, Deborah A.

1990-01-01

Describes a course based on the interdisciplinary approach to demography linked to environmental issues. Analytic and interpretive skills are an integral element in the study of population-related problems. Points out that the interdisciplinary approach maintains demographic literacy while analyzing population problems. (SLM)

Application of time series analysis in modelling and forecasting emergency department visits in a medical centre in Southern Taiwan

PubMed Central

Juang, Wang-Chuan; Huang, Sin-Jhih; Huang, Fong-Dee; Cheng, Pei-Wen; Wann, Shue-Ren

2017-01-01

Objective Emergency department (ED) overcrowding is acknowledged as an increasingly important issue worldwide. Hospital managers are increasingly paying attention to ED crowding in order to provide higher quality medical services to patients. One of the crucial elements for a good management strategy is demand forecasting. Our study sought to construct an adequate model and to forecast monthly ED visits. Methods We retrospectively gathered monthly ED visits from January 2009 to December 2016 to carry out a time series autoregressive integrated moving average (ARIMA) analysis. Initial development of the model was based on past ED visits from 2009 to 2016. A best-fit model was further employed to forecast the monthly data of ED visits for the next year (2016). Finally, we evaluated the predicted accuracy of the identified model with the mean absolute percentage error (MAPE). The software packages SAS/ETS V.9.4 and Office Excel 2016 were used for all statistical analyses. Results A series of statistical tests showed that six models, including ARIMA (0, 0, 1), ARIMA (1, 0, 0), ARIMA (1, 0, 1), ARIMA (2, 0, 1), ARIMA (3, 0, 1) and ARIMA (5, 0, 1), were candidate models. The model that gave the minimum Akaike information criterion and Schwartz Bayesian criterion and followed the assumptions of residual independence was selected as the adequate model. Finally, a suitable ARIMA (0, 0, 1) structure, yielding a MAPE of 8.91%, was identified and obtained as Visitt=7111.161+(at+0.37462 at−1). Conclusion The ARIMA (0, 0, 1) model can be considered adequate for predicting future ED visits, and its forecast results can be used to aid decision-making processes. PMID:29196487

The Emergency Department: Challenges and Opportunities for Suicide Prevention.

PubMed

Asarnow, Joan Rosenbaum; Babeva, Kalina; Horstmann, Elizabeth

2017-10-01

Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives. Copyright © 2017 Elsevier Inc. All rights reserved.

Modelling seasonal variations in presentations at a paediatric emergency department.

PubMed

Takase, Miyuki; Carlin, John

2012-09-01

Overcrowding is a phenomenon commonly observed at emergency departments (EDs) in many hospitals, and negatively impacts patients, healthcare professionals and organisations. Health care organisations are expected to act proactively to cope with a high patient volume by understanding and predicting the patterns of ED presentations. The aim of this study was, therefore, to identify the patterns of patient flow at a paediatric ED in order to assist the management of EDs. Data for ED presentations were collected from the Royal Children's Hospital in Melbourne, Australia, with the time-frame of July 2003 to June 2008. A linear regression analysis with trigonometric functions was used to identify the pattern of patient flow at the ED. The results showed that a logarithm of the daily average ED presentations was increasing exponentially (as explained by 0.004t + 0.00005t2 with t representing time, p<0.001). The model also indicated that there was a yearly oscillation in the frequency of ED presentations, in which lower frequencies were observed in summer and higher frequencies during winter (as explained by -0.046 sin(2(pi)t/12)-0.083 cos(2(pi)t/12), p<0.001). In addition, the variation of the oscillations was increasing over time (as explained by -0.002t*sin(2(pi)t/12)-0.001t*cos(2(pi)t/12), p<0.05). The identified regression model explained a total of 96% of the variance in the pattern of ED presentations. This model can be used to understand the trend of the current patient flow as well as to predict the future flow at the ED. Such an understanding will assist health care managers to prepare resources and environment more effectively to cope with overcrowding.

Funding emergency care: Australian style.

PubMed

Bell, Anthony; Crilly, Julia; Williams, Ged; Wylie, Kate; Toloo, Ghasem Sam; Burke, John; FitzGerald, Gerry

2014-08-01

The ongoing challenge for ED leaders is to remain abreast of system-wide changes that impact on the day-to-day management of their departments. Changes to the funding model creates another layer of complexity and this introductory paper serves as the beginning of a discussion about the way in which EDs are funded and how this can and will impact on business decisions, models of care and resource allocation within Australian EDs. Furthermore it is evident that any funding model today will mature and change with time, and moves are afoot to refine and contextualise ED funding over the medium term. This perspective seeks to provide a basis of understanding for our current and future funding arrangements in Australian EDs. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The Independent Gradient Model: A New Approach for Probing Strong and Weak Interactions in Molecules from Wave Function Calculations.

PubMed

Lefebvre, Corentin; Khartabil, Hassan; Boisson, Jean-Charles; Contreras-García, Julia; Piquemal, Jean-Philip; Hénon, Eric

2018-03-19

Extraction of the chemical interaction signature from local descriptors based on electron density (ED) is still a fruitful field of development in chemical interpretation. In a previous work that used promolecular ED (frozen ED), the new descriptor, δg , was defined. It represents the difference between a virtual upper limit of the ED gradient (∇ρIGM , IGM=independent gradient model) that represents a noninteracting system and the true ED gradient (∇ρ ). It can be seen as a measure of electron sharing brought by ED contragradience. A compelling feature of this model is to provide an automatic workflow that extracts the signature of interactions between selected groups of atoms. As with the noncovalent interaction (NCI) approach, it provides chemists with a visual understanding of the interactions present in chemical systems. ∇ρIGM is achieved simply by using absolute values upon summing the individual gradient contributions that make up the total ED gradient. Hereby, we extend this model to relaxed ED calculated from a wave function. To this end, we formulated gradient-based partitioning (GBP) to assess the contribution of each orbital to the total ED gradient. We highlight these new possibilities across two prototypical examples of organic chemistry: the unconventional hexamethylbenzene dication, with a hexa-coordinated carbon atom, and β-thioaminoacrolein. It will be shown how a bond-by-bond picture can be obtained from a wave function, which opens the way to monitor specific interactions along reaction paths. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Forecasting daily patient volumes in the emergency department.

PubMed

Jones, Spencer S; Thomas, Alun; Evans, R Scott; Welch, Shari J; Haug, Peter J; Snow, Gregory L

2008-02-01

Shifts in the supply of and demand for emergency department (ED) resources make the efficient allocation of ED resources increasingly important. Forecasting is a vital activity that guides decision-making in many areas of economic, industrial, and scientific planning, but has gained little traction in the health care industry. There are few studies that explore the use of forecasting methods to predict patient volumes in the ED. The goals of this study are to explore and evaluate the use of several statistical forecasting methods to predict daily ED patient volumes at three diverse hospital EDs and to compare the accuracy of these methods to the accuracy of a previously proposed forecasting method. Daily patient arrivals at three hospital EDs were collected for the period January 1, 2005, through March 31, 2007. The authors evaluated the use of seasonal autoregressive integrated moving average, time series regression, exponential smoothing, and artificial neural network models to forecast daily patient volumes at each facility. Forecasts were made for horizons ranging from 1 to 30 days in advance. The forecast accuracy achieved by the various forecasting methods was compared to the forecast accuracy achieved when using a benchmark forecasting method already available in the emergency medicine literature. All time series methods considered in this analysis provided improved in-sample model goodness of fit. However, post-sample analysis revealed that time series regression models that augment linear regression models by accounting for serial autocorrelation offered only small improvements in terms of post-sample forecast accuracy, relative to multiple linear regression models, while seasonal autoregressive integrated moving average, exponential smoothing, and artificial neural network forecasting models did not provide consistently accurate forecasts of daily ED volumes. This study confirms the widely held belief that daily demand for ED services is characterized by seasonal and weekly patterns. The authors compared several time series forecasting methods to a benchmark multiple linear regression model. The results suggest that the existing methodology proposed in the literature, multiple linear regression based on calendar variables, is a reasonable approach to forecasting daily patient volumes in the ED. However, the authors conclude that regression-based models that incorporate calendar variables, account for site-specific special-day effects, and allow for residual autocorrelation provide a more appropriate, informative, and consistently accurate approach to forecasting daily ED patient volumes.

On the relative role of fire and rainfall in determining vegetation patterns in tropical savannas: a simulation study

NASA Astrophysics Data System (ADS)

Spessa, Allan; Fisher, Rosie

2010-05-01

Tropical savannas cover 18% of the world's land surface and are amongst the most productive terrestrial systems in the world. They comprise 15% of the total terrestrial carbon stock, with an estimated mean net primary productivity (NPP) of 7.2 tCha-1yr-1 or two thirds of NPP in tropical forests. Tropical savannas are the most frequently burnt biome, with fire return intervals in highly productive areas being typically 1-2 years. Fires shape vegetation species composition, tree to grass ratios and nutrient redistribution, as well as the biosphere-atmosphere exchange of trace gases, momentum and radiative energy. Tropical savannas are a major source of emissions, contributing 38 % of total annual CO2 from biomass burning, 30% CO, 19 % CH4 and 59 % NOx. Climatically, they occur in regions subject to a strongly seasonal ‘wet-dry' regime, usually under monsoonal control from the movement of the inter-tropical convergence zone. In general, rainfall during the prior wet season(s) determines the amount of grass fuel available for burning while the length of the dry season influences fuel moisture content. Rainfall in tropical savannas exhibits high inter-annual variability, and under future climate change, is projected to change significantly in much of Africa, South America and northern Australia. Process-based simulation models of fire-vegetation dynamics and feedbacks are critical for determining the impacts of wildfires under projected future climate change on i) ecosystem structure and function, and ii) emissions of trace gases and aerosols from biomass burning. A new mechanistic global fire model SPITFIRE (SPread and InTensity of FIRE) has been designed to overcome many of the limitations in existing fire models set within Dynamic Global Vegetation Models (DGVMs). SPITFIRE has been applied in coupled mode globally and southern Africa, both as part of the LPJ DGVM. It has also been driven with MODIS burnt area data applied to sub-Saharan Africa, while coupled to the LPJ-GUESS vegetation model. Recently, SPIFTIRE has been coupled to the Ecosystem Demography (ED) model, which simulates global vegetation dynamics as part of the new land surface scheme JULES (Joint UK Environment Simulator) within the QUEST Earth System Model (http://www.quest-esm.ac.uk/). This study forms part of on-going work to further improve and test the ability of JULES to accurately simulate the terrestrial carbon cycle and land-atmosphere exchanges under different climates. Using the JULES (ED-SPITFIRE) model driven by observed climate (1901-2002), and focusing on large-scale rainfall gradients in the tropical savannas of west Africa, the Northern Territory (Australia) and central-southern Brazil, this study assesses: i) simulated versus observed vegetation dynamics and distributions, and ii) the relative importance of fire versus rainfall in determining vegetation patterns. A sensitivity analysis approach was used.

"DEP'ART." Un Modele de Prevision des Departs des Enseignants. Documents Demographie Scolaire 9-16 ("DEP'ART." A Model for Predicting Teacher Attrition. Scholastic Demographic Document 9-16).

ERIC Educational Resources Information Center

Meublat, Guy

This document forms part of a research project initiated by the Ministry of Education in Quebec and designed to forecast teacher demand over the next 15 years. It analyzes the problem of identifying potential teacher dropouts by means of a statistical model which provides simulations of various hypotheses and which can be easily revised by the…

Chapter 8: Demographic characteristics and population modeling

Treesearch

Scott H. Stoleson; Mary J. Whitfield; Mark K. Sogge

2000-01-01

An understanding of the basic demography of a species is necessary to estimate and evaluate population trends. The relative impact of different demographic parameters on growth rates can be assessed through a sensitivity analysis, in which different parameters are altered singly to assess the effect on population growth. Identification of critical parameters can allow...

Comparison of emergency department crowding scores: a discrete-event simulation approach.

PubMed

Ahalt, Virginia; Argon, Nilay Tanık; Ziya, Serhan; Strickler, Jeff; Mehrotra, Abhi

2018-03-01

According to American College of Emergency Physicians, emergency department (ED) crowding occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. ED crowding is a widely reported problem and several crowding scores are proposed to quantify crowding using hospital and patient data as inputs for assisting healthcare professionals in anticipating imminent crowding problems. Using data from a large academic hospital in North Carolina, we evaluate three crowding scores, namely, EDWIN, NEDOCS, and READI by assessing strengths and weaknesses of each score, particularly their predictive power. We perform these evaluations by first building a discrete-event simulation model of the ED, validating the results of the simulation model against observations at the ED under consideration, and utilizing the model results to investigate each of the three ED crowding scores under normal operating conditions and under two simulated outbreak scenarios in the ED. We conclude that, for this hospital, both EDWIN and NEDOCS prove to be helpful measures of current ED crowdedness, and both scores demonstrate the ability to anticipate impending crowdedness. Utilizing both EDWIN and NEDOCS scores in combination with the threshold values proposed in this work could provide a real-time alert for clinicians to anticipate impending crowding, which could lead to better preparation and eventually better patient care outcomes.

Resilience in eating disorders: A qualitative study.

PubMed

Las Hayas, Carlota; Padierna, Jesús A; Muñoz, Pedro; Aguirre, Maialen; Gómez Del Barrio, Andrés; Beato-Fernández, Luís; Calvete, Esther

2016-07-01

The objectives of the authors in this study were two-fold: (1) to explore the role of resilience in recovery from eating disorders (EDs), and (2) to develop a model of resilience in women with EDs. Semi-structured interviews with ten women were conducted in April 2011, along with two focus groups with women who had recovered from EDs (n  = 5 women each; conducted in April 2012 at the University of Deusto, Spain), one focus group with clinical experts (n = 8; conducted in April 2012 at the Foundation Against EDs of Biskay, Spain), and six narratives from primary caregivers of ED patients living in Biskay, Spain (conducted in November 2012). All data were analyzed using a grounded theory approach. All female participants acknowledged experiencing resilience in their recovery. The analysis resulted in a conceptual model of resilience composed of the following categories: deep dissatisfaction with life, turning point, acceptance, hope, determination to change, accountability for the ED, active coping, getting social support, gaining self-knowledge, getting information about EDs, increase well-being, trait resilience, initiating new projects and living in the here and now. According to the model presented, resilience preceded the experience of recovery in women with EDs in this sample and could be a useful asset for future interventions.

Grass competition suppresses savanna tree growth across multiple demographic stages.

PubMed

Riginos, Corinna

2009-02-01

Savanna ecosystems, defined by the codominance of trees and grasses, cover one-fifth of the world's land surface and are of great socioeconomic and biological importance. Yet, the fundamental question of how trees and grasses coexist to maintain the savanna state remains poorly understood. Many models have been put forward to explain tree-grass coexistence, but nearly all have assumed that grasses do not limit tree growth and demography beyond the sapling stage. This assumption, however, has rarely been tested. Here I show that grass can strongly suppress the growth of trees. I removed grass around trees of three size classes in an Acacia drepanolobium savanna in Laikipia, Kenya. For even the largest trees, grass removal led to a doubling in growth and a doubling in the probability of transitioning to the next size class over two years. These results suggest that grass competition in productive (nutrient-rich) savannas may limit tree growth as much as herbivory and fire (the main factors thought to determine tree demography within a rainfall region) and should be incorporated into savanna models if tree-grass coexistence and savanna dynamics are to be understood.

Simulating an emergency department: the importance of modeling the interactions between physicians and delegates in a discrete event simulation.

PubMed

Lim, Morgan E; Worster, Andrew; Goeree, Ron; Tarride, Jean-Éric

2013-05-22

Computer simulation studies of the emergency department (ED) are often patient driven and consider the physician as a human resource whose primary activity is interacting directly with the patient. In many EDs, physicians supervise delegates such as residents, physician assistants and nurse practitioners each with different skill sets and levels of independence. The purpose of this study is to present an alternative approach where physicians and their delegates in the ED are modeled as interacting pseudo-agents in a discrete event simulation (DES) and to compare it with the traditional approach ignoring such interactions. The new approach models a hierarchy of heterogeneous interacting pseudo-agents in a DES, where pseudo-agents are entities with embedded decision logic. The pseudo-agents represent a physician and delegate, where the physician plays a senior role to the delegate (i.e. treats high acuity patients and acts as a consult for the delegate). A simple model without the complexity of the ED is first created in order to validate the building blocks (programming) used to create the pseudo-agents and their interaction (i.e. consultation). Following validation, the new approach is implemented in an ED model using data from an Ontario hospital. Outputs from this model are compared with outputs from the ED model without the interacting pseudo-agents. They are compared based on physician and delegate utilization, patient waiting time for treatment, and average length of stay. Additionally, we conduct sensitivity analyses on key parameters in the model. In the hospital ED model, comparisons between the approach with interaction and without showed physician utilization increase from 23% to 41% and delegate utilization increase from 56% to 71%. Results show statistically significant mean time differences for low acuity patients between models. Interaction time between physician and delegate results in increased ED length of stay and longer waits for beds. This example shows the importance of accurately modeling physician relationships and the roles in which they treat patients. Neglecting these relationships could lead to inefficient resource allocation due to inaccurate estimates of physician and delegate time spent on patient related activities and length of stay.

Changes in erectile dysfunction over time in relation to Framingham cardiovascular risk in the Boston Area Community Health (BACH) Survey.

PubMed

Fang, Shona C; Rosen, Raymond C; Vita, Joseph A; Ganz, Peter; Kupelian, Varant

2015-01-01

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear. The aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk. We studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/< 50 years). Framingham CVD risk and change in Framingham CVD risk were the main outcome measures. Transient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men <50 years, but not in older men. Data suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years. © 2014 International Society for Sexual Medicine.

Predictors of early survival in Soay sheep: cohort-, maternal- and individual-level variation

PubMed Central

Jones, Owen R; Crawley, Michael J; Pilkington, Jill G; Pemberton, Josephine M

2005-01-01

A demographic understanding of population dynamics requires an appreciation of the processes influencing survival—a demographic rate influenced by parameters varying at the individual, maternal and cohort level. There have been few attempts to partition the variance in demography contributed by each of these parameter types. Here, we use data from a feral population of Soay sheep (Ovis aries), from the island of St Kilda, to explore the relative importance of these parameter types on early survival. We demonstrate that the importance of variation occurring at the level of the individual, and maternally, far outweighs that occurring at the cohort level. The most important variables within the individual and maternal levels were birth weight and maternal age class, respectively. This work underlines the importance of using individual based models in ecological demography and we, therefore, caution against studies that focus solely on population processes. PMID:16321784

Unit Cohesion and the Surface Navy: Does Cohesion Affect Performance

DTIC Science & Technology

1989-12-01

v. 68, 1968. Neter, J., Wasserman, W., and Kutner, M. H., Applied Linear Regression Models, 2d ed., Boston, MA: Irwin, 1989. Rand Corporation R-2607...Neter, J., Wasserman, W., and Kutner, M. H., Applied Linear Regression Models, 2d ed., Boston, MA: Irwin, 1989. SAS User’s Guide: Basics, Version 5 ed

Changes in Male Rat Sexual Behavior and Brain Activity Revealed by Functional Magnetic Resonance Imaging in Response to Chronic Mild Stress.

PubMed

Chen, Guotao; Yang, Baibing; Chen, Jianhuai; Zhu, Leilei; Jiang, Hesong; Yu, Wen; Zang, Fengchao; Chen, Yun; Dai, Yutian

2018-02-01

Non-organic erectile dysfunction (noED) at functional imaging has been related to abnormal brain activity and requires animal models for further research on the associated molecular mechanisms. To develop a noED animal model based on chronic mild stress and investigate brain activity changes. We used 6 weeks of chronic mild stress to induce depression. The sucrose consumption test was used to assess the hedonic state. The apomorphine test and sexual behavior test were used to select male rats with ED. Rats with depression and ED were considered to have noED. Blood oxygen level-dependent-based resting-state functional magnetic resonance imaging (fMRI) studies were conducted on these rats, and the amplitude of low-frequency fluctuations and functional connectivity were analyzed to determine brain activity changes. The sexual behavior test and resting-state fMRI were used for outcome measures. The induction of depression was confirmed by the sucrose consumption test. A low intromission ratio and increased mount and intromission latencies were observed in male rats with depression. No erection was observed in male rats with depression during the apomorphine test. Male rats with depression and ED were considered to have noED. The possible central pathologic mechanism shown by fMRI involved the amygdaloid body, dorsal thalamus, hypothalamus, caudate-putamen, cingulate gyrus, insular cortex, visual cortex, sensory cortex, motor cortex, and cerebellum. Similar findings have been found in humans. The present study provided a novel noED rat model for further research on the central mechanism of noED. The present study developed a novel noED rat model and analyzed brain activity changes based at fMRI. The observed brain activity alterations might not extend to humans. The present study developed a novel noED rat model with brain activity alterations related to sexual arousal and erection, which will be helpful for further research involving the central mechanism of noED. Chen G, Yang B, Chen J, et al. Changes in Male Rat Sexual Behavior and Brain Activity Revealed by Functional Magnetic Resonance Imaging in Response to Chronic Mild Stress. J Sex Med 2018;15:136-147. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The unsafe haven: Eating disorders as attachment relationships.

PubMed

Forsén Mantilla, Emma; Clinton, David; Birgegård, Andreas

2018-05-21

Some patients with eating disorders (EDs) seem to experience their illness as an entity, a symbolic other to whom they relate, and which may influence both symptom levels and self-image. Extending previous research, this study investigated whether the patient-ED relationship has attachment qualities. Structural Analysis of Social Behaviour was used to operationalize the patient-ED relationship, and the Attachment Style Questionnaire was used to measure attachment. We examined ED patients' (N = 148) relationship with their ED, attachment behaviour, symptoms, and self-image. Attachment dimensions of Confidence, Anxious/ambivalence, and Avoidance were found to be significantly correlated with aspects of the patient-ED relationship. Introjection (i.e., whether ED actions were incorporated into patients' self-image) was investigated by examining the match between self-image profiles and the actions of patients' EDs. A double mediation model was tested in which ED control/emancipation and patients' Self-blame mediated the effect of attachment security on ED symptoms. Attachment insecurity was associated with greater ED control and patient submission. In 28.5% of patients, there was a high degree of correlation between self-image and ED action profile. Data supported the mediation model. Attachment processes appear to be associated with the manner in which ED patients relate to their disorder, at least in some cases. Attempts to maintain psychological proximity to the ED as an introjected attachment figure may help to explain treatment resistance and ambivalence about change. This perspective may be useful in treatment. Attachment behaviours are associated with the patient-ED relationship, in which attachment insecurity is correlated with greater eating disorder control and patient submission. Some patients seem to incorporate the actions of the ED in their self-image, suggesting the presence of introjection. The patient-ED relationship may help explain patients' anxiety and ambivalence about change, seen from an attachment perspective. In treatment, it may be important to explore alternative safe havens and secure bases to the ED, such as interpersonal relationships and activities. © 2018 The British Psychological Society.

Reconstructing the historic demography of an endangered seabird

Treesearch

Steven R. Beissinger; Zachariah M. Peery

2007-01-01

Reducing extinction risk for threatened species requires determining which demographic parameters are depressed and causing population declines. Museum collections may constitute a unique, underutilized resource for measuring demographic changes over long time periods using age-ratio analysis. We reconstruct the historic demography of a U.S. federally endangered...

Demography of Disadvantage in Tennessee.

ERIC Educational Resources Information Center

Jones, Lewis W., Comp.; And Others

In this report, demography conceptualizes significant characteristics to serve as a basis for more intensive study, planning, and procedures focusing on the target group. A compilation of the latest reports available and primarily tabular in form, identifies and locates Tennessee's disadvantaged people, ranking the 95 counties on each of 8…

Higher Education and Adult Demography.

ERIC Educational Resources Information Center

Brazziel, William F.

This paper examines the changing demographics of American society and the impact of these changes on higher education. Discussions include a historical background of early American demography, the building and expansion of the population base, and census changes through various generations of the baby boom years and beyond. Next, the report…

Diagnosing the dangerous demography of manta rays using life history theory.

PubMed

Dulvy, Nicholas K; Pardo, Sebastián A; Simpfendorfer, Colin A; Carlson, John K

2014-01-01

Background. The directed harvest and global trade in the gill plates of mantas, and devil rays, has led to increased fishing pressure and steep population declines in some locations. The slow life history, particularly of the manta rays, is cited as a key reason why such species have little capacity to withstand directed fisheries. Here, we place their life history and demography within the context of other sharks and rays. Methods. Despite the limited availability of data, we use life history theory and comparative analysis to estimate the intrinsic risk of extinction (as indexed by the maximum intrinsic rate of population increase r max) for a typical generic manta ray using a variant of the classic Euler-Lotka demographic model. This model requires only three traits to calculate the maximum intrinsic population growth rate r max: von Bertalanffy growth rate, annual pup production and age at maturity. To account for the uncertainty in life history parameters, we created plausible parameter ranges and propagate these uncertainties through the model to calculate a distribution of the plausible range of r max values. Results. The maximum population growth rate r max of manta ray is most sensitive to the length of the reproductive cycle, and the median r max of 0.116 year(-1) 95th percentile [0.089-0.139] is one of the lowest known of the 106 sharks and rays for which we have comparable demographic information. Discussion. In common with other unprotected, unmanaged, high-value large-bodied sharks and rays the combination of very low population growth rates of manta rays, combined with the high value of their gill rakers and the international nature of trade, is highly likely to lead to rapid depletion and potential local extinction unless a rapid conservation management response occurs worldwide. Furthermore, we show that it is possible to derive important insights into the demography extinction risk of data-poor species using well-established life history theory.

The Impact of Population Demography and Selection on the Genetic Architecture of Complex Traits

PubMed Central

Lohmueller, Kirk E.

2014-01-01

Population genetic studies have found evidence for dramatic population growth in recent human history. It is unclear how this recent population growth, combined with the effects of negative natural selection, has affected patterns of deleterious variation, as well as the number, frequency, and effect sizes of mutations that contribute risk to complex traits. Because researchers are performing exome sequencing studies aimed at uncovering the role of low-frequency variants in the risk of complex traits, this topic is of critical importance. Here I use simulations under population genetic models where a proportion of the heritability of the trait is accounted for by mutations in a subset of the exome. I show that recent population growth increases the proportion of nonsynonymous variants segregating in the population, but does not affect the genetic load relative to a population that did not expand. Under a model where a mutation's effect on a trait is correlated with its effect on fitness, rare variants explain a greater portion of the additive genetic variance of the trait in a population that has recently expanded than in a population that did not recently expand. Further, when using a single-marker test, for a given false-positive rate and sample size, recent population growth decreases the expected number of significant associations with the trait relative to the number detected in a population that did not expand. However, in a model where there is no correlation between a mutation's effect on fitness and the effect on the trait, common variants account for much of the additive genetic variance, regardless of demography. Moreover, here demography does not affect the number of significant associations detected. These findings suggest recent population history may be an important factor influencing the power of association tests and in accounting for the missing heritability of certain complex traits. PMID:24875776

Diagnosing the dangerous demography of manta rays using life history theory

PubMed Central

Pardo, Sebastián A.; Simpfendorfer, Colin A.; Carlson, John K.

2014-01-01

Background. The directed harvest and global trade in the gill plates of mantas, and devil rays, has led to increased fishing pressure and steep population declines in some locations. The slow life history, particularly of the manta rays, is cited as a key reason why such species have little capacity to withstand directed fisheries. Here, we place their life history and demography within the context of other sharks and rays. Methods. Despite the limited availability of data, we use life history theory and comparative analysis to estimate the intrinsic risk of extinction (as indexed by the maximum intrinsic rate of population increase rmax) for a typical generic manta ray using a variant of the classic Euler–Lotka demographic model. This model requires only three traits to calculate the maximum intrinsic population growth rate rmax: von Bertalanffy growth rate, annual pup production and age at maturity. To account for the uncertainty in life history parameters, we created plausible parameter ranges and propagate these uncertainties through the model to calculate a distribution of the plausible range of rmax values. Results. The maximum population growth rate rmax of manta ray is most sensitive to the length of the reproductive cycle, and the median rmax of 0.116 year−1 95th percentile [0.089–0.139] is one of the lowest known of the 106 sharks and rays for which we have comparable demographic information. Discussion. In common with other unprotected, unmanaged, high-value large-bodied sharks and rays the combination of very low population growth rates of manta rays, combined with the high value of their gill rakers and the international nature of trade, is highly likely to lead to rapid depletion and potential local extinction unless a rapid conservation management response occurs worldwide. Furthermore, we show that it is possible to derive important insights into the demography extinction risk of data-poor species using well-established life history theory. PMID:24918029

A Spatial Poisson Hurdle Model for Exploring Geographic Variation in Emergency Department Visits

PubMed Central

Neelon, Brian; Ghosh, Pulak; Loebs, Patrick F.

2012-01-01

Summary We develop a spatial Poisson hurdle model to explore geographic variation in emergency department (ED) visits while accounting for zero inflation. The model consists of two components: a Bernoulli component that models the probability of any ED use (i.e., at least one ED visit per year), and a truncated Poisson component that models the number of ED visits given use. Together, these components address both the abundance of zeros and the right-skewed nature of the nonzero counts. The model has a hierarchical structure that incorporates patient- and area-level covariates, as well as spatially correlated random effects for each areal unit. Because regions with high rates of ED use are likely to have high expected counts among users, we model the spatial random effects via a bivariate conditionally autoregressive (CAR) prior, which introduces dependence between the components and provides spatial smoothing and sharing of information across neighboring regions. Using a simulation study, we show that modeling the between-component correlation reduces bias in parameter estimates. We adopt a Bayesian estimation approach, and the model can be fit using standard Bayesian software. We apply the model to a study of patient and neighborhood factors influencing emergency department use in Durham County, North Carolina. PMID:23543242

Borrowing yet another technique from manufacturing, investigators find that 'operational flexibility' can offer dividends to ED operations.

PubMed

2015-03-01

Through the use of a sophisticated modeling technique, investigators at the University of Cincinnati have found that the creation of a so-called "flex track" that includes beds that can be assigned to either high-acuity or Iow-acuity- patients has the potential to lower mean wait times for patients when it is i added to the traditional fast-track and high-acuity areas of a 50-bed ED that sees 85,000 patients per year. Investigators used discrete-event simulation to model the patient flow and characteristics of the ED at the University of Cincinnati Medical Center, and to test out various operational scenarios without disrupting real-world operations. The investigators concluded that patient wait times were lowest when three flex beds were appropriated from the 10-bed fast track area of the EDs. In light of the results, three flex rooms are being incorporated into a newly remodeled ED scheduled for completion laterthis spring. Investigators suggest the modeling technique could be useful to other EDs interested in optimizing their operational plans. Further, they suggest that ED administrators consider ways to introduce flexibility into departments that are now more rigidly divided between high- and low-acuity areas.

Emergency Department Telepsychiatry Service Model for a Rural Regional Health System: The First Steps.

PubMed

Meyer, James D; McKean, Alastair J S; Blegen, Rebecca N; Demaerschalk, Bart M

2018-05-09

Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation. Dedicated beds to MH range from zero (in EDs with only 3 beds) to 6 (in an ED with 38 beds). We conducted a needs assessment of this health system. This included a survey of emergency room providers with a 67% response rate and site visits to directly observe patient flow and communication with ED staff. A visioning workshop provided input from ED staff. Data were also obtained, which reflected ED admissions for the year 2015. The data provide a summary of provider concerns, a summary of MH presentations and diagnosis, and age groupings. The data also provide a time when most MH concerns present to the ED. Based upon these results, a proposed model for delivering comprehensive regional emergency telepsychiatry and behavioral health services is proposed. Emergency telepsychiatry services may be a tenable solution for addressing the shortage of psychiatric consultation to EDs in light of increasing demand for MH treatment in the ED.

Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

PubMed Central

Sharp, Brian R.; Sharp, Kristen M.; Patterson, Brian; Dooley-Hash, Suzanne

2016-01-01

Introduction Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06–1.61]), high parity (OR 1.50 95% CI [1.12–2.00]), and early gestational age (OR 0.74 95% CI [0.60–0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59–0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002). Conclusion NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition. PMID:27625723

Optimizing patient/caregiver satisfaction through quality of communication in the pediatric emergency department.

PubMed

Locke, Robert; Stefano, Mariane; Koster, Alex; Taylor, Beth; Greenspan, Jay

2011-11-01

Optimizing patient/family caregiver satisfaction with emergency department (ED) encounters has advantages for improving patient health outcomes, adherence with medical plans, patient rights, and shared participation in care, provider satisfaction, improved health economics, institutional market share, and liability reduction. The variables that contribute to an optimal outcome in the pediatric ED setting have been less well investigated. The specific hypothesis tested was that patient/family caregiver-provider communication and 24-hour postdischarge phone contact would be associated with an increased frequency of highest possible satisfaction scores. A consecutive set of Press Ganey satisfaction survey responses between June and December 2009 in a large tertiary referral pediatric ED was evaluated. Press Ganey responses were subsequently linked to defined components of the electronic medical record associated with each survey respondent's ED visit to ascertain specific objective ED data. Multivariate modeling utilizing generalized linear equations was achieved to obtain a composite model of drivers of patient/caregiver satisfaction. Primary drivers of satisfaction and willingness to return or refer others to the ED were as follows: being informed about delays, ease of the insurance process, overall physician rating, registered nurse attention to needs, control of pain, and successful completion of postdischarge phone call to a family caregiver. Multiple wait time variables that were statistically significant in univariate modeling, including total length of time in the ED, time in waiting room, comfort of waiting room, time in treatment room, and play items, were not statistically significant once controlling for the other variables in the model. Type of insurance, race, patient age, or time of year did not influence the models. Achieving optimal patient/caregiver satisfaction scores in the pediatric ED is highly dependent on the quality of the interpersonal interaction and communication of ED activities. Wait time and other throughput variables are less important than perceived quality of the health interaction and interpersonal communication. Patient satisfaction has advantages greater than market share and should be considered a component of the care-delivery paradigm.

Application of time series analysis in modelling and forecasting emergency department visits in a medical centre in Southern Taiwan.

PubMed

Juang, Wang-Chuan; Huang, Sin-Jhih; Huang, Fong-Dee; Cheng, Pei-Wen; Wann, Shue-Ren

2017-12-01

Emergency department (ED) overcrowding is acknowledged as an increasingly important issue worldwide. Hospital managers are increasingly paying attention to ED crowding in order to provide higher quality medical services to patients. One of the crucial elements for a good management strategy is demand forecasting. Our study sought to construct an adequate model and to forecast monthly ED visits. We retrospectively gathered monthly ED visits from January 2009 to December 2016 to carry out a time series autoregressive integrated moving average (ARIMA) analysis. Initial development of the model was based on past ED visits from 2009 to 2016. A best-fit model was further employed to forecast the monthly data of ED visits for the next year (2016). Finally, we evaluated the predicted accuracy of the identified model with the mean absolute percentage error (MAPE). The software packages SAS/ETS V.9.4 and Office Excel 2016 were used for all statistical analyses. A series of statistical tests showed that six models, including ARIMA (0, 0, 1), ARIMA (1, 0, 0), ARIMA (1, 0, 1), ARIMA (2, 0, 1), ARIMA (3, 0, 1) and ARIMA (5, 0, 1), were candidate models. The model that gave the minimum Akaike information criterion and Schwartz Bayesian criterion and followed the assumptions of residual independence was selected as the adequate model. Finally, a suitable ARIMA (0, 0, 1) structure, yielding a MAPE of 8.91%, was identified and obtained as Visit t =7111.161+(a t +0.37462 a t -1). The ARIMA (0, 0, 1) model can be considered adequate for predicting future ED visits, and its forecast results can be used to aid decision-making processes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Integrated Canada-U.S. Power Sector Modeling with the Regional Energy Deployment System (ReEDS)

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

Martinez, A.; Eurek, K.; Mai, T.

2013-02-01

The electric power system in North America is linked between the United States and Canada. Canada has historically been a net exporter of electricity to the United States. The extent to which this remains true will depend on the future evolution of power markets, technology deployment, and policies. To evaluate these and related questions, we modify the Regional Energy Deployment System (ReEDS) model to include an explicit representation of the grid-connected power system in Canada to the continental United States. ReEDS is unique among long-term capacity expansion models for its high spatial resolution and statistical treatment of the impact ofmore » variable renewable generation on capacity planning and dispatch. These unique traits are extended to new Canadian regions. We present example scenario results using the fully integrated Canada-U.S. version of ReEDS to demonstrate model capabilities. The newly developed, integrated Canada-U.S. ReEDS model can be used to analyze the dynamics of electricity transfers and other grid services between the two countries under different scenarios.« less

The association of weather on pediatric emergency department visits in Changwon, Korea (2005-2014).

PubMed

Lee, Hae Jeong; Jin, Mi Hyeon; Lee, Jun Hwa

2016-05-01

It is widely believed that patients are less likely to visit hospitals during bad weather. We hypothesized that weather and emergency department (ED) visits are associated. Thus, we investigated the association between pediatric ED visits and weather, and sought to determine whether admissions to the ED are affected by meteorological factors. We retrospectively analyzed all 87,242 emergency visits to Samsung Changwon Hospital by pediatric patients under 19years of age from January 2005 to December 2014. ED visits were categorized by disease. We used Poisson regression and generalized linear model to examine the relationships between current weather and ED visits. Additionally a distributed lag non-linear model was used to investigate the effect of weather on ED visits. During this 10-year study period, the average temperature and diurnal temperature range (DTR) were 14.7°C and 8.2°C, respectively. There were 1,145days of rain or snow (31.4%) during the 3,652-day study period. The volume of ED visits decreased on days of rain or snow. Additionally ED visits increased 2days after rainy or snowy days. The volume of ED visits increased 1.013 times with every 1°C increase in DTR. The volume of ED visits by patients with trauma, digestive diseases, and respiratory diseases increased when DTR was over 10°C. As rainfall increased to over 25mm, the ward admission rate (23.8%, p=0.018) of ED patients increased significantly. The volume of ED visits decreased on days of rain or snow and the ED visits were increased 2days after rainy or snowy days. The volume of ED visits increased for every 1°C increase in DTR. Copyright © 2016. Published by Elsevier B.V.

Serotonin transporter gene polymorphism in eating disorders: Data from a new biobank and META-analysis of previous studies.

PubMed

Solmi, M; Gallicchio, D; Collantoni, E; Correll, C U; Clementi, M; Pinato, C; Forzan, M; Cassina, M; Fontana, F; Giannunzio, V; Piva, I; Siani, R; Salvo, P; Santonastaso, P; Tenconi, E; Veronese, N; Favaro, A

2016-06-01

Objectives Growing interest focuses on the association between 5-HTTLPR polymorphism and eating disorders (ED), but published findings have been conflicting. Methods The Italian BIO.VE.D.A. biobank provided 976 samples (735 ED patients and 241 controls) for genotyping. We conducted a literature search of studies published up to 1 April 2015, including studies reporting on 5HTTLPR genotype and allele frequencies in obesity and/or ED. We ran a meta-analysis, including data from BIO.VE.D.A. - comparing low and high-functioning genotype and allele frequencies in ED vs. Results Data from 21 studies, plus BIO.VE.D.A., were extracted providing information from 3,736 patients and 2,707 controls. Neither low- nor high-functioning genotype frequencies in ED patients, with both bi- and tri-allelic models, differed from controls. Furthermore, neither low- nor high-functioning allele frequencies in ED or in BN, in both bi- and triallelic models, differed from control groups. After sensitivity analysis, results were the same in AN vs. Results remained unaltered when investigating recessive and dominant models. Conclusions 5HTTLPR does not seem to be associated with ED in general, or with AN or BN in particular. Future studies in ED should explore the role of ethnicity and psychiatric comorbidity as a possible source of bias.

Demography of northern flying squirrels informs ecosystem management of western interior forests.

Treesearch

John F. Lehmkuhl; Keith D. Kistler; James S. Begley; John. Boulanger

2006-01-01

We studied northern flying squirrel (Glaucomys sabrinus) demography in the eastern Washington Cascade Range to test hypotheses about regional and local abundance patterns and to inform managers of the possible effects of fire and fuels management on flying squirrels. We quantified habitat characteristics and squirrel density, population trends, and...

Presentations to Alberta emergency departments for asthma: a time series analysis.

PubMed

Rosychuk, Rhonda J; Youngson, Erik; Rowe, Brian H

2015-08-01

Asthma is a common chronic respiratory condition, and exacerbations may cause individuals to seek care in emergency departments (EDs). This study examines the monthly patterns of asthma presentations to EDs in Alberta, Canada. All presentations to the ED for asthma from April 1999 to March 2011 were extracted from provincial administrative health databases. Data included age, sex, and health zone of residence. Crude rates per 100,000 population were calculated. Seasonal autoregressive integrated moving average (SARIMA) time-series models were developed. There were a total of 362,430 ED presentations for asthma, and the monthly rate of presentation declined from 115.5 to 41.6 per 100,000 during the study period. Males made 50.1% of ED presentations, and adults made 52.8%. The absolute number of ED presentations for asthma declined in each of the five administrative health zones in the province, with smaller percentage decreases seen in the most urbanized zones (32.1%) than the other zones (46.9%). One SARIMA model closely predicted overall presentation rates as well as the rates of ED presentations for age and zone subgroups. These models showed strong seasonal components, with the strongest estimates occurring for the pediatric subgroup and the southernmost provincial zone. Rates of ED presentations for asthma have been declining in this province during the past decade. The reasons for this decline warrant further exploration. The SARIMA models quantified the temporal patterns and may be helpful for planning research and health care service needs. © 2015 by the Society for Academic Emergency Medicine.

Hydrology and density feedbacks control the ecology of intermediate hosts of schistosomiasis across habitats in seasonal climates

PubMed Central

Perez-Saez, Javier; Mande, Theophile; Ceperley, Natalie; Bertuzzo, Enrico; Mari, Lorenzo; Rinaldo, Andrea

2016-01-01

We report about field and theoretical studies on the ecology of the aquatic snails (Bulinus spp. and Biomphalaria pfeifferi) that serve as obligate intermediate hosts in the complex life cycle of the parasites causing human schistosomiasis. Snail abundance fosters disease transmission, and thus the dynamics of snail populations are critically important for schistosomiasis modeling and control. Here, we single out hydrological drivers and density dependence (or lack of it) of ecological growth rates of local snail populations by contrasting novel ecological and environmental data with various models of host demography. Specifically, we study various natural and man-made habitats across Burkina Faso’s highly seasonal climatic zones. Demographic models are ranked through formal model comparison and structural risk minimization. The latter allows us to evaluate the suitability of population models while clarifying the relevant covariates that explain empirical observations of snail abundance under the actual climatic forcings experienced by the various field sites. Our results link quantitatively hydrological drivers to distinct population dynamics through specific density feedbacks, and show that statistical methods based on model averaging provide reliable snail abundance projections. The consistency of our ranking results suggests the use of ad hoc models of snail demography depending on habitat type (e.g., natural vs. man-made) and hydrological characteristics (e.g., ephemeral vs. permanent). Implications for risk mapping and space-time allocation of control measures in schistosomiasis-endemic contexts are discussed. PMID:27162339

Hydrology and density feedbacks control the ecology of intermediate hosts of schistosomiasis across habitats in seasonal climates.

PubMed

Perez-Saez, Javier; Mande, Theophile; Ceperley, Natalie; Bertuzzo, Enrico; Mari, Lorenzo; Gatto, Marino; Rinaldo, Andrea

2016-06-07

We report about field and theoretical studies on the ecology of the aquatic snails (Bulinus spp. and Biomphalaria pfeifferi) that serve as obligate intermediate hosts in the complex life cycle of the parasites causing human schistosomiasis. Snail abundance fosters disease transmission, and thus the dynamics of snail populations are critically important for schistosomiasis modeling and control. Here, we single out hydrological drivers and density dependence (or lack of it) of ecological growth rates of local snail populations by contrasting novel ecological and environmental data with various models of host demography. Specifically, we study various natural and man-made habitats across Burkina Faso's highly seasonal climatic zones. Demographic models are ranked through formal model comparison and structural risk minimization. The latter allows us to evaluate the suitability of population models while clarifying the relevant covariates that explain empirical observations of snail abundance under the actual climatic forcings experienced by the various field sites. Our results link quantitatively hydrological drivers to distinct population dynamics through specific density feedbacks, and show that statistical methods based on model averaging provide reliable snail abundance projections. The consistency of our ranking results suggests the use of ad hoc models of snail demography depending on habitat type (e.g., natural vs. man-made) and hydrological characteristics (e.g., ephemeral vs. permanent). Implications for risk mapping and space-time allocation of control measures in schistosomiasis-endemic contexts are discussed.

Long-term change in a behavioural trait: truncated spawning distribution and demography in Northeast Arctic cod

PubMed Central

Opdal, Anders Frugård; Jørgensen, Christian

2015-01-01

Harvesting may be a potent driver of demographic change and contemporary evolution, which both may have great impacts on animal populations. Research has focused on changes in phenotypic traits that are easily quantifiable and for which time series exist, such as size, age, sex, or gonad size, whereas potential changes in behavioural traits have been under-studied. Here, we analyse potential drivers of long-term changes in a behavioural trait for the Northeast Arctic stock of Atlantic cod Gadus morhua, namely choice of spawning location. For 104 years (1866–1969), commercial catches were recorded annually and reported by county along the Norwegian coast. During this time period, spawning ground distribution has fluctuated with a trend towards more northerly spawning. Spawning location is analysed against a suite of explanatory factors including climate, fishing pressure, density dependence, and demography. We find that demography (age or age at maturation) had the highest explanatory power for variation in spawning location, while climate had a limited effect below statistical significance. As to potential mechanisms, some effects of climate may act through demography, and explanatory variables for demography may also have absorbed direct evolutionary change in migration distance for which proxies were unavailable. Despite these caveats, we argue that fishing mortality, either through demographic or evolutionary change, has served as an effective driver for changing spawning locations in cod, and that additional explanatory factors related to climate add no significant information. PMID:25336028

Reinventing Emergency Department Flow via Healthcare Delivery Science.

PubMed

DeFlitch, Christopher; Geeting, Glenn; Paz, Harold L

2015-01-01

Healthcare system flow resulting in emergency departments (EDs) crowding is a quality and access problem. This case study examines an overcrowded academic health center ED with increasing patient volumes and limited physical space for expansion. ED capacity and efficiency improved via engineering principles application, addressing patient and staffing flows, and reinventing the delivery model. Using operational data and staff input, patient and staff flow models were created, identifying bottlenecks (points of inefficiency). A new flow model of emergency care delivery, physician-directed queuing, was developed. Expanding upon physicians in triage, providers passively evaluate all patients upon arrival, actively manage patients requiring fewer resources, and direct patients requiring complex resources to further evaluation in ED areas. Sustained over time, ED efficiency improved as measured by near elimination of "left without being seen" patients and waiting times with improvement in door to doctor, patient satisfaction, and total length of stay. All improvements were in the setting on increased patient volume and no increase in physician staffing. Our experience suggests that practical application of healthcare delivery science can be used to improve ED efficiency. © The Author(s) 2015.

Modelling climate change responses in tropical forests: similar productivity estimates across five models, but different mechanisms and responses

NASA Astrophysics Data System (ADS)

Rowland, L.; Harper, A.; Christoffersen, B. O.; Galbraith, D. R.; Imbuzeiro, H. M. A.; Powell, T. L.; Doughty, C.; Levine, N. M.; Malhi, Y.; Saleska, S. R.; Moorcroft, P. R.; Meir, P.; Williams, M.

2015-04-01

Accurately predicting the response of Amazonia to climate change is important for predicting climate change across the globe. Changes in multiple climatic factors simultaneously result in complex non-linear ecosystem responses, which are difficult to predict using vegetation models. Using leaf- and canopy-scale observations, this study evaluated the capability of five vegetation models (Community Land Model version 3.5 coupled to the Dynamic Global Vegetation model - CLM3.5-DGVM; Ecosystem Demography model version 2 - ED2; the Joint UK Land Environment Simulator version 2.1 - JULES; Simple Biosphere model version 3 - SiB3; and the soil-plant-atmosphere model - SPA) to simulate the responses of leaf- and canopy-scale productivity to changes in temperature and drought in an Amazonian forest. The models did not agree as to whether gross primary productivity (GPP) was more sensitive to changes in temperature or precipitation, but all the models were consistent with the prediction that GPP would be higher if tropical forests were 5 °C cooler than current ambient temperatures. There was greater model-data consistency in the response of net ecosystem exchange (NEE) to changes in temperature than in the response to temperature by net photosynthesis (An), stomatal conductance (gs) and leaf area index (LAI). Modelled canopy-scale fluxes are calculated by scaling leaf-scale fluxes using LAI. At the leaf-scale, the models did not agree on the temperature or magnitude of the optimum points of An, Vcmax or gs, and model variation in these parameters was compensated for by variations in the absolute magnitude of simulated LAI and how it altered with temperature. Across the models, there was, however, consistency in two leaf-scale responses: (1) change in An with temperature was more closely linked to stomatal behaviour than biochemical processes; and (2) intrinsic water use efficiency (IWUE) increased with temperature, especially when combined with drought. These results suggest that even up to fairly extreme temperature increases from ambient levels (+6 °C), simulated photosynthesis becomes increasingly sensitive to gs and remains less sensitive to biochemical changes. To improve the reliability of simulations of the response of Amazonian rainforest to climate change, the mechanistic underpinnings of vegetation models need to be validated at both leaf- and canopy-scales to improve accuracy and consistency in the quantification of processes within and across an ecosystem.

Bringing a Realistic Global Climate Modeling Experience to a Broader Audience

NASA Astrophysics Data System (ADS)

Sohl, L. E.; Chandler, M. A.; Zhou, J.

2010-12-01

EdGCM, the Educational Global Climate Model, was developed with the goal of helping students learn about climate change and climate modeling by giving them the ability to run a genuine NASA global climate model (GCM) on a desktop computer. Since EdGCM was first publicly released in January 2005, tens of thousands of users on seven continents have downloaded the software. EdGCM has been utilized by climate science educators from middle school through graduate school levels, and on occasion even by researchers who otherwise do not have ready access to climate model at national labs in the U.S. and elsewhere. The EdGCM software is designed to walk users through the same process a climate scientist would use in designing and running simulations, and analyzing and visualizing GCM output. Although the current interface design gives users a clear view of some of the complexities involved in using a climate model, it can be daunting for users whose main focus is on climate science rather than modeling per se. As part of the work funded by NASA’s Global Climate Change Education (GCCE) program, we will begin modifications to the user interface that will improve the accessibility of EdGCM to a wider array of users, especially at the middle school and high school levels, by: 1) Developing an automated approach (a “wizard”) to simplify the user experience in setting up new climate simulations; 2) Produce a catalog of “rediscovery experiments” that allow users to reproduce published climate model results, and in some cases compare model projections to real world data; and 3) Enhance distance learning and online learning opportunities through the development of a web-based interface. The prototypes for these modifications will then be presented to educators belonging to an EdGCM Users Group for feedback, so that we can further refine the EdGCM software, and thus deliver the tools and materials educators want and need across a wider range of learning environments.

Spatial structure and nest demography reveal the influence of competition, parasitism and habitat quality on slavemaking ants and their hosts

PubMed Central

2011-01-01

Background Natural communities are structured by intra-guild competition, predation or parasitism and the abiotic environment. We studied the relative importance of these factors in two host-social parasite ecosystems in three ant communities in Europe (Bavaria) and North America (New York, West Virginia). We tested how these factors affect colony demography, life-history and the spatial pattern of colonies, using a large sample size of more than 1000 colonies. The strength of competition was measured by the distance to the nearest competitor. Distance to the closest social parasite colony was used as a measure of parasitism risk. Nest sites (i.e., sticks or acorns) are limited in these forest ecosystems and we therefore included nest site quality as an abiotic factor in the analysis. In contrast to previous studies based on local densities, we focus here on the positioning and spatial patterns and we use models to compare our predictions to random expectations. Results Colony demography was universally affected by the size of the nest site with larger and more productive colonies residing in larger nest sites of higher quality. Distance to the nearest competitor negatively influenced host demography and brood production in the Bavarian community, pointing to an important role of competition, while social parasitism was less influential in this community. The New York community was characterized by the highest habitat variability, and productive colonies were clustered in sites of higher quality. Colonies were clumped on finer spatial scales, when we considered only the nearest neighbors, but more regularly distributed on coarser scales. The analysis of spatial positioning within plots often produced different results compared to those based on colony densities. For example, while host and slavemaker densities are often positively correlated, slavemakers do not nest closer to potential host colonies than expected by random. Conclusions The three communities are differently affected by biotic and abiotic factors. Some of the differences can be attributed to habitat differences and some to differences between the two slavemaking-host ecosystems. The strong effect of competition in the Bavarian community points to the scarcity of resources in this uniform habitat compared to the other more diverse sites. The decrease in colony aggregation with scale indicates fine-scale resource hotspots: colonies are locally aggregated in small groups. Our study demonstrates that species relationships vary across scales and spatial patterns can provide important insights into species interactions. These results could not have been obtained with analyses based on local densities alone. Previous studies focused on social parasitism and its effect on host colonies. The broader approach taken here, considering several possible factors affecting colony demography and not testing each one in isolation, shows that competition and environmental variability can have a similar strong impact on demography and life-history of hosts. We conclude that the effects of parasites or predators should be studied in parallel to other ecological influences. PMID:21443778

Spatial structure and nest demography reveal the influence of competition, parasitism and habitat quality on slavemaking ants and their hosts.

PubMed

Scharf, Inon; Fischer-Blass, Birgit; Foitzik, Susanne

2011-03-28

Natural communities are structured by intra-guild competition, predation or parasitism and the abiotic environment. We studied the relative importance of these factors in two host-social parasite ecosystems in three ant communities in Europe (Bavaria) and North America (New York, West Virginia). We tested how these factors affect colony demography, life-history and the spatial pattern of colonies, using a large sample size of more than 1000 colonies. The strength of competition was measured by the distance to the nearest competitor. Distance to the closest social parasite colony was used as a measure of parasitism risk. Nest sites (i.e., sticks or acorns) are limited in these forest ecosystems and we therefore included nest site quality as an abiotic factor in the analysis. In contrast to previous studies based on local densities, we focus here on the positioning and spatial patterns and we use models to compare our predictions to random expectations. Colony demography was universally affected by the size of the nest site with larger and more productive colonies residing in larger nest sites of higher quality. Distance to the nearest competitor negatively influenced host demography and brood production in the Bavarian community, pointing to an important role of competition, while social parasitism was less influential in this community. The New York community was characterized by the highest habitat variability, and productive colonies were clustered in sites of higher quality. Colonies were clumped on finer spatial scales, when we considered only the nearest neighbors, but more regularly distributed on coarser scales. The analysis of spatial positioning within plots often produced different results compared to those based on colony densities. For example, while host and slavemaker densities are often positively correlated, slavemakers do not nest closer to potential host colonies than expected by random. The three communities are differently affected by biotic and abiotic factors. Some of the differences can be attributed to habitat differences and some to differences between the two slavemaking-host ecosystems. The strong effect of competition in the Bavarian community points to the scarcity of resources in this uniform habitat compared to the other more diverse sites. The decrease in colony aggregation with scale indicates fine-scale resource hotspots: colonies are locally aggregated in small groups. Our study demonstrates that species relationships vary across scales and spatial patterns can provide important insights into species interactions. These results could not have been obtained with analyses based on local densities alone. Previous studies focused on social parasitism and its effect on host colonies. The broader approach taken here, considering several possible factors affecting colony demography and not testing each one in isolation, shows that competition and environmental variability can have a similar strong impact on demography and life-history of hosts. We conclude that the effects of parasites or predators should be studied in parallel to other ecological influences.

Evaluation of multiple institutions' models for knowledge-based planning of volumetric modulated arc therapy (VMAT) for prostate cancer.

PubMed

Ueda, Yoshihiro; Fukunaga, Jun-Ichi; Kamima, Tatsuya; Adachi, Yumiko; Nakamatsu, Kiyoshi; Monzen, Hajime

2018-03-20

The aim of this study was to evaluate the performance of a commercial knowledge-based planning system, in volumetric modulated arc therapy for prostate cancer at multiple radiation therapy departments. In each institute, > 20 cases were assessed. For the knowledge-based planning, the estimated dose (ED) based on geometric and dosimetric information of plans was generated in the model. Lower and upper limits of estimated dose were saved as dose volume histograms for each organ at risk. To verify whether the models performed correctly, KBP was compared with manual optimization planning in two cases. The relationships between the EDs in the models and the ratio of the OAR volumes overlapping volume with PTV to the whole organ volume (V overlap /V whole ) were investigated. There were no significant dosimetric differences in OARs and PTV between manual optimization planning and knowledge-based planning. In knowledge-based planning, the difference in the volume ratio of receiving 90% and 50% of the prescribed dose (V90 and V50) between institutes were more than 5.0% and 10.0%, respectively. The calculated doses with knowledge-based planning were between the upper and lower limits of ED or slightly under the lower limit of ED. The relationships between the lower limit of ED and V overlap /V whole were different among the models. In the V90 and V50 for the rectum, the maximum differences between the lower limit of ED among institutes were 8.2% and 53.5% when V overlap /V whole for the rectum was 10%. In the V90 and V50 for the bladder, the maximum differences of the lower limit of ED among institutes were 15.1% and 33.1% when V overlap /V whole for the bladder was 10%. Organs' upper and lower limits of ED in the models correlated closely with the V overlap /V whole . It is important to determine whether the models in KBP match a different institute's plan design before the models can be shared.

The economic case for digital interventions for eating disorders among United States college students.

PubMed

Kass, Andrea E; Balantekin, Katherine N; Fitzsimmons-Craft, Ellen E; Jacobi, Corinna; Wilfley, Denise E; Taylor, C Barr

2017-03-01

Eating disorders (EDs) are serious health problems affecting college students. This article aimed to estimate the costs, in United States (US) dollars, of a stepped care model for online prevention and treatment among US college students to inform meaningful decisions regarding resource allocation and adoption of efficient care delivery models for EDs on college campuses. Using a payer perspective, we estimated the costs of (1) delivering an online guided self-help (GSH) intervention to individuals with EDs, including the costs of "stepping up" the proportion expected to "fail"; (2) delivering an online preventive intervention compared to a "wait and treat" approach to individuals at ED risk; and (3) applying the stepped care model across a population of 1,000 students, compared to standard care. Combining results for online GSH and preventive interventions, we estimated a stepped care model would cost less and result in fewer individuals needing in-person psychotherapy (after receiving less-intensive intervention) compared to standard care, assuming everyone in need received intervention. A stepped care model was estimated to achieve modest cost savings compared to standard care, but these estimates need to be tested with sensitivity analyses. Model assumptions highlight the complexities of cost calculations to inform resource allocation, and considerations for a disseminable delivery model are presented. Efforts are needed to systematically measure the costs and benefits of a stepped care model for EDs on college campuses, improve the precision and efficacy of ED interventions, and apply these calculations to non-US care systems with different cost structures. © 2017 Wiley Periodicals, Inc.

Are fashion models a group at risk for eating disorders and substance abuse?

PubMed

Santonastaso, Paolo; Mondini, Silvia; Favaro, Angela

2002-01-01

Few studies to date have investigated whether in fact the prevalence of eating disorders (ED) and/or use of illicit drugs is higher among models than among other groups of females. A group of 63 professional fashion models of various nationalities were studied by means of self-reported questionnaires. They were compared with a control group of 126 female subjects recruited from the general population. Fashion models weigh significantly less than controls, but only a small percentage of them uses unhealthy methods to control their weight. The current frequency of full-syndrome ED did not differ between the groups, but partial-syndrome ED were significantly more common among fashion models than among controls. Current substance use or alcohol abuse was reported by 35% of fashion models and 12% of controls. Our findings suggest that fashion models are more at risk for partial ED and use of illicit drugs than females in the general population. Copyright 2002 S. Karger AG, Basel

Managing resource capacity using hybrid simulation

NASA Astrophysics Data System (ADS)

Ahmad, Norazura; Ghani, Noraida Abdul; Kamil, Anton Abdulbasah; Tahar, Razman Mat

2014-12-01

Due to the diversity of patient flows and interdependency of the emergency department (ED) with other units in hospital, the use of analytical models seems not practical for ED modeling. One effective approach to study the dynamic complexity of ED problems is by developing a computer simulation model that could be used to understand the structure and behavior of the system. Attempts to build a holistic model using DES only will be too complex while if only using SD will lack the detailed characteristics of the system. This paper discusses the combination of DES and SD in order to get a better representation of the actual system than using either modeling paradigm solely. The model is developed using AnyLogic software that will enable us to study patient flows and the complex interactions among hospital resources for ED operations. Results from the model show that patients' length of stay is influenced by laboratories turnaround time, bed occupancy rate and ward admission rate.

Assessing the effect of marginal water use efficiency on water use of loblolly pine and sweetgum in ambient and elevated CO2 conditions

NASA Astrophysics Data System (ADS)

Kim, D.; Medvigy, D.; Xu, X.; Oren, R.; Ward, E. J.

2017-12-01

Stomata are the common pathways through which diffusion of CO2 and water vapor take place in a plant. Therefore, the responses of stomatal conductance to environmental conditions are important to quantify carbon assimilation and water use of plants. In stomatal optimality theory, plants may adjust the stomatal conductance to maximize carbon assimilation for a given water availability. The carbon cost for unit water loss, marginal water use efficiency (λ), depends on changes in atmospheric CO2 concentration and pre-dawn leaf water potential. The relationship can be described by λ with no water stress (λ0) and the sensitivity of λ to pre-dawn leaf water potential (β0), which may vary by plant functional type. Assessment of sensitivity of tree and canopy water use to those parameters and the estimation of the parameters for individual plant functional type or species are needed. We modeled tree water use of loblolly pine (Pinus taeda) and sweetgum (Liquidambar styraciflua) in ambient and elevated CO2 (+200 µmol mol-1) at the Duke Forest free-air CO2 enrichment (FACE) site with Ecosystem Demography model 2 (ED2), a demographic terrestrial biosphere model that scales up individual-level competition for light, water and nutrients to the ecosystem-level. Simulated sap flux density for different tree size classes and species was compared to observations. The sensitivity analysis with respect to the model's hydraulic parameters was performed. The initial results showed that the impacts of λ on tree water use were greater than other hydraulic traits in the model, such as vertical hydraulic conductivity and leaf and stem capacitance. With 10% increase in λ, modeled water flow from root to leaf decreased by 2.5 and 1.6% for P. taeda and by 7.9 and 5.1% for L. styraciflua in ambient and elevated CO2 conditions, respectively. Values of hydraulic traits (λ0 and β0) for P. taeda and L. styraciflua in ambient an elevated CO2 conditions were also suggested.

The role of nitrogen fixation in neotropical dry forests: insights from ecosystem modeling and field data

NASA Astrophysics Data System (ADS)

Trierweiler, A.; Xu, X.; Gei, M. G.; Powers, J. S.; Medvigy, D.

2016-12-01

Tropical dry forests (TDFs) have immense functional diversity and face multiple resource constraints (both water and nutrients). Legumes are abundant and exhibit a wide diversity of N2-fixing strategies in TDFs. The abundance and diversity of legumes and their interaction with N2-fixing bacteria may strongly control the coupled carbon-nitrogen cycle in the biome and influence whether TDFs will be particularly vulnerable or uniquely adapted to projected global change. However, the importance of N2-fixation in TDFs and the carbon cost of acquiring N through symbiotic relationships are not fully understood. Here, we use models along with field measurements to examine the role of legumes, nitrogen fixation, and plant-symbiont nutrient exchanges in TDFs. We use a new version of the Ecosystem Demography (ED2) model that has been recently parameterized for TDFs. The new version incorporates plant-mycorrhizae interactions and multiple resource constraints (carbon, nitrogen, phosphorus, and water). We represent legumes and other functional groups found in TDFs with a range of resource acquisition strategies. In the model, plants then can dynamically adjust their carbon allocation and nutrient acquisition strategies (e.g. N2-fixing bacteria and mycorrhizal fungi) according to the nutrient limitation status. We test (i) the model's performance against a nutrient gradient of field sites in Costa Rica and (ii) the model's sensitivity to the carbon cost to acquire N through fixation and mycorrhizal relationships. We also report on simulated tree community responses to ongoing field nutrient fertilization experiments. We found that the inclusion of the N2-fixation legume plant functional traits were critical to reproducing community dynamics of Costa Rican field TDF sites and have a large impact on forest biomass. Simulated ecosystem fixation rates matched the magnitude and temporal patterns of field measured fixation. Our results show that symbiotic nitrogen fixation plays an important role in tropical dry forests and biomass accumulation. Also, we suggest that fixation's tight link to the rainy season could result in potential nutrient cycling vulnerabilities with projected rainfall changes.

Modeling and strain gauging of eddy current repulsion deicing systems

NASA Technical Reports Server (NTRS)

Smith, Samuel O.

1993-01-01

Work described in this paper confirms and extends work done by Zumwalt, et al., on a variety of in-flight deicing systems that use eddy current repulsion for repelling ice. Two such systems are known as electro-impulse deicing (EIDI) and the eddy current repulsion deicing strip (EDS). Mathematical models for these systems are discussed for their capabilities and limitations. The author duplicates a particular model of the EDS. Theoretical voltage, current, and force results are compared directly to experimental results. Dynamic strain measurements results are presented for the EDS system. Dynamic strain measurements near EDS or EIDI coils are complicated by the high magnetic fields in the vicinity of the coils. High magnetic fields induce false voltage signals out of the gages.

Life-history differences favor evolution of male dimorphism in competitive games.

PubMed

Smallegange, Isabel M; Johansson, Jacob

2014-02-01

Many species exhibit two discrete male morphs: fighters and sneakers. Fighters are large and possess weapons but may mature slowly. Sneakers are small and have no weapons but can sneak matings and may mature quickly to start mating earlier in life than fighters. However, how differences in competitive ability and life history interact to determine male morph coexistence has not yet been investigated within a single framework. Here we integrate demography and game theory into a two-sex population model to study the evolution of strategies that result in the coexistence of fighters and sneakers. We incorporate differences in maturation time between the morphs and use a mating-probability matrix analogous to the classic hawk-dove game. Using adaptive dynamics, we show that male dimorphism evolves more easily in our model than in classic game theory approaches. Our results also revealed an interaction between life-history differences and sneaker competitiveness, which shows that demography and competitive games should be treated as interlinked mechanisms to understand the evolution of male dimorphism. Applying our approach to empirical data on bulb mites (Rhizoglyphus robini), coho salmon (Oncorhynchus kisutch), and bullhorned dung beetles (Onthophagus taurus) indicates that observed occurrences of male dimorphism are in general agreement with model predictions.

The demography of a small population of yellow columbines in the Organ Mountains

Treesearch

Chris J. Stubben; Brook G. Milligan

2001-01-01

Yellow-flowered columbines (Aquilegia chrysantha Gray) are usually found in small, isolated populations near streams and pools in mountain ranges throughout the southwestern United States. To study the long-term dynamics of these populations, which are vulnerable to extinction, we have monitored the demography of a population in Fillmore Canyon in the Organ Mountains...

Demography of Mexican spotted owls in the Sacramento Mountains, New Mexico

Treesearch

Joseph L. Ganey; Gary C. White; James P. Ward; Sean C. Kyle; Darrell L. Apprill; Todd A. Rawlinson; Ryan S. Jonnes

2014-01-01

Information on population dynamics is key to gauging the status of threatened or endangered species. We monitored demography of a population of threatened Mexican spotted owls (Strix occidentalis lucida) in the Sacramento Mountains, New Mexico from 2003 to 2011. We estimated reproductive output for territorial pairs of owls; used mark-recapture methodology and Pradel...

[Romanian demography (1975-1989)].

PubMed

Trebici, V

1990-01-01

The author describes developments in the study of demography in Romania over the period 1975-1989. The books and articles mentioned are classified by subject. The author notes that although few full-length monographs were published during the Ceausescu years, a steady stream of demographic articles appeared, most of which were published in the journal Viitorul Social, now retitled Sociologie Romaneasca.

Demography and life history characteristics of two honey bee races (Apis mellifera).

PubMed

Winston, Mark L; Dropkin, Jennifer A; Taylor, Orley R

1981-03-01

Intra-colony demography and life history characteristics of neotropical Africanized and temperate European honey bearaces were compared under simulated feral conditions. Major differences in colony demography were found which nevertheless resulted in some similar reproductive characteristics. European colonies were larger than Africanized colonies, had more rapid initral growth rates of worker populations, showed better survivorship of brood and adult workers, and differed in patterns of worker age distribution. However, both races were similar in the brood and adult populations when colonies swarmed, the frequency and timing of swarming, and the number of workers in prime swarms. The factors most important in determining these colony growth and reproductive patterns were likely worker mortality rates, climate, and resource availability.

What factors shape genetic diversity in cetaceans?

PubMed

Vachon, Felicia; Whitehead, Hal; Frasier, Timothy R

2018-02-01

Understanding what factors drive patterns of genetic diversity is a central aspect of many biological questions, ranging from the inference of historical demography to assessing the evolutionary potential of a species. However, as a larger number of datasets have become available, it is becoming clear that the relationship between the characteristics of a species and its genetic diversity is more complex than previously assumed. This may be particularly true for cetaceans, due to their relatively long lifespans, long generation times, complex social structures, and extensive ranges. In this study, we used microsatellite and mitochondrial DNA data from a systematic literature review to produce estimates of diversity for both markers across 42 cetacean species. Factors relating to demography, distribution, classification, biology, and behavior were then tested using phylogenetic methods and linear models to assess their relative influence on the genetic diversity of both marker types. The results show that while relative nuclear diversity is correlated with population size, mitochondrial diversity is not. This is particularly relevant given the widespread use of mitochondrial DNA to infer historical demography. Instead, mitochondrial diversity was mostly influenced by the range and social structure of the species. In addition to population size, habitat type (neritic vs. oceanic) had a significant correlation with relative nuclear diversity. Combined, these results show that many often-unconsidered factors are likely influencing patterns of genetic diversity in cetaceans, with implications regarding how to interpret, and what can be inferred from, existing patterns of diversity.

Fishing-induced changes in adult length are mediated by skipped-spawning.

PubMed

Wang, Hui-Yu; Chen, Ying-Shiuan; Hsu, Chien-Chung; Shen, Sheng-Feng

2017-01-01

Elucidating fishing effects on fish population dynamics is a critical step toward sustainable fisheries management. Despite previous studies that have suggested age or size truncation in exploited fish populations, other aspects of fishing effects on population demography, e.g., via altering life histories and density, have received less attention. Here, we investigated the fishing effects altering adult demography via shifting reproductive trade-offs in the iconic, overexploited, Pacific bluefin tuna Thunnus orientalis. We found that, contrary to our expectation, mean lengths of catch increased over time in longline fisheries. On the other hand, mean catch lengths for purse seine fisheries did not show such increasing trends. We hypothesized that the size-dependent energetic cost of the spawning migration and elevated fishing mortality on the spawning grounds potentially drive size-dependent skipped spawning for adult tuna, mediating the observed changes in the catch lengths. Using eco-genetic individual-based modeling, we demonstrated that fishing-induced evolution of skipped spawning and size truncation interacted to shape the observed temporal changes in mean catch lengths for tuna. Skipped spawning of the small adults led to increased mean catch lengths for the longline fisheries, while truncation of small adults by the purse seines could offset such a pattern. Our results highlight the eco-evolutionary dynamics of fishing effects on population demography and caution against using demographic traits as a basis for fisheries management of the Pacific bluefin tuna as well as other migratory species. © 2016 by the Ecological Society of America.

Improving Predictions of Tree Drought Mortality in the Community Land Model Using Hydraulic Physiology Theory and its Effects on Carbon Metabolism

NASA Astrophysics Data System (ADS)

McNellis, B.; Hudiburg, T. W.

2017-12-01

Tree mortality due to drought is predicted to have increasing impacts on ecosystem structure and function during the 21st century. Models can attempt to predict which forests are most at risk from drought, but novel environments may preclude analysis that relies on past observations. The inclusion of more mechanistic detail may reduce uncertainty in predictions, but can also compound model complexity, especially in global models. The Community Land Model version 5 (CLM5), itself a component of the Community Earth System Model (CESM), has recently integrated cohort-based demography into its dynamic vegetation component and is in the process of coupling this demography to a model of plant hydraulic physiology (FATES-Hydro). Previous treatment of drought stress and plant mortality within CLM has been relatively broad, but a detailed hydraulics module represents a key step towards accurate mortality prognosis. Here, we examine the structure of FATES-Hydro with respect to two key physiological attributes: tissue osmotic potentials and embolism refilling. Specifically, we ask how FATES-Hydro captures mechanistic realism within each attribute and how much support there is within the physiological literature for its further elaboration within the model structure. Additionally, connections to broader aspects of carbon metabolism within FATES are explored to better resolve emergent consequences of drought stress on ecosystem function and tree demographics. An on-going field experiment in managed stands of Pinus ponderosa and mixed conifers is assessed for model parameterization and performance across PNW forests, with important implications for future forest management strategy.

Disease spread models to estimate highly uncertain emerging diseases losses for animal agriculture insurance policies: an application to the U.S. farm-raised catfish industry.

PubMed

Zagmutt, Francisco J; Sempier, Stephen H; Hanson, Terril R

2013-10-01

Emerging diseases (ED) can have devastating effects on agriculture. Consequently, agricultural insurance for ED can develop if basic insurability criteria are met, including the capability to estimate the severity of ED outbreaks with associated uncertainty. The U.S. farm-raised channel catfish (Ictalurus punctatus) industry was used to evaluate the feasibility of using a disease spread simulation modeling framework to estimate the potential losses from new ED for agricultural insurance purposes. Two stochastic models were used to simulate the spread of ED between and within channel catfish ponds in Mississippi (MS) under high, medium, and low disease impact scenarios. The mean (95% prediction interval (PI)) proportion of ponds infected within disease-impacted farms was 7.6% (3.8%, 22.8%), 24.5% (3.8%, 72.0%), and 45.6% (4.0%, 92.3%), and the mean (95% PI) proportion of fish mortalities in ponds affected by the disease was 9.8% (1.4%, 26.7%), 49.2% (4.7%, 60.7%), and 88.3% (85.9%, 90.5%) for the low, medium, and high impact scenarios, respectively. The farm-level mortality losses from an ED were up to 40.3% of the total farm inventory and can be used for insurance premium rate development. Disease spread modeling provides a systematic way to organize the current knowledge on the ED perils and, ultimately, use this information to help develop actuarially sound agricultural insurance policies and premiums. However, the estimates obtained will include a large amount of uncertainty driven by the stochastic nature of disease outbreaks, by the uncertainty in the frequency of future ED occurrences, and by the often sparse data available from past outbreaks. © 2013 Society for Risk Analysis.

Owned dog ecology and demography in Villa de Tezontepec, Hidalgo, Mexico.

PubMed

Kisiel, Luz Maria; Jones-Bitton, Andria; Sargeant, Jan M; Coe, Jason B; Flockhart, D T Tyler; Reynoso Palomar, Alejandro; Canales Vargas, Erick J; Greer, Amy L

2016-12-01

Dog overpopulation in developing countries has negative implications for the health and safety of people, including the transmission of zoonotic diseases, physical attacks and intimidation to humans and animals, as well as impacts on canine welfare. Understanding the ecology and demographic characteristics of a dog population can help in the planning and monitoring of canine population control programs. Little data exist regarding demography and dynamics of domestic dog populations in semi-urban areas in Mexico. A cross-sectional study was carried out between October 21 and November 7, 2015, to characterize the dog ecology and demography in Villa de Tezontepec, Hidalgo, Mexico. A face-to-face survey was used to collect data from randomly selected households in four contiguous communities using stratified two-stage cluster sampling. Within each household, adults answered questions related to their dogs and their experiences with dog bites and aggression. A total of 328 households were interviewed, representing a participation rate of 90.9% (328/361) and 1,450 people. Approximately 65.2% of the households owned one or more dogs, with a mean of 1.3 (SD=1.5) and 2.0 (SD=1.5) owned dogs in all participant households and dog-owning households, respectively. The human: owned dog ratio for all participant households was 3.4:1 (1450/428), and for the dog-owning households was 2.3:1 (984/428). The owned dog male: female ratio was 1.4:1 (249/179). Approximately 74.4% (95.0% CI=69.8% - 78.7%) of the owned dogs were older than one year (mean age: 2.9 years; SD=2.5). The mean age of owned female dogs at first litter was 1.9 years (SD=1.2) and the mean litter size was 4.2 puppies (SD=2.1). Approximately 36.9% (95.0% CI=31.8% - 46.4%) of the females were spayed, and 14.1% (95.0% CI=10.7% - 19.7%) of the males were neutered. Only 44.9% (95.0% CI=40.1% - 49.7%) were always confined when unsupervised. Approximately 84.4% (95.0% CI=80.6% - 87.7%) were reported to have been vaccinated against rabies in 2015. The knowledge of owned dog demography and ecology provided by this study can inform local government planning of dog population control interventions, and could serve as a baseline for the development of agent-based models to evaluate the effects of different dog population control strategies on dog demography. Copyright © 2016 Elsevier B.V. All rights reserved.

Estimating Density and Temperature Dependence of Juvenile Vital Rates Using a Hidden Markov Model

PubMed Central

McElderry, Robert M.

2017-01-01

Organisms in the wild have cryptic life stages that are sensitive to changing environmental conditions and can be difficult to survey. In this study, I used mark-recapture methods to repeatedly survey Anaea aidea (Nymphalidae) caterpillars in nature, then modeled caterpillar demography as a hidden Markov process to assess if temporal variability in temperature and density influence the survival and growth of A. aidea over time. Individual encounter histories result from the joint likelihood of being alive and observed in a particular stage, and I have included hidden states by separating demography and observations into parallel and independent processes. I constructed a demographic matrix containing the probabilities of all possible fates for each stage, including hidden states, e.g., eggs and pupae. I observed both dead and live caterpillars with high probability. Peak caterpillar abundance attracted multiple predators, and survival of fifth instars declined as per capita predation rate increased through spring. A time lag between predator and prey abundance was likely the cause of improved fifth instar survival estimated at high density. Growth rates showed an increase with temperature, but the preferred model did not include temperature. This work illustrates how state-space models can include unobservable stages and hidden state processes to evaluate how environmental factors influence vital rates of cryptic life stages in the wild. PMID:28505138

ReEDS-Mexico: A Capacity Expansion Model of the Mexican Power System

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

Ho, Jonathan L; Cole, Wesley J; Spyrou, Evangelia

This report documents the ReEDS-Mexico capacity expansion model, which is an extension of the ReEDS model to the Mexican power system. In recent years Mexico’s power sector has undergone considerable reform that has significant potential to impact the future electricity mix (Alpizar–Castro and Rodríguez–Monroy 2016). Day-ahead and real-time trading in Mexico’s power markets opened in early 2016. In addition to this reform, Mexico is striving to ensure that 35% of its electricity is generated from clean energy sources by 2024, 40% by 2035, and 50% by 2050 (Presidencia de la República 2016). These rapid changes in both the market andmore » the generation mix create a need for robust tools that can help electricity sector stakeholders make informed decisions. The purpose of this report is to document the extension of the National Renewable Energy Laboratory’s (NREL’s) Regional Energy Deployment System (ReEDS) model (Eurek et al. 2016) to cover the Mexico power system. This extension, which we will refer to throughout this paper as ReEDS-Mexico, provides a model of the Mexico power sector using a system-wide, least-cost optimization framework.« less

Increased risk of osteoporosis in patients with erectile dysfunction

PubMed Central

Wu, Chieh-Hsin; Lu, Ying-Yi; Chai, Chee-Yin; Su, Yu-Feng; Tsai, Tai-Hsin; Tsai, Feng-Ji; Lin, Chih-Lung

2016-01-01

Abstract In this study, we aimed to investigate the risk of osteoporosis in patients with erectile dysfunction (ED) by analyzing data from the Taiwan National Health Insurance Research Database (NHIRD). From the Taiwan NHIRD, we analyzed data on 4460 patients aged ≥40 years diagnosed with ED between 1996 and 2010. In total, 17,480 age-matched patients without ED in a 1:4 ratio were randomly selected as the non-ED group. The relationship between ED and the risk of osteoporosis was estimated using Cox proportional hazard regression models. During the follow-up period, 264 patients with ED (5.92%) and 651 patients without ED (3.65%) developed osteoporosis. The overall incidence of osteoporosis was 3.04-fold higher in the ED group than in the non-ED group (9.74 vs 2.47 per 1000 person-years) after controlling for covariates. Compared with patients without ED, patients with psychogenic and organic ED were 3.19- and 3.03-fold more likely to develop osteoporosis. Our results indicate that patients with a history of ED, particularly younger men, had a high risk of osteoporosis. Patients with ED should be examined for bone mineral density, and men with osteoporosis should be evaluated for ED. PMID:27368024

The Usefulness of the MEESSI Score for Risk Stratification of Patients With Acute Heart Failure at the Emergency Department.

PubMed

Miró, Òscar; Rosselló, Xavier; Gil, Víctor; Martín-Sánchez, Francisco Javier; Llorens, Pere; Herrero, Pablo; Jacob, Javier; López-Grima, María Luisa; Gil, Cristina; Lucas Imbernón, Francisco Javier; Garrido, José Manuel; Pérez-Durá, María José; López-Díez, María Pilar; Richard, Fernando; Bueno, Héctor; Pocock, Stuart J

2018-06-11

The MEESSI scale stratifies acute heart failure (AHF) patients at the emergency department (ED) according to the 30-day mortality risk. We validated the MEESSI risk score in a new cohort of Spanish patients to assess its accuracy in stratifying patients by risk and to compare its performance in different settings. We included consecutive patients diagnosed with AHF in 30 EDs during January and February 2016. The MEESSI score was calculated for each patient. The c-statistic measured the discriminatory capacity to predict 30-day mortality of the full MEESSI model and secondary models. Further comparisons were made among subgroups of patients from university and community hospitals, EDs with high-, medium- or low-activity and EDs that recruited or not patients in the original MEESSI derivation cohort. We analyzed 4711 patients (university/community hospitals: 3811/900; high-/medium-/low-activity EDs: 2695/1479/537; EDs participating/not participating in the previous MEESSI derivation study: 3892/819). The distribution of patients according to the MEESSI risk categories was: 1673 (35.5%) low risk, 2023 (42.9%) intermediate risk, 530 (11.3%) high risk and 485 (10.3%) very high risk, with 30-day mortality of 2.0%, 7.8%, 17.9%, and 41.4%, respectively. The c-statistic for the full model was 0.810 (95%CI, 0.790-0.830), ranging from 0.731 to 0.785 for the subsequent secondary models. The discriminatory capacity of the MEESSI risk score was similar among subgroups of hospital type, ED activity, and original recruiter EDs. The MEESSI risk score successfully stratifies AHF patients at the ED according to the 30-day mortality risk, potentially helping clinicians in the decision-making process for hospitalizing patients. Copyright © 2018. Published by Elsevier España, S.L.U.

Emergency department length of stay for ethanol intoxication encounters.

PubMed

Klein, Lauren R; Driver, Brian E; Miner, James R; Martel, Marc L; Cole, Jon B

2017-12-08

Emergency Department (ED) encounters for ethanol intoxication are becoming increasingly common. The purpose of this study was to explore factors associated with ED length of stay (LOS) for ethanol intoxication encounters. This was a multi-center, retrospective, observational study of patients presenting to the ED for ethanol intoxication. Data were abstracted from the electronic medical record. To explore factors associated with ED LOS, we created a mixed-effects generalized linear model. We identified 18,664 eligible patients from 6 different EDs during the study period (2012-2016). The median age was 37years, 69% were male, and the median ethanol concentration was 213mg/dL. Median LOS was 348min (range 43-1658). Using a mixed-effects generalized linear model, independent variables associated with a significant increase in ED LOS included use of parenteral sedation (beta=0.30, increase in LOS=34%), laboratory testing (beta=0.21, increase in LOS=23%), as well as the hour of arrival to the ED, such that patients arriving to the ED during evening hours (between 18:00 and midnight) had up to an 86% increase in LOS. Variables not significantly associated with an increase in LOS included age, gender, ethanol concentration, psychiatric disposition, using the ED frequently for ethanol intoxication, CT use, and daily ED volume. Variables such as diagnostic testing, treatments, and hour of arrival may influence ED LOS in patients with acute ethanol intoxication. Identification and further exploration of these factors may assist in developing hospital and community based improvements to modify LOS in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

Modeling and experimental assessment of a buried Leu–Ile mutation in dengue envelope domain III

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

Kulkarni, Manjiri R.; Numoto, Nobutaka; Ito, Nobutoshi

Envelope protein domain III (ED3) of the dengue virus is important for both antibody binding and host cell interaction. Here, we focused on how a L387I mutation in the protein core could take place in DEN4 ED3, but cannot be accommodated in DEN3 ED3 without destabilizing its structure. To this end, we modeled a DEN4-L387I structure using the Penultimate Rotamer Library and taking the DEN4 ED3 main-chain as a fixed template. We found that three out of seven Ile{sup 387} conformers fit in DEN4 ED3 without introducing the severe atomic clashes that are observed when DEN3 serotype’s ED3 is usedmore » as a template. A more extensive search using 273 side-chain rotamers of the residues surrounding Ile{sup 387} confirmed this prediction. In order to assess the prediction, we determined the crystal structure of DEN4-L387I at 2 Å resolution. Ile{sup 387} indeed adopted one of the three predicted rotamers. Altogether, this study demonstrates that the effects of single mutations are to a large extent successfully predicted by systematically modeling the side-chain structures of the mutated as well as those of its surrounding residues using fixed main-chain structures and assessing inter-atomic steric clashes. More accurate and reliable predictions require considering sub-angstrom main-chain deformation, which remains a challenging task. - Highlights: • We mutated L387I of DEN4 ED3 and examined its effects on structure and stability. • We modeled the side-chain of Ile{sup 387} using DEN4 ED3's structure as a template. • We determined the crystal structure of DEN4-L387I and confirmed the modeling. • Side-chain repacking occurring around Ile{sup 387} involved >3 inter-connected residues. • These results explained why L387I mutation in DEN4 ED3 conserves thermostability.« less

Cultural evolutionary theory: How culture evolves and why it matters

PubMed Central

Creanza, Nicole; Kolodny, Oren; Feldman, Marcus W.

2017-01-01

Human cultural traits—behaviors, ideas, and technologies that can be learned from other individuals—can exhibit complex patterns of transmission and evolution, and researchers have developed theoretical models, both verbal and mathematical, to facilitate our understanding of these patterns. Many of the first quantitative models of cultural evolution were modified from existing concepts in theoretical population genetics because cultural evolution has many parallels with, as well as clear differences from, genetic evolution. Furthermore, cultural and genetic evolution can interact with one another and influence both transmission and selection. This interaction requires theoretical treatments of gene–culture coevolution and dual inheritance, in addition to purely cultural evolution. In addition, cultural evolutionary theory is a natural component of studies in demography, human ecology, and many other disciplines. Here, we review the core concepts in cultural evolutionary theory as they pertain to the extension of biology through culture, focusing on cultural evolutionary applications in population genetics, ecology, and demography. For each of these disciplines, we review the theoretical literature and highlight relevant empirical studies. We also discuss the societal implications of the study of cultural evolution and of the interactions of humans with one another and with their environment. PMID:28739941

Cultural evolutionary theory: How culture evolves and why it matters.

PubMed

Creanza, Nicole; Kolodny, Oren; Feldman, Marcus W

2017-07-24

Human cultural traits-behaviors, ideas, and technologies that can be learned from other individuals-can exhibit complex patterns of transmission and evolution, and researchers have developed theoretical models, both verbal and mathematical, to facilitate our understanding of these patterns. Many of the first quantitative models of cultural evolution were modified from existing concepts in theoretical population genetics because cultural evolution has many parallels with, as well as clear differences from, genetic evolution. Furthermore, cultural and genetic evolution can interact with one another and influence both transmission and selection. This interaction requires theoretical treatments of gene-culture coevolution and dual inheritance, in addition to purely cultural evolution. In addition, cultural evolutionary theory is a natural component of studies in demography, human ecology, and many other disciplines. Here, we review the core concepts in cultural evolutionary theory as they pertain to the extension of biology through culture, focusing on cultural evolutionary applications in population genetics, ecology, and demography. For each of these disciplines, we review the theoretical literature and highlight relevant empirical studies. We also discuss the societal implications of the study of cultural evolution and of the interactions of humans with one another and with their environment.

Long-term change in a behavioural trait: truncated spawning distribution and demography in Northeast Arctic cod.

PubMed

Opdal, Anders Frugård; Jørgensen, Christian

2015-04-01

Harvesting may be a potent driver of demographic change and contemporary evolution, which both may have great impacts on animal populations. Research has focused on changes in phenotypic traits that are easily quantifiable and for which time series exist, such as size, age, sex, or gonad size, whereas potential changes in behavioural traits have been under-studied. Here, we analyse potential drivers of long-term changes in a behavioural trait for the Northeast Arctic stock of Atlantic cod Gadus morhua, namely choice of spawning location. For 104 years (1866-1969), commercial catches were recorded annually and reported by county along the Norwegian coast. During this time period, spawning ground distribution has fluctuated with a trend towards more northerly spawning. Spawning location is analysed against a suite of explanatory factors including climate, fishing pressure, density dependence, and demography. We find that demography (age or age at maturation) had the highest explanatory power for variation in spawning location, while climate had a limited effect below statistical significance. As to potential mechanisms, some effects of climate may act through demography, and explanatory variables for demography may also have absorbed direct evolutionary change in migration distance for which proxies were unavailable. Despite these caveats, we argue that fishing mortality, either through demographic or evolutionary change, has served as an effective driver for changing spawning locations in cod, and that additional explanatory factors related to climate add no significant information. © 2014 The Authors. Global Change Biology Published by John Wiley & Sons Ltd.

Long-Term Prediction of Emergency Department Revenue and Visitor Volume Using Autoregressive Integrated Moving Average Model

PubMed Central

Chen, Chieh-Fan; Ho, Wen-Hsien; Chou, Huei-Yin; Yang, Shu-Mei; Chen, I-Te; Shi, Hon-Yi

2011-01-01

This study analyzed meteorological, clinical and economic factors in terms of their effects on monthly ED revenue and visitor volume. Monthly data from January 1, 2005 to September 30, 2009 were analyzed. Spearman correlation and cross-correlation analyses were performed to identify the correlation between each independent variable, ED revenue, and visitor volume. Autoregressive integrated moving average (ARIMA) model was used to quantify the relationship between each independent variable, ED revenue, and visitor volume. The accuracies were evaluated by comparing model forecasts to actual values with mean absolute percentage of error. Sensitivity of prediction errors to model training time was also evaluated. The ARIMA models indicated that mean maximum temperature, relative humidity, rainfall, non-trauma, and trauma visits may correlate positively with ED revenue, but mean minimum temperature may correlate negatively with ED revenue. Moreover, mean minimum temperature and stock market index fluctuation may correlate positively with trauma visitor volume. Mean maximum temperature, relative humidity and stock market index fluctuation may correlate positively with non-trauma visitor volume. Mean maximum temperature and relative humidity may correlate positively with pediatric visitor volume, but mean minimum temperature may correlate negatively with pediatric visitor volume. The model also performed well in forecasting revenue and visitor volume. PMID:22203886

Long-term prediction of emergency department revenue and visitor volume using autoregressive integrated moving average model.

PubMed

Chen, Chieh-Fan; Ho, Wen-Hsien; Chou, Huei-Yin; Yang, Shu-Mei; Chen, I-Te; Shi, Hon-Yi

2011-01-01

This study analyzed meteorological, clinical and economic factors in terms of their effects on monthly ED revenue and visitor volume. Monthly data from January 1, 2005 to September 30, 2009 were analyzed. Spearman correlation and cross-correlation analyses were performed to identify the correlation between each independent variable, ED revenue, and visitor volume. Autoregressive integrated moving average (ARIMA) model was used to quantify the relationship between each independent variable, ED revenue, and visitor volume. The accuracies were evaluated by comparing model forecasts to actual values with mean absolute percentage of error. Sensitivity of prediction errors to model training time was also evaluated. The ARIMA models indicated that mean maximum temperature, relative humidity, rainfall, non-trauma, and trauma visits may correlate positively with ED revenue, but mean minimum temperature may correlate negatively with ED revenue. Moreover, mean minimum temperature and stock market index fluctuation may correlate positively with trauma visitor volume. Mean maximum temperature, relative humidity and stock market index fluctuation may correlate positively with non-trauma visitor volume. Mean maximum temperature and relative humidity may correlate positively with pediatric visitor volume, but mean minimum temperature may correlate negatively with pediatric visitor volume. The model also performed well in forecasting revenue and visitor volume.

Evidence of salicylic acid pathway with EDS1 and PAD4 proteins by molecular dynamics simulation for grape improvement.

PubMed

Tandon, Gitanjali; Jaiswal, Sarika; Iquebal, M A; Kumar, Sunil; Kaur, Sukhdeep; Rai, Anil; Kumar, Dinesh

2015-01-01

Biotic stress is a major cause of heavy loss in grape productivity. In order to develop biotic stress-resistant grape varieties, the key defense genes along with its pathway have to be deciphered. In angiosperm plants, lipase-like protein phytoalexin deficient 4 (PAD4) is well known to be essential for systemic resistance against biotic stress. PAD4 functions together with its interacting partner protein enhanced disease susceptibility 1 (EDS1) to promote salicylic acid (SA)-dependent and SA-independent defense pathway. Existence and structure of key protein of systemic resistance EDS1 and PAD4 are not known in grapes. Before SA pathway studies are taken in grape, molecular evidence of EDS1: PAD4 complex is to be established. To establish this, EDS1 protein sequence was retrieved from NCBI and homologous PAD4 protein was generated using Arabidopsis thaliana as template and conserved domains were confirmed. In this study, computational methods were used to model EDS1 and PAD4 and simulated the interactions of EDS1 and PAD4. Since no structural details of the proteins were available, homology modeling was employed to construct three-dimensional structures. Further, molecular dynamic simulations were performed to study the dynamic behavior of the EDS1 and PAD4. The modeled proteins were validated and subjected to molecular docking analysis. Molecular evidence of stable complex of EDS1:PAD4 in grape supporting SA defense pathway in response to biotic stress is reported in this study. If SA defense pathway genes are explored, then markers of genes involved can play pivotal role in grape variety development especially against biotic stress leading to higher productivity.

A meta-analysis of the relationships between body checking, body image avoidance, body image dissatisfaction, mood, and disordered eating.

PubMed

Walker, D Catherine; White, Emily K; Srinivasan, Vamshek J

2018-04-16

Body checking (BC) and body image avoidance (BIA) have been proposed as etiological and maintaining mechanisms for eating disorder (ED) pathology. To date, no comprehensive review summarizes the relationships of BC and BIA with ED pathology, body image dissatisfaction, or mood/affect. Meta-analyses examined the relationships of BC and BIA with ED pathology, body image dissatisfaction, and mood/affect. Gender, publication status, and presence or absence of ED diagnoses were examined as potential moderators. Results showed strong relationships between BC and ED pathology (ρ = 0.588) and BC and body image dissatisfaction (ρ = 0.631) and a moderate relationship between BC and mood/affect (ρ = 0.385). Similarly, results showed strong relationships between BIA and ED pathology (ρ = 0.553) and BIA and body image dissatisfaction (ρ = 0.543) and a moderate relationship between BIA and mood/affect (ρ = 0.392). Overall, limited evidence supported publication bias; however, publication bias may exist in the relationship between BIA and body image dissatisfaction in the literature. Subgroup moderator analyses suggested that gender moderates the strength of the relationships between BC and ED pathology, body image dissatisfaction, and mood/affect and between BIA and body image dissatisfaction. Results are consistent with cognitive-behavioral models of ED pathology that suggest BC and BIA are behavioral expressions of overvaluation of weight and shape. Notably, more published research has investigated BC than BIA. Future studies, incorporating methods such as meta-analytic structural equation modeling, should examine these variables to further test cognitive-behavioral models of ED development and maintenance. © 2018 Wiley Periodicals, Inc.

Demography, Identity and the 2016 Presidential Election

ERIC Educational Resources Information Center

Davidson, Fiona M.; Sours, Tad; Moll, Rebecca Luebker

2016-01-01

Demography is the study of human population statistics. The United States Census Bureau has measured the demographics of the U.S. population since 1790. Why? The main purpose was for division of representatives of the people in government and for taxes. As time has gone on, it gives us a better picture of who we are as a nation and how to better…

Area Handbook Series: Finland: A Country Study

DTIC Science & Technology

1988-12-01

79 DEMOGRAPHY ................................... 79 External M igration ........................... 81 Internal...blue-collar workers (see Demography ; Social Struc- ture, ch. 2). Along with the changes in social and in economic cir- cumstances went changes in popular...examination of the social forces involved in the for- mation of the Finnish state. C. Leonard Lundin’s Finland in the Second World War was a pioneering work

Grand Forks - East Grand Forks Urban Water Resources Study. Background Information Appendix.

DTIC Science & Technology

1981-07-01

Social Organization 121 Introduction 121 Demography 122 Racial Distribution 139 Ethnic Groups 141 Neighborhood Groups 141 Religion 143 Crime 144...of agricultural clearing operations and urban growth. Native tree species are important because of their longevity and now relatively infrequent... Demography Geographic Distribution Governmental Organiization Economy Occupational Structure Education Social Support Services 109 CULTURAL ELEM1ENTS

Eastern wood-pewee (Contopus virens) breeding demography across a gradient of savanna, woodland, and forest in the Missouri Ozarks

Treesearch

Sarah W. Kendrick; Frank R. Thompson; Jennifer L. Reidy

2013-01-01

Better knowledge of bird response to savanna and woodland restoration is needed to inform management of these communities. We related temporal and habitat variables to breeding demography and densities of the Eastern Wood-Pewee (Contopus virens) across a gradient of savanna, woodland, and forest. We determined nest success, clutch size, young fledged...

Prospective evaluation of an automated method to identify patients with severe sepsis or septic shock in the emergency department.

PubMed

Brown, Samuel M; Jones, Jason; Kuttler, Kathryn Gibb; Keddington, Roger K; Allen, Todd L; Haug, Peter

2016-08-22

Sepsis is an often-fatal syndrome resulting from severe infection. Rapid identification and treatment are critical for septic patients. We therefore developed a probabilistic model to identify septic patients in the emergency department (ED). We aimed to produce a model that identifies 80 % of sepsis patients, with no more than 15 false positive alerts per day, within one hour of ED admission, using routine clinical data. We developed the model using retrospective data for 132,748 ED encounters (549 septic), with manual chart review to confirm cases of severe sepsis or septic shock from January 2006 through December 2008. A naïve Bayes model was used to select model features, starting with clinician-proposed candidate variables, which were then used to calculate the probability of sepsis. We evaluated the accuracy of the resulting model in 93,733 ED encounters from April 2009 through June 2010. The final model included mean blood pressure, temperature, age, heart rate, and white blood cell count. The area under the receiver operating characteristic curve (AUC) for the continuous predictor model was 0.953. The binary alert achieved 76.4 % sensitivity with a false positive rate of 4.7 %. We developed and validated a probabilistic model to identify sepsis early in an ED encounter. Despite changes in process, organizational focus, and the H1N1 influenza pandemic, our model performed adequately in our validation cohort, suggesting that it will be generalizable.

Load Balancing at Emergency Departments using ‘Crowdinforming’

PubMed Central

Friesen, Marcia R; Strome, Trevor; Mukhi, Shamir; McLoed, Robert

2011-01-01

Background: Emergency Department (ED) overcrowding is an important healthcare issue facing increasing public and regulatory scrutiny in Canada and around the world. Many approaches to alleviate excessive waiting times and lengths of stay have been studied. In theory, optimal ED patient flow may be assisted via balancing patient loads between EDs (in essence spreading patients more evenly throughout this system). This investigation utilizes simulation to explore “Crowdinforming” as a basis for a process control strategy aimed to balance patient loads between six EDs within a mid-sized Canadian city. Methods: Anonymous patient visit data comprising 120,000 ED patient visits over six months to six ED facilities were obtained from the region’s Emergency Department Information System (EDIS) to (1) determine trends in ED visits and interactions between parameters; (2) to develop a process control strategy integrating crowdinforming; and, (3) apply and evaluate the model in a simulated environment to explore the potential impact on patient self-redirection and load balancing between EDs. Results: As in reality, the data available and subsequent model demonstrated that there are many factors that impact ED patient flow. Initial results suggest that for this particular data set used, ED arrival rates were the most useful metric for ED ‘busyness’ in a process control strategy, and that Emergency Department performance may benefit from load balancing efforts. Conclusions: The simulation supports the use of crowdinforming as a potential tool when used in a process control strategy to balance the patient loads between EDs. The work also revealed that the value of several parameters intuitively expected to be meaningful metrics of ED ‘busyness’ was not evident, highlighting the importance of finding parameters meaningful within one’s particular data set. The information provided in the crowdinforming model is already available in a local context at some ED sites. The extension to a wider dissemination of information via an Internet web service accessible by smart phones is readily achievable and not a technological obstacle. Similarly, the system could be extended to help direct patients by including future estimates or predictions in the crowdinformed data. The contribution of the simulation is to allow for effective policy evaluation to better inform the public of ED ‘busyness’ as part of their decision making process in attending an emergency department. In effect, this is a means of providing additional decision support insights garnered from a simulation, prior to a real world implementation. PMID:23569610

Forecasting daily emergency department visits using calendar variables and ambient temperature readings.

PubMed

Marcilio, Izabel; Hajat, Shakoor; Gouveia, Nelson

2013-08-01

This study aimed to develop different models to forecast the daily number of patients seeking emergency department (ED) care in a general hospital according to calendar variables and ambient temperature readings and to compare the models in terms of forecasting accuracy. The authors developed and tested six different models of ED patient visits using total daily counts of patient visits to an ED in Sao Paulo, Brazil, from January 1, 2008, to December 31, 2010. The first 33 months of the data set were used to develop the ED patient visits forecasting models (the training set), leaving the last 3 months to measure each model's forecasting accuracy by the mean absolute percentage error (MAPE). Forecasting models were developed using three different time-series analysis methods: generalized linear models (GLM), generalized estimating equations (GEE), and seasonal autoregressive integrated moving average (SARIMA). For each method, models were explored with and without the effect of mean daily temperature as a predictive variable. The daily mean number of ED visits was 389, ranging from 166 to 613. Data showed a weekly seasonal distribution, with highest patient volumes on Mondays and lowest patient volumes on weekends. There was little variation in daily visits by month. GLM and GEE models showed better forecasting accuracy than SARIMA models. For instance, the MAPEs from GLM models and GEE models at the first month of forecasting (October 2012) were 11.5 and 10.8% (models with and without control for the temperature effect, respectively), while the MAPEs from SARIMA models were 12.8 and 11.7%. For all models, controlling for the effect of temperature resulted in worse or similar forecasting ability than models with calendar variables alone, and forecasting accuracy was better for the short-term horizon (7 days in advance) than for the longer term (30 days in advance). This study indicates that time-series models can be developed to provide forecasts of daily ED patient visits, and forecasting ability was dependent on the type of model employed and the length of the time horizon being predicted. In this setting, GLM and GEE models showed better accuracy than SARIMA models. Including information about ambient temperature in the models did not improve forecasting accuracy. Forecasting models based on calendar variables alone did in general detect patterns of daily variability in ED volume and thus could be used for developing an automated system for better planning of personnel resources. © 2013 by the Society for Academic Emergency Medicine.

Exercise dependence as a mediator of the exercise and eating disorders relationship: a pilot study.

PubMed

Cook, Brian; Hausenblas, Heather; Crosby, Ross D; Cao, Li; Wonderlich, Stephen A

2015-01-01

Excessive exercise is a common feature of eating disorders (ED) and is associated with earlier ED onset, more ED symptoms, and higher persistence of ED behavior. Research indicates that exercise amount alone is not associated with ED. The purpose of this study was to investigate pathological attitudes and behaviors related to exercise (e.g., exercise dependence) as a mediator of the exercise and ED relationship. Participants were 43 women with an ED who completed measures of ED symptoms, exercise behavior, and exercise dependence. Analyses were conducted using the indirect bootstrapping method for examining mediation. Exercise dependence mediated the relationship between exercise and ED. This mediation model accounted for 14.34% of the variance in the relationship. Our results extend the literature by offering preliminary evidence of a psychological variable that may be a candidate for future interventions on the exercise and ED relationship. Implications and suggestions for future research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Projecting the past and future impacts of hurricanes on the carbon balance of eastern U.S. forests (1851-2100)

NASA Astrophysics Data System (ADS)

Fisk, J.; Hurtt, G. C.; Chambers, J. Q.; Zeng, H.

2009-12-01

In U.S. Atlantic coastal areas, hurricanes are a principal agent of catastrophic wind damage, with dramatic impacts on the structure and functioning of forests. Estimates of the carbon emissions resulting from single storms range as high as ~100 Tg C, an amount equivalent to the annual U.S. carbon sink in forest trees. Recent studies have estimated the historic regional carbon emissions from hurricane activity using an empirically based approach. Here, we use a mechanistic ecosystem model, the Ecosystem Demography (ED) model, driven by maps of mortality and damage based on historic hurricane tracks and future scenarios to predict the past and future impacts of hurricanes on the carbon balance of eastern U.S. forests. Model estimates compare well to previous empirically based estimates, with mean annual biomass loss of 26 Tg C yr-1 (range 0 to ~225 Tg C yr-1) resulting from hurricanes during the period 1851-2000. Using the mechanistic model, we are able to include the effects of both disturbance and recovery on the net carbon flux. We find a regional carbon sink throughout much of the 20th century resulting from forest recovery following a peak in hurricane activity during the late 19th century exceeding biomass loss. Recent increased hurricane activity has resulted in the region becoming a net carbon source. For the future, several recent studies have linked increased sea surface temperatures expected with climate change to increased hurricane activity. Based on these relationships, we investigate a range of scenarios of future hurricane activity and find the potential for substantial increases in emissions from hurricane mortality and reductions in regional carbon stocks. In our scenario with the largest increase in hurricane activity, we find a 35% increase in area disturbed by 2100, but due to the reduction of standing biomass, only a 20% increase in biomass loss per year. Developing this kind of predictive modeling capability that tracks disturbance events and recovery is key to our understanding and ability to predict the carbon balance of forests of the eastern U.S.

The co-evolution of social institutions, demography, and large-scale human cooperation.

PubMed

Powers, Simon T; Lehmann, Laurent

2013-11-01

Human cooperation is typically coordinated by institutions, which determine the outcome structure of the social interactions individuals engage in. Explaining the Neolithic transition from small- to large-scale societies involves understanding how these institutions co-evolve with demography. We study this using a demographically explicit model of institution formation in a patch-structured population. Each patch supports both social and asocial niches. Social individuals create an institution, at a cost to themselves, by negotiating how much of the costly public good provided by cooperators is invested into sanctioning defectors. The remainder of their public good is invested in technology that increases carrying capacity, such as irrigation systems. We show that social individuals can invade a population of asocials, and form institutions that support high levels of cooperation. We then demonstrate conditions where the co-evolution of cooperation, institutions, and demographic carrying capacity creates a transition from small- to large-scale social groups. © 2013 John Wiley & Sons Ltd/CNRS.

Intrafamily and intragenomic conflicts in human warfare

PubMed Central

2017-01-01

Recent years have seen an explosion of multidisciplinary interest in ancient human warfare. Theory has emphasized a key role for kin-selected cooperation, modulated by sex-specific demography, in explaining intergroup violence. However, conflicts of interest remain a relatively underexplored factor in the evolutionary-ecological study of warfare, with little consideration given to which parties influence the decision to go to war and how their motivations may differ. We develop a mathematical model to investigate the interplay between sex-specific demography and human warfare, showing that: the ecology of warfare drives the evolution of sex-biased dispersal; sex-biased dispersal modulates intrafamily and intragenomic conflicts in relation to warfare; intragenomic conflict drives parent-of-origin-specific patterns of gene expression—i.e. ‘genomic imprinting’—in relation to warfare phenotypes; and an ecological perspective of conflicts at the levels of the gene, individual, and social group yields novel predictions as to pathologies associated with mutations and epimutations at loci underpinning human violence. PMID:28228515

Intrafamily and intragenomic conflicts in human warfare.

PubMed

Micheletti, Alberto J C; Ruxton, Graeme D; Gardner, Andy

2017-02-22

Recent years have seen an explosion of multidisciplinary interest in ancient human warfare. Theory has emphasized a key role for kin-selected cooperation, modulated by sex-specific demography, in explaining intergroup violence. However, conflicts of interest remain a relatively underexplored factor in the evolutionary-ecological study of warfare, with little consideration given to which parties influence the decision to go to war and how their motivations may differ. We develop a mathematical model to investigate the interplay between sex-specific demography and human warfare, showing that: the ecology of warfare drives the evolution of sex-biased dispersal; sex-biased dispersal modulates intrafamily and intragenomic conflicts in relation to warfare; intragenomic conflict drives parent-of-origin-specific patterns of gene expression-i.e. 'genomic imprinting'-in relation to warfare phenotypes; and an ecological perspective of conflicts at the levels of the gene, individual, and social group yields novel predictions as to pathologies associated with mutations and epimutations at loci underpinning human violence. © 2017 The Authors.

Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

PubMed

Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

2017-10-31

The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

Air pollution and ED visits for asthma in Australian children: a case-crossover analysis.

PubMed

Jalaludin, Bin; Khalaj, Behnoosh; Sheppeard, Vicky; Morgan, Geoff

2008-08-01

We aimed to determine the effects of ambient air pollutants on emergency department (ED) visits for asthma in children. We obtained routinely collected ED visit data for asthma (ICD9 493) and air pollution (PM(10), PM(2.5), O(3), NO(2), CO and SO(2)) and meteorological data for metropolitan Sydney for 1997-2001. We used the time stratified case-crossover design and conditional logistic regression to model the association between air pollutants and ED visits for four age-groups (1-4, 5-9, 10-14 and 1-14 years). Estimated relative risks for asthma ED visits were calculated for an exposure corresponding to the inter-quartile range in pollutant level. We included same day average temperature, same day relative humidity, daily temperature range, school holidays and public holidays in all models. Associations between ambient air pollutants and ED visits for asthma in children were most consistent for all six air pollutants in the 1-4 years age-group, for particulates and CO in the 5-9 years age-group and for CO in the 10-14 years age-group. The greatest effects were most consistently observed for lag 0 and effects were greater in the warm months for particulates, O(3) and NO(2). In two pollutant models, effect sizes were generally smaller compared to those derived from single pollutant models. We observed the effects of ambient air pollutants on ED attendances for asthma in a city where the ambient concentrations of air pollutants are relatively low.

Association between preoperative erectile dysfunction and prostate cancer features--an analysis from the Duke Prostate Center Database.

PubMed

Kimura, Masaki; Bañez, Lionel L; Gerber, Leah; Qi, Jim; Tsivian, Matvey; Freedland, Stephen J; Satoh, Takefumi; Polascik, Thomas J; Baba, Shiro; Moul, Judd W

2012-04-01

Erectile dysfunction (ED) is related to several co-morbidities including obesity, metabolic syndrome, cigarette smoking, and low testosterone, all of which have been reported to be associated with adverse prostate cancer features. To examine whether preoperative ED has a relationship with adverse prostate cancer features in patients who underwent radical prostatectomy (RP). We analyzed data from our institution on 676 patients who underwent RP between 2001 and 2010. Crude and adjusted logistic regression models were used to investigate the association between preoperative ED and several pathological parameters. The log-rank test and multivariate proportional hazards model were conducted to determine the association of preoperative ED with biochemical recurrence (BCR). The expanded prostate cancer index composite (EPIC) instrument was used to evaluate preoperative erectile function (EF). Preoperative normal EF was defined as EPIC-SF ≥ 60 points while ED was defined as preoperative EPIC-SF lower than 60 points. Preoperatively, a total of 343 (50.7%) men had normal EF and 333 (49.3%) men had ED. After adjusting for covariates, preoperative ED was identified a risk factor for positive extracapsular extension (OR 1.57; P = 0.029) and high percentage of tumor involvement (OR 1.56; P = 0.047). In a Kaplan-Meier curve, a trend was identified that patients with ED had higher incidence of BCR than men with normal EF (P = 0.091). Moreover, using a multivariate Cox model, higher preoperative EF was negatively associated with BCR (HR 0.99; P = 0.014). These results suggest that the likelihood for adverse pathological outcomes as well as BCR following prostatectomy is higher among men with preoperative ED, though these results require validation in larger datasets. The present study indicates that preoperative ED might be a surrogate for adverse prostate cancer outcomes following RP. © 2011 International Society for Sexual Medicine.

A systematic review of the effects of neuromodulation on eating and body weight: evidence from human and animal studies.

PubMed

McClelland, Jessica; Bozhilova, Natali; Campbell, Iain; Schmidt, Ulrike

2013-11-01

Eating disorders (ED) are chronic and sometimes deadly illnesses. Existing treatments have limited proven efficacy, especially in the case of adults with anorexia nervosa (AN). Emerging neural models of ED provide a rationale for more targeted, brain-directed interventions. This systematic review has examined the effects of neuromodulation techniques on eating behaviours and body weight and assessed their potential for therapeutic use in ED. All articles in PubMed, PsychInfo and Web of Knowledge were considered and screened against a priori inclusion/exclusion criteria. The effects of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, vagus nerve stimulation (VNS) and deep brain stimulation (DBS) were examined across studies in ED samples, other psychiatric and neurological disorders, and animal models. Sixty studies were identified. There is evidence for ED symptom reduction following rTMS and DBS in both AN and bulimia nervosa. Findings from studies of other psychiatric and neurological disorders and from animal studies demonstrate that increases in food intake and body weight can be achieved following DBS and that VNS has potential value as a means of controlling eating and inducing weight loss. Neuromodulation tools have potential for reducing ED symptomatology and related behaviours, and for altering food intake and body weight. In response to such findings, and emerging neural models of ED, treatment approaches are highly unlikely to remain 'brainless'. More research is required to evaluate the potential of neuromodulation procedures for improving long-term outcomes in ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Dynamic Energy Budgets and Bioaccumulation: A Model for Marine Mammals and Marine Mammal Populations

DTIC Science & Technology

2006-06-01

energy into them to increase in size, or spend energy to maintain them and stay alive. Supply-side energy budget models have been pioneered by S.A.L.M...of the National Academy of Science of the United States of America 72:4172-4176. Fujiwara, M., and H. Caswell 2001. Demography of the endangered North...fraction of body tissue, which complicates measurements because of heterogeneities within tissues (Aguilar and Borrell 1991). Longevity makes it hard to

America's Demography in the New Century: Aging Baby Boomers and New Immigrants as Major Players. Milken Institute Policy Brief.

ERIC Educational Resources Information Center

Frey, William H.; DeVol, Ross C.

America's demography in the new century will be affected by the aging baby boom generation and by new immigrants. Focus on just the national implications of aging baby boomers and the new immigrants is inadequate. This policy brief takes a regional perspective, examining recent trends and population statistics and making the case that aging baby…

Research, Teaching Training in Demography: A Directory of Institutions in the ESCAP Region. Asian Population Studies Series No. 8, Supplement No. 3.

ERIC Educational Resources Information Center

United Nations Economic and Social Commission for Asia and the Pacific, Bangkok (Thailand).

This directory contains information on 39 institutions and 108 projects of research teaching and training in demography in Asia and the Pacific. Eight countries are represented: Australia, Bangladesh, Hong Kong, India, Iran, Japan, New Zealand, and Pakistan. The following information is given for each institution: name, address, person in charge,…

QSAR classification models for the prediction of endocrine disrupting activity of brominated flame retardants.

PubMed

Kovarich, Simona; Papa, Ester; Gramatica, Paola

2011-06-15

The identification of potential endocrine disrupting (ED) chemicals is an important task for the scientific community due to their diffusion in the environment; the production and use of such compounds will be strictly regulated through the authorization process of the REACH regulation. To overcome the problem of insufficient experimental data, the quantitative structure-activity relationship (QSAR) approach is applied to predict the ED activity of new chemicals. In the present study QSAR classification models are developed, according to the OECD principles, to predict the ED potency for a class of emerging ubiquitary pollutants, viz. brominated flame retardants (BFRs). Different endpoints related to ED activity (i.e. aryl hydrocarbon receptor agonism and antagonism, estrogen receptor agonism and antagonism, androgen and progesterone receptor antagonism, T4-TTR competition, E2SULT inhibition) are modeled using the k-NN classification method. The best models are selected by maximizing the sensitivity and external predictive ability. We propose simple QSARs (based on few descriptors) characterized by internal stability, good predictive power and with a verified applicability domain. These models are simple tools that are applicable to screen BFRs in relation to their ED activity, and also to design safer alternatives, in agreement with the requirements of REACH regulation at the authorization step. Copyright © 2011 Elsevier B.V. All rights reserved.

Automated contour detection in X-ray left ventricular angiograms using multiview active appearance models and dynamic programming.

PubMed

Oost, Elco; Koning, Gerhard; Sonka, Milan; Oemrawsingh, Pranobe V; Reiber, Johan H C; Lelieveldt, Boudewijn P F

2006-09-01

This paper describes a new approach to the automated segmentation of X-ray left ventricular (LV) angiograms, based on active appearance models (AAMs) and dynamic programming. A coupling of shape and texture information between the end-diastolic (ED) and end-systolic (ES) frame was achieved by constructing a multiview AAM. Over-constraining of the model was compensated for by employing dynamic programming, integrating both intensity and motion features in the cost function. Two applications are compared: a semi-automatic method with manual model initialization, and a fully automatic algorithm. The first proved to be highly robust and accurate, demonstrating high clinical relevance. Based on experiments involving 70 patient data sets, the algorithm's success rate was 100% for ED and 99% for ES, with average unsigned border positioning errors of 0.68 mm for ED and 1.45 mm for ES. Calculated volumes were accurate and unbiased. The fully automatic algorithm, with intrinsically less user interaction was less robust, but showed a high potential, mostly due to a controlled gradient descent in updating the model parameters. The success rate of the fully automatic method was 91% for ED and 83% for ES, with average unsigned border positioning errors of 0.79 mm for ED and 1.55 mm for ES.

The past, present, and future of urgent matters: lessons learned from a decade of emergency department flow improvement.

PubMed

McClelland, Mark Stephen; Lazar, Danielle; Sears, Vickie; Wilson, Marcia; Siegel, Bruce; Pines, Jesse M

2011-12-01

Over the past decade, emergency departments (ED) have encountered major challenges due to increased crowding and a greater public focus on quality measurement and quality improvement. Responding to these challenges, many EDs have worked to improve their processes and develop new and innovative models of care delivery. Urgent Matters has contributed to ED quality and patient flow improvement by working with hospitals throughout the United States. Recognizing that EDs across the country are struggling with many of the same issues, Urgent Matters-a program funded by the Robert Wood Johnson Foundation (RWJF)-has sought to identify, develop, and disseminate innovative approaches, interventions, and models to improve ED flow and quality. Using a variety of techniques, such as learning networks (collaboratives), national conferences, e-newsletters, webinars, best practices toolkits, and social media, Urgent Matters has served as a thought leader and innovator in ED quality improvement initiatives. The Urgent Matters Seven Success Factors were drawn from the early work done by program participants and propose practical guidelines for implementing and sustaining ED improvement activities. This article chronicles the history, activities, lessons learned, and future of the Urgent Matters program. © 2011 by the Society for Academic Emergency Medicine.

Psychobiological mechanisms of exercise dependence.

PubMed

Hamer, Mark; Karageorghis, Costas I

2007-01-01

Exercise dependence (ED) is characterised by an obsessive and unhealthy preoccupation with exercise. Previous research has focused largely on identifying behavioural aspects of ED, although the biological mechanisms remain unknown and are under researched. We review various ED hypotheses including affect regulation, anorexia analogue, sympathetic arousal and beta-endorphin. We also present a novel hypothesis pertaining to ED and interleukin (IL)-6, which combines previous hypotheses with literature from the field of psycho-neuroimmunology. We explore the notion that IL-6 provides a link from the periphery to the brain, which may mediate the underlying features of ED. We propose a conceptual model indicating that, in individuals prone to ED, exercise results in a transient reduction in negative affect, but concurrently results in excessive production of IL-6 and the activation of neuroendocrine pathways, which are associated with behavioural and psychological disturbances of exercise withdrawal. Our intention is for this model to serve as a basis for further research in the area of ED, which may eventually lead to the development of successful treatment strategies. Recent developments in methods to reliably assess these biological markers from blood and saliva samples should encourage such research to be undertaken in exercise settings.

Community characteristics affecting emergency department use by Medicaid enrollees.

PubMed

Lowe, Robert A; Fu, Rongwei; Ong, Emerson T; McGinnis, Paul B; Fagnan, Lyle J; Vuckovic, Nancy; Gallia, Charles

2009-01-01

In seeking to identify modifiable, system-level factors affecting emergency department (ED) use, we used a statewide Medicaid database to study community variation in ED use and ascertain community characteristics associated with higher use. This historical cohort study used administrative data from July 1, 2003 to December 31, 2004. Residence ZIP codes were used to assign all 555,219 Medicaid enrollees to 130 primary care service areas (PCSAs). PCSA characteristics studied included rural/urban status, presence of hospital(s), driving time to hospital, and several measures of primary care capacity. Statistical analyses used a 2-stage model. In the first stage (enrollee level), ED utilization rates adjusted for enrollee demographics and medical conditions were calculated for each PCSA. In the second stage (community level), a mixed effects linear model was used to determine the association between PCSA characteristics and ED use. ED utilization rates varied more than 20-fold among the PCSAs. Compared with PCSAs with primary care capacity less than need, PCSAs with capacity 1 to 2 times the need had 0.12 (95% CI: -0.044, -0.20) fewer ED visits/person/yr. Compared with PCSAs with the nearest hospital accessible within 10 minutes, PCSAs with the nearest hospital >30 minutes' drive had 0.26 (95% CI: -0.38, -0.13) fewer ED visits/person/yr. Within this Medicaid population, ED utilization was determined not only by patient characteristics but by community characteristics. Better understanding of system-level factors affecting ED use can enable communities to improve their health care delivery systems-augmenting access to care and reducing reliance on EDs.

Does probability of occurrence relate to population dynamics?

USGS Publications Warehouse

Thuiller, Wilfried; Münkemüller, Tamara; Schiffers, Katja H.; Georges, Damien; Dullinger, Stefan; Eckhart, Vincent M.; Edwards, Thomas C.; Gravel, Dominique; Kunstler, Georges; Merow, Cory; Moore, Kara; Piedallu, Christian; Vissault, Steve; Zimmermann, Niklaus E.; Zurell, Damaris; Schurr, Frank M.

2014-01-01

Hutchinson defined species' realized niche as the set of environmental conditions in which populations can persist in the presence of competitors. In terms of demography, the realized niche corresponds to the environments where the intrinsic growth rate (r) of populations is positive. Observed species occurrences should reflect the realized niche when additional processes like dispersal and local extinction lags do not have overwhelming effects. Despite the foundational nature of these ideas, quantitative assessments of the relationship between range-wide demographic performance and occurrence probability have not been made. This assessment is needed both to improve our conceptual understanding of species' niches and ranges and to develop reliable mechanistic models of species geographic distributions that incorporate demography and species interactions.The objective of this study is to analyse how demographic parameters (intrinsic growth rate r and carrying capacity K ) and population density (N ) relate to occurrence probability (Pocc ). We hypothesized that these relationships vary with species' competitive ability. Demographic parameters, density, and occurrence probability were estimated for 108 tree species from four temperate forest inventory surveys (Québec, western USA, France and Switzerland). We used published information of shade tolerance as indicators of light competition strategy, assuming that high tolerance denotes high competitive capacity in stable forest environments.Interestingly, relationships between demographic parameters and occurrence probability did not vary substantially across degrees of shade tolerance and regions. Although they were influenced by the uncertainty in the estimation of the demographic parameters, we found that r was generally negatively correlated with Pocc, while N, and for most regions K, was generally positively correlated with Pocc. Thus, in temperate forest trees the regions of highest occurrence probability are those with high densities but slow intrinsic population growth rates. The uncertain relationships between demography and occurrence probability suggests caution when linking species distribution and demographic models.

ED QUEST: A Model Procedure for Futures Planning in Educational Organizations.

ERIC Educational Resources Information Center

Adams, Charles F.

Most educational planning models are weak at identifying future events and assessing their impact on education. At best they assume a surprise-free future in which present trends continue unabated and interrelationships among social, economic, political, and technological forces stay the same. The ED QUEST model was developed to ameliorate these…

Estimating differential reproductive success from nests of related individuals, with application to a study of the Mottled Sculpin, Cottus bairdi

Treesearch

Beatrix Jones; Gary D. Grossman; Daniel C.I. Walsh; Brady A. Porter; John C. Avise; Anthony C. Flumera

2007-01-01

Understanding how variation in reproductive success is related to demography is a critical component in understanding the life history of an organism. Parentage analysis using molecular markers can be used to estimate the reproductive success of different groups of individuals in natural populations. Previous models have been developed for cases where offspring are...

Habitat Selection by the Gopher Tortoise (Gopherus polyphemus)

DTIC Science & Technology

2007-03-01

distribution. Herpetological Review 32:191. Clark, E.E. 2003. Relocation and population modeling for gopher tortoise recovery. M.S. Thesis...Gopherus polyphemus in northern Florida. Journal of Herpetology 26:158-165. Diemer, J.E. 1992b. Demography of the tortoise Gopherus polyphemus...in northern Florida. Journal of Herpetology 26:281-289. ERDC/CERL TR-07-1 33 Dozier, J., and J. Stowe. 1999. Tillman Sand Ridge Heritage

East Europe Report.

DTIC Science & Technology

1986-08-22

pioneer journey to Stralsund 2 years ago. Nevertheless, clear statements on internal East German excesses would be highly consistent with the Social...as: new dimensions in promoting health and increasing the longevity and span of active life for all the people - tasks stemming from the historic...34Demografija—metodi, modeli i ana- liza [ Demography —Methods, Models, and Analysis], Belgrade, Naucna knjiga, 1980; and then in "Seminaire sur les

Emergency department and 'Google flu trends' data as syndromic surveillance indicators for seasonal influenza.

PubMed

Thompson, L H; Malik, M T; Gumel, A; Strome, T; Mahmud, S M

2014-11-01

We evaluated syndromic indicators of influenza disease activity developed using emergency department (ED) data - total ED visits attributed to influenza-like illness (ILI) ('ED ILI volume') and percentage of visits attributed to ILI ('ED ILI percent') - and Google flu trends (GFT) data (ILI cases/100 000 physician visits). Congruity and correlation among these indicators and between these indicators and weekly count of laboratory-confirmed influenza in Manitoba was assessed graphically using linear regression models. Both ED and GFT data performed well as syndromic indicators of influenza activity, and were highly correlated with each other in real time. The strongest correlations between virological data and ED ILI volume and ED ILI percent, respectively, were 0·77 and 0·71. The strongest correlation of GFT was 0·74. Seasonal influenza activity may be effectively monitored using ED and GFT data.

Overcrowding in emergency departments: A review of strategies to decrease future challenges.

PubMed

Yarmohammadian, Mohammad H; Rezaei, Fatemeh; Haghshenas, Abbas; Tavakoli, Nahid

2017-01-01

Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track. Patients might be directed to different streaming channels depending on clinical status and required practitioners. The most comprehensive strategy is ideal ED patient journey models, in which ten interrelated substrategies are provided. ED leaders should apply strategies that provide a continuous care process without deeply depending on external services.

A proposed simulation optimization model framework for emergency department problems in public hospital

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2015-12-01

The Emergency Department (ED) is a very complex system with limited resources to support increase in demand. ED services are considered as good quality if they can meet the patient's expectation. Long waiting times and length of stay is always the main problem faced by the management. The management of ED should give greater emphasis on their capacity of resources in order to increase the quality of services, which conforms to patient satisfaction. This paper is a review of work in progress of a study being conducted in a government hospital in Selangor, Malaysia. This paper proposed a simulation optimization model framework which is used to study ED operations and problems as well as to find an optimal solution to the problems. The integration of simulation and optimization is hoped can assist management in decision making process regarding their resource capacity planning in order to improve current and future ED operations.

Gout and subsequent erectile dysfunction: a population-based cohort study from England.

PubMed

Abdul Sultan, Alyshah; Mallen, Christian; Hayward, Richard; Muller, Sara; Whittle, Rebecca; Hotston, Matthew; Roddy, Edward

2017-06-06

An association has been suggested between gout and erectile dysfunction (ED), however studies quantifying the risk of ED amongst gout patients are lacking. We aimed to precisely determine the population-level absolute and relative rate of ED reporting among men with gout over a decade in England. We utilised the UK-based Clinical Practice Research Datalink to identify 9653 men with incident gout age- and practice-matched to 38,218 controls. Absolute and relative rates of incident ED were calculated using Cox regression models. Absolute rates within specific time periods before and after gout diagnosis were compared to control using a Poisson regression model. Overall, the absolute rate of ED post-gout diagnosis was 193 (95% confidence interval (CI): 184-202) per 10,000 person-years. This corresponded to a 31% (hazard ratio (HR): 1.31 95%CI: 1.24-1.40) increased relative risk and 0.6% excess absolute risk compared to those without gout. We did not observe statistically significant differences in the risk of ED among those prescribed ULT within 1 and 3 years after gout diagnosis. Compared to those unexposed, the risk of ED was also high in the year before gout diagnosis (relative rate = 1.63 95%CI 1.27-2.08). Similar findings were also observed for severe ED warranting pharmacological intervention. We have shown a statistically significant increased risk of ED among men with gout. Our findings will have important implications in planning a multidisciplinary approach to managing patients with gout.

Communication and Influencing for ED Professionals: A training programme developed in the emergency department for the emergency department.

PubMed

Rixon, Andrew; Rixon, Sascha; Addae-Bosomprah, Hansel; Ding, Mingshuang; Bell, Anthony

2016-08-01

The objective of the present study is to develop and pilot a communication and influencing skills training programme that meets ED health professionals' needs at an urban district hospital. Qualitative methods within a participatory action research framework were utilised. An interdisciplinary team guided the programme's design and development. A training needs analysis saw team meetings, interviews, focus groups and observations conducted across the ED. Thematic analysis of the data identified health professionals' communication and influencing challenges. The training needs analysis informed the training programme curriculum's development. The pilot programme involved an interdisciplinary group of seven health professionals across 5 × 2 h sessions over 3 months, followed by a post-training survey. Five themes of communication and influencing challenges were identified: participating in effective handovers, involving patients in bedside handovers, effectively communicating with interdepartmental colleagues, asking ED colleagues to do tasks and understanding ED colleagues' roles, expectations and assumptions. Based on these challenges, the formulated RESPECT model (which stands for Relationships, Expectations, Styles, Partnerships, Enquiry, Coaching and Teamwork) informed the training curriculum. The peer coaching model used in the training programme was highly regarded by participants. Communication and Influencing for ED Professionals™ (Babel Fish Group Pty Ltd, Melbourne, Victoria, Australia) addresses a gap for communication programmes developed in the ED for the ED. Future research will evaluate the programme's impact in this ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Pathological motivations for exercise and eating disorder specific health-related quality of life.

PubMed

Cook, Brian; Engel, Scott; Crosby, Ross; Hausenblas, Heather; Wonderlich, Stephen; Mitchell, James

2014-04-01

To examine associations among pathological motivations for exercise with eating disorder (ED) specific health-related quality of life (HRQOL). Survey data assessing ED severity (i.e., Eating Disorder Diagnostic Survey), ED specific HRQOL (i.e., Eating Disorders Quality of Life Instrument), and pathological motivations for exercise (i.e., Exercise Dependence Scale) were collected from female students (N = 387) at seven universities throughout the United States. Regression analyses were conducted to examine the associations among exercise dependence, ED-specific HRQOL and ED severity, and the interaction of exercise dependence and ED severity on HRQOL scores. The overall model examining the impact of ED severity and exercise dependence (independent variables) on HRQOL (dependent variable) was significant and explained 16.1% of the variance in HRQOL scores. Additionally, the main effects for ED severity and exercise dependence and the interaction among ED severity and exercise dependence were significant, suggesting that the combined effects of ED severity and exercise dependence significantly impacts HRQOL. Our results suggest that pathological motivations for exercise may exacerbate ED's detrimental impact on HRQOL. Our results offer one possible insight into why exercise may be associated with deleterious effects on ED HRQOL. Future research is needed to elucidate the relationship among psychological aspects of exercise, ED, and HRQOL. Copyright © 2013 Wiley Periodicals, Inc.

Excessive daytime sleepiness in Parkinson disease: a SPECT study.

PubMed

Matsui, Hideaki; Nishinaka, Kazuto; Oda, Masaya; Hara, Narihiro; Komatsu, Kenichi; Kubori, Tamotsu; Udaka, Fukashi

2006-07-01

The underlying pathologic mechanism of excessive daytime sleepiness (EDS) in Parkinson disease and the relative contributions of brain function to this process are poorly understood. We compared brain perfusion images between patients with Parkinson disease and EDS and those without EDS using n-isopropyl-p-1231 iodoamphetamine single photon emission computed tomography. Clinical study. Sumitomo Hospital. Thirteen patients with Parkinson disease with EDS (EDS group) and 27 patients with Parkinson disease without EDS (no-EDS group) were studied. Whether or not each case had EDS was determined according to the response to the Epworth Sleepiness Scale: patients with an Epworth Sleepiness Scale score > or = 10 were included in the EDS group, and patients with an Epworth Sleepiness Scale score < or = 9 were included in the no-EDS group. There were significant hypoperfusions in the left parietal and temporal association cortex in the EDS group. In the multivariable logistic regression model, attention and decreased regional cerebral blood flow of the left parietal association cortex and right caudate and increased regional cerebral blood flow of the right thalamus were the independent and significant factors. The cortical hypofunction relative to hyperfunction of the brain stem may relate to EDS in Parkinson disease. This is the first imaging study about EDS in Parkinson disease, and further studies are required.

Process-based modeling of species' responses to climate change - a proof of concept using western North American trees

NASA Astrophysics Data System (ADS)

Evans, M. E.; Merow, C.; Record, S.; Menlove, J.; Gray, A.; Cundiff, J.; McMahon, S.; Enquist, B. J.

2013-12-01

Current attempts to forecast how species' distributions will change in response to climate change suffer under a fundamental trade-off: between modeling many species superficially vs. few species in detail (between correlative vs. mechanistic models). The goals of this talk are two-fold: first, we present a Bayesian multilevel modeling framework, dynamic range modeling (DRM), for building process-based forecasts of many species' distributions at a time, designed to address the trade-off between detail and number of distribution forecasts. In contrast to 'species distribution modeling' or 'niche modeling', which uses only species' occurrence data and environmental data, DRMs draw upon demographic data, abundance data, trait data, occurrence data, and GIS layers of climate in a single framework to account for two processes known to influence range dynamics - demography and dispersal. The vision is to use extensive databases on plant demography, distributions, and traits - in the Botanical Information and Ecology Network, the Forest Inventory and Analysis database (FIA), and the International Tree Ring Data Bank - to develop DRMs for North American trees. Second, we present preliminary results from building the core submodel of a DRM - an integral projection model (IPM) - for a sample of dominant tree species in western North America. IPMs are used to infer demographic niches - i.e., the set of environmental conditions under which population growth rate is positive - and project population dynamics through time. Based on >550,000 data points derived from FIA for nine tree species in western North America, we show IPM-based models of their current and future distributions, and discuss how IPMs can be used to forecast future forest productivity, mortality patterns, and inform efforts at assisted migration.

Meeting the Next Generation Science Standards Through "Rediscovered" Climate Model Experiments

NASA Astrophysics Data System (ADS)

Sohl, L. E.; Chandler, M. A.; Zhou, J.

2013-12-01

Since the Educational Global Climate Model (EdGCM) Project made its debut in January 2005, over 150 institutions have employed EdGCM software for a variety of uses ranging from short lab exercises to semester-long and year-long thesis projects. The vast majority of these EdGCM adoptees have been at the undergraduate and graduate levels, with few users at the K-12 level. The K-12 instructors who have worked with EdGCM in professional development settings have commented that, although EdGCM can be used to illustrate a number of the Disciplinary Core Ideas and connects to many of the Common Core State Standards across subjects and grade levels, significant hurdles preclude easy integration of EdGCM into their curricula. Time constraints, a scarcity of curriculum materials, and classroom technology are often mentioned as obstacles in providing experiences to younger grade levels in realistic climate modeling research. Given that the NGSS incorporates student performance expectations relating to Earth System Science, and to climate science and the human dimension in particular, we feel that a streamlined version of EdGCM -- one that eliminates the need to run the climate model on limited computing resources, and provides a more guided climate modeling experience -- would be highly beneficial for the K-12 community. This new tool currently under development, called EzGCM, functions through a browser interface, and presents "rediscovery experiments" that allow students to do their own exploration of model output from published climate experiments, or from sensitivity experiments designed to illustrate how climate models as well as the climate system work. The experiments include background information and sample questions, with more extensive notes for instructors so that the instructors can design their own reflection questions or follow-on activities relating to physical or human impacts, as they choose. An added benefit of the EzGCM tool is that, like EdGCM, it helps illustrate the process of doing research on a complex topic, in a way that builds upon earlier experiences in inquiry-based learning. By having students work through a multi-stage process that requires them to plan several steps ahead, through data processing, analysis and interpretation, they learn how to do research in addition to improving their understanding of climate change.

Influence of Price and Labeling on Energy Drink Purchasing in an Experimental Convenience Store.

PubMed

Temple, Jennifer L; Ziegler, Amanda M; Epstein, Leonard H

2016-01-01

To examine the impact of energy drink (ED) pricing and labeling on the purchase of EDs. Participants visited a laboratory-based convenience store 3 times and purchased a beverage under different ED labeling (none, caffeine content, and warning labels) and pricing conditions. The 36 participants (aged 15-30 years) were classified as energy drink consumers (≥ 2 energy drinks/wk) and nonconsumers (< 1 energy drink/mo). Data were log transformed to generate elasticity coefficients. The authors analyzed changes in elasticity as a function of price and labeling using mixed-effects regression models. Increasing the price of EDs reduced ED purchases and increased purchasing of other caffeinated beverages among ED consumers. Energy drink labels affected ED sales in adolescents. These data suggest that ED pricing and labeling may influence the purchasing of ED, especially in adolescent consumers. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The future demographic niche of a declining grassland bird fails to shift poleward in response to climate change

USGS Publications Warehouse

McCauley, Lisa A.; Ribic, Christine; Pomara, Lars Y.; Zuckerberg, Benjamin

2017-01-01

ContextTemperate grasslands and their dependent species are exposed to high variability in weather and climate due to the lack of natural buffers such as forests. Grassland birds are particularly vulnerable to this variability, yet have failed to shift poleward in response to recent climate change like other bird species in North America. However, there have been few studies examining the effect of weather on grassland bird demography and consequent influence of climate change on population persistence and distributional shifts.ObjectivesThe goal of this study was to estimate the vulnerability of Henslow’s Sparrow (Ammodramus henslowii), an obligate grassland bird that has been declining throughout much of its range, to past and future climatic variability.MethodsWe conducted a demographic meta-analysis from published studies and quantified the relationship between nest success rates and variability in breeding season climate. We projected the climate-demography relationships spatially, throughout the breeding range, and temporally, from 1981 to 2050. These projections were used to evaluate population dynamics by implementing a spatially explicit population model.ResultsWe uncovered a climate-demography linkage for Henslow’s Sparrow with summer precipitation, and to a lesser degree, temperature positively affecting nest success. We found that future climatic conditions—primarily changes in precipitation—will likely contribute to reduced population persistence and a southwestward range contraction.ConclusionsFuture distributional shifts in response to climate change may not always be poleward and assessing projected changes in precipitation is critical for grassland bird conservation and climate change adaptation.

Contribution of Interpersonal Problems to Eating Disorder Psychopathology via Negative Affect in Treatment-seeking Men and Women: Testing the Validity of the Interpersonal Model in an Understudied Population.

PubMed

Ivanova, Iryna V; Tasca, Giorgio A; Proulx, Geneviève; Bissasda, Hany

2017-07-01

Research on the psychosocial correlates and theoretical frameworks of men presenting with eating disorders (ED) psychopathology is limited. This study compared treatment-seeking men and women in terms of their levels of interpersonal functioning (affiliation and dominance), regulation of negative emotions (negative affect and instability) and ED psychopathology. The study also investigated the validity of the interpersonal model of ED in men. Results from the cross-sectional data of 388 participants (137 men and 251 women) demonstrated that the structural models fit and that paths were invariant across men and women. There were significant indirect effects of interpersonal functioning on ED psychopathology, mediated through negative affect and instability, for both men and women. Negative affect and instability partially explain the relationship between interpersonal problems and ED psychopathology in treatment-seeking men and women. Current findings highlight the need to evaluate the validity of the model using longitudinal designs to test whether men and women are likely to benefit equally from interpersonal therapies for ED. Copyright © 2016 John Wiley & Sons, Ltd. Negative affect and instability mediated the relationship between interpersonal problems and eating disorder psychopathology for treatment-seeking men and women. There were no gender differences between levels of negative affect, emotional instability and interpersonal dysfunction, but women reported slightly higher eating concerns than men. Interpersonal model is a framework that is applicable to understanding and potentially treating men with eating disorders. Copyright © 2016 John Wiley & Sons, Ltd.

Patient flow within UK emergency departments: a systematic review of the use of computer simulation modelling methods

PubMed Central

Mohiuddin, Syed; Busby, John; Savović, Jelena; Richards, Alison; Northstone, Kate; Hollingworth, William; Donovan, Jenny L; Vasilakis, Christos

2017-01-01

Objectives Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK. Methods We searched eight bibliographic databases (MEDLINE, EMBASE, COCHRANE, WEB OF SCIENCE, CINAHL, INSPEC, MATHSCINET and ACM DIGITAL LIBRARY) from date of inception until 31 March 2016. Studies were included if they used a computer simulation method to capture patient progression within the ED of an established UK National Health Service hospital. Studies were summarised in terms of simulation method, key assumptions, input and output data, conclusions drawn and implementation of results. Results Twenty-one studies met the inclusion criteria. Of these, 19 used discrete event simulation and 2 used system dynamics models. The purpose of many of these studies (n=16; 76%) centred on service redesign. Seven studies (33%) provided no details about the ED being investigated. Most studies (n=18; 86%) used specific hospital models of ED patient flow. Overall, the reporting of underlying modelling assumptions was poor. Nineteen studies (90%) considered patient waiting or throughput times as the key outcome measure. Twelve studies (57%) reported some involvement of stakeholders in the simulation study. However, only three studies (14%) reported on the implementation of changes supported by the simulation. Conclusions We found that computer simulation can provide a means to pretest changes to ED care delivery before implementation in a safe and efficient manner. However, the evidence base is small and poorly developed. There are some methodological, data, stakeholder, implementation and reporting issues, which must be addressed by future studies. PMID:28487459

Emergency department waiting times: Do the raw data tell the whole story?

PubMed

Green, Janette; Dawber, James; Masso, Malcolm; Eagar, Kathy

2014-02-01

To determine whether there are real differences in emergency department (ED) performance between Australian states and territories. Cross-sectional analysis of 2009-10 attendances at an ED contributing to the Australian non-admitted patient ED care database. The main outcome measure was difference in waiting time across triage categories. There were more than 5.8 million ED attendances. Raw ED waiting times varied by a range of factors including jurisdiction, triage category, geographic location and hospital peer group. All variables were significant in a model designed to test the effect of jurisdiction on ED waiting times, including triage category, hospital peer group, patient socioeconomic status and patient remoteness. When the interaction between triage category and jurisdiction entered the model, it was found to have a significant effect on ED waiting times (P<0.001) and triage was also significant (P<0.001). Jurisdiction was no longer statistically significant (P=0.248 using all triage categories and 0.063 using only Australian Triage Scale 2 and 3). Although the Council of Australian Governments has adopted raw measures for its key ED performance indicators, raw waiting time statistics are misleading. There are no consistent differences in ED waiting times between states and territories after other factors are accounted for. WHAT IS KNOWN ABOUT THE TOPIC? The length of time patients wait to be treated after presenting at an ED is routinely used to measure ED performance. In national health agreements with the federal government, each state and territory in Australia is expected to meet waiting time performance targets for the five ED triage categories. The raw data indicate differences in performance between states and territories. WHAT DOES THIS PAPER ADD? Measuring ED performance using raw data gives misleading results. There are no consistent differences in ED waiting times between the states and territories after other factors are taken into account. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Judgements regarding differences in performance across states and territories for triage waiting times need to take into account the mix of patients and the mix of hospitals.

A Comparison of Parallel and Integrated Models for Implementation of Routine HIV Screening in a Large, Urban Emergency Department.

PubMed

Hankin, Abigail; Freiman, Heather; Copeland, Brittney; Travis, Natasha; Shah, Bijal

2016-01-01

This study compared two approaches for implementation of non-targeted HIV screening in the emergency department (ED): (1) designated HIV counselors screening in parallel with ED care and (2) nurse-based screening integrated into patient triage. A retrospective analysis was performed to compare parallel and integrated screening models using data from the first 12 months of each program. Data for the parallel screening model were extracted from information collected by HIV test counselors and the electronic medical record (EMR). Integrated screening model data were extracted from the EMR and supplemented by data collected by HIV social workers during patient interaction. For both programs, data included demographics, HIV test offer, test acceptance or declination, and test result. A Z-test between two proportions was performed to compare screening frequencies and results. During the first 12 months of parallel screening, approximately 120,000 visits were made to the ED, with 3,816 (3%) HIV tests administered and 65 (2%) new diagnoses of HIV infection. During the first 12 months of integrated screening, 111,738 patients were triaged in the ED, with 16,329 (15%) patients tested and 190 (1%) new diagnoses. Integrated screening resulted in an increased frequency of HIV screening compared with parallel screening (0.15 tests per ED patient visit vs. 0.03 tests per ED patient visit, p<0.001) and an increase in the absolute number of new diagnoses (190 vs. 65), representing a slight decrease in the proportion of new diagnoses (1% vs. 2%, p=0.007). Non-targeted, integrated HIV screening, with test offer and order by ED nurses during patient triage, is feasible and resulted in an increased frequency of HIV screening and a threefold increase in the absolute number of newly identified HIV-positive patients.

Erectile dysfunction and exposure to ambient Air pollution in a nationally representative cohort of older Men.

PubMed

Tallon, Lindsay A; Manjourides, Justin; Pun, Vivian C; Mittleman, Murray A; Kioumourtzoglou, Marianthi-Anna; Coull, Brent; Suh, Helen

2017-02-17

Little is known about the association between air pollution and erectile dysfunction (ED), a disorder occurring in 64% of men over the age of 70, and to date, no studies have been published. To address this significant knowledge gap, we explored the relationship between ED and air pollution in a group of older men who were part of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative cohort study of older Americans. We obtained incident ED status and participant data for 412 men (age 57-85). Fine particulate matter (PM 2.5 ) exposures were estimated using spatio-temporal models based on participants' geocoded addresses, while nitrogen dioxide (NO 2 ) and ozone (O 3 ) concentrations were estimated using nearest measurements from the Environmental Protection Agency's Air Quality System. The association between air pollution and incident ED (newly developed in Wave 2) was examined and logistic regression models were run with adjusted models controlling for race, education, season, smoking, obesity, diabetes, depression, and median household income of census tract. We found positive, although statistically insignificant, associations between PM 2.5 , NO 2 , and O 3 exposures and odds of incident ED for each of our examined exposure windows, including 1 to 7 year moving averages. Odds ratios (OR) for 1 and 7 year moving averages equaled 1.16 (95% CI: 0.87, 1.55) and 1.16 (95% CI: 0.92, 1.46), respectively, for an IQR increase in PM 2.5 exposures. Observed associations were robust to model specifications and were not significantly modified by any of the examined risk factors for ED. We found associations between PM 2.5 , NO 2 , and O 3 exposures and odds of developing ED that did not reach nominal statistical significance, although exposures to each pollutant were consistently associated with higher odds of developing ED. While more research is needed, our findings suggest a relationship between air pollutant exposure and incident cases of ED, a common condition in older men.

A daily herd Markov-chain model to study the reproductive and economic impact of reproductive programs combining timed artificial insemination and estrus detection.

PubMed

Giordano, J O; Kalantari, A S; Fricke, P M; Wiltbank, M C; Cabrera, V E

2012-09-01

Our objective was to compare the economic and reproductive performance of programs combining timed artificial insemination (TAI) and different levels of AI after estrus detection (ED) using a daily Markov-chain model. A dairy herd was modeled with every cow following daily probabilistic events of aging, replacement, mortality, pregnancy, pregnancy loss, and calving. The probability of pregnancy depended on the combination of probability of insemination and conception rate (CR). All nonpregnant cows had a probability of pregnancy between the end of the voluntary waiting period and days in milk cutoff for AI. After the cutoff, cows were labeled as do not breed and replaced when milk production was below a minimum milk threshold. A similar model was created to represent a replacement heifer herd to simulate and adjust the supply and demand of replacements. The net value (NV) of a program was the sum of milk income over feed cost, replacement and mortality cost, income from newborns, and reproductive costs. The model was used to compare the NV of 19 programs. One program used 100% TAI (42% CR for first TAI and 30% for second-and-later services), whereas the other programs combined TAI with ED. The proportion of cows receiving AI after ED for the combined programs ranged from 30 to 80%, with levels of CR of 25, 30, and 35%. As the proportion of cows receiving AI after ED increased, the CR of cows receiving TAI decreased. The combined programs with CR of 35% for cows receiving AI after ED had the greatest NV and reproductive performance at all levels of ED. The program using 100% TAI had greater NV and better reproductive performance than all programs with 25% CR after ED inseminations, whereas it had very similar performance to combined programs with up to 60% of cows receiving AI after ED and 30% CR. The factor with the greatest relative contribution to the differences among programs was income over feed cost, followed by replacement and reproductive costs. Adjusting the days in milk cutoff for AI to match the supply and demand of heifer replacements improved the NV of all programs except for those with 25% CR after ED, which had either no change or a decrease in NV. In summary, the economic value of reproductive management programs combining TAI and ED depended on the proportion of cows receiving AI after ED and the resulting CR. Adjusting the heifer supply and demand increased the NV of programs with heifer surplus and decreased the NV of programs with heifer deficit. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Biological processes dominate seasonality of remotely sensed canopy greenness in an Amazon evergreen forest.

PubMed

Wu, Jin; Kobayashi, Hideki; Stark, Scott C; Meng, Ran; Guan, Kaiyu; Tran, Ngoc Nguyen; Gao, Sicong; Yang, Wei; Restrepo-Coupe, Natalia; Miura, Tomoaki; Oliviera, Raimundo Cosme; Rogers, Alistair; Dye, Dennis G; Nelson, Bruce W; Serbin, Shawn P; Huete, Alfredo R; Saleska, Scott R

2018-03-01

Satellite observations of Amazon forests show seasonal and interannual variations, but the underlying biological processes remain debated. Here we combined radiative transfer models (RTMs) with field observations of Amazon forest leaf and canopy characteristics to test three hypotheses for satellite-observed canopy reflectance seasonality: seasonal changes in leaf area index, in canopy-surface leafless crown fraction and/or in leaf demography. Canopy RTMs (PROSAIL and FLiES), driven by these three factors combined, simulated satellite-observed seasonal patterns well, explaining c. 70% of the variability in a key reflectance-based vegetation index (MAIAC EVI, which removes artifacts that would otherwise arise from clouds/aerosols and sun-sensor geometry). Leaf area index, leafless crown fraction and leaf demography independently accounted for 1, 33 and 66% of FLiES-simulated EVI seasonality, respectively. These factors also strongly influenced modeled near-infrared (NIR) reflectance, explaining why both modeled and observed EVI, which is especially sensitive to NIR, captures canopy seasonal dynamics well. Our improved analysis of canopy-scale biophysics rules out satellite artifacts as significant causes of satellite-observed seasonal patterns at this site, implying that aggregated phenology explains the larger scale remotely observed patterns. This work significantly reconciles current controversies about satellite-detected Amazon phenology, and improves our use of satellite observations to study climate-phenology relationships in the tropics. No claim to original US Government works New Phytologist © 2017 New Phytologist Trust.

Supermassive black-hole growth over cosmic time: active galaxy demography, physics, and ecology from Chandra surveys.

PubMed

Brandt, W N; Alexander, D M

2010-04-20

Extragalactic X-ray surveys over the past decade have dramatically improved understanding of the majority populations of active galactic nuclei (AGNs) over most of the history of the universe. Here we briefly highlight some of the exciting discoveries about AGN demography, physics, and ecology, with a focus on results from Chandra. We also discuss some key unresolved questions and future prospects.

Supermassive black-hole growth over cosmic time: Active galaxy demography, physics, and ecology from Chandra surveys

PubMed Central

Brandt, W. N.; Alexander, D. M.

2010-01-01

Extragalactic X-ray surveys over the past decade have dramatically improved understanding of the majority populations of active galactic nuclei (AGNs) over most of the history of the universe. Here we briefly highlight some of the exciting discoveries about AGN demography, physics, and ecology, with a focus on results from Chandra. We also discuss some key unresolved questions and future prospects. PMID:20404160

Medical Mondays: ED Utilization for Medicaid Recipients Depends on the Day of the Week, Season, and Holidays.

PubMed

Castner, Jessica; Yin, Yong; Loomis, Dianne; Hewner, Sharon

2016-07-01

The purpose of this study is to describe and explain the temporal and seasonal trends in ED utilization for a low-income population. A retrospective analysis of 66,487 ED Medicaid-insured health care claims in 2009 was conducted for 2 Western New York Counties using time-series analysis with autoregressive moving average (ARMA) models. The final ARMA (2,0) model indicated an autoregressive structure with up to a 2-day lag. ED volume is lower on weekends than on weekdays, and the highest volumes are on Mondays. Summer and fall seasons demonstrated higher volumes, whereas lower volume outliers were associated with holidays. Day of the week was an influential predictor of ED utilization in low-income persons. Season and holidays are also predictors of ED utilization. These calendar-based patterns support the need for ongoing and future emergency leaders' collaborations in community-based care system redesign to meet the health care access needs of low-income persons. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Antenatal and Postnatal Psychopathology Among Women with Current and Past Eating Disorders: Longitudinal Patterns

PubMed Central

Easter, Abigail; Solmi, Francessca; Bye, Amanda; Taborelli, Emma; Corfield, Freya; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

2015-01-01

This study aims to investigate longitudinal patterns of psychopathology during the antenatal and postnatal periods among women with current (C-ED) and past (P-ED) eating disorders. Women were recruited to a prospective longitudinal study: C-ED (n = 31), P-ED (n = 29) and healthy control (HC; n = 57). Anxiety, depression and ED symptoms were measured at four time points: first/second trimester, third trimester, 8 weeks and 6 months postpartum. Linear mixed effects models were used to test for group differences. Women with C-ED and P-ED, in all diagnostic categories, had significantly higher levels of psychopathology at all time points. ED symptoms decreased in the C-ED group, compared with an overall increase in the other two groups but subsequently increased after pregnancy. Overall, depression and state and trait anxiety scores decreased in the C-ED group compared with the HC group throughout the antenatal and postnatal periods. High levels of psychopathology are common throughout the antenatal and postnatal periods among women with current and past ED, and despite some overall reductions, symptoms remain clinically significant. © 2014 The Authors. European Eating Disorders Review published by John Wiley & Sons, Ltd. PMID:25345371

Applying the ED QUEST Planning Model in a School of Management: A Case Study.

ERIC Educational Resources Information Center

Ptaszynski, James Garner; Morrison, James L.

1990-01-01

The Strategic Planning Committee at the Graduate School of Management, Wake Forest University, identified what issues, trends, and possible events might affect the school in the future. The implementation of the ED QUEST planning model is described. (MLW)

Dependence and physical exercise: Spanish validation of the Exercise Dependence Scale-Revised (EDS-R).

PubMed

Sicilia, Alvaro; González-Cutre, David

2011-05-01

The purpose of this study was to validate the Spanish version of the Exercise Dependence Scale-Revised (EDS-R). To achieve this goal, a sample of 531 sport center users was used and the psychometric properties of the EDS-R were examined through different analyses. The results supported both the first-order seven-factor model and the higher-order model (seven first-order factors and one second-order factor). The structure of both models was invariant across age. Correlations among the subscales indicated a related factor model, supporting construct validity of the scale. Alpha values over .70 (except for Reduction in Other Activities) and suitable levels of temporal stability were obtained. Users practicing more than three days per week had higher scores in all subscales than the group practicing with a frequency of three days or fewer. The findings of this study provided reliability and validity for the EDS-R in a Spanish context.

Optimal time--energy allocation and the evolution of colony demography among eusocial insects. [Polistes fuscatus, Vespa orientalis, ants

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

Macevicz, S.C.

1979-05-09

This thesis attempts to explain the evolution of certain features of social insect colony population structure by the use of optimization models. Two areas are examined in detail. First, the optimal reproductive strategies of annual eusocial insects are considered. A model is constructed for the growth of workers and reproductives as a function of the resources allocated to each. Next the allocation schedule is computed which yields the maximum number of reproductives by season's end. The results indicate that if there is constant return to scale for allocated resources the optimal strategy is to invest in colony growth until approximatelymore » one generation before season's end, whereupon worker production ceases and reproductive effort is switched entirely to producing queens and males. Furthermore, the results indicate that if there is decreasing return to scale for allocated resources then simultaneous production of workers and reproductives is possible. The model is used to explain the colony demography of two species of wasp, Polistes fuscatus and Vespa orientalis. Colonies of these insects undergo a sudden switch from the production of workers to the production of reproductives. The second area examined concerns optimal forager size distributions for monomorphic ant colonies. A model is constructed that describes the colony's energetic profit as a function which depends on the size distribution of food resources as well as forager efficiency, metabolic costs, and manufacturing costs.« less

Influences on emergency department length of stay for older people.

PubMed

Street, Maryann; Mohebbi, Mohammadreza; Berry, Debra; Cross, Anthony; Considine, Julie

2018-02-14

The aim of this study was to examine the influences on emergency department (ED) length of stay (LOS) for older people and develop a predictive model for an ED LOS more than 4 h. This retrospective cohort study used organizational data linkage at the patient level from a major Australian health service. The study population was aged 65 years or older, attending an ED during the 2013/2014 financial year. We developed and internally validated a clinical prediction rule. Discriminatory performance of the model was evaluated by receiver operating characteristic (ROC) curve analysis. An integer-based risk score was developed using multivariate logistic regression. The risk score was evaluated using ROC analysis. There were 33 926 ED attendances: 57.5% (n=19 517) had an ED LOS more than 4 h. The area under ROC for age, usual accommodation, triage category, arrival by ambulance, arrival overnight, imaging, laboratory investigations, overcrowding, time to be seen by doctor, ED visits with admission and access block relating to ED LOS more than 4 h was 0.796, indicating good performance. In the validation set, area under ROC was 0.80, P-value was 0.36 and prediction mean square error was 0.18, indicating good calibration. The risk score value attributed to each risk factor ranged from 2 to 68 points. The clinical prediction rule stratified patients into five levels of risk on the basis of the total risk score. Objective identification of older people at intermediate and high risk of an ED LOS more than 4 h early in ED care enables targeted approaches to streamline the patient journey, decrease ED LOS and optimize emergency care for older people.

The NOURISHED randomised controlled trial comparing mentalisation-based treatment for eating disorders (MBT-ED) with specialist supportive clinical management (SSCM-ED) for patients with eating disorders and symptoms of borderline personality disorder.

PubMed

Robinson, Paul; Hellier, Jennifer; Barrett, Barbara; Barzdaitiene, Daiva; Bateman, Anthony; Bogaardt, Alexandra; Clare, Ajay; Somers, Nadia; O'Callaghan, Aine; Goldsmith, Kimberley; Kern, Nikola; Schmidt, Ulrike; Morando, Sara; Ouellet-Courtois, Catherine; Roberts, Alice; Skårderud, Finn; Fonagy, Peter

2016-11-17

In this multi-centre randomized controlled trial (RCT) we compared modified mentalisation-based treatment (MBT-ED) to specialist supportive clinical management (SSCM-ED) in patients with eating disorders (EDs) and borderline personality disorder symptoms (BPD). This group of patients presents complex challenges to clinical services, and a treatment which addresses their multiple problems has the potential to improve outcome. MBT has been shown to be effective in improving outcome in patients with BPD, but its use has not been reported in ED. Sixty-eight eligible participants were randomised to MBT-ED or SSCM-ED. The primary outcome measure was the global score on the Eating Disorder Examination. Secondary outcomes included measures of BPD symptoms (the Zanarini Rating Scale for Borderline Personality Disorder), general psychiatric state, quality of life and service utilisation. Participants were assessed at baseline and at 6, 12 and 18 months after randomisation. Analysis was performed using linear mixed models. Only 15 participants (22 %) completed the 18 month follow-up. Early drop-out occurred significantly more in the SSCM-ED group. Drop-out did not vary with treatment model later in therapy and was sometimes attributed to participants moving away. There was higher drop--out amongst smokers and those with higher neuroticism scores. 47.1 % of participants in the MBT-ED arm and 37.1 % in the SSCM-ED arm attended at least 50 % of therapy sessions offered. Amongst those remaining in the trial, at 12 and 18 months MBT-ED was associated with a greater reduction in Shape Concern and Weight Concern in the Eating Disorder Examination compared to SSCM-ED. At 6, 12 and 18 months there was a decline of ED and BPD symptoms in both groups combined. Ten participants were reported as having had adverse events during the trial, mostly self-harm, and there was one death, attributed as 'unexplained' by the coroner. The high drop-out rate made interpretation of the results difficult. Greater involvement of research staff in clinical management might have improved compliance with both therapy and research assessment. MBT-ED may have had an impact on core body image psychopathology. Current Controlled Trials: ISRCTN51304415 . Registered on 19 April 2011.

Mapping patient flow in a regional Australian emergency department: a model driven approach.

PubMed

Martin, Mary; Champion, Robert; Kinsman, Leigh; Masman, Kevin

2011-04-01

Unified Modelling Language (UML) models of the patient journey in a regional Australian emergency department (ED) were used to develop an accurate, complete representation of ED processes and drive the collection of comprehensive quantitative and qualitative service delivery and patient treatment data as an evidence base for hospital service planning. The focus was to identify bottle-necks that contribute to over-crowding. Data was collected entirely independently of the routine hospital data collection system. The greatest source of delay in patient flow was the waiting time from a bed request to exit from the ED for hospital admission. It represented 61% of the time that these patients occupied ED cubicles. The physical layout of the triage area was identified as counterproductive to efficient triaging, and the results of investigations were often observed to be available for some time before clinical staff became aware. The use of independent primary data to construct UML models of the patient journey was effective in identifying sources of delay in patient flow, and aspects of ED activity that could be improved. The findings contributed to recent department re-design and informed an initiative to develop a business intelligence system for predicting impending occurrence of access block. Copyright © 2010 Elsevier Ltd. All rights reserved.

Detailed spectral profile analysis of electrocorticograms during freezing against penicillin-induced epileptiform discharges in the anesthetized rat.

PubMed

Tokiwa, Tatsuji; Zimin, Lev; Inoue, Takao; Nomura, Sadahiro; Suzuki, Michiyasu; Yamakawa, Takeshi

2018-07-01

Cryosurgery is an alternative technique for minimally invasive treatment of lesions. We have recently examined cryosurgery for epilepsy in animal models, and found that penicillin G (PG)-induced epileptiform discharges (EDs) mostly vanished after freezing. However, EDs were provoked again after insufficient freezing. Inadequate freezing is not visually detectable during and just after freezing and is not predictable beforehand. To manage this problem, we examined whether intraoperative monitoring of electrocorticograms (ECoGs) can predict recurrence of EDs after cryosurgery. A palm-sized cryoprobe system was applied to focal seizures in a Wistar rat model in which EDs were induced in advance by intracerebral injection of PG. During stable induction of EDs, the cryoprobe was carefully inserted into the epileptic region and this region was immediately frozen. After the series of prefreezing, freezing, and postfreezing, rats in which PG-induced EDs relapsed within 3 h were defined as the ED-relapsed (EDR) group, and other rats were defined as the ED-vanished (EDV) group. Time-frequency analysis was conducted on the ECoGs in each group through each freezing series. Relapse of PG-induced EDs on ECoG after the freezing series was associated with the remaining power of the delta band in the freezing period more strongly in the EDR group than in the EDV group. Success or failure of the freezing procedure can be predicted by the specificity of the delta band of the ECoG obtained intraoperatively. Copyright © 2018 Elsevier B.V. All rights reserved.

Child, caregiver, and family characteristics associated with emergency department use by children who remain at home after a child protective services investigation

PubMed Central

Hurlburt, Michael S.; Leslie, Laurel K.; Zhang, Jinjin; Horwitz, Sarah McCue

2012-01-01

Objectives To examine emergency department (ED) use among children involved with child protective services (CPS) in the U.S. but who remain at home, and to determine if ED use is related to child, caregiver and family characteristics as well as receipt of CPS services. Method We analyzed data on 4,001 children in the National Survey of Child and Adolescent Well-being. Multivariate models compared rates of ED use for whether the family received CPS services or did not receive CPS services as well as child characteristics, caregiver characteristics and caregiver/family psychological variables. Results ED use among children who remained at home receiving CPS services was similar to that of children who did not receive CPS services (35.6% and 37.4%, respectively). In multivariate modeling, children with families who received CPS services, children six years or older, and children without a chronic health problem were less likely to use the ED. Children who remained at home in families identified with numerous stressors and, therefore, likely at high risk for future abuse and neglect were 1.73 times (95% CI, 1.14–2.63) more likely to have repeat ED use than children in low risk families. Conclusion Children who remain at home after a CPS evaluation are at high risk for ED use. Future research should focus on the health problems that precipitate an ED visit as well as the relationship between primary care and ED use. PMID:22265905

Simulating changes in ecosystem structure and composition in response to climate change: a case study focused on tropical nitrogen-fixing trees (Invited)

NASA Astrophysics Data System (ADS)

Medvigy, D.; Levy, J.; Xu, X.; Batterman, S. A.; Hedin, L.

2013-12-01

Ecosystems, by definition, involve a community of organisms. These communities generally exhibit heterogeneity in their structure and composition as a result of local variations in climate, soil, topography, disturbance history, and other factors. Climate-driven shifts in ecosystems will likely include an internal re-organization of community structure and composition and as well as the introduction of novel species. In terms of vegetation, this ecosystem heterogeneity can occur at relatively small scales, sometimes of the order of tens of meters or even less. Because this heterogeneous landscape generally has a variable and nonlinear response to environmental perturbations, it is necessary to carefully aggregate the local competitive dynamics between individual plants to the large scales of tens or hundreds of kilometers represented in climate models. Accomplishing this aggregation in a computationally efficient way has proven to be an extremely challenging task. To meet this challenge, the Ecosystem Demography 2 (ED2) model statistically characterizes a distribution of local resource environments, and then simulates the competition between individuals of different sizes and species (or functional groupings). Within this framework, it is possible to explicitly simulate the impacts of climate change on ecosystem structure and composition, including both internal re-organization and the introduction of novel species or functional groups. This presentation will include several illustrative applications of the evolution of ecosystem structure and composition under climate change. One application pertains to the role of nitrogen-fixing species in tropical forests. Will increasing CO2 concentrations increase the demand for nutrients and perhaps give a competitive edge to nitrogen-fixing species? Will potentially warmer and drier conditions make some tropical forests more water-limited, reducing the demand for nitrogen, thereby giving a competitive advantage to non-nitrogen-fixing species? Will the response of nitrogen-fixing species to climate change be sensitive to local disturbance histories?

An Archaeological an Bioarchaeological Perspective. The Tucker (41DT104) and Sinclair (41DT105) Cemeteries of Delta County, Texas

DTIC Science & Technology

1988-01-01

Gilbert and Mielke 1985). The adaptive efficiency will be measured here by demography , childhood mortality, adult longevity , disease, and fiequency of...Episodes of childhood stress through time by individual 6-month intervals .... ............ .. 105 15. The demography of the Tucker Cemetery...tradition, it represented a very practical position among many pioneer , rural families where: few churches existed in the early years of settlement

Grand Forks - East Grand Forks Urban Water Resources Study. Social and Environmental Inventory.

DTIC Science & Technology

1979-01-01

61 Introduction 57IPrehistoric 58 Historic 58-61 Social Organization 62-72 Introduction 62 Demography 62-63 Population Distribution by Age 64-65 Urban...programs, native timber is decreasing due to agricultural clearing operatings and urban growth. Native tree species are important because of their longevity ... Demography 62-63 Population Distribution by Age 64-65 Urban-Rural Distribution 66 Population Projections 67-68 Racial Distribution 69 Ethnic Groups 70

Merced County Streams Project, Bear Reservoir, California. Intensive Cultural Resources Survey.

DTIC Science & Technology

1982-03-01

all shown on the Official Map of Mariposa County for 1897. William A. Grade, a pioneer merchant of Mariposa, began buying ranch lands to the north of...divided into four areas: (1) cultural change, (2) subsistence and settlement, (3) cultural and social interactions, and (4) paleo- demography . Numerous...indicative of the Yosemite region. Other research questions, based upon research domains such as demography , are possible but, given the limitations of a cul

Climatic and biotic stochasticity: disparate causes of convergent demographies in rare, sympatric plants.

PubMed

Fox, Laurel R

2007-12-01

Species with known demographies may be used as proxies, or approximate models, to predict vital rates and ecological properties of target species that either have not been studied or are species for which data may be difficult to obtain. These extrapolations assume that model and target species with similar properties respond in the same ways to the same ecological factors, that they have similar population dynamics, and that the similarity of vital rates reflects analogous responses to the same factors. I used two rare, sympatric annual plants (sand gilia [Gilia tenuiflora arenaria] and Monterey spineflower [Chorizanthe pungens pungens]) to test these assumptions experimentally. The vital rates of these species are similar and strongly correlated with rainfall, and I added water and/or prevented herbivore access to experimental plots. Their survival and reproduction were driven by different, largely stochastic factors and processes: sand gilia by herbivory and Monterey spineflower by rainfall. Because the causal agents and processes generating similar demographic patterns were species specific, these results demonstrate, both theoretically and empirically, that it is critical to identify the ecological processes generating observed effects and that experimental manipulations are usually needed to determine causal mechanisms. Without such evidence to identify mechanisms, extrapolations among species may lead to counterproductive management and conservation practices.

Do we have to choose between feeding the human population and conserving nature? Modelling the global dependence of people on ecosystem services.

PubMed

Cazalis, Victor; Loreau, Michel; Henderson, Kirsten

2018-09-01

The ability of the human population to continue growing depends strongly on the ecosystem services provided by nature. Nature, however, is becoming more and more degraded as the number of individuals increases, which could potentially threaten the future well-being of the human population. We use a dynamic model to conceptualise links between the global proportion of natural habitats and human demography, through four categories of ecosystem services (provisioning, regulating, cultural recreational and informational) to investigate the common future of nature and humanity in terms of size and well-being. Our model shows that there is generally a trade-off between the quality of life and human population size and identifies four short-term scenarios, corresponding to three long-term steady states of the model. First, human population could experience declines if nature becomes too degraded and regulating services diminish; second the majority of the population could be in a famine state, where the population continues to grow with minimal food provision. Between these scenarios, a desirable future scenario emerges from the model. It occurs if humans convert enough land to feed all the population, while maintaining biodiversity and ecosystem services. Finally, we find a fourth scenario, which combines famine and a decline in the population because of an overexploitation of land leading to a decrease in food production. Human demography is embedded in natural dynamics; the two factors should be considered together if we are to identify a desirable future for both nature and humans. Copyright © 2018 Elsevier B.V. All rights reserved.

The financial consequences of lost demand and reducing boarding in hospital emergency departments.

PubMed

Pines, Jesse M; Batt, Robert J; Hilton, Joshua A; Terwiesch, Christian

2011-10-01

Some have suggested that emergency department (ED) boarding is prevalent because it maximizes revenue as hospitals prioritize non-ED admissions, which reimburse higher than ED admissions. We explore the revenue implications to the overall hospital of reducing boarding in the ED. We quantified the revenue effect of reducing boarding-the balance of higher ED demand and the reduction of non-ED admissions-using financial modeling informed by regression analysis and discrete-event simulation with data from 1 inner-city teaching hospital during 2 years (118,000 ED visits, 22% ED admission rate, 7% left without being seen rate, 36,000 non-ED admissions). Various inpatient bed management policies for reducing non-ED admissions were tested. Non-ED admissions generated more revenue than ED admissions ($4,118 versus $2,268 per inpatient day). A 1-hour reduction in ED boarding time would result in $9,693 to $13,298 of additional daily revenue from capturing left without being seen and diverted ambulance patients. To accommodate this demand, we found that simulated management policies in which non-ED admissions are reduced without consideration to hospital capacity (ie, static policies) mostly did not result in higher revenue. Many dynamic policies requiring cancellation of various proportions of non-ED admissions when the hospital reaches specific trigger points increased revenue. The optimal strategies tested resulted in an estimated $2.7 million and $3.6 in net revenue per year, depending on whether left without being seen patients were assumed to be outpatients or mirrored ambulatory admission rates, respectively. Dynamic inpatient bed management in inner-city teaching hospitals in which non-ED admissions are occasionally reduced to ensure that EDs have reduced boarding times is a financially attractive strategy. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Emotional Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder-Validity, Predictability, Severity, and Comorbidity.

PubMed

Corbisiero, Salvatore; Mörstedt, Beatrice; Bitto, Hannes; Stieglitz, Rolf-Dieter

2017-01-01

Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. However, this triad might not be able to explain the complete spectrum of ADHD symptoms, as emotional dysregulation (ED) frequently seems to accompany the disorder. The aim of this study was to further understand the role of ED in adult ADHD. The sample comprised 393 adults with ADHD without or with comorbidity, and 121 adults without ADHD or any other mental disorder. Additionally, the sample focused on ED. The contribution of core symptoms and the effect of comorbidity on ED were tested and the predictive value of ED for the ADHD diagnosis itself analyzed. Finally, all subjects were categorized into groups-No ADHD, ADHD, and ADHD + ED-to analyze the differences in the severity of ADHD symptomatology in the three groups. ED levels were found to be elevated in patients with ADHD. The core symptoms affected ED, and the ADHD diagnosis was predicted by ED. The addition of ED to a regression model with the core symptoms was shown to improve the predictability of the ADHD diagnosis. The presence of ED proved to be an indicator of the severity of adult ADHD independent of a present comorbidity. ED is a significant symptom in adult patients with ADHD and appears to be associated with ADHD itself. Whilst the presence of other mental disorders intensifies symptoms of ED, ED seems not to manifest solely as a consequence of comorbidity. © 2016 Wiley Periodicals, Inc.

Staphylococcus aureus leukocidin ED contributes to systemic infection by targeting neutrophils and promoting bacterial growth in vivo

PubMed Central

Alonzo, Francis; Benson, Meredith A.; Chen, John; Novick, Richard P.; Shopsin, Bo; Torres, Victor J.

2011-01-01

SUMMARY Bloodstream infection with Staphylococcus aureus is common and can be fatal. However, virulence factors that contribute to lethality in S. aureus bloodstream infection are poorly defined. We discovered that LukED, a commonly overlooked leukotoxin, is critical for S. aureus bloodstream infection in mice. We also determined that LukED promotes S. aureus replication in vivo by directly killing phagocytes recruited to sites of hematogenously-seeded tissue. Furthermore, we established that murine neutrophils are the primary target of LukED, as the greater virulence of wild type S. aureus compared to a lukED mutant was abrogated by depleting neutrophils. The in vivo toxicity of LukED toward murine phagocytes is unique among S. aureus leukotoxins, implying its crucial role in pathogenesis. Moreover, the tropism of LukED for murine phagocytes highlights the utility of murine models to study LukED pathobiology, including development and testing of strategies to inhibit toxin activity and control bacterial infection. PMID:22142035

Genetics and Epigenetics of Eating Disorders

PubMed Central

Yilmaz, Zeynep; Hardaway, J. Andrew; Bulik, Cynthia M.

2015-01-01

Eating disorders (EDs) are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of AN, BN, and BED, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research. PMID:27013903

Are we there yet? A Practitioner's View of DO-178C/ED-12C

NASA Astrophysics Data System (ADS)

Daniels, Dewi

RTCA DO-178B/EUROCAE ED-12B is the industry-accepted guidance for determining that the software aspects of airborne systems and equipment comply with airworthiness requirements. DO-178B/ED-12B, published in 1992, is being updated to DO-178C/ED-12C. Nearly six years in the making, DO- 178C/ED-12C is expected to be completed in December 2010. It will be accompanied by a new set of supplements providing additional and much-needed guidance on tool qualification, model based development and verification, objectoriented technologies, and formal methods. Written by a member of the DO-178C/ED-12C editorial team who is also a practising software developer and verifier, this paper provides a practitioner's view of the new standard and its supplements. It explains how they will affect your organisation, focusing on the practical implications of the many changes between DO-178B/ED-12B and DO-178C/ED-12C.

Impact of ED management on hospital quality measures: the negative case of atrial fibrillation.

PubMed

Piela, Nicole E; Sacchetti, Alfred; Sholevar, Darius; Blaber, Reginald; Levi, Steven

2013-05-01

Emergency department (ED) cardioversion and discharge of atrial fibrillation (AF) is an evolving treatment. Emergency department cardioversion patients have few comorbidities, and their discharge directly from the ED leads to a sicker in-patient population of AF patients. This study examines whether the quality care markers, hospital charges (HC) and length of stay (LOS), negatively reflect the practice of ED cardioversion. Median HC and LOS were determined for 2 different quality assessment reporting models. In a standard model (SM), patients discharged from the ED were not included in any hospital statistics and only admitted, or observation patients were used to calculate the HC and LOS of AF patients. In an inclusive model (IM), patients discharged from the ED were also included in the hospital statistics but given the same LOS as observation patients. Differences across medians were analyzed using Wilcoxon rank sum tests. A total of 312 patients were evaluated for AF over an 18-month period. Of these, 197 (62%) were admitted, 21 (7%) were placed in observation status, and 95 (31%) were discharged from the ED. Median values for LOS were 3 days (interquartile range [IQR], 1-5) for the SM and 1 day (IQR, 0-4) for the IM. Median values for HC were $33062 (IQR, $19267-$60614) for the SM and $20059 (IQR, $4249-$47195) for the IM. Emergency department cardioversion selects out a less sick cohort of patients whose removal from a hospital's admission numbers negatively skews quality performance profiles. Copyright © 2013 Elsevier Inc. All rights reserved.

Eating disorders and associated mental health comorbidities in female veterans.

PubMed

Mitchell, Karen S; Rasmusson, Ann; Bartlett, Brooke; Gerber, Megan R

2014-11-30

Eating disorders (EDs) remain understudied among veterans, possibly due to the perception that primarily male population does not suffer from EDs. However, previous research suggests that male and female veterans do experience EDs. The high rates of posttraumatic stress disorder (PTSD), depression, and obesity observed among veterans may make this group vulnerable to disordered eating. Retrospective chart review was used to obtain data from 492 female veterans who were presented to a women's primary care center at a large, urban VA medical center between 2007 and 2009. A total of 2.8% of this sample had been diagnosed with an ED. In bivariate analyses, presence of PTSD and depression were significantly associated with having an ED diagnosis. However, when these two disorders were included in a multivariate model controlling for age, only depression diagnosis and lower age were significantly related to ED status. In sum, the rate of EDs in this sample is comparable to prevalence estimates of EDs in the general population. Current findings underscore the importance of assessing for EDs among VA patients and the need for further research among veterans. Published by Elsevier Ireland Ltd.

Outcomes of Embedded Care Management in a Family Medicine Residency Patient-Centered Medical Home.

PubMed

Newman, Robert J; Bikowski, Richard; Nakayama, Kristy; Cunningham, Tina; Acker, Pam; Bradshaw, Dana

2017-01-01

Much attention is devoted nationally to preventing hospital readmissions and emergency department (ED) use, given the high cost of this care. There is a growing body of evidence from the Patient Centered Primary Care Collaborative that a patient-centered medical home (PCMH) model successfully lowers these costs. Our study evaluates a specific intervention in a family medicine residency PCMH to decrease readmissions and ED utilization using an embedded care manager. The Department of Family and Community Medicine at Eastern Virginia Medical School in Norfolk, VA, hired an RN care manager in May of 2013 with a well-defined job description focused on decreasing hospital readmissions and ED usage. Our primary outcomes for the study were number of monthly hospital admissions and readmissions over 23 months and monthly ED visits over 20 months. Readmission rates averaged 22.2% per month in the first year of the intervention and 18.3% in the second year, a statistically significant 3.9% decrease. ED visits averaged 176 per month in the first year and 146 per month in the second year, a statistically significant 17% reduction. Our study adds to the evidence that a PCMH model of care with an embedded RN care manager can favorably lower readmission rates and ED utilization in a family medicine residency practice. Developing a viable business model to support this important work remains a challenge.

Social and Psychological Factors Related to Risk of Eating Disorders Among High School Girls.

PubMed

Alfoukha, Marwa M; Hamdan-Mansour, Ayman M; Banihani, Manar Ali

2017-01-01

Prevalence of eating disorders (EDs) has increased among adolescents in Arabic and Western countries. The purposes are to identify the risk of ED and psychosocial correlates of risk of ED among high school girls in Jordan. The researchers employed a cross-sectional, correlational design using 799 high school girls from governmental and private schools in the central region of Jordan. The results indicate that prevalence of the risk of ED was 12%. The risk of ED had significant and positive correlation with body shape dissatisfaction, self-esteem, psychological distress, and pressure from family, peers, and media ( p < .001). Body shape dissatisfaction, low self-esteem, negative peer pressure, and being young were significant predictors of the risk of EDs. Risk of ED is highly prevalent among high school girls, and school nurses need to adopt a model of care addressing the risk factors while caring for high school girls.

SED-ED, a workflow editor for computational biology experiments written in SED-ML.

PubMed

Adams, Richard R

2012-04-15

The simulation experiment description markup language (SED-ML) is a new community data standard to encode computational biology experiments in a computer-readable XML format. Its widespread adoption will require the development of software support to work with SED-ML files. Here, we describe a software tool, SED-ED, to view, edit, validate and annotate SED-ML documents while shielding end-users from the underlying XML representation. SED-ED supports modellers who wish to create, understand and further develop a simulation description provided in SED-ML format. SED-ED is available as a standalone Java application, as an Eclipse plug-in and as an SBSI (www.sbsi.ed.ac.uk) plug-in, all under an MIT open-source license. Source code is at https://sed-ed-sedmleditor.googlecode.com/svn. The application itself is available from https://sourceforge.net/projects/jlibsedml/files/SED-ED/.

Neuroglian activates Echinoid to antagonize the Drosophila EGF receptor signaling pathway.

PubMed

Islam, Rafique; Wei, Shu-Yi; Chiu, Wei-Hsin; Hortsch, Michael; Hsu, Jui-Chou

2003-05-01

echinoid (ed) encodes an cell-adhesion molecule (CAM) that contains immunoglobulin domains and regulates the EGFR signaling pathway during Drosophila eye development. Based on our previous genetic mosaic and epistatic analysis, we proposed that Ed, via homotypic interactions, activates a novel, as yet unknown pathway that antagonizes EGFR signaling. In this report, we demonstrate that Ed functions as a homophilic adhesion molecule and also engages in a heterophilic trans-interaction with Drosophila Neuroglian (Nrg), an L1-type CAM. Co-expression of ed and nrg in the eye exhibits a strong genetic synergy in inhibiting EGFR signaling. This synergistic effect requires the intracellular domain of Ed, but not that of Nrg. In addition, Ed and Nrg colocalize in the Drosophila eye and are efficiently co-immunoprecipitated. Together, our results suggest a model in which Nrg acts as a heterophilic ligand and activator of Ed, which in turn antagonizes EGFR signaling.

Emergency department throughput, crowding, and financial outcomes for hospitals.

PubMed

Handel, Daniel A; Hilton, Joshua A; Ward, Michael J; Rabin, Elaine; Zwemer, Frank L; Pines, Jesse M

2010-08-01

Emergency department (ED) crowding has been identified as a major public health problem in the United States by the Institute of Medicine. ED crowding not only is associated with poorer patient outcomes, but it also contributes to lost demand for ED services when patients leave without being seen and hospitals must go on ambulance diversion. However, somewhat paradoxically, ED crowding may financially benefit hospitals. This is because ED crowding allows hospitals to maximize occupancy with well-insured, elective patients while patients wait in the ED. In this article, the authors propose a more holistic model of hospital flow and revenue that contradicts this notion and offer suggestions for improvements in ED and hospital management that may not only reduce crowding and improve quality, but also increase hospital revenues. Also proposed is that increased efficiency and quality in U.S. hospitals will require changes in systematic microeconomic and macroeconomic incentives that drive the delivery of health services in the United States. Finally, the authors address several questions to propose mutually beneficial solutions to ED crowding that include the realignment of hospital incentives, changing culture to promote flow, and several ED-based strategies to improve ED efficiency.

Contrasting analytical and data-driven frameworks for radiogenomic modeling of normal tissue toxicities in prostate cancer.

PubMed

Coates, James; Jeyaseelan, Asha K; Ybarra, Norma; David, Marc; Faria, Sergio; Souhami, Luis; Cury, Fabio; Duclos, Marie; El Naqa, Issam

2015-04-01

We explore analytical and data-driven approaches to investigate the integration of genetic variations (single nucleotide polymorphisms [SNPs] and copy number variations [CNVs]) with dosimetric and clinical variables in modeling radiation-induced rectal bleeding (RB) and erectile dysfunction (ED) in prostate cancer patients. Sixty-two patients who underwent curative hypofractionated radiotherapy (66 Gy in 22 fractions) between 2002 and 2010 were retrospectively genotyped for CNV and SNP rs5489 in the xrcc1 DNA repair gene. Fifty-four patients had full dosimetric profiles. Two parallel modeling approaches were compared to assess the risk of severe RB (Grade⩾3) and ED (Grade⩾1); Maximum likelihood estimated generalized Lyman-Kutcher-Burman (LKB) and logistic regression. Statistical resampling based on cross-validation was used to evaluate model predictive power and generalizability to unseen data. Integration of biological variables xrcc1 CNV and SNP improved the fit of the RB and ED analytical and data-driven models. Cross-validation of the generalized LKB models yielded increases in classification performance of 27.4% for RB and 14.6% for ED when xrcc1 CNV and SNP were included, respectively. Biological variables added to logistic regression modeling improved classification performance over standard dosimetric models by 33.5% for RB and 21.2% for ED models. As a proof-of-concept, we demonstrated that the combination of genetic and dosimetric variables can provide significant improvement in NTCP prediction using analytical and data-driven approaches. The improvement in prediction performance was more pronounced in the data driven approaches. Moreover, we have shown that CNVs, in addition to SNPs, may be useful structural genetic variants in predicting radiation toxicities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Antenatal and postnatal psychopathology among women with current and past eating disorders: longitudinal patterns.

PubMed

Easter, Abigail; Solmi, Francessca; Bye, Amanda; Taborelli, Emma; Corfield, Freya; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

2015-01-01

This study aims to investigate longitudinal patterns of psychopathology during the antenatal and postnatal periods among women with current (C-ED) and past (P-ED) eating disorders. Women were recruited to a prospective longitudinal study: C-ED (n = 31), P-ED (n = 29) and healthy control (HC; n = 57). Anxiety, depression and ED symptoms were measured at four time points: first/second trimester, third trimester, 8 weeks and 6 months postpartum. Linear mixed effects models were used to test for group differences. Women with C-ED and P-ED, in all diagnostic categories, had significantly higher levels of psychopathology at all time points. ED symptoms decreased in the C-ED group, compared with an overall increase in the other two groups but subsequently increased after pregnancy. Overall, depression and state and trait anxiety scores decreased in the C-ED group compared with the HC group throughout the antenatal and postnatal periods. High levels of psychopathology are common throughout the antenatal and postnatal periods among women with current and past ED, and despite some overall reductions, symptoms remain clinically significant. © 2014 The Authors. European Eating Disorders Review published by John Wiley & Sons, Ltd. © 2014 The Authors. European Eating Disorders Review published by John Wiley & Sons, Ltd.

Development of metabolic and inflammatory mediator biomarker phenotyping for early diagnosis and triage of pediatric sepsis.

PubMed

Mickiewicz, Beata; Thompson, Graham C; Blackwood, Jaime; Jenne, Craig N; Winston, Brent W; Vogel, Hans J; Joffe, Ari R

2015-09-09

The first steps in goal-directed therapy for sepsis are early diagnosis followed by appropriate triage. These steps are usually left to the physician's judgment, as there is no accepted biomarker available. We aimed to determine biomarker phenotypes that differentiate children with sepsis who require intensive care from those who do not. We conducted a prospective, observational nested cohort study at two pediatric intensive care units (PICUs) and one pediatric emergency department (ED). Children ages 2-17 years presenting to the PICU or ED with sepsis or presenting for procedural sedation to the ED were enrolled. We used the judgment of regional pediatric ED and PICU attending physicians as the standard to determine triage location (PICU or ED). We performed metabolic and inflammatory protein mediator profiling with serum and plasma samples, respectively, collected upon presentation, followed by multivariate statistical analysis. Ninety-four PICU sepsis, 81 ED sepsis, and 63 ED control patients were included. Metabolomic profiling revealed clear separation of groups, differentiating PICU sepsis from ED sepsis with accuracy of 0.89, area under the receiver operating characteristic curve (AUROC) of 0.96 (standard deviation [SD] 0.01), and predictive ability (Q(2)) of 0.60. Protein mediator profiling also showed clear separation of the groups, differentiating PICU sepsis from ED sepsis with accuracy of 0.78 and AUROC of 0.88 (SD 0.03). Combining metabolomic and protein mediator profiling improved the model (Q(2) =0.62), differentiating PICU sepsis from ED sepsis with accuracy of 0.87 and AUROC of 0.95 (SD 0.01). Separation of PICU sepsis or ED sepsis from ED controls was even more accurate. Prespecified age subgroups (2-5 years old and 6-17 years old) improved model accuracy minimally. Seventeen metabolites or protein mediators accounted for separation of PICU sepsis and ED sepsis with 95% confidence. In children ages 2-17 years, combining metabolomic and inflammatory protein mediator profiling early after presentation may differentiate children with sepsis requiring care in a PICU from children with or without sepsis safely cared for outside a PICU. This may aid in making triage decisions, particularly in an ED without pediatric expertise. This finding requires validation in an independent cohort.

Process-Improvement Cost Model for the Emergency Department.

PubMed

Dyas, Sheila R; Greenfield, Eric; Messimer, Sherri; Thotakura, Swati; Gholston, Sampson; Doughty, Tracy; Hays, Mary; Ivey, Richard; Spalding, Joseph; Phillips, Robin

2015-01-01

The objective of this report is to present a simplified, activity-based costing approach for hospital emergency departments (EDs) to use with Lean Six Sigma cost-benefit analyses. The cost model complexity is reduced by removing diagnostic and condition-specific costs, thereby revealing the underlying process activities' cost inefficiencies. Examples are provided for evaluating the cost savings from reducing discharge delays and the cost impact of keeping patients in the ED (boarding) after the decision to admit has been made. The process-improvement cost model provides a needed tool in selecting, prioritizing, and validating Lean process-improvement projects in the ED and other areas of patient care that involve multiple dissimilar diagnoses.

Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland.

PubMed

Rowland, Sandi; Leider, Jonathon P; Davidson, Clare; Brady, Joanne; Knudson, Alana

2016-12-01

To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed.

Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland

PubMed Central

Rowland, Sandi; Davidson, Clare; Brady, Joanne; Knudson, Alana

2016-01-01

Objectives. To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP’s impact on dental-related visits to a regional emergency department (ED). Methods. We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. Results. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Conclusions. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Policy Implications. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed. PMID:27736218

The Cost-Effectiveness of School-Based Eating Disorder Screening

PubMed Central

Austin, S. Bryn; LeAnn Noh, H.; Jiang, Yushan; Sonneville, Kendrin R.

2014-01-01

Objectives. We aimed to assess the value of school-based eating disorder (ED) screening for a hypothetical cohort of US public school students. Methods. We used a decision-analytic microsimulation model to model the effectiveness (life-years with ED and quality-adjusted life-years [QALYs]), total direct costs, and cost-effectiveness (cost per QALY gained) of screening relative to current practice. Results. The screening strategy cost $2260 (95% confidence interval [CI] = $1892, $2668) per student and resulted in a per capita gain of 0.25 fewer life-years with ED (95% CI = 0.21, 0.30) and 0.04 QALYs (95% CI = 0.03, 0.05) relative to current practice. The base case cost-effectiveness of the intervention was $9041 per life-year with ED avoided (95% CI = $6617, $12 344) and $56 500 per QALY gained (95% CI = $38 805, $71 250). Conclusions. At willingness-to-pay thresholds of $50 000 and $100 000 per QALY gained, school-based ED screening is 41% and 100% likely to be cost-effective, respectively. The cost-effectiveness of ED screening is comparable to many other accepted pediatric health interventions, including hypertension screening. PMID:25033131

Cost of health care utilization among homeless frequent emergency department users.

PubMed

Mitchell, Matthew S; León, Casey L K; Byrne, Thomas H; Lin, Wen-Chieh; Bharel, Monica

2017-05-01

Research demonstrates that homelessness is associated with frequent use of emergency department (ED) services, yet prior studies have not adequately examined the relationship between frequent ED use and utilization of non-ED health care services among those experiencing homelessness. There has also been little effort to assess heterogeneity among homeless individuals who make frequent use of ED services. To address these gaps, the present study used Medicaid claims data from 2010 to estimate the association between the number of ED visits and non-ED health care costs for a cohort of 6,338 Boston Health Care for the Homeless Program patients, and to identify distinct subgroups of persons in this cohort who made frequent use of ED services based on their clinical and demographic characteristics. A series of gamma regression models found more frequent ED use to be associated with higher non-ED costs, even after adjusting for demographic and clinical characteristics. Latent class analysis was used to examine heterogeneity among frequent ED users, and the results identified 6 characteristically distinct subgroups among these persons. The subgroup of persons with trimorbid illness had non-ED costs that far exceeded members of all 5 other subgroups. Study findings reinforce the connection between frequent ED use and high health care costs among homeless individuals and suggest that different groups of homeless frequent ED users may benefit from interventions that vary in terms of their composition and intensity. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

[Population, ethics and equity].

PubMed

Berlinguer, G

1997-01-01

"Demography is, explicitly and not, imbued with an [ethical] content.... As demography involves both public policies and individual choices, the [ethical] slant should be [examined]. Thus, what we have on the one hand is an [ethical] state, which dictates its citizens' personal behaviour and, on the other, a state based on liberty, backed up by three shared values: human rights, pluralism and equality. This article looks at how today these may be reinterpreted when making decisions regarding the population." (EXCERPT)

King penguin demography since the last glaciation inferred from genome-wide data

PubMed Central

Trucchi, Emiliano; Gratton, Paolo; Whittington, Jason D.; Cristofari, Robin; Le Maho, Yvon; Stenseth, Nils Chr; Le Bohec, Céline

2014-01-01

How natural climate cycles, such as past glacial/interglacial patterns, have shaped species distributions at the high-latitude regions of the Southern Hemisphere is still largely unclear. Here, we show how the post-glacial warming following the Last Glacial Maximum (ca 18 000 years ago), allowed the (re)colonization of the fragmented sub-Antarctic habitat by an upper-level marine predator, the king penguin Aptenodytes patagonicus. Using restriction site-associated DNA sequencing and standard mitochondrial data, we tested the behaviour of subsets of anonymous nuclear loci in inferring past demography through coalescent-based and allele frequency spectrum analyses. Our results show that the king penguin population breeding on Crozet archipelago steeply increased in size, closely following the Holocene warming recorded in the Epica Dome C ice core. The following population growth can be explained by a threshold model in which the ecological requirements of this species (year-round ice-free habitat for breeding and access to a major source of food such as the Antarctic Polar Front) were met on Crozet soon after the Pleistocene/Holocene climatic transition. PMID:24920481

Density dependence in demography and dispersal generates fluctuating invasion speeds

PubMed Central

Li, Bingtuan; Miller, Tom E. X.

2017-01-01

Density dependence plays an important role in population regulation and is known to generate temporal fluctuations in population density. However, the ways in which density dependence affects spatial population processes, such as species invasions, are less understood. Although classical ecological theory suggests that invasions should advance at a constant speed, empirical work is illuminating the highly variable nature of biological invasions, which often exhibit nonconstant spreading speeds, even in simple, controlled settings. Here, we explore endogenous density dependence as a mechanism for inducing variability in biological invasions with a set of population models that incorporate density dependence in demographic and dispersal parameters. We show that density dependence in demography at low population densities—i.e., an Allee effect—combined with spatiotemporal variability in population density behind the invasion front can produce fluctuations in spreading speed. The density fluctuations behind the front can arise from either overcompensatory population growth or density-dependent dispersal, both of which are common in nature. Our results show that simple rules can generate complex spread dynamics and highlight a source of variability in biological invasions that may aid in ecological forecasting. PMID:28442569

Marginal analysis in assessing factors contributing time to physician in the Emergency Department using operations data.

PubMed

Pathan, Sameer A; Bhutta, Zain A; Moinudheen, Jibin; Jenkins, Dominic; Silva, Ashwin D; Sharma, Yogdutt; Saleh, Warda A; Khudabakhsh, Zeenat; Irfan, Furqan B; Thomas, Stephen H

2016-01-01

Background: Standard Emergency Department (ED) operations goals include minimization of the time interval (tMD) between patients' initial ED presentation and initial physician evaluation. This study assessed factors known (or suspected) to influence tMD with a two-step goal. The first step was generation of a multivariate model identifying parameters associated with prolongation of tMD at a single study center. The second step was the use of a study center-specific multivariate tMD model as a basis for predictive marginal probability analysis; the marginal model allowed for prediction of the degree of ED operations benefit that would be affected with specific ED operations improvements. Methods: The study was conducted using one month (May 2015) of data obtained from an ED administrative database (EDAD) in an urban academic tertiary ED with an annual census of approximately 500,000; during the study month, the ED saw 39,593 cases. The EDAD data were used to generate a multivariate linear regression model assessing the various demographic and operational covariates' effects on the dependent variable tMD. Predictive marginal probability analysis was used to calculate the relative contributions of key covariates as well as demonstrate the likely tMD impact on modifying those covariates with operational improvements. Analyses were conducted with Stata 14MP, with significance defined at p  < 0.05 and confidence intervals (CIs) reported at the 95% level. Results: In an acceptable linear regression model that accounted for just over half of the overall variance in tMD (adjusted r 2 0.51), important contributors to tMD included shift census ( p  = 0.008), shift time of day ( p  = 0.002), and physician coverage n ( p  = 0.004). These strong associations remained even after adjusting for each other and other covariates. Marginal predictive probability analysis was used to predict the overall tMD impact (improvement from 50 to 43 minutes, p  < 0.001) of consistent staffing with 22 physicians. Conclusions: The analysis identified expected variables contributing to tMD with regression demonstrating significance and effect magnitude of alterations in covariates including patient census, shift time of day, and number of physicians. Marginal analysis provided operationally useful demonstration of the need to adjust physician coverage numbers, prompting changes at the study ED. The methods used in this analysis may prove useful in other EDs wishing to analyze operations information with the goal of predicting which interventions may have the most benefit.

Economic Analysis. Computer Simulation Models.

ERIC Educational Resources Information Center

Sterling Inst., Washington, DC. Educational Technology Center.

A multimedia course in economic analysis was developed and used in conjunction with the United States Naval Academy. (See ED 043 790 and ED 043 791 for final reports of the project evaluation and development model.) This volume of the text discusses the simulation of behavioral relationships among variable elements in an economy and presents…

Alcohol Mixed with Energy Drinks: Daily Context of Use.

PubMed

Linden-Carmichael, Ashley N; Lau-Barraco, Cathy

2017-04-01

The link between use of alcohol mixed with energy drinks (AmEDs) and alcohol-related harms is well established, but limited research has examined the context in which AmEDs are consumed. Identifying the social and environmental characteristics of use may illuminate whether AmEDs are used in settings that could increase the likelihood of engaging in risky behaviors or experiencing harms. This study used a 2-week daily diary assessment to compare days in which AmEDs were consumed ("AmED days") and days where other types of alcohol were used ("non-AmED days") on where, when, and with whom drinking occurred. Participants were 122 (90 women) heavy drinking college students who reported mixing caffeine with alcohol at least once in the past week. Data were collected across 389 drinking days; 40 of these days involved AmED use. Multilevel modeling findings revealed that odds of drinking AmEDs were higher on days where individuals drank at a bar or club and drank at home relative to other locations. In addition, odds of pregaming were higher on AmED days as compared to non-AmED days. AmED use was linked with lower odds of drinking game behavior. Overall, AmEDs appear to be consumed in potentially risky contexts. In combination with prior findings that AmED days are linked with heavier alcohol use and more harms experienced, these findings support the unique nature of AmED consumption in terms of the factors that may predict or maintain potentially hazardous drinking patterns. Copyright © 2017 by the Research Society on Alcoholism.

Low caregiver health literacy is associated with higher pediatric emergency department use and nonurgent visits.

PubMed

Morrison, Andrea K; Schapira, Marilyn M; Gorelick, Marc H; Hoffmann, Raymond G; Brousseau, David C

2014-01-01

We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits. This year long cross-sectional study utilized the Newest Vital Sign questionnaire to measure the health literacy of caregivers accompanying children to a pediatric ED. Prior ED visits were extracted from a regional database. ED visit urgency was classified by resources utilized during the index ED visit. Regression analyses were used to model 2 outcomes-prior ED visits and ED visit urgency-stratified by chronic illness. Analyses were weighted by triage level. Overall, 503 caregivers completed the study; 55% demonstrated low health literacy. Children of caregivers with low health literacy had more prior ED visits (adjusted incidence rate ratio 1.5; 95% confidence interval 1.2, 1.8) and increased odds of a nonurgent index ED visit (adjusted odds ratio 2.4; 95% confidence interval 1.3, 4.4). Among children without chronic illness, low caregiver health literacy was associated with an increased proportion of nonurgent index ED visits (48% vs. 22%; adjusted odds ratio 3.2; 1.8, 5.7). Over half of caregivers presenting with their children to the ED have low health literacy. Low caregiver health literacy is an independent predictor of higher ED use and use of the ED for nonurgent conditions. In children without a chronic illness, low health literate caregivers had more than 3 times greater odds of presenting for a nonurgent condition than those with adequate health literacy. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Low Caregiver Health Literacy is Associated with Higher Pediatric Emergency Department Use and Non-urgent Visits

PubMed Central

Morrison, Andrea K.; Schapira, Marilyn M.; Gorelick, Marc H.; Hoffmann, Raymond G.; Brousseau, David C.

2014-01-01

Objective We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits. Methods This year long cross-sectional study utilized the Newest Vital Sign to measure the health literacy of caregivers accompanying children to a pediatric ED. Prior ED visits were extracted from a regional database. ED visit urgency was classified by resources utilized during the index ED visit. Regression analyses were used to model the outcomes: 1) prior ED visits and 2) ED visit urgency, stratified by chronic illness. Analyses were weighted by triage level. Results Overall, 503 caregivers completed the study; 55% demonstrated low health literacy. Children of caregivers with low health literacy had more prior ED visits (aIRR 1.5; 95% C.I.1.2, 1.8) and increased odds of a non-urgent index ED visit (AOR 2.4; 1.3, 4.4). Among children without chronic illness, low caregiver health literacy was associated with an increased proportion of non-urgent index ED visits (48% vs 22%; AOR 3.2; 1.8, 5.7). Conclusions Over half of caregivers presenting with their children to the ED have low health literacy. Low caregiver health literacy is an independent predictor of higher ED use and use of the ED for non-urgent conditions. In children without a chronic illness, low health literate caregivers had more than three times great odds of presenting for a non-urgent condition than those with adequate health literacy. PMID:24767784

Using demography and movement behavior to predict range expansion of the southern sea otter.

USGS Publications Warehouse

Tinker, M.T.; Doak, D.F.; Estes, J.A.

2008-01-01

In addition to forecasting population growth, basic demographic data combined with movement data provide a means for predicting rates of range expansion. Quantitative models of range expansion have rarely been applied to large vertebrates, although such tools could be useful for restoration and management of many threatened but recovering populations. Using the southern sea otter (Enhydra lutris nereis) as a case study, we utilized integro-difference equations in combination with a stage-structured projection matrix that incorporated spatial variation in dispersal and demography to make forecasts of population recovery and range recolonization. In addition to these basic predictions, we emphasize how to make these modeling predictions useful in a management context through the inclusion of parameter uncertainty and sensitivity analysis. Our models resulted in hind-cast (1989–2003) predictions of net population growth and range expansion that closely matched observed patterns. We next made projections of future range expansion and population growth, incorporating uncertainty in all model parameters, and explored the sensitivity of model predictions to variation in spatially explicit survival and dispersal rates. The predicted rate of southward range expansion (median = 5.2 km/yr) was sensitive to both dispersal and survival rates; elasticity analysis indicated that changes in adult survival would have the greatest potential effect on the rate of range expansion, while perturbation analysis showed that variation in subadult dispersal contributed most to variance in model predictions. Variation in survival and dispersal of females at the south end of the range contributed most of the variance in predicted southward range expansion. Our approach provides guidance for the acquisition of further data and a means of forecasting the consequence of specific management actions. Similar methods could aid in the management of other recovering populations.

The cost of an emergency department visit and its relationship to emergency department volume.

PubMed

Bamezai, Anil; Melnick, Glenn; Nawathe, Amar

2005-05-01

This article addresses 2 questions: (1) to what extent do emergency departments (EDs) exhibit economies of scale; and (2) to what extent do publicly available accounting data understate the marginal cost of an outpatient ED visit? Understanding the appropriate role for EDs in the overall health care system is crucially dependent on answers to these questions. The literature on these issues is sparse and somewhat dated and fails to differentiate between trauma and nontrauma hospitals. We believe a careful review of these questions is necessary because several changes (greater managed care penetration, increased price competition, cost of compliance with Emergency Medical Treatment and Active Labor Act regulations, and so on) may have significantly altered ED economics in recent years. We use a 2-pronged approach, 1 based on descriptive analyses of publicly available accounting data and 1 based on statistical cost models estimated from a 9-year panel of hospital data, to address the above-mentioned questions. Neither the descriptive analyses nor the statistical models support the existence of significant scale economies. Furthermore, the marginal cost of outpatient ED visits, even without the emergency physician component, appear quite high--in 1998 dollars, US295 dollars and US412 dollars for nontrauma and trauma EDs, respectively. These statistical estimates exceed the accounting estimates of per-visit costs by a factor of roughly 2. Our findings suggest that the marginal cost of an outpatient ED visit is higher than is generally believed. Hospitals thus need to carefully review how EDs fit within their overall operations and cost structure and may need to pay special attention to policies and procedures that guide the delivery of nonurgent care through the ED.

Bayesian Nonparametric Prediction and Statistical Inference

DTIC Science & Technology

1989-09-07

Kadane, J. (1980), "Bayesian decision theory and the sim- plification of models," in Evaluation of Econometric Models, J. Kmenta and J. Ramsey , eds...the random model and weighted least squares regression," in Evaluation of Econometric Models, ed. by J. Kmenta and J. Ramsey , Academic Press, 197-217...likelihood function. On the other hand, H. Jeffreys’s theory of hypothesis testing covers the most important situations in which the prior is not diffuse. See

Linking big models to big data: efficient ecosystem model calibration through Bayesian model emulation

NASA Astrophysics Data System (ADS)

Fer, I.; Kelly, R.; Andrews, T.; Dietze, M.; Richardson, A. D.

2016-12-01

Our ability to forecast ecosystems is limited by how well we parameterize ecosystem models. Direct measurements for all model parameters are not always possible and inverse estimation of these parameters through Bayesian methods is computationally costly. A solution to computational challenges of Bayesian calibration is to approximate the posterior probability surface using a Gaussian Process that emulates the complex process-based model. Here we report the integration of this method within an ecoinformatics toolbox, Predictive Ecosystem Analyzer (PEcAn), and its application with two ecosystem models: SIPNET and ED2.1. SIPNET is a simple model, allowing application of MCMC methods both to the model itself and to its emulator. We used both approaches to assimilate flux (CO2 and latent heat), soil respiration, and soil carbon data from Bartlett Experimental Forest. This comparison showed that emulator is reliable in terms of convergence to the posterior distribution. A 10000-iteration MCMC analysis with SIPNET itself required more than two orders of magnitude greater computation time than an MCMC run of same length with its emulator. This difference would be greater for a more computationally demanding model. Validation of the emulator-calibrated SIPNET against both the assimilated data and out-of-sample data showed improved fit and reduced uncertainty around model predictions. We next applied the validated emulator method to the ED2, whose complexity precludes standard Bayesian data assimilation. We used the ED2 emulator to assimilate demographic data from a network of inventory plots. For validation of the calibrated ED2, we compared the model to results from Empirical Succession Mapping (ESM), a novel synthesis of successional patterns in Forest Inventory and Analysis data. Our results revealed that while the pre-assimilation ED2 formulation cannot capture the emergent demographic patterns from ESM analysis, constrained model parameters controlling demographic processes increased their agreement considerably.

The Reduction in ED and Hospital Admissions in Medical Home Practices Is Specific to Primary Care-Sensitive Chronic Conditions.

PubMed

Green, Lee A; Chang, Hsiu-Ching; Markovitz, Amanda R; Paustian, Michael L

2018-04-01

To determine whether the Patient-Centered Medical Home (PCMH) transformation reduces hospital and ED utilization, and whether the effect is specific to chronic conditions targeted for management by the PCMH in our setting. All patients aged 18 years and older in 2,218 primary care practices participating in a statewide PCMH incentive program sponsored by Blue Cross Blue Shield of Michigan (BCBSM) in 2009-2012. Quantitative observational study, jointly modeling PCMH-targeted versus other hospital admissions and ED visits on PCMH score, patient, and practice characteristics in a hierarchical multivariate model using the generalized gamma distribution. Claims data and PCMH scores held by BCBSM. Both hospital and ED utilization were reduced proportionately to PCMH score. Hospital utilization was reduced by 13.9 percent for PCMH-targeted conditions versus only 3.8 percent for other conditions (p = .003), and ED utilization by 11.2 percent versus 3.7 percent (p = .010). Hospital PMPM cost was reduced by 17.2 percent for PCMH-targeted conditions versus only 3.1 percent for other conditions (p < .001), and ED PMPM cost by 9.4 percent versus 3.6 percent (p < .001). PCMH transformation reduces hospital and ED use, and the majority of the effect is specific to PCMH-targeted conditions. © Health Research and Educational Trust.

A view to the future of natural gas and electricity: An integrated modeling approach

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

Cole, Wesley J.; Medlock, Kenneth B.; Jani, Aditya

This paper demonstrates the value of integrating two highly spatially resolved models: the Rice World Gas Trade Model (RWGTM) of the natural gas sector and the Regional Energy Deployment System (ReEDS) model of the U.S. electricity sector. The RWGTM passes electricity-sector natural gas prices to the ReEDS model, while the ReEDS model returns electricity-sector natural gas demand to the RWGTM. The two models successfully converge to a solution under reference scenario conditions. We present electricity-sector and natural gas sector evolution using the integrated models for this reference scenario. This paper demonstrates that the integrated models produced similar national-level results asmore » when running in a stand-alone form, but that regional and state-level results can vary considerably. As we highlight, these regional differences have potentially significant implications for electric sector planners especially in the wake of substantive policy changes for the sector (e.g., the Clean Power Plan).« less

A view to the future of natural gas and electricity: An integrated modeling approach

DOE PAGES

Cole, Wesley J.; Medlock, Kenneth B.; Jani, Aditya

2016-03-17

This paper demonstrates the value of integrating two highly spatially resolved models: the Rice World Gas Trade Model (RWGTM) of the natural gas sector and the Regional Energy Deployment System (ReEDS) model of the U.S. electricity sector. The RWGTM passes electricity-sector natural gas prices to the ReEDS model, while the ReEDS model returns electricity-sector natural gas demand to the RWGTM. The two models successfully converge to a solution under reference scenario conditions. We present electricity-sector and natural gas sector evolution using the integrated models for this reference scenario. This paper demonstrates that the integrated models produced similar national-level results asmore » when running in a stand-alone form, but that regional and state-level results can vary considerably. As we highlight, these regional differences have potentially significant implications for electric sector planners especially in the wake of substantive policy changes for the sector (e.g., the Clean Power Plan).« less

Minimizing patient waiting time in emergency department of public hospital using simulation optimization approach

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2017-04-01

Emergency department (ED) is the main unit of a hospital that provides emergency treatment. Operating 24 hours a day with limited number of resources invites more problems to the current chaotic situation in some hospitals in Malaysia. Delays in getting treatments that caused patients to wait for a long period of time are among the frequent complaints against government hospitals. Therefore, the ED management needs a model that can be used to examine and understand resource capacity which can assist the hospital managers to reduce patients waiting time. Simulation model was developed based on 24 hours data collection. The model developed using Arena simulation replicates the actual ED's operations of a public hospital in Selangor, Malaysia. The OptQuest optimization in Arena is used to find the possible combinations of a number of resources that can minimize patients waiting time while increasing the number of patients served. The simulation model was modified for improvement based on results from OptQuest. The improvement model significantly improves ED's efficiency with an average of 32% reduction in average patients waiting times and 25% increase in the total number of patients served.

Sci—Thur AM: YIS - 02: Radiogenomic Modeling of Normal Tissue Toxicities in Prostate Cancer Patients Receiving Hypofractionated Radiotherapy

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

Coates, J; Jeyaseelan, K; Ybarra, N

2014-08-15

Inter-patient radiation sensitivity variability has recently been shown to have a genetic component. This genetic component may play a key role in explaining the fluctuating rates of radiation-induced toxicities (RITs). Single nucleotide polymorphisms (SNPs) have thus far yielded inconsistent results in delineating RITs while copy number variations (CNVs) have not yet been investigated for such purposes. We explore a radiogenomic modeling approach to investigate the association of CNVs and SNPs, along with clinical and dosimetric variables, in radiation induced rectal bleeding (RB) and erectile dysfunction (ED) in prostate cancer patients treated with curative hypofractionated irradiation. A cohort of 62 prostatemore » cancer patients who underwent hypofractionated radiotherapy (66 Gy in 22 fractions) between 2002 to 2010 were retrospectively genotyped for CNV and SNP rs5489 in the xrcc1 DNA repair gene. Late toxicity rates for RB grade 2 and 3 and grade 3 alone were 29.0% and 12.9%, respectively. ED toxicity was found to be 62.9%. Radiogenomic model performance was evaluated using receiver operating characteristic area under the curve (AUC) and resampling by cross-validation. Binary variables were evaluated using Chi-squared contingency table analysis and multivariate models by Spearman's rank correlation coefficient (rs). Ten patients were found to have three copies of xrcc1 CNV (RB: χ{sup 2}=14.6, p<0.001 and ED: χ{sup 2}=4.88, p=0.0272) and twelve had heterozygous rs25489 SNP (RB: χ{sup 2}=0.278, p=0.599 and ED: χ{sup 2}=0.112, p=0.732). Radiogenomic modeling yielded significant, cross-validated NTCP models for RB (AUC=0.665) and ED (AUC=0.754). These results indicate that CNVs may be potential predictive biomarkers of both late ED and RB.« less

Impact of co-located general practitioner (GP) clinics and patient choice on duration of wait in the emergency department.

PubMed

Sharma, Anurag; Inder, Brett

2011-08-01

To empirically model the determinants of duration of wait of emergency (triage category 2) patients in an emergency department (ED) focusing on two questions: (i) What is the effect of enhancing the degree of choice for non-urgent (triage category 5) patients on duration of wait for emergency (category 2) patients in EDs; and (ii) What is the effect of co-located GP clinics on duration of wait for emergency patients in EDs? The answers to these questions will help in understanding the effectiveness of demand management strategies, which are identified as one of the solutions to ED crowding. The duration of wait for each patient (difference between arrival time and time first seen by treating doctor) was modelled as a function of input factors (degree of choice, patient characteristics, weekend admission, metro/regional hospital, concentration of emergency (category 2) patients in hospital service area), throughput factors (availability of doctors and nurses) and output factor (hospital bed capacity). The unit of analysis was a patient episode and the model was estimated using a survival regression technique. The degree of choice for non-urgent (category 5) patients has a non-linear effect: more choice for non-urgent patients is associated with longer waits for emergency patients at lower values and shorter waits at higher values of degree of choice. Thus more choice of EDs for non-urgent patients is related to a longer wait for emergency (category 2) patients in EDs. The waiting time for emergency patients in hospital campuses with co-located GP clinics was 19% lower (1.5 min less) on average than for those waiting in campuses without co-located GP clinics. These findings suggest that diverting non-urgent (category 5) patients to an alternative model of care (co-located GP clinics) is a more effective demand management strategy and will reduce ED crowding.

Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome.

PubMed

Wang, X-J; Xia, L-L; Xu, T-Y; Zhang, X-H; Zhu, Z-W; Zhang, M-G; Liu, Y; Xu, C; Zhong, S; Shen, Z-J

2016-04-01

There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats. © 2015 Blackwell Verlag GmbH.

The demographic consequences of mutualism: ants increase host-plant fruit production but not population growth

Treesearch

Kevin Ford; Joshua H. Ness; Judith L. Bronstein; William F. Morris

2015-01-01

The impact of mutualists on a partner’s demography depends on how they affect the partner’s multiple vital rates and how those vital rates, in turn, affect population growth. However, mutualism studies rarely measure effects on multiple vital rates or integrate them to assess the ultimate impact on population growth. We used vital rate data, population models and...

A generic method for evaluating crowding in the emergency department.

PubMed

Eiset, Andreas Halgreen; Erlandsen, Mogens; Møllekær, Anders Brøns; Mackenhauer, Julie; Kirkegaard, Hans

2016-06-14

Crowding in the emergency department (ED) has been studied intensively using complicated non-generic methods that may prove difficult to implement in a clinical setting. This study sought to develop a generic method to describe and analyse crowding from measurements readily available in the ED and to test the developed method empirically in a clinical setting. We conceptualised a model with ED patient flow divided into separate queues identified by timestamps for predetermined events. With temporal resolution of 30 min, queue lengths were computed as Q(t + 1) = Q(t) + A(t) - D(t), with A(t) = number of arrivals, D(t) = number of departures and t = time interval. Maximum queue lengths for each shift of each day were found and risks of crowding computed. All tests were performed using non-parametric methods. The method was applied in the ED of Aarhus University Hospital, Denmark utilising an open cohort design with prospectively collected data from a one-year observation period. By employing the timestamps already assigned to the patients while in the ED, a generic queuing model can be computed from which crowding can be described and analysed in detail. Depending on availability of data, the model can be extended to include several queues increasing the level of information. When applying the method empirically, 41,693 patients were included. The studied ED had a high risk of bed occupancy rising above 100 % during day and evening shift, especially on weekdays. Further, a 'carry over' effect was shown between shifts and days. The presented method offers an easy and generic way to get detailed insight into the dynamics of crowding in an ED.

Next day discharge rate has little use as a quality measure for individual physician performance.

PubMed

Inabnit, Christopher; Markwell, Stephen; Gruwell, Jack; Jaeger, Cassie; Millburg, Lance; Griffen, David

2018-06-18

Emergency Department (ED) physicians' next day discharge rate (NDDR), the percentage of patients who were admitted from the ED and subsequently discharged within the next calendar day was hypothesized as a potential measure for unnecessary admissions. The objective was to determine if NDDR has validity as a measure for quality of individual ED physician performance. Hospital admission data was obtained for thirty-six ED physicians for calendar year 2015. Funnel plots were used to identify NDDR outliers beyond 95% control limits. A mixed model logistic regression was built to investigate factors contributing to NDDR. To determine yearly variation, data from calendar years 2014 and 2016 were analyzed, again by funnel plots and logistic regression. Intraclass correlation coefficient was used to estimate the percent of total variation in NDDR attributable to individual ED physicians. NDDR varied significantly among ED physicians. Individual ED physician outliers in NDDR varied year to year. Individual ED physician contribution to NDDR variation was minimal, accounting for 1%. Years of experience in Emergency Medicine practice was not correlated with NDDR. NDDR does not appear to be a reliable independent quality measure for individual ED physician performance. The percent of variance attributable to the ED physician was 1%. Copyright © 2018. Published by Elsevier Inc.

Biomarkers from distinct biological pathways improve early risk stratification in medical emergency patients: the multinational, prospective, observational TRIAGE study.

PubMed

Schuetz, Philipp; Hausfater, Pierre; Amin, Devendra; Amin, Adina; Haubitz, Sebastian; Faessler, Lukas; Kutz, Alexander; Conca, Antoinette; Reutlinger, Barbara; Canavaggio, Pauline; Sauvin, Gabrielle; Bernard, Maguy; Huber, Andreas; Mueller, Beat

2015-10-29

Early risk stratification in the emergency department (ED) is vital to reduce time to effective treatment in high-risk patients and to improve patient flow. Yet, there is a lack of investigations evaluating the incremental usefulness of multiple biomarkers measured upon admission from distinct biological pathways for predicting fatal outcome and high initial treatment urgency in unselected ED patients in a multicenter and multinational setting. We included consecutive, adult, medical patients seeking ED care into this observational, cohort study in Switzerland, France and the USA. We recorded initial clinical parameters and batch-measured prognostic biomarkers of inflammation (pro-adrenomedullin [ProADM]), stress (copeptin) and infection (procalcitonin). During a 30-day follow-up, 331 of 7132 (4.6 %) participants reached the primary endpoint of death within 30 days. In logistic regression models adjusted for conventional risk factors available at ED admission, all three biomarkers strongly predicted the risk of death (AUC 0.83, 0.78 and 0.75), ICU admission (AUC 0.67, 0.69 and 0.62) and high initial triage priority (0.67, 0.66 and 0.58). For the prediction of death, ProADM significantly improved regression models including (a) clinical information available at ED admission (AUC increase from 0.79 to 0.84), (b) full clinical information at ED discharge (AUC increase from 0.85 to 0.88), and (c) triage information (AUC increase from 0.67 to 0.83) (p <0.01 for each comparison). Similarly, ProADM also improved clinical models for prediction of ICU admission and high initial treatment urgency. Results were robust in regard to predefined patient subgroups by center, main diagnosis, presenting symptoms, age and gender. Combination of clinical information with results of blood biomarkers measured upon ED admission allows early and more adequate risk stratification in individual unselected medical ED patients. A randomized trial is needed to answer the question whether biomarker-guided initial patient triage reduces time to initial treatment of high-risk patients in the ED and thereby improves patient flow and clinical outcomes. ClinicalTrials.gov NCT01768494 . Registered January 9, 2013.

Comparing Emergency Department Use Among Medicaid and Commercial Patients Using All-Payer All-Claims Data.

PubMed

Kim, Hyunjee; McConnell, K John; Sun, Benjamin C

2017-08-01

The high rate of emergency department (ED) use by Medicaid patients is not fully understood. The objective of this paper is (1) to provide context for ED service use by comparing Medicaid and commercial patients' differences across ED and non-ED health service use, and (2) to assess the extent to which Medicaid-commercial differences in ED use can be explained by observable factors in administrative data. Statistical decomposition methods were applied to ED, mental health, and inpatient care using 2011-2013 Medicaid and commercial insurance claims from the Oregon All Payer All Claims database. Demographics, comorbidities, health services use, and neighborhood characteristics accounted for 44% of the Medicaid-commercial difference in ED use, compared to 83% for mental health care and 75% for inpatient care. This suggests that relative to mental health and inpatient care, a large portion of ED use cannot be explained by administrative data. Models that further accounted for patient access to different primary care physicians explained an additional 8% of the Medicaid-commercial difference in ED use, suggesting that the quality of primary care may influence ED use. The remaining unexplained difference suggests that appropriately reducing ED use remains a credible target for policy makers, although success may require knowledge about patients' perceptions and behaviors as well as social determinants of health.

An Approximate Markov Model for the Wright-Fisher Diffusion and Its Application to Time Series Data.

PubMed

Ferrer-Admetlla, Anna; Leuenberger, Christoph; Jensen, Jeffrey D; Wegmann, Daniel

2016-06-01

The joint and accurate inference of selection and demography from genetic data is considered a particularly challenging question in population genetics, since both process may lead to very similar patterns of genetic diversity. However, additional information for disentangling these effects may be obtained by observing changes in allele frequencies over multiple time points. Such data are common in experimental evolution studies, as well as in the comparison of ancient and contemporary samples. Leveraging this information, however, has been computationally challenging, particularly when considering multilocus data sets. To overcome these issues, we introduce a novel, discrete approximation for diffusion processes, termed mean transition time approximation, which preserves the long-term behavior of the underlying continuous diffusion process. We then derive this approximation for the particular case of inferring selection and demography from time series data under the classic Wright-Fisher model and demonstrate that our approximation is well suited to describe allele trajectories through time, even when only a few states are used. We then develop a Bayesian inference approach to jointly infer the population size and locus-specific selection coefficients with high accuracy and further extend this model to also infer the rates of sequencing errors and mutations. We finally apply our approach to recent experimental data on the evolution of drug resistance in influenza virus, identifying likely targets of selection and finding evidence for much larger viral population sizes than previously reported. Copyright © 2016 by the Genetics Society of America.

Effects of emergency department expansion on emergency department patient flow.

PubMed

Mumma, Bryn E; McCue, James Y; Li, Chin-Shang; Holmes, James F

2014-05-01

Emergency department (ED) crowding is an increasing problem associated with adverse patient outcomes. ED expansion is one method advocated to reduce ED crowding. The objective of this analysis was to determine the effect of ED expansion on measures of ED crowding. This was a retrospective study using administrative data from two 11-month periods before and after the expansion of an ED from 33 to 53 adult beds in an academic medical center. ED volume, staffing, and hospital admission and occupancy data were obtained either from the electronic health record (EHR) or from administrative records. The primary outcome was the rate of patients who left without being treated (LWBT), and the secondary outcome was total ED boarding time for admitted patients. A multivariable robust linear regression model was used to determine whether ED expansion was associated with the outcome measures. The mean (±SD) daily adult volume was 128 (±14) patients before expansion and 145 (±17) patients after. The percentage of patients who LWBT was unchanged: 9.0% before expansion versus 8.3% after expansion (difference = 0.6%, 95% confidence interval [CI] = -0.16% to 1.4%). Total ED boarding time increased from 160 to 180 hours/day (difference = 20 hours, 95% CI = 8 to 32 hours). After daily ED volume, low-acuity area volume, daily wait time, daily boarding hours, and nurse staffing were adjusted for, the percentage of patients who LWBT was not independently associated with ED expansion (p = 0.053). After ED admissions, ED intensive care unit (ICU) admissions, elective surgical admissions, hospital occupancy rate, ICU occupancy rate, and number of operational ICU beds were adjusted for, the increase in ED boarding hours was independently associated with the ED expansion (p = 0.005). An increase in ED bed capacity was associated with no significant change in the percentage of patients who LWBT, but had an unintended consequence of an increase in ED boarding hours. ED expansion alone does not appear to be an adequate solution to ED crowding. © 2014 by the Society for Academic Emergency Medicine.

Antinociception and anti-inflammation induced by simvastatin in algesiometric assays in mice.

PubMed

Miranda, Hugo F; Noriega, Viviana; Olavarria, Loreto; Zepeda, Ramiro J; Sierralta, Fernando; Prieto, Juan C

2011-12-01

Statins, belonging to a well-known drug class used for lowering cholesterol through competitive inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, also have other pleiotropic properties, such as anti-inflammatory action. The purpose of this study was to evaluate the antinociceptive and anti-inflammatory effects of simvastatin in five models of nociceptive behaviour. Oral gavage administration of simvastatin induced a dose-dependent inhibition of nociception for 1 day in the acetic acid writhing (ED(50) = 5.59 ± 0.07), tail-flick (ED(50) = 112.96 ± 8.00), hot-plate (ED(50) = 134.87 ± 2.20), formalin hind paw (ED(50) = 19.86 ± 1.12 in phase I and 23.30 ± 2.05 in phase II) and orofacial formalin (ED(50) = 5.54 ± 2.74 in phase I and 11.48 ± 1.88 in phase II) tests. However, after 3 days, the values were in the acetic acid writhing (ED(50) = 6.14 ± 0.51), tail-flick (ED(50) = 154 ± 8.88), hot-plate (ED(50) = 136.14 ± 2.94), formalin hind paw (ED(50) = 15.93 ± 0.42 in phase I and 17.10 ± 1.80 in phase II) and orofacial formalin (ED(50) = 6.79 ± 0.66 in phase I and 5.80 ± 1.49 in phase II) tests. This study demonstrated the antinociceptive and anti-inflammatory activities of simvastatin in five models of tonic or phasic pain. These actions seem to be related to the inhibition of cytokine and prostanoid release and stimulation of nitric oxide synthesis. A possible clinical role of simvastatin could be related to the potentially beneficial effects in the neuropathic pain, and by their pleiotropic properties, they could play a clinical role in anti-inflammatory disease. © 2011 The Authors. Basic & Clinical Pharmacology & Toxicology © 2011 Nordic Pharmacological Society.

Erectile dysfunction is independently associated with apnea-hypopnea index and oxygen desaturation index in elderly, but not younger, community-dwelling men.

PubMed

Martin, Sean A; Appleton, Sarah L; Adams, Robert J; Taylor, Anne W; Vincent, Andrew; Brook, Nicholas R; Catcheside, Peter G; Vakulin, Andrew; McEvoy, R Douglas; Antic, Nick A; Wittert, Gary A

2017-08-01

To examine the association between obstructive sleep apnea (OSA) and other sleep indices using polysomnography (PSG) data and erectile dysfunction (ED) in a representative cohort of men. Cross-sectional. Community-based. Aged 40+ years (n=734; mean age [SD], 60.8 [10.9]). Men with no prior OSA diagnosis who underwent in-home PSG (Embletta X100; 2010-11) and ED assessment (Global Impotence Rating) were selected. Un-adjusted and multi-adjusted regression models of ED were fitted against PSG measures, along with qualifying sociodemographic, lifestyle, and health-related covariates. Mediation effects were examined using the Baron-Kenny method. Of the men examined, 24.7% (n=181) had ED, most notably in men older than 65years (cf. men 35-49 and 50-64years; P<.001). There was no significant association between ED and any of the PSG measures for allaged men. Given an observed ageinteraction within OSA categories (P=.005), analyses were repeated in age-stratified samples (<65 years; 65+ years). In men younger than 65years, only severe OSA was found to have an association with ED (2.01; 1.13-4.69) in unadjusted models. For men aged 65+ years, an independent association with ED was found for apnea-hyponea index (AHI; 1.55;1.02-2.36), moderate (AHI:10.0-19.9; 1.79;1.18-2.43), and severe (AHI:20.0+; 4.84;2.56-9.93) OSA, and oxygen desaturation index (ODI; both continuous [1.48;1.03-1.99] and >16 seconds [2.79;1.23-6.32]). The effect of AHI on ED was shown to be primarily mediated through ODI (63.4%, Sobel P value=.29). In younger, community-based men, there appeared no independent relationship between objective measures of sleep and ED. However, there appears a strong, independent relationship between OSA, ODI, and ED in men 65 years and older. Copyright © 2017 National Sleep Foundation. All rights reserved.

Learning, Attention/Hyperactivity, and Conduct Problems as Sequelae of Excessive Daytime Sleepiness in a General Population Study of Young Children

PubMed Central

Calhoun, Susan L.; Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Mayes, Susan D.; Tsaoussoglou, Marina; Rodriguez-Muñoz, Alfredo; Bixler, Edward O.

2012-01-01

Study Objectives: Although excessive daytime sleepiness (EDS) is a common problem in children, with estimates of 15%; few studies have investigated the sequelae of EDS in young children. We investigated the association of EDS with objective neurocognitive measures and parent reported learning, attention/hyperactivity, and conduct problems in a large general population sample of children. Design: Cross-sectional. Setting: Population based. Participants: 508 children from The Penn State Child Cohort. Interventions: N/A. Measurements and Results: Children underwent a 9-h polysomnogram, comprehensive neurocognitive testing, and parent rating scales. Children were divided into 2 groups: those with and without parent-reported EDS. Structural equation modeling was used to examine whether processing speed and working memory performance would mediate the relationship between EDS and learning, attention/hyperactivity, and conduct problems. Logistic regression models suggest that parent-reported learning, attention/hyperactivity, and conduct problems, as well as objective measurement of processing speed and working memory are significant sequelae of EDS, even when controlling for AHI and objective markers of sleep. Path analysis demonstrates that processing speed and working memory performance are strong mediators of the association of EDS with learning and attention/hyperactivity problems, while to a slightly lesser degree are mediators from EDS to conduct problems. Conclusions: This study suggests that in a large general population sample of young children, parent-reported EDS is associated with neurobehavioral (learning, attention/hyperactivity, conduct) problems and poorer performance in processing speed and working memory. Impairment due to EDS in daytime cognitive and behavioral functioning can have a significant impact on children's development. Citation: Calhoun SL; Fernandez-Mendoza J; Vgontzas AN; Mayes SD; Tsaoussoglou M; Rodriguez-Muñoz A; Bixler EO. Learning, attention/hyperactivity, and conduct problems as sequelae of excessive daytime sleepiness in a general population study of young children. SLEEP 2012;35(5):627-632. PMID:22547888

Excessive daytime sleepiness and falls among older men and women: cross-sectional examination of a population-based sample.

PubMed

Hayley, Amie C; Williams, Lana J; Kennedy, Gerard A; Holloway, Kara L; Berk, Michael; Brennan-Olsen, Sharon L; Pasco, Julie A

2015-07-05

Excessive daytime sleepiness (EDS) has been associated with an increased risk for falls among clinical samples of older adults. However, there is little detailed information among population-representative samples. The current study aimed to assess the relationship between EDS and falls among a cohort of population-based older adults. This study assessed 367 women aged 60-93 years (median 72, interquartile range 65-79) and 451 men aged 60-92 years (median 73, interquartile range 66-80) who participated in the Geelong Osteoporosis Study between the years 2001 and 2008. Falls during the prior year were documented via self-report, and for men, falls risk score was obtained using an Elderly Fall Screening Test (EFST). Sleepiness was assessed using the Epworth Sleepiness Scale (ESS), and scores of  ≥ 10 indicated EDS. Differences among those with and without EDS in regard to falls were tested using logistic regression models. Among women, 50 (13.6%) individuals reported EDS. Women with EDS were more likely to report a fall, and were more likely to report the fall occurring outside. EDS was similarly associated with an increased risk of a fall following adjustment for use of a walking aid, cases of nocturia and antidepressant medication use (adjusted OR = 2.54, 95% CI 1.24-5.21). Multivariate modelling revealed antidepressant use (current) as an effect modifier (p < .001 for the interaction term). After stratifying the data by antidepressant medication use, the association between EDS and falls was sustained following adjustment for nocturia among antidepressant non-users (adjusted OR = 2.63, 95% CI 1.31-5.30). Among men, 72 (16.0%) individuals reported EDS. No differences were detected for men with and without EDS in regard to reported falls, and a trend towards significance was noted between EDS and a high falls risk as assessed by the EFST (p = 0.06), however, age explained this relationship (age adjusted OR = 2.20, 95% CI 1.03-1.10). For women, EDS is independently associated with at least one fall during the previous year, and this is more likely to occur whilst located outside. Amelioration of EDS may assist in improving functional outcomes among these individuals by reducing the risk for falls.

[The Impact of Demography, Migration, New Technologies and the Self-Actualization Movement on the Education System and on the Economic System.] Testimony of Jerry L. Fletcher, Prepared for The Joint Economic Committee Special Study on Economic Change, June 1, 1978.

ERIC Educational Resources Information Center

Fletcher, Jerry L.

Demography, urban to rural migration, new educational technologies, and the human potential movement all impact on education. With the decline in number of school-aged children, schools can try to expand the number of students downward (early childhood education/day care), outward (special education, dropouts), or upward (adults), expand service…

Emergency department clinical redesign, team-based care and improvements in hospital performance: A time series analysis.

PubMed

Dinh, Michael M; Green, Timothy C; Bein, Kendall J; Lo, Serigne; Jones, Aaron; Johnson, Terence

2015-08-01

The objective was to evaluate the impact of an ED clinical redesign project that involved team-based care and early senior assessment on hospital performance. This was an interrupted time series analysis performed using daily hospital performance data 6 months before and 8 months after the implementation of the clinical redesign intervention that involved Emergency Consultant-led team-based care, redistribution of ED beds and implementation of a senior nursing coordination roles in the ED. The primary outcome was the daily National Emergency Access Target (NEAT) performance (proportion of total daily ED presentations that were admitted to an inpatient ward or discharged from ED within 4 h of arrival). Secondary outcomes were daily ALOS in ED, inpatient Clinical Emergency Response System (CERS) calls and hospital mortality. Autoregressive Integrated Moving Average analysis was used to model NEAT performance. Hospital mortality was modelled using negative binomial regression. After adjusting for patient volume, inpatient admissions, ambulance, hospital occupancy, weekends ED Consultant numbers, weekends and underlying trends, there was a 17% improvement in NEAT associated with the post-intervention period (95% CI 12, 19% P < 0.001). There was no change in the number of CERS calls and the median daily hospital mortality rate reduced from 1.04% to 0.96% (P = 0.025). An ED-focused clinical redesign project was associated with a 17% improvement in NEAT performance with no evidence of an increase in clinical deterioration on inpatient wards and evidence for an improvement in hospital mortality. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Low-acuity presentations to regional emergency departments: What is the issue?

PubMed

Cheek, Colleen; Allen, Penny; Shires, Lizzi; Parry, Denise; Ruigrok, Marielle

2016-04-01

To explore GP-referrals and self-referrals to EDs and factors associated with patients seeking low-acuity care at ED. Retrospective analysis of all ED presentations to Mersey Community Hospital and North West Regional Hospital (Tasmania) between 1 January 2009 and 31 December 2013. Cross-sectional survey of patients presenting to the EDs for care triaged as low-acuity. There were 255,365 ED presentations in the retrospective data: 11,252 (4.4%) GP-referrals and 218,205 (85.4%) self-referrals. At ED 49% of GP-referrals were triaged ATS 4 or 5 and 35% of self-referrals were triaged ATS 1-3. There were 138 (84.2%) low-acuity patients who completed the survey; predominantly, all attended for acute injury or illness. Single point-of-care convenience was most commonly selected (71%) as a reason for attending ED. Over 85% of patients who seek emergency care in this region self-refer, so understanding health-seeking behaviour is important. Most low-acuity patients are acutely injured or unwell, and the decision to go to ED is based on their perception of accessibility of expertise aligned with their need. The term 'GP-type' is misleading in this context and should not be used. Providing low-acuity care in parallel with providing a specialised emergency service meets the needs of the local community and is likely to be the lowest cost model in a regional and rural area. Funding models must reflect the actual cost of delivering this important service rather than presentation types. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The emergency department prediction of disposition (EPOD) study.

PubMed

Vaghasiya, Milan R; Murphy, Margaret; O'Flynn, Daniel; Shetty, Amith

2014-11-01

Emergency departments (ED) continue to evolve models of care and streaming as interventions to tackle the effects of access block and overcrowding. Tertiary ED may be able to design patient-flow based on predicted dispositions in the department. Segregating discharge-stream patients may help develop patient-flows within the department, which is less affected by availability of beds in a hospital. We aim to determine if triage nurses and ED doctors can predict disposition outcomes early in the patient journey and thus lead to successful streaming of patients in the ED. During this study, triage nurses and ED doctors anonymously predicted disposition outcomes for patients presenting to triage after their brief assessments. Patient disposition at the 24-h post ED presentation was considered as the actual outcome and compared against predicted outcomes. Triage nurses were able to predict actual discharges of 445 patients out of 490 patients with a positive predictive value (PPV) of 90.8% (95% CI 87.8-93.2%). ED registrars were able to predict actual discharges of 85 patients out of 93 patients with PPV of 91.4% (95% CI 83.3-95.9%). ED consultants were able to predict actual discharges of 111 patients out of 118 patients with PPV 94.1% (95% CI 87.7-97.4%). PPVs for admission among ED consultants, ED registrars and Triage nurses were 59.7%, 54.4% and 48.5% respectively. Triage nurses, ED consultants and ED registrars are able to predict a patient's discharge disposition at triage with high levels of confidence. Triage nurses, ED consultants, and ED registrars can predict patients who are likely to be admitted with equal ability. This data may be used to develop specific admission and discharge streams based on early decision-making in EDs by triage nurses, ED registrars or ED consultants. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Leisure-Time Physical Activity and Sedentary Behavior and Their Cross-Sectional Associations with Excessive Daytime Sleepiness in the French SU.VI.MAX-2 Study.

PubMed

Andrianasolo, Roland M; Menai, Mehdi; Galan, Pilar; Hercberg, Serge; Oppert, Jean-Michel; Kesse-Guyot, Emmanuelle; Andreeva, Valentina A

2016-04-01

The potential benefit of physical activity in terms of decreasing excessive daytime sleepiness (EDS) prevalence is unclear, especially in aging adults. We aimed to elucidate the associations among physical activity, sedentariness, and EDS in middle-aged and older adults. We conducted a cross-sectional analysis using data from a subsample of participants in the SU.VI.MAX-2 observational study (2007-2009; N = 4179; mean age = 61.9 years). EDS was defined as a score >10 on the Epworth Sleepiness Scale. Leisure-time physical activity and different types of sedentary behavior were assessed with the Modifiable Activity Questionnaire. The associations were examined with multivariable logistic regression models. In the adjusted multivariable model, total leisure-time physical activity (modeled in quartiles, Q) was significantly, inversely associated with EDS (odds ratios (OR)Q4 vs Q1 = 0.70, 95 % confidence interval (CI) = 0.54-0.89). The association persisted in analyses restricted to individuals not taking sleep medication (ORQ4 vs Q1 = 0.72, 95 % CI = 0.54-0.95). In turn, time spent watching television and time spent reading appeared protective against EDS (ORQ4 vs Q1 = 0.73, 95 % CI = 0.57-0.94; ORQ4 vs Q1 = 0.76, 95 % CI = 0.60-0.97, respectively), whereas time spent on a computer appeared to confer an increased risk for EDS (ORQ4 vs Q1 = 1.30, 95 % CI = 1.05-1.62). When physical activity and sedentariness were modeled jointly, using WHO recommendation-based cutoffs for high/low levels, no significant associations were observed in the fully adjusted models. The findings reinforce public health recommendations promoting behavior modification and specifically moderate-intensity exercise in middle-aged and older adults. The association of high physical activity/low sedentariness with EDS, which was not supported by the data, merits further investigation before firm conclusions could be drawn.

Different rates of DNA replication at early versus late S-phase sections: multiscale modeling of stochastic events related to DNA content/EdU (5-ethynyl-2'deoxyuridine) incorporation distributions.

PubMed

Li, Biao; Zhao, Hong; Rybak, Paulina; Dobrucki, Jurek W; Darzynkiewicz, Zbigniew; Kimmel, Marek

2014-09-01

Mathematical modeling allows relating molecular events to single-cell characteristics assessed by multiparameter cytometry. In the present study we labeled newly synthesized DNA in A549 human lung carcinoma cells with 15-120 min pulses of EdU. All DNA was stained with DAPI and cellular fluorescence was measured by laser scanning cytometry. The frequency of cells in the ascending (left) side of the "horseshoe"-shaped EdU/DAPI bivariate distributions reports the rate of DNA replication at the time of entrance to S phase while their frequency in the descending (right) side is a marker of DNA replication rate at the time of transition from S to G2 phase. To understand the connection between molecular-scale events and scatterplot asymmetry, we developed a multiscale stochastic model, which simulates DNA replication and cell cycle progression of individual cells and produces in silico EdU/DAPI scatterplots. For each S-phase cell the time points at which replication origins are fired are modeled by a non-homogeneous Poisson Process (NHPP). Shifted gamma distributions are assumed for durations of cell cycle phases (G1, S and G2 M), Depending on the rate of DNA synthesis being an increasing or decreasing function, simulated EdU/DAPI bivariate graphs show predominance of cells in left (early-S) or right (late-S) side of the horseshoe distribution. Assuming NHPP rate estimated from independent experiments, simulated EdU/DAPI graphs are nearly indistinguishable from those experimentally observed. This finding proves consistency between the S-phase DNA-replication rate based on molecular-scale analyses, and cell population kinetics ascertained from EdU/DAPI scatterplots and demonstrates that DNA replication rate at entrance to S is relatively slow compared with its rather abrupt termination during S to G2 transition. Our approach opens a possibility of similar modeling to study the effect of anticancer drugs on DNA replication/cell cycle progression and also to quantify other kinetic events that can be measured during S-phase. © 2014 International Society for Advancement of Cytometry.

Integrating physically based simulators with Event Detection Systems: Multi-site detection approach.

PubMed

Housh, Mashor; Ohar, Ziv

2017-03-01

The Fault Detection (FD) Problem in control theory concerns of monitoring a system to identify when a fault has occurred. Two approaches can be distinguished for the FD: Signal processing based FD and Model-based FD. The former concerns of developing algorithms to directly infer faults from sensors' readings, while the latter uses a simulation model of the real-system to analyze the discrepancy between sensors' readings and expected values from the simulation model. Most contamination Event Detection Systems (EDSs) for water distribution systems have followed the signal processing based FD, which relies on analyzing the signals from monitoring stations independently of each other, rather than evaluating all stations simultaneously within an integrated network. In this study, we show that a model-based EDS which utilizes a physically based water quality and hydraulics simulation models, can outperform the signal processing based EDS. We also show that the model-based EDS can facilitate the development of a Multi-Site EDS (MSEDS), which analyzes the data from all the monitoring stations simultaneously within an integrated network. The advantage of the joint analysis in the MSEDS is expressed by increased detection accuracy (higher true positive alarms and fewer false alarms) and shorter detection time. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Model Program for Teenage Youth: First Year Evaluation of Knowledge Development.

ERIC Educational Resources Information Center

Pooley, Richard C.

Progress in the second 6 months of a program development model for learning disabled (LD) and emotionally disturbed (ED) adolescents is reported. The program is designed to teach ED and LD children necessary work skills so that they can become productive members of society. Three methods are under investigation: (1) use of audio/visual resources…

Low-Intensity Shock Wave Therapy and Its Application to Erectile Dysfunction

PubMed Central

Lei, Hongen; Liu, Jing; Li, Huixi; Wang, Lin; Xu, Yongde; Tian, Wenjie; Lin, Guiting

2013-01-01

Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED. PMID:24459653

Low-intensity shock wave therapy and its application to erectile dysfunction.

PubMed

Lei, Hongen; Liu, Jing; Li, Huixi; Wang, Lin; Xu, Yongde; Tian, Wenjie; Lin, Guiting; Xin, Zhongcheng

2013-12-01

Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.

Frequent use of emergency departments by older people: a comparative cohort study of characteristics and outcomes.

PubMed

Street, Maryann; Berry, Debra; Considine, Julie

2018-04-12

To characterise older people who frequently use emergency departments (EDs) and compare patient outcomes with older non-frequent ED attenders. Retrospective comparative cohort study. Logistic regression modelling of patient characteristics and health service usage, comparing older frequent ED attenders (≥4 ED attendances in 12 months) to non-frequent ED attenders. Three Australian public hospital EDs, with a total of 143 327 emergency attendances in the 12 months. People aged ≥65 years attending the ED in financial year 2013/2014. The primary outcome was frequent ED use; secondary outcomes were ED length of stay, discharge destination from ED, hospital length of stay, re-presentation within 48 h, hospital readmission within 30 days and in-hospital mortality. Five percent of older people were frequent attenders (n = 1046/21 073), accounting for 16.9% (n = 5469/32 282) of all attendances by older people. Frequent ED attenders were more likely to be male, aged 75-84 years, arrive by ambulance and have a diagnosis relating to chronic illness. Frequent attenders stayed 0.4 h longer in ED (P < 0.001), were more likely to be admitted to hospital (69.2% vs 67.2%; P = 0.004), and had a 1 day longer hospital stay (P < 0.001). In-hospital mortality for older frequent ED attenders was double that of non-frequent attenders (7.0% vs 3.2%, P < 0.001) over 12 months. Older frequent ED attenders had more chronic disease and care needs requiring hospital admission than non-frequent attenders. A new approach to care planning and coordination is recommended, to optimise the patient journey and improve outcomes.

Alcohol mixed with energy drinks: Associations with risky drinking and functioning in high school.

PubMed

Tucker, Joan S; Troxel, Wendy M; Ewing, Brett A; D'Amico, Elizabeth J

2016-10-01

Mixing alcohol with energy drinks is associated with heavier drinking and related problems among college students. However, little is known about how high school drinkers who mix alcohol with energy drinks (AmED) compare to those who do not (AwoED). This study compares high school AmED and AwoED users on their alcohol use during middle and high school, as well as key domains of functioning in high school. Two surveys were conducted three years apart in adolescents initially recruited from 16 middle schools in Southern California. The analytic sample consists of 696 past month drinkers. Multivariable models compared AmED and AwoED users on alcohol use, mental health, social functioning, academic orientation, delinquency and other substance use at age 17, and on their alcohol use and related cognitions at age 14. AmED was reported by 13% of past month drinkers. AmED and AwoED users did not differ on alcohol use or cognitions in middle school, but AmED users drank more often, more heavily, and reported more negative consequences in high school. AmED users were also more likely to report poor grades, delinquent behavior, substance use-related unsafe driving, public intoxication, and drug use than AwoED users in high school. Group differences were not found on mental health, social functioning, or academic aspirations. AmED use is common among high school drinkers. The higher risk behavioral profile of these young AmED users, which includes drug use and substance use-related unsafe driving, is a significant cause for concern and warrants further attention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The meaning of (quality of) life in patients with eating disorders: a comparison of generic and disease-specific measures across diagnosis and outcome.

PubMed

Ackard, Diann M; Richter, Sara; Egan, Amber; Engel, Scott; Cronemeyer, Catherine L

2014-04-01

Compare general and disease-specific health-related quality of life (HRQoL) among female patients with an eating disorder (ED). Female patients (n = 221; 95.3% Caucasian; 94.0% never married) completed the Medical Outcome Short Form Health Survey (SF-36) and Eating Disorders Quality of Life (EDQoL) as part of a study of treatment outcomes. Multivariate regression models were used to compare HRQoL differences across initial ED diagnosis (85 AN-R, 19 AN-B/P, 27 BN, 90 EDNOS) and ED diagnostic classification at time of outcome assessment (140 no ED, 38 subthreshold ED, 43 full threshold ED). There were no significant differences across ED diagnosis at initial assessment on either of the SF-36 Component Summary scores. However, patients with AN-B/P scored poorer on the work/school EDQoL subscales than other ED diagnoses, and on the psychological EDQoL subscale compared to AN-R and EDNOS. At outcome assessment, comparisons across full threshold, subthreshold and no ED classification indicated that those with no ED reported better HRQoL than those with full threshold ED on the SF-36 Mental Components Summary and three of four EDQoL subscales. Furthermore, those with no ED reported better psychological HRQoL than those with subthreshold ED. Disease-specific HRQOL measures are important to use when comparing HRQoL in ED patients across treatment and outcome, and may have the sensitivity to detect meaningful differences by diagnosis more so than generic instruments. EDQoL scores from patients remitted from symptoms approach but do not reach scores for unaffected college females; thus, treatment should continue until quality of life is restored. Copyright © 2013 Wiley Periodicals, Inc.

A multicenter observational study of US adults with acute asthma: who are the frequent users of the emergency department?

PubMed

Hasegawa, Kohei; Sullivan, Ashley F; Tovar Hirashima, Eva; Gaeta, Theodore J; Fee, Christopher; Turner, Stuart J; Massaro, Susan; Camargo, Carlos A

2014-01-01

Despite the substantial burden of asthma-related emergency department (ED) visits, there have been no recent multicenter efforts to characterize this high-risk population. We aimed to characterize patients with asthma according to their frequency of ED visits and to identify factors associated with frequent ED visits. A multicenter chart review study of 48 EDs across 23 US states. We identified ED patients ages 18 to 54 years with acute asthma during 2011 and 2012. Primary outcome was frequency of ED visits for acute asthma in the past year, excluding the index ED visit. Of the 1890 enrolled patients, 863 patients (46%) had 1 or more (frequent) ED visits in the past year. Specifically, 28% had 1 to 2 visits, 11% had 3 to 5 visits, and 7% had 6 or more visits. Among frequent ED users, guideline-recommended management was suboptimal. For example, of patients with 6 or more ED visits, 85% lacked evidence of prior evaluation by an asthma specialist, and 43% were not treated with inhaled corticosteroids. In a multivariable model, significant predictors of frequent ED visits were public insurance, no insurance, and markers for chronic asthma severity (all P < .05). Stronger associations were found among those with a higher frequency of asthma-related ED visits (eg, 6 or more ED visits). This multicenter study of US adults with acute asthma demonstrated many frequent ED users and suboptimal preventive management in this high-risk population. Future reductions in asthma morbidity and associated health care utilization will require continued efforts to bridge these major gaps in asthma care. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

LinkEHR-Ed: a multi-reference model archetype editor based on formal semantics.

PubMed

Maldonado, José A; Moner, David; Boscá, Diego; Fernández-Breis, Jesualdo T; Angulo, Carlos; Robles, Montserrat

2009-08-01

To develop a powerful archetype editing framework capable of handling multiple reference models and oriented towards the semantic description and standardization of legacy data. The main prerequisite for implementing tools providing enhanced support for archetypes is the clear specification of archetype semantics. We propose a formalization of the definition section of archetypes based on types over tree-structured data. It covers the specialization of archetypes, the relationship between reference models and archetypes and conformance of data instances to archetypes. LinkEHR-Ed, a visual archetype editor based on the former formalization with advanced processing capabilities that supports multiple reference models, the editing and semantic validation of archetypes, the specification of mappings to data sources, and the automatic generation of data transformation scripts, is developed. LinkEHR-Ed is a useful tool for building, processing and validating archetypes based on any reference model.

Time series modeling for syndromic surveillance.

PubMed

Reis, Ben Y; Mandl, Kenneth D

2003-01-23

Emergency department (ED) based syndromic surveillance systems identify abnormally high visit rates that may be an early signal of a bioterrorist attack. For example, an anthrax outbreak might first be detectable as an unusual increase in the number of patients reporting to the ED with respiratory symptoms. Reliably identifying these abnormal visit patterns requires a good understanding of the normal patterns of healthcare usage. Unfortunately, systematic methods for determining the expected number of (ED) visits on a particular day have not yet been well established. We present here a generalized methodology for developing models of expected ED visit rates. Using time-series methods, we developed robust models of ED utilization for the purpose of defining expected visit rates. The models were based on nearly a decade of historical data at a major metropolitan academic, tertiary care pediatric emergency department. The historical data were fit using trimmed-mean seasonal models, and additional models were fit with autoregressive integrated moving average (ARIMA) residuals to account for recent trends in the data. The detection capabilities of the model were tested with simulated outbreaks. Models were built both for overall visits and for respiratory-related visits, classified according to the chief complaint recorded at the beginning of each visit. The mean absolute percentage error of the ARIMA models was 9.37% for overall visits and 27.54% for respiratory visits. A simple detection system based on the ARIMA model of overall visits was able to detect 7-day-long simulated outbreaks of 30 visits per day with 100% sensitivity and 97% specificity. Sensitivity decreased with outbreak size, dropping to 94% for outbreaks of 20 visits per day, and 57% for 10 visits per day, all while maintaining a 97% benchmark specificity. Time series methods applied to historical ED utilization data are an important tool for syndromic surveillance. Accurate forecasting of emergency department total utilization as well as the rates of particular syndromes is possible. The multiple models in the system account for both long-term and recent trends, and an integrated alarms strategy combining these two perspectives may provide a more complete picture to public health authorities. The systematic methodology described here can be generalized to other healthcare settings to develop automated surveillance systems capable of detecting anomalies in disease patterns and healthcare utilization.

Impact of a Two-step Emergency Department Triage Model with START, then CTAS, on Patient Flow During a Simulated Mass-casualty Incident.

PubMed

Lee, James S; Franc, Jeffrey M

2015-08-01

A high influx of patients during a mass-casualty incident (MCI) may disrupt patient flow in an already overcrowded emergency department (ED) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step ED triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on patient flow during a MCI simulation exercise. Hypothesis/Problem It was hypothesized that there would be no difference in time intervals nor patient volumes at each patient-flow milestone. Physicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. Patient-flow milestones including time intervals and patient volumes from ED arrival to triage, ED arrival to bed assignment, ED arrival to physician assessment, and ED arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes. There were no significant differences in the time interval from ED arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), ED arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), ED arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and ED arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of patients to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar in both groups (57% vs 70%; 95% CI for the difference -15% to 41%; P=.46). Experienced triage nurses were able to apply CTAS effectively during a MCI simulation exercise. A two-step ED triage model using START, then CTAS, had similar patient flow and triage accuracy when compared to START alone.

Understanding native Russian listeners' errors on an English word recognition test: model-based analysis of phoneme confusion.

PubMed

Shi, Lu-Feng; Morozova, Natalia

2012-08-01

Word recognition is a basic component in a comprehensive hearing evaluation, but data are lacking for listeners speaking two languages. This study obtained such data for Russian natives in the US and analysed the data using the perceptual assimilation model (PAM) and speech learning model (SLM). Listeners were randomly presented 200 NU-6 words in quiet. Listeners responded verbally and in writing. Performance was scored on words and phonemes (word-initial consonants, vowels, and word-final consonants). Seven normal-hearing, adult monolingual English natives (NM), 16 English-dominant (ED), and 15 Russian-dominant (RD) Russian natives participated. ED and RD listeners differed significantly in their language background. Consistent with the SLM, NM outperformed ED listeners and ED outperformed RD listeners, whether responses were scored on words or phonemes. NM and ED listeners shared similar phoneme error patterns, whereas RD listeners' errors had unique patterns that could be largely understood via the PAM. RD listeners had particular difficulty differentiating vowel contrasts /i-I/, /æ-ε/, and /ɑ-Λ/, word-initial consonant contrasts /p-h/ and /b-f/, and word-final contrasts /f-v/. Both first-language phonology and second-language learning history affect word and phoneme recognition. Current findings may help clinicians differentiate word recognition errors due to language background from hearing pathologies.

A new model to study sleep deprivation-induced seizure.

PubMed

Lucey, Brendan P; Leahy, Averi; Rosas, Regine; Shaw, Paul J

2015-05-01

A relationship between sleep and seizures is well-described in both humans and rodent animal models; however, the mechanism underlying this relationship is unknown. Using Drosophila melanogaster mutants with seizure phenotypes, we demonstrate that seizure activity can be modified by sleep deprivation. Seizure activity was evaluated in an adult bang-sensitive seizure mutant, stress sensitive B (sesB(9ed4)), and in an adult temperature sensitive seizure mutant seizure (sei(ts1)) under baseline and following 12 h of sleep deprivation. The long-term effect of sleep deprivation on young, immature sesB(9ed4) flies was also assessed. Laboratory. Drosophila melanogaster. Sleep deprivation. Sleep deprivation increased seizure susceptibility in adult sesB(9ed4)/+ and sei(ts1) mutant flies. Sleep deprivation also increased seizure susceptibility when sesB was disrupted using RNAi. The effect of sleep deprivation on seizure activity was reduced when sesB(9ed4)/+ flies were given the anti-seizure drug, valproic acid. In contrast to adult flies, sleep deprivation during early fly development resulted in chronic seizure susceptibility when sesB(9ed4)/+ became adults. These findings show that Drosophila is a model organism for investigating the relationship between sleep and seizure activity. © 2015 Associated Professional Sleep Societies, LLC.

Applications of Perron-Frobenius theory to population dynamics.

PubMed

Li, Chi-Kwong; Schneider, Hans

2002-05-01

By the use of Perron-Frobenius theory, simple proofs are given of the Fundamental Theorem of Demography and of a theorem of Cushing and Yicang on the net reproductive rate occurring in matrix models of population dynamics. The latter result, which is closely related to the Stein-Rosenberg theorem in numerical linear algebra, is further refined with some additional nonnegative matrix theory. When the fertility matrix is scaled by the net reproductive rate, the growth rate of the model is $1$. More generally, we show how to achieve a given growth rate for the model by scaling the fertility matrix. Demographic interpretations of the results are given.

The Lagrangian Ensemble metamodel for simulating plankton ecosystems

NASA Astrophysics Data System (ADS)

Woods, J. D.

2005-10-01

This paper presents a detailed account of the Lagrangian Ensemble (LE) metamodel for simulating plankton ecosystems. It uses agent-based modelling to describe the life histories of many thousands of individual plankters. The demography of each plankton population is computed from those life histories. So too is bio-optical and biochemical feedback to the environment. The resulting “virtual ecosystem” is a comprehensive simulation of the plankton ecosystem. It is based on phenotypic equations for individual micro-organisms. LE modelling differs significantly from population-based modelling. The latter uses prognostic equations to compute demography and biofeedback directly. LE modelling diagnoses them from the properties of individual micro-organisms, whose behaviour is computed from prognostic equations. That indirect approach permits the ecosystem to adjust gracefully to changes in exogenous forcing. The paper starts with theory: it defines the Lagrangian Ensemble metamodel and explains how LE code performs a number of computations “behind the curtain”. They include budgeting chemicals, and deriving biofeedback and demography from individuals. The next section describes the practice of LE modelling. It starts with designing a model that complies with the LE metamodel. Then it describes the scenario for exogenous properties that provide the computation with initial and boundary conditions. These procedures differ significantly from those used in population-based modelling. The next section shows how LE modelling is used in research, teaching and planning. The practice depends largely on hindcasting to overcome the limits to predictability of weather forecasting. The scientific method explains observable ecosystem phenomena in terms of finer-grained processes that cannot be observed, but which are controlled by the basic laws of physics, chemistry and biology. What-If? Prediction ( WIP), used for planning, extends hindcasting by adding events that describe natural or man-made hazards and remedial actions. Verification is based on the Ecological Turing Test, which takes account of uncertainties in the observed and simulated versions of a target ecological phenomenon. The rest of the paper is devoted to a case study designed to show what LE modelling offers the biological oceanographer. The case study is presented in two parts. The first documents the WB model (Woods & Barkmann, 1994) and scenario used to simulate the ecosystem in a mesocosm moored in deep water off the Azores. The second part illustrates the emergent properties of that virtual ecosystem. The behaviour and development of an individual plankton lineage are revealed by an audit trail of the agent used in the computation. The fields of environmental properties reveal the impact of biofeedback. The fields of demographic properties show how changes in individuals cumulatively affect the birth and death rates of their population. This case study documents the virtual ecosystem used by Woods, Perilli and Barkmann (2005; hereafter WPB); to investigate the stability of simulations created by the Lagrangian Ensemble metamodel. The Azores virtual ecosystem was created and analysed on the Virtual Ecology Workbench (VEW) which is described briefly in the Appendix.

Teaching Business Demography Using Case Studies.

PubMed

Swanson, David A; Morrison, Peter A

2010-02-01

Many faculty members consider using case studies but not all end up using them. We provide a brief review of what cases are intended to do and identify three ways in which they can be used. We then use an example to illustrate how we have used the case study method in teaching business demography. Among other benefits, we note that the case studies method not only encourages the acquisition of skills by students, but can be used to promote "deep structure learning," an approach naturally accommodates other features associated with the case studies method-the development of critical thinking skills, the use of real world problems, the emphasis of concepts over mechanics, writing and presentation skills, active cooperative learning and the "worthwhileness" of a course. As noted by others, we understand the limitations of the case study method. However, given its strengths, we believe it has a place in the instructional toolbox for courses in business demography. The fact that courses we teach is a testament to our perceived efficacy of this tool.

Women, Demography, and Politics: How Lower Fertility Rates Lead to Democracy.

PubMed

Sommer, Udi

2018-04-01

Where connections between demography and politics are examined in the literature, it is largely in the context of the effects of male aspects of demography on phenomena such as political violence. This project aims to place the study of demographic variables' influence on politics, particularly on democracy, squarely within the scope of political and social sciences, and to focus on the effects of woman-related demographics-namely, fertility rate. I test the hypothesis that demographic variables-female-related predictors, in particular-have an independent effect on political structure. Comparing countries over time, this study finds a growth in democracy when fertility rates decline. In the theoretical framework developed, it is family structure as well as the economic and political status of women that account for this change at the macro and micro levels. Findings based on data for more than 140 countries over three decades are robust when controlling not only for alternative effects but also for reverse causality and data limitations.

Scale-dependent portfolio effects explain growth inflation and volatility reduction in landscape demography

PubMed Central

2017-01-01

Population demography is central to fundamental ecology and for predicting range shifts, decline of threatened species, and spread of invasive organisms. There is a mismatch between most demographic work, carried out on few populations and at local scales, and the need to predict dynamics at landscape and regional scales. Inspired by concepts from landscape ecology and Markowitz’s portfolio theory, we develop a landscape portfolio platform to quantify and predict the behavior of multiple populations, scaling up the expectation and variance of the dynamics of an ensemble of populations. We illustrate this framework using a 35-y time series on gypsy moth populations. We demonstrate the demography accumulation curve in which the collective growth of the ensemble depends on the number of local populations included, highlighting a minimum but adequate number of populations for both regional-scale persistence and cross-scale inference. The attainable set of landscape portfolios further suggests tools for regional population management for both threatened and invasive species. PMID:29109261

DESCARTES' RULE OF SIGNS AND THE IDENTIFIABILITY OF POPULATION DEMOGRAPHIC MODELS FROM GENOMIC VARIATION DATA.

PubMed

Bhaskar, Anand; Song, Yun S

2014-01-01

The sample frequency spectrum (SFS) is a widely-used summary statistic of genomic variation in a sample of homologous DNA sequences. It provides a highly efficient dimensional reduction of large-scale population genomic data and its mathematical dependence on the underlying population demography is well understood, thus enabling the development of efficient inference algorithms. However, it has been recently shown that very different population demographies can actually generate the same SFS for arbitrarily large sample sizes. Although in principle this nonidentifiability issue poses a thorny challenge to statistical inference, the population size functions involved in the counterexamples are arguably not so biologically realistic. Here, we revisit this problem and examine the identifiability of demographic models under the restriction that the population sizes are piecewise-defined where each piece belongs to some family of biologically-motivated functions. Under this assumption, we prove that the expected SFS of a sample uniquely determines the underlying demographic model, provided that the sample is sufficiently large. We obtain a general bound on the sample size sufficient for identifiability; the bound depends on the number of pieces in the demographic model and also on the type of population size function in each piece. In the cases of piecewise-constant, piecewise-exponential and piecewise-generalized-exponential models, which are often assumed in population genomic inferences, we provide explicit formulas for the bounds as simple functions of the number of pieces. Lastly, we obtain analogous results for the "folded" SFS, which is often used when there is ambiguity as to which allelic type is ancestral. Our results are proved using a generalization of Descartes' rule of signs for polynomials to the Laplace transform of piecewise continuous functions.

DESCARTES’ RULE OF SIGNS AND THE IDENTIFIABILITY OF POPULATION DEMOGRAPHIC MODELS FROM GENOMIC VARIATION DATA1

PubMed Central

Bhaskar, Anand; Song, Yun S.

2016-01-01

The sample frequency spectrum (SFS) is a widely-used summary statistic of genomic variation in a sample of homologous DNA sequences. It provides a highly efficient dimensional reduction of large-scale population genomic data and its mathematical dependence on the underlying population demography is well understood, thus enabling the development of efficient inference algorithms. However, it has been recently shown that very different population demographies can actually generate the same SFS for arbitrarily large sample sizes. Although in principle this nonidentifiability issue poses a thorny challenge to statistical inference, the population size functions involved in the counterexamples are arguably not so biologically realistic. Here, we revisit this problem and examine the identifiability of demographic models under the restriction that the population sizes are piecewise-defined where each piece belongs to some family of biologically-motivated functions. Under this assumption, we prove that the expected SFS of a sample uniquely determines the underlying demographic model, provided that the sample is sufficiently large. We obtain a general bound on the sample size sufficient for identifiability; the bound depends on the number of pieces in the demographic model and also on the type of population size function in each piece. In the cases of piecewise-constant, piecewise-exponential and piecewise-generalized-exponential models, which are often assumed in population genomic inferences, we provide explicit formulas for the bounds as simple functions of the number of pieces. Lastly, we obtain analogous results for the “folded” SFS, which is often used when there is ambiguity as to which allelic type is ancestral. Our results are proved using a generalization of Descartes’ rule of signs for polynomials to the Laplace transform of piecewise continuous functions. PMID:28018011

Persistent oscillations and backward bifurcation in a malaria model with varying human and mosquito populations: implications for control.

PubMed

Ngonghala, Calistus N; Teboh-Ewungkem, Miranda I; Ngwa, Gideon A

2015-06-01

We derive and study a deterministic compartmental model for malaria transmission with varying human and mosquito populations. Our model considers disease-related deaths, asymptomatic immune humans who are also infectious, as well as mosquito demography, reproduction and feeding habits. Analysis of the model reveals the existence of a backward bifurcation and persistent limit cycles whose period and size is determined by two threshold parameters: the vectorial basic reproduction number Rm, and the disease basic reproduction number R0, whose size can be reduced by reducing Rm. We conclude that malaria dynamics are indeed oscillatory when the methodology of explicitly incorporating the mosquito's demography, feeding and reproductive patterns is considered in modeling the mosquito population dynamics. A sensitivity analysis reveals important control parameters that can affect the magnitudes of Rm and R0, threshold quantities to be taken into consideration when designing control strategies. Both Rm and the intrinsic period of oscillation are shown to be highly sensitive to the mosquito's birth constant λm and the mosquito's feeding success probability pw. Control of λm can be achieved by spraying, eliminating breeding sites or moving them away from human habitats, while pw can be controlled via the use of mosquito repellant and insecticide-treated bed-nets. The disease threshold parameter R0 is shown to be highly sensitive to pw, and the intrinsic period of oscillation is also sensitive to the rate at which reproducing mosquitoes return to breeding sites. A global sensitivity and uncertainty analysis reveals that the ability of the mosquito to reproduce and uncertainties in the estimations of the rates at which exposed humans become infectious and infectious humans recover from malaria are critical in generating uncertainties in the disease classes.

Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

PubMed Central

Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

2014-01-01

We analyzed 2010 U.S. National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million NTDC-related ED visits in 2010. Less than 1.0% (children) and 2.1% (adults) of all ED visits were for NTDC. There was no significant difference in NTDC-related ED visits or costs for children by ASD status. Adults with ASD had significantly lower odds of NTDC-related ED visits (OR=0.39; 95% CI: 0.29, 0.52; P<0.001) but incurred significantly greater mean costs for NTDC-related ED visits (P<0.006) than did adults without ASD. PMID:25374135

An Innovative Model to Predict Pediatric Emergency Department Return Visits.

PubMed

Bergese, Ilaria; Frigerio, Simona; Clari, Marco; Castagno, Emanuele; De Clemente, Antonietta; Ponticelli, Elena; Scavino, Enrica; Berchialla, Paola

2016-10-06

Return visit (RV) to the emergency department (ED) is considered a benchmarking clinical indicator for health care quality. The purpose of this study was to develop a predictive model for early readmission risk in pediatric EDs comparing the performances of 2 learning machine algorithms. A retrospective study based on all children younger than 15 years spontaneously returning within 120 hours after discharge was conducted in an Italian university children's hospital between October 2012 and April 2013. Two predictive models, artificial neural network (ANN) and classification tree (CT), were used. Accuracy, specificity, and sensitivity were assessed. A total of 28,341 patient records were evaluated. Among them, 626 patients returned to the ED within 120 hours after their initial visit. Comparing ANN and CT, our analysis has shown that CT is the best model to predict RVs. The CT model showed an overall accuracy of 81%, slightly lower than the one achieved by the ANN (91.3%), but CT outperformed ANN with regard to sensitivity (79.8% vs 6.9%, respectively). The specificity was similar for the 2 models (CT, 97% vs ANN, 98.3%). In addition, the time of arrival and discharge along with the priority code assigned in triage, age, and diagnosis play a pivotal role to identify patients at high risk of RVs. These models provide a promising predictive tool for supporting the ED staff in preventing unnecessary RVs.

Community-level demographic consequences of urbanization: an ecological network approach.

PubMed

Rodewald, Amanda D; Rohr, Rudolf P; Fortuna, Miguel A; Bascompte, Jordi

2014-11-01

Ecological networks are known to influence ecosystem attributes, but we poorly understand how interspecific network structure affect population demography of multiple species, particularly for vertebrates. Establishing the link between network structure and demography is at the crux of being able to use networks to understand population dynamics and to inform conservation. We addressed the critical but unanswered question, does network structure explain demographic consequences of urbanization? We studied 141 ecological networks representing interactions between plants and nesting birds in forests across an urbanization gradient in Ohio, USA, from 2001 to 2011. Nest predators were identified by video-recording nests and surveyed from 2004 to 2011. As landscapes urbanized, bird-plant networks were more nested, less compartmentalized and dominated by strong interactions between a few species (i.e. low evenness). Evenness of interaction strengths promoted avian nest survival, and evenness explained demography better than urbanization, level of invasion, numbers of predators or other qualitative network metrics. Highly uneven networks had approximately half the nesting success as the most even networks. Thus, nest survival reflected how urbanization altered species interactions, particularly with respect to how nest placement affected search efficiency of predators. The demographic effects of urbanization were not direct, but were filtered through bird-plant networks. This study illustrates how network structure can influence demography at the community level and further, that knowledge of species interactions and a network approach may be requisite to understanding demographic responses to environmental change. © 2014 The Authors. Journal of Animal Ecology © 2014 British Ecological Society.

Modified Maxium Likelihood Estimation Method for Completely Separated and Quasi-Completely Separated Data for a Dose-Response Model

DTIC Science & Technology

2015-08-01

McCullagh, P.; Nelder, J.A. Generalized Linear Model , 2nd ed.; Chapman and Hall: London, 1989. 7. Johnston, J. Econometric Methods, 3rd ed.; McGraw...FOR A DOSE-RESPONSE MODEL ECBC-TN-068 Kyong H. Park Steven J. Lagan RESEARCH AND TECHNOLOGY DIRECTORATE August 2015 Approved for public release...Likelihood Estimation Method for Completely Separated and Quasi-Completely Separated Data for a Dose-Response Model 5a. CONTRACT NUMBER 5b. GRANT

Staggered work shifts: a way to downsize and restructure an emergency department workforce yet maintain current operational performance.

PubMed

Sinreich, David; Jabali, Ola

2007-09-01

Starting from the last decade of the twentieth century, most hospital Emergency Department (ED) budgets did not keep up with the demand for ED services made by growing populations and aging societies. Since labor consumes over 50% of the total monies invested in EDs and other healthcare systems, any downsizing, streamlining and reorganization plan needs to first address staffing issues such as determining the correct size of the workforce and its work shift scheduling. In this context, it is very important to remember that downsizing certainly does not mean a general cut-across-the-board. This study shows that a selective downsizing process in which each resource is treated separately (increasing the work capacity of some resources is also possible), based on its unique contribution to the overall ED operational performance, can approximately maintain current ED operational measures in terms patient length of stay (LOS) despite an overall reduction in staff hours. A linear optimization model (S-model) and a heuristic iterative simulation based algorithm (SWSSA) are used in this study for scheduling the resources' work shifts, one resource at a time. The algorithm was tested using data that was gathered from five general hospital EDs. By leveling the workload of the different resources in the ED, SWSSA was able to achieve LOS values within -19 to 4% of the original values despite a reduction of 8-17.5% in physicians' work hours and a reduction of 13-47% in the nurses' work hours.

A Theory of Bayesian Data Analysis

DTIC Science & Technology

1989-10-10

and the sim- plification of models," in Evaluation of Econometric Models, J. Kmenta and J. 20 Ramsey , eds., Academic Press, 245-268. Edwards, W...Evaluation of Econometric Models, ed. by J. Kmenta and J. Ramsey , Academic Press, 197-217. Hill, Bruce M., (1980c), Review of Specification Searches, by E...also Hill (1970a, 1975a) for earlier thoughts the subject with regard to tests of significance, and Smith.(1986). The Baesi theory of tests of

Thinking about internal states, a qualitative investigation into metacognitions in women with eating disorders

PubMed Central

2013-01-01

Background There is a need for qualitative research to help develop case conceptualisations to guide the development of Metacognitive Therapy interventions for Eating Disorders. Method A qualitative study informed by grounded theory methodology was conducted involving open-ended interviews with 27 women aged 18–55 years, who were seeking or receiving treatment for a diagnosed ED. Results The categories identified in this study appeared to be consistent with a metacognitive model including constructs of a Cognitive Attentional Syndrome and metacognitive beliefs. These categories appear to be transdiagnostic, and the interaction between the categories is proposed to explain the maintenance of EDs. Conclusions The transdiagnostic model proposed may be useful to guide the development of future metacognitive therapy interventions for EDs with the hope that this will lead to improved outcomes for individuals with EDs. PMID:24999403

[Proposing a physiological model for Emergency Department. Operating principles, classification of overcrowding and guidelines for redesign].

PubMed

Herrera Carranza, M; Aguado Correa, F; Padilla Garrido, N; López Camacho, F

2017-04-30

The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants. Based on this theoretical approach we classify the different types of ED overcrowding and systematise its causes and the different waiting lists that it generates, which can help to redesign the service and avoid its saturation.

Expression of the apelin-APJ pathway and effects on erectile function in a mouse model of vasculogenic erectile dysfunction.

PubMed

Kwon, Mi-Hye; Tuvshintur, Buyankhuu; Kim, Woo Jean; Jin, Hai-Rong; Yin, Guo Nan; Song, Kang-Moon; Choi, Min Ji; Kwon, Ki-Dong; Batbold, Dulguun; Ryu, Ji-Kan; Suh, Jun-Kyu

2013-12-01

Much attention has recently been focused on therapeutic angiogenesis as a treatment for erectile dysfunction (ED). The apelin and apelin receptor (APJ) system is known to cause endothelium-dependent vasodilatation and to be involved in angiogenesis. To examine the differential expression of apelin and APJ in animal models of vasculogenic ED and to determine whether and how enhancement of apelin-APJ signaling restores erectile function in hypercholesterolemic mice. Acute cavernous ischemia was induced in C57BL/6J mice by bilateral occlusion of internal iliac arteries, and chronic vasculogenic ED was induced by feeding a high-cholesterol diet or by intraperitoneal injection of streptozotocin. Messenger RNA (mRNA) levels of apelin and APJ were determined in cavernous tissue of each vasculogenic ED model by semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). We evaluated erectile function by electrical stimulation of the cavernous nerve in hypercholesterolemic mice 1, 3, 7, and 14 days after a single intracavernous injection of apelin protein (5 μg/20 μL). The penis was harvested for histologic examinations and Western blot analysis. The cavernous mRNA expression of apelin and APJ was up-regulated in acute ischemia model and down-regulated in chronic vasculogenic ED models. A significant restoration of erectile function was noted 1 day after injection of apelin protein into the penis of hypercholesterolemic mice; however, erectile function returned to baseline values thereafter. The beneficial effects of apelin on erectile function resulted mainly from an activation of endothelial nitric oxide synthase and increase in nitric oxide bioavailability through reduction in reactive oxygen species-mediated endothelial apoptosis rather than through direct endothelial cell proliferation. These findings suggest that apelin-APJ signaling is a potential therapeutic target in the treatment of vasculogenic ED. Further studies are needed to develop a potent agonist for APJ and to determine the role of repeated dosing of apelin on long-term recovery of erectile function. © 2013 International Society for Sexual Medicine.

A collaborative quality improvement model and electronic community of practice to support sepsis management in emergency departments: investigating care harmonization for provincial knowledge translation.

PubMed

Ho, Kendall; Marsden, Julian; Jarvis-Selinger, Sandra; Novak Lauscher, Helen; Kamal, Noreen; Stenstrom, Rob; Sweet, David; Goldman, Ran D; Innes, Grant

2012-07-12

Emergency medicine departments within several organizations are now advocating the adoption of early intervention guidelines for patients with the signs and symptoms of sepsis. This proposed research will lead to a comprehensive understanding of how diverse emergency department (ED) sites across British Columbia (BC), Canada, engage in a quality improvement collaborative to lead to improvements in time-based process measures and clinical outcomes for septic patients in EDs. To address the challenge of sepsis management, in 2007, the BC Ministry of Health began working with emergency health professionals, including health administrators, to establish a provincial ED collaborative: Evidence to Excellence (E2E). The E2E initiative employs the Institute for Healthcare Improvement (IHI) model and is supported by a Web-based community of practice (CoP) in emergency medicine. It aims to (1) support clinicians in accessing and applying evidence to clinical practice in emergency medicine, (2) support system change and clinical process improvement, and (3) develop resources and strategies to facilitate knowledge translation and process improvement. Improving sepsis management is one of the central foci of the E2E initiative. The primary purpose of our research is to investigate whether the application of sepsis management protocols leads to improved time-based process measures and clinical outcomes for patients presenting to EDs with sepsis. Also, we seek to investigate the implementation of sepsis protocols among different EDs. For example: (1) How can sepsis protocols be harmonized among different EDs? (2) What are health professionals' perspectives on interprofessional collaboration with various EDs? and (3) What are the factors affecting the level of success among EDs? Lastly, working in collaboration with the BC Ministry of Health as our policy-maker partner, the research will investigate how the demonstrated efficacy of this research can be applied on a provincial and national level to establish a template for policy makers from other jurisdictions to translate knowledge into action for EDs. This research study will employ the IHI model for improvement, incorporate the principles of participatory action research, and use the E2E online CoP to engage ED practitioners (eg, physicians, nurses, and administrators, exchanging ideas, engaging in discussions, sharing resources, and amalgamating knowledge) from across BC to (1) share the evidence of early intervention in sepsis, (2) adapt the evidence to their patterns of practice, (3) develop a common set of orders for implementing the sepsis pathway, and (4) agree on common indicators to measure clinical outcomes. Our hypothesis is that combining the social networking ability of an electronic CoP and its inherent knowledge translation capacity with the structured project management of the IHI model will result in widespread and sustained improvement in the emergency and overall care of patients with severe sepsis presenting to EDs throughout BC.

Life-History and Spatial Determinants of Somatic Growth Dynamics in Komodo Dragon Populations

PubMed Central

Laver, Rebecca J.; Purwandana, Deni; Ariefiandy, Achmad; Imansyah, Jeri; Forsyth, David; Ciofi, Claudio; Jessop, Tim S.

2012-01-01

Somatic growth patterns represent a major component of organismal fitness and may vary among sexes and populations due to genetic and environmental processes leading to profound differences in life-history and demography. This study considered the ontogenic, sex-specific and spatial dynamics of somatic growth patterns in ten populations of the world’s largest lizard the Komodo dragon (Varanus komodoensis). The growth of 400 individual Komodo dragons was measured in a capture-mark-recapture study at ten sites on four islands in eastern Indonesia, from 2002 to 2010. Generalized Additive Mixed Models (GAMMs) and information-theoretic methods were used to examine how growth rates varied with size, age and sex, and across and within islands in relation to site-specific prey availability, lizard population density and inbreeding coefficients. Growth trajectories differed significantly with size and between sexes, indicating different energy allocation tactics and overall costs associated with reproduction. This leads to disparities in maximum body sizes and longevity. Spatial variation in growth was strongly supported by a curvilinear density-dependent growth model with highest growth rates occurring at intermediate population densities. Sex-specific trade-offs in growth underpin key differences in Komodo dragon life-history including evidence for high costs of reproduction in females. Further, inverse density-dependent growth may have profound effects on individual and population level processes that influence the demography of this species. PMID:23028983

Invasion and Persistence of Infectious Agents in Fragmented Host Populations

PubMed Central

Jesse, Marieke; Mazzucco, Rupert; Dieckmann, Ulf; Heesterbeek, Hans; Metz, Johan A. J.

2011-01-01

One of the important questions in understanding infectious diseases and their prevention and control is how infectious agents can invade and become endemic in a host population. A ubiquitous feature of natural populations is that they are spatially fragmented, resulting in relatively homogeneous local populations inhabiting patches connected by the migration of hosts. Such fragmented population structures are studied extensively with metapopulation models. Being able to define and calculate an indicator for the success of invasion and persistence of an infectious agent is essential for obtaining general qualitative insights into infection dynamics, for the comparison of prevention and control scenarios, and for quantitative insights into specific systems. For homogeneous populations, the basic reproduction ratio plays this role. For metapopulations, defining such an ‘invasion indicator’ is not straightforward. Some indicators have been defined for specific situations, e.g., the household reproduction number . However, these existing indicators often fail to account for host demography and especially host migration. Here we show how to calculate a more broadly applicable indicator for the invasion and persistence of infectious agents in a host metapopulation of equally connected patches, for a wide range of possible epidemiological models. A strong feature of our method is that it explicitly accounts for host demography and host migration. Using a simple compartmental system as an example, we illustrate how can be calculated and expressed in terms of the key determinants of epidemiological dynamics. PMID:21980339

Mapping the Indonesian territory, based on pollution, social demography and geographical data, using self organizing feature map

NASA Astrophysics Data System (ADS)

Hernawati, Kuswari; Insani, Nur; Bambang S. H., M.; Nur Hadi, W.; Sahid

2017-08-01

This research aims to mapping the 33 (thirty-three) provinces in Indonesia, based on the data on air, water and soil pollution, as well as social demography and geography data, into a clustered model. The method used in this study was unsupervised method that combines the basic concept of Kohonen or Self-Organizing Feature Maps (SOFM). The method is done by providing the design parameters for the model based on data related directly/ indirectly to pollution, which are the demographic and social data, pollution levels of air, water and soil, as well as the geographical situation of each province. The parameters used consists of 19 features/characteristics, including the human development index, the number of vehicles, the availability of the plant's water absorption and flood prevention, as well as geographic and demographic situation. The data used were secondary data from the Central Statistics Agency (BPS), Indonesia. The data are mapped into SOFM from a high-dimensional vector space into two-dimensional vector space according to the closeness of location in term of Euclidean distance. The resulting outputs are represented in clustered grouping. Thirty-three provinces are grouped into five clusters, where each cluster has different features/characteristics and level of pollution. The result can used to help the efforts on prevention and resolution of pollution problems on each cluster in an effective and efficient way.

Project Integrate: Translating Screening and Brief Interventions for Alcohol Problems to a Community Hospital Emergency Department

ERIC Educational Resources Information Center

Mello, Michael J.; Baird, Janette; Nirenberg, Ted D.; Smith, Jennifer C.; Woolard, Robert H.; Dinwoodie, Robert G.

2009-01-01

Screening and brief intervention (SBI) for alcohol problems in the emergency department (ED) is effective. The objective of this study was to examine the translation of SBI into a busy community ED environment. The authors assessed key stakeholders views of SBI delivery model, then utilized feedback to adapt model. Adoption of SBI was recorded,…

ExpandED Schools National Demonstration: Lessons for Scale and Sustainability

ERIC Educational Resources Information Center

Russell, Christina A.; Hildreth, Jeanine L.; Stevens, Pamela

2016-01-01

The ExpandED Schools model for expanded learning is designed to transform schools by changing the use of time, both as experienced by students in learning and by teachers in instruction. The model is grounded in the belief that strategically adding time to the school day can enhance skills and knowledge and broaden horizons by engaging students in…

Resilience Scale-25 Spanish version: validation and assessment in eating disorders.

PubMed

Las Hayas, Carlota; Calvete, Esther; Gómez del Barrio, Andrés; Beato, Luís; Muñoz, Pedro; Padierna, Jesús Ángel

2014-08-01

To validate into Spanish the Wagnild and Young Resilience Scale - 25 (RS-25), assess and compare the scores on the scale among women from the general population, eating disorder (ED) patients and recovered ED patients. This is a cross-sectional study. ED participants were invited to participate by their respective therapists. The sample from the general population was gathered via an open online survey. Participants (N general population=279; N ED patients=124; and N recovered ED patients=45) completed the RS-25, the World Health Organization Quality of Life Scale-BREF and the Hospital Anxiety and Depression Scale. Mean age of participants ranged from 28.87 to 30.42years old. Statistical analysis included a multi-group confirmatory factor analysis and ANOVA. The two-factor model of the RS-25 produced excellent fit indexes. Measurement invariance across samples was generally supported. The ANOVA found statistically significant differences in the RS-25 mean scores between the ED patients (Mean=103.13, SD=31.32) and the recovered ED participants (Mean=138.42, SD=22.26) and between the ED patients and the general population participants (Mean=136.63, SD=19.56). The Spanish version of the RS-25 is a psychometrically sound measurement tool in samples of ED patients. Resilience is lower in people diagnosed with ED than in recovered individuals and the general population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Health Information Technology Adoption in the Emergency Department.

PubMed

Selck, Frederic W; Decker, Sandra L

2016-02-01

To describe the trend in health information technology (IT) systems adoption in hospital emergency departments (EDs) and its effect on ED efficiency and resource use. 2007-2010 National Hospital Ambulatory Medical Care Survey - ED Component. We assessed changes in the percent of visits to EDs with health IT capability and the estimated effect on waiting time to see a provider, visit length, and resource use. The percent of ED visits that took place in an ED with at least a basic health IT or an advanced IT system increased from 25.2 and 3.1 percent in 2007 to 69.1 and 30.6 percent in 2010, respectively (p < .05). Controlling for ED fixed effects, waiting times were reduced by 6.0 minutes in advanced IT-equipped EDs (p < .05), and the number of tests ordered increased by 9 percent (p < .01). In models using a 1-year lag, advanced systems also showed an increase in the number of medications and images ordered per visit. Almost a third of visits now occur in EDs with advanced IT capability. While advanced IT adoption may decrease wait times, resource use during ED visits may also increase depending on how long the system has been in place. We were not able to determine if these changes indicated more appropriate care. © Health Research and Educational Trust.

Relationship between office-based provider visits and emergency department encounters among publicly-insured adults with epilepsy.

PubMed

Lekoubou, Alain; Bishu, Kinfe G; Ovbiagele, Bruce

2018-03-01

The proportion of adults with epilepsy using the emergency department (ED) is high. Among this patient population, increased frequency of office-based provider visits may be associated with lesser frequency of ED encounters, and key patient features may be linked to more ED encounters. We analyzed the Medical Expenditure Panel Survey Household Component (MEPS-HC) dataset for years 2003-2014, which represents a weighted sample of 842,249 publicly-insured US adults aged ≥18years. The Hurdle Poisson model that accommodates excess zeros was used to estimate the association between office-based and ED visits. Annual mean ED and office-based visits for publicly-insured adults with epilepsy were 0.70 and 10.8 respectively. Probability of at least one ED visit was 0.4% higher for every unit of office-based visit. Individuals in the high income category were less likely to visit the ED at least once while women with epilepsy had a higher likelihood of visiting the ED at least once. Among those who visited the ED at least once, there was a 0.3% higher likelihood of visiting the ED for every unit of office-based visit. Among individuals who visited the ED at least once, being aged 45-64years, residing in the West, and the year 2011/14 were associated with higher ED visits. In this representative sample of publicly-insured adults with epilepsy, higher frequency of office visits was not associated with lower ED utilization, which may be due to underlying greater disease severity or propensity for more treatment complications. Copyright © 2018 Elsevier Inc. All rights reserved.

Typology of alcohol mixed with energy drink consumers: motivations for use.

PubMed

Peacock, Amy; Droste, Nicolas; Pennay, Amy; Miller, Peter; Lubman, Dan I; Bruno, Raimondo

2015-06-01

Previous research on alcohol mixed with energy drinks (AmED) has shown that use is typically driven by hedonistic, social, functional, and intoxication-related motives, with differential associations with alcohol-related harm across these constructs. There has been no research looking at whether there are subgroups of consumers based on patterns of motivations. Consequently, the aims were to determine the typology of motivations for AmED use among a community sample and to identify correlates of subgroup membership. In addition, we aimed to determine whether this structure of motivations applied to a university student sample. Data were used from an Australian community sample (n = 731) and an Australian university student sample (n = 594) who were identified as AmED consumers when completing an online survey about their alcohol and ED use. Participants reported their level of agreement with 14 motivations for AmED use; latent classes of AmED consumers were identified based on patterns of motivation endorsement using latent class analysis. A 4-class model was selected using data from the community sample: (i) taste consumers (31%): endorsed pleasurable taste; (ii) energy-seeking consumers (24%): endorsed functional and taste motives; (iii) hedonistic consumers (33%): endorse pleasure and sensation-seeking motives, as well as functional and taste motives; and (iv) intoxication-related consumers (12%): endorsed motives related to feeling in control of intoxication, as well as hedonistic, functional, and taste motives. The consumer subgroups typically did not differ on demographics, other drug use, alcohol and ED use, and AmED risk taking. The patterns of motivations for the 4-class model were similar for the university student sample. This study indicated the existence of 4 subgroups of AmED consumers based on their patterns of motivations for AmED use consistently structured across the community and university student sample. These findings lend support to the growing conceptualization of AmED consumers as a heterogeneous group in regard to motivations for use, with a hierarchical and cumulative class order in regard to the number of types of motivation for AmED use. Prospective research may endeavor to link session-specific motives and outcomes, as it is apparent that primary consumption motives may be fluid between sessions. Copyright © 2015 by the Research Society on Alcoholism.

A New Model to Study Sleep Deprivation-Induced Seizure

PubMed Central

Lucey, Brendan P.; Leahy, Averi; Rosas, Regine; Shaw, Paul J.

2015-01-01

Background and Study Objectives: A relationship between sleep and seizures is well-described in both humans and rodent animal models; however, the mechanism underlying this relationship is unknown. Using Drosophila melanogaster mutants with seizure phenotypes, we demonstrate that seizure activity can be modified by sleep deprivation. Design: Seizure activity was evaluated in an adult bang-sensitive seizure mutant, stress sensitive B (sesB9ed4), and in an adult temperature sensitive seizure mutant seizure (seits1) under baseline and following 12 h of sleep deprivation. The long-term effect of sleep deprivation on young, immature sesB9ed4 flies was also assessed. Setting: Laboratory. Participants: Drosophila melanogaster. Interventions: Sleep deprivation. Measurements and Results: Sleep deprivation increased seizure susceptibility in adult sesB9ed4/+ and seits1 mutant flies. Sleep deprivation also increased seizure susceptibility when sesB was disrupted using RNAi. The effect of sleep deprivation on seizure activity was reduced when sesB9ed4/+ flies were given the anti-seizure drug, valproic acid. In contrast to adult flies, sleep deprivation during early fly development resulted in chronic seizure susceptibility when sesB9ed4/+ became adults. Conclusions: These findings show that Drosophila is a model organism for investigating the relationship between sleep and seizure activity. Citation: Lucey BP, Leahy A, Rosas R, Shaw PJ. A new model to study sleep deprivation-induced seizure. SLEEP 2015;38(5):777–785. PMID:25515102

Rural-urban disparities in child abuse management resources in the emergency department.

PubMed

Choo, Esther K; Spiro, David M; Lowe, Robert A; Newgard, Craig D; Hall, Michael Kennedy; McConnell, Kenneth John

2010-01-01

To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs. Multivariate analysis was performed to examine the association between a variety of hospital characteristics, in addition to rural location, and presence of child abuse resources. Fifty-five Oregon hospitals were surveyed. A smaller proportion of rural EDs had written abuse policies (62% vs 95%, P= .006) or on-site child abuse advocates (35% vs 71%, P= .009). Thirty-two percent of rural EDs had none of the examined abuse resources (vs 0% of urban EDs, P= .01). Of hospital characteristics studied in the multivariate model, only rural location was associated with decreased availability of child abuse resources (OR 0.19 [95% CI, 0.05-0.70]). Rural EDs have fewer resources than urban EDs for the management of child abuse. Other studied hospital characteristics were not associated with availability of abuse resources. Further work is needed to identify barriers to resource utilization and to create resources that can be made accessible to all ED settings. © 2010 National Rural Health Association.

PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation

PubMed Central

Mitchell, Karen S.; Wolf, Erika J.

2016-01-01

Posttraumatic stress disorder (PTSD) has been associated with eating disorders (EDs) and addictive behaviors, including the relatively new construct food addiction. However, few studies have investigated mechanisms that account for these associations, and men are underrepresented in studies of EDs and food addiction. We examined whether lifetime PTSD symptoms were associated with current food addiction and ED symptoms, and whether emotion regulation (expressive suppression and cognitive reappraisal), which has been associated with both PTSD and EDs, mediated these relations, in a sample of trauma-exposed, male (n = 642) and female (n = 55) veterans. Participants were recruited from the Knowledge Networks-GfK Research Panel and completed an online questionnaire. Structural equation modeling revealed that PTSD was directly associated with ED symptoms, food addiction, expressive suppression, and cognitive reappraisal in the full sample and with all constructs except cognitive reappraisal in the male subsample. Expressive suppression was significantly associated with ED symptoms and mediated the PTSD—ED relation. These results highlight the importance of investigating PTSD as a risk factor for food addiction and ED symptoms and the potential mediating role of emotion regulation in the development of PTSD and EDs in order to identify targets for treatments. PMID:27344589

PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation.

PubMed

Mitchell, Karen S; Wolf, Erika J

2016-09-30

Posttraumatic stress disorder (PTSD) has been associated with eating disorders (EDs) and addictive behaviors, including the relatively new construct food addiction. However, few studies have investigated mechanisms that account for these associations, and men are underrepresented in studies of EDs and food addiction. We examined whether lifetime PTSD symptoms were associated with current food addiction and ED symptoms, and whether emotion regulation (expressive suppression and cognitive reappraisal), which has been associated with both PTSD and EDs, mediated these relations, in a sample of trauma-exposed, male (n=642) and female (n=55) veterans. Participants were recruited from the Knowledge Networks-GfK Research Panel and completed an online questionnaire. Structural equation modeling revealed that PTSD was directly associated with ED symptoms, food addiction, expressive suppression, and cognitive reappraisal in the full sample and with all constructs except cognitive reappraisal in the male subsample. Expressive suppression was significantly associated with ED symptoms and mediated the PTSD-ED relation. These results highlight the importance of investigating PTSD as a risk factor for food addiction and ED symptoms and the potential mediating role of emotion regulation in the development of PTSD and EDs in order to identify targets for treatments. Published by Elsevier Ireland Ltd.

An expression database for roots of the model legume Medicago truncatula under salt stress

PubMed Central

2009-01-01

Background Medicago truncatula is a model legume whose genome is currently being sequenced by an international consortium. Abiotic stresses such as salt stress limit plant growth and crop productivity, including those of legumes. We anticipate that studies on M. truncatula will shed light on other economically important legumes across the world. Here, we report the development of a database called MtED that contains gene expression profiles of the roots of M. truncatula based on time-course salt stress experiments using the Affymetrix Medicago GeneChip. Our hope is that MtED will provide information to assist in improving abiotic stress resistance in legumes. Description The results of our microarray experiment with roots of M. truncatula under 180 mM sodium chloride were deposited in the MtED database. Additionally, sequence and annotation information regarding microarray probe sets were included. MtED provides functional category analysis based on Gene and GeneBins Ontology, and other Web-based tools for querying and retrieving query results, browsing pathways and transcription factor families, showing metabolic maps, and comparing and visualizing expression profiles. Utilities like mapping probe sets to genome of M. truncatula and In-Silico PCR were implemented by BLAT software suite, which were also available through MtED database. Conclusion MtED was built in the PHP script language and as a MySQL relational database system on a Linux server. It has an integrated Web interface, which facilitates ready examination and interpretation of the results of microarray experiments. It is intended to help in selecting gene markers to improve abiotic stress resistance in legumes. MtED is available at http://bioinformatics.cau.edu.cn/MtED/. PMID:19906315

An expression database for roots of the model legume Medicago truncatula under salt stress.

PubMed

Li, Daofeng; Su, Zhen; Dong, Jiangli; Wang, Tao

2009-11-11

Medicago truncatula is a model legume whose genome is currently being sequenced by an international consortium. Abiotic stresses such as salt stress limit plant growth and crop productivity, including those of legumes. We anticipate that studies on M. truncatula will shed light on other economically important legumes across the world. Here, we report the development of a database called MtED that contains gene expression profiles of the roots of M. truncatula based on time-course salt stress experiments using the Affymetrix Medicago GeneChip. Our hope is that MtED will provide information to assist in improving abiotic stress resistance in legumes. The results of our microarray experiment with roots of M. truncatula under 180 mM sodium chloride were deposited in the MtED database. Additionally, sequence and annotation information regarding microarray probe sets were included. MtED provides functional category analysis based on Gene and GeneBins Ontology, and other Web-based tools for querying and retrieving query results, browsing pathways and transcription factor families, showing metabolic maps, and comparing and visualizing expression profiles. Utilities like mapping probe sets to genome of M. truncatula and In-Silico PCR were implemented by BLAT software suite, which were also available through MtED database. MtED was built in the PHP script language and as a MySQL relational database system on a Linux server. It has an integrated Web interface, which facilitates ready examination and interpretation of the results of microarray experiments. It is intended to help in selecting gene markers to improve abiotic stress resistance in legumes. MtED is available at http://bioinformatics.cau.edu.cn/MtED/.

Influence of hyperforin on the morphology of internal organs and biochemical parameters, in experimental model in mice.

PubMed

Negreş, Simona; Scutari, Corina; Ionică, Floriana Elvira; Gonciar, Veaceslav; Velescu, Bruno Ştefan; Şeremet, Oana Cristina; Zanfirescu, Anca; Zbârcea, Cristina Elena; Ştefănescu, Emil; Ciobotaru, Emilia; ChiriŢă, Cornel

2016-01-01

Hyperforin (HY) is used to treat depression and skin irritation and has been shown a number of pharmacological activities. The literature does no cite data on changes that may occur in the body after HY intake (ethylene diammonium salt - EDS) in long-term administration. From this point of view, the present work is a key to determining the pharmacotoxicological profile of the HY-EDS, in long-term administration. In present research, the influence of toxic doses of HY-EDS was investigated on the biochemical serum parameters and the histopathological changes in internal organs on the experimental mice model. For acute toxicity determination, the HY-EDS was tested in doses of 2000-5000 mg÷kg, administered once per day orally. For subacute toxicity, the HY-EDS was tested in three groups of mice, in doses of 50, 75 and 100 mg÷kg÷day, administered once daily, for 28 consecutive days. As concern acute toxicity, a lethal effect has not occurred at any of the two tested doses and HY-EDS was classified as Class V toxic: median lethal dose (LD50) >5000 mg÷kg, p.o. After 14 days of follow-up in acute toxicity, the experimental results showed a statistically significant increase of aspartate transaminase (AST) and alanine transaminase (ALT), compared to the control group. There were no changes in creatinine and serum glucose compared to the control group. After the administration of repeated doses, it was observed an increase of serum transaminases and alkaline phosphatase. Histological examination revealed that the liver injuries were in an initial stage, making them reversible in case of HY-EDS treatment discontinuation. There was no evidence of kidney damage to any of the doses of HY-EDS.

Is emergency department crowding associated with increased “bounceback” admissions?

PubMed Central

Hsia, Renee Y.; Asch, Steven M.; Weiss, Robert E.; Zingmond, David; Gabayan, Gelareh; Liang, Li-Jung; Han, Weijuan; McCreath, Heather; Sun, Benjamin C.

2013-01-01

Objective Emergency department (ED) crowding is linked with poor quality of care and worse outcomes, including higher mortality. With the growing emphasis on hospital performance measures, there is additional concern whether inadequate care during crowded periods increases a patient’s likelihood of subsequent inpatient admission. We sought to determine if ED crowding during the index visit was associated with these “bounceback” admissions. Methods We used comprehensive, non-public, statewide ED and inpatient discharge data from the California Office of Statewide Health Planning and Development from 2007 to identify index outpatient ED visits and bounceback admissions within seven days. We further used ambulance diversion data collected from California local emergency medical services agencies to identify crowded days using intra-hospital daily diversion hour quartiles. Using a hierarchical logistic regression model, we then determined if patients visiting on crowded days were more likely to have a subsequent bounceback admission. Results We analyzed 3,368,527 index visits across 202 hospitals, of which 596,471 (17.7%) observations were on crowded days. We found no association between ED crowding and bounceback admissions. This lack of relationship persisted in both a discrete (high/low) model (OR 1.01, 95% CI 0.99, 1.02) and a secondary model using ambulance diversion hours as a continuous predictor (OR 1.00, 95% CI 1.00, 1.00). Conclusions Crowding as measured by ambulance diversion does not have an association with hospitalization within 7 days of an ED visit discharge. Therefore, bounceback admission may be a poor measure of delayed or worsened quality of care due to crowding. PMID:24036997

A stable isotope model for combined source apportionment and degradation quantification of environmental pollutants

NASA Astrophysics Data System (ADS)

Lutz, Stefanie; Van Breukelen, Boris

2014-05-01

Natural attenuation can represent a complementary or alternative approach to engineered remediation of polluted sites. In this context, compound specific stable isotope analysis (CSIA) has proven a useful tool, as it can provide evidence of natural attenuation and assess the extent of in-situ degradation based on changes in isotope ratios of pollutants. Moreover, CSIA can allow for source identification and apportionment, which might help to identify major emission sources in complex contamination scenarios. However, degradation and mixing processes in aquifers can lead to changes in isotopic compositions, such that their simultaneous occurrence might complicate combined source apportionment (SA) and assessment of the extent of degradation (ED). We developed a mathematical model (stable isotope sources and sinks model; SISS model) based on the linear stable isotope mixing model and the Rayleigh equation that allows for simultaneous SA and quantification of the ED in a scenario of two emission sources and degradation via one reaction pathway. It was shown that the SISS model with CSIA of at least two elements contained in the pollutant (e.g., C and H in benzene) allows for unequivocal SA even in the presence of degradation-induced isotope fractionation. In addition, the model enables precise quantification of the ED provided degradation follows instantaneous mixing of two sources. If mixing occurs after two sources have degraded separately, the model can still yield a conservative estimate of the overall extent of degradation. The SISS model was validated against virtual data from a two-dimensional reactive transport model. The model results for SA and ED were in good agreement with the simulation results. The application of the SISS model to field data of benzene contamination was, however, challenged by large uncertainties in measured isotope data. Nonetheless, the use of the SISS model provided a better insight into the interplay of mixing and degradation processes at the field site, as it revealed the prevailing contribution of one emission source and a low overall ED. The model can be extended to a larger number of sources and sinks. It may aid in forensics and natural attenuation assessment of soil, groundwater, surface water, or atmospheric pollution.

Evaluating the Value of High Spatial Resolution in National Capacity Expansion Models using ReEDS

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

Krishnan, Venkat; Cole, Wesley

2016-11-14

Power sector capacity expansion models (CEMs) have a broad range of spatial resolutions. This paper uses the Regional Energy Deployment System (ReEDS) model, a long-term national scale electric sector CEM, to evaluate the value of high spatial resolution for CEMs. ReEDS models the United States with 134 load balancing areas (BAs) and captures the variability in existing generation parameters, future technology costs, performance, and resource availability using very high spatial resolution data, especially for wind and solar modeled at 356 resource regions. In this paper we perform planning studies at three different spatial resolutions--native resolution (134 BAs), state-level, and NERCmore » region level--and evaluate how results change under different levels of spatial aggregation in terms of renewable capacity deployment and location, associated transmission builds, and system costs. The results are used to ascertain the value of high geographically resolved models in terms of their impact on relative competitiveness among renewable energy resources.« less

Male erectile dysfunction: integrating psychopharmacology and psychotherapy.

PubMed

Simopoulos, Eugene F; Trinidad, Anton C

2013-01-01

Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is the most common sexual problem in men. ED arises when there is disruption of the complex interplay between vascular, neurologic, hormonal and psychologic factors necessary for normal erectile function. It may have a significant effect on quality of life and portend undetected cardiovascular disease. Risk factors for development of ED include advancing age, tobacco use, a history of pelvic irradiation or surgery and antipsychotic use (Table 1) [1]. Treatment guidelines continue to evolve for optimal management of ED. In this article, we review diagnostic and treatment strategies for ED relevant to psychiatrists. We present an integrative approach to the treatment of ED based on a review of the urologic and psychiatric literature. ED is multifactorial in origin and responsive to a variety of therapeutic interventions, including psychopharmacology and psychotherapy in which cognitive underpinnings of poor sexual performance, including diminished self-esteem, lack of confidence and perceived failures in the male role, are examined. Psychiatrists can readily perform a basic workup for ED as they integrate both a medical and therapeutic model when confronted with such patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Structural basis for signaling by exclusive EDS1 heteromeric complexes with SAG101 or PAD4 in plant innate immunity.

PubMed

Wagner, Stephan; Stuttmann, Johannes; Rietz, Steffen; Guerois, Raphael; Brunstein, Elena; Bautor, Jaqueline; Niefind, Karsten; Parker, Jane E

2013-12-11

Biotrophic plant pathogens encounter a postinfection basal resistance layer controlled by the lipase-like protein enhanced disease susceptibility 1 (EDS1) and its sequence-related interaction partners, senescence-associated gene 101 (SAG101) and phytoalexin deficient 4 (PAD4). Maintainance of separate EDS1 family member clades through angiosperm evolution suggests distinct functional attributes. We report the Arabidopsis EDS1-SAG101 heterodimer crystal structure with juxtaposed N-terminal α/β hydrolase and C-terminal α-helical EP domains aligned via a large conserved interface. Mutational analysis of the EDS1-SAG101 heterodimer and a derived EDS1-PAD4 structural model shows that EDS1 signals within mutually exclusive heterocomplexes. Although there is evolutionary conservation of α/β hydrolase topology in all three proteins, a noncatalytic resistance mechanism is indicated. Instead, the respective N-terminal domains appear to facilitate binding of the essential EP domains to create novel interaction surfaces on the heterodimer. Transitions between distinct functional EDS1 heterodimers might explain the central importance and versatility of this regulatory node in plant immunity. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluating the Relationship between Productivity and Quality in Emergency Departments

PubMed Central

Bastian, Nathaniel D.; Riordan, John P.

2017-01-01

Background In the United States, emergency departments (EDs) are constantly pressured to improve operational efficiency and quality in order to gain financial benefits and maintain a positive reputation. Objectives The first objective is to evaluate how efficiently EDs transform their input resources into quality outputs. The second objective is to investigate the relationship between the efficiency and quality performance of EDs and the factors affecting this relationship. Methods Using two data sources, we develop a data envelopment analysis (DEA) model to evaluate the relative efficiency of EDs. Based on the DEA result, we performed multinomial logistic regression to investigate the relationship between ED efficiency and quality performance. Results The DEA results indicated that the main source of inefficiencies was working hours of technicians. The multinomial logistic regression result indicated that the number of electrocardiograms and X-ray procedures conducted in the ED and the length of stay were significantly associated with the trade-offs between relative efficiency and quality. Structural ED characteristics did not influence the relationship between efficiency and quality. Conclusions Depending on the structural and operational characteristics of EDs, different factors can affect the relationship between efficiency and quality. PMID:29065673

Travel distance and sociodemographic correlates of potentially avoidable emergency department visits in California, 2006-2010: an observational study.

PubMed

Chen, Brian K; Hibbert, James; Cheng, Xi; Bennett, Kevin

2015-03-21

Use of the hospital emergency department (ED) for medical conditions not likely to require immediate treatment is a controversial topic. It has been faulted for ED overcrowding, increased expenditures, and decreased quality of care. On the other hand, such avoidable ED utilization may be a manifestation of barriers to primary care access. A random 10% subsample of all ED visits with unmasked variables, or approximately 7.2% of all ED visits in California between 2006 and 2010 are used in the analysis. Using panel data methods, we employ linear probability and fractional probit models with hospital fixed effects to analyze the associations between avoidable ED utilization in California and observable patient characteristics. We also test whether shorter estimated road distances to the hospital ED are correlated with non-urgent ED utilization, as defined by the New York University ED Algorithm. We then investigate whether proximity of a Federally Qualified Health Center (FQHC) is correlated with reductions in non-urgent ED utilization among Medicaid patients. We find that relative to the reference group of adults aged 35-64, younger patients generally have higher scores for non-urgent conditions and lower scores for urgent conditions. However, elderly patients (≥65) use the ED for conditions more likely to be urgent. Relative to male and white patients, respectively, female patients and all identified racial and ethnic minorities use the ED for conditions more likely to be non-urgent. Patients with non-commercial insurance coverage also use the ED for conditions more likely to be non-urgent. Medicare and Medicaid patients who live closer to the hospital ED have higher probability scores for non-emergent visits. However, among Medicaid enrollees, those who live in zip codes with an FQHC within 0.5 mile of the zip code population centroid visit the ED for medical conditions less likely to be non-emergent. These patterns of ED utilization point to potential barriers to care among historically vulnerable groups, observable even when using rough estimates of travel distances and avoidable ED utilization.

Portrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey.

PubMed

Fleet, Richard; Poitras, Julien; Archambault, Patrick; Tounkara, Fatoumata Korika; Chauny, Jean-Marc; Ouimet, Mathieu; Gauthier, Josée; Dupuis, Gilles; Tanguay, Alain; Lévesque, Jean-Frédéric; Simard-Racine, Geneviève; Haggerty, Jeannie; Légaré, France

2015-12-23

Rural emergency departments (EDs) constitute crucial safety nets for the 20% of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines "the provincial ED management Guide". The aim of this study was to provide a detailed description of rural EDs in Québec and utilization of the provincial ED management Guide. We selected EDs offering 24/7 medical coverage, with hospitalization beds, located in rural or small towns. We collected data via telephone, paper, and online surveys with rural ED/hospital staff. Data were also collected from Québec's Ministry of Health databases and from Statistics Canada. We computed descriptive statistics, ANOVA and t-tests were used to examine the relationship between ED census, services and inter-facility transfer requirements. A total of 23 of Québec's 26 rural EDs (88%) consented to participate in the study. The mean annual ED visits was 18 813 (Standard Deviation = 6 151). Thirty one percent of ED physicians were recent graduates with fewer than 5 years of experience. Only 6 % had residency training or certification in emergency medicine. Teams have good local access (24/7) to diagnostic equipment such as CT scanner (74%), intensive unit care (78%) and general surgical services (78%), but limited access to other consultants. Sixty one percent of participants have reported good knowledge of the provincial ED management Guide, but only 23% of them have used the guidelines. Furthermore, more than 40% of EDs were more than 300 km from levels 1 to 2 trauma centers, and only 30% had air transport access. Rural EDs in Québec are staffed by relatively new graduates working as solo physicians in well-resourced and moderately busy (by rural standards) EDs. The provincial ED management Guide may have contributed to this model of service attribution. However, the majority of rural ED staff report limited knowledge or use of the provincial ED management Guide and increased efforts at disseminating this Guide are warranted.

Perception of threat from emotions and its role in poor emotional expression within eating pathology.

PubMed

Ioannou, Korina; Fox, John R E

2009-01-01

Recent research has documented links between eating disorder (ED) symptomatology and emotional expression deficits. Relevant theoretical models have alluded to the functional role of disordered eating in alleviating affect that is felt to be otherwise unmanageable and threatening. Nevertheless, research examining ED individuals' perceptions of emotional states has been sparse, while empirical studies have predominantly focused on global conceptualizations of emotion, failing to address discrete affect states. The current study had three aims: (a) to determine the relation between ED symptomatology and emotional expression, in a sample of women with ED, in an attempt to confirm previous findings of an inverse relation; (b) to test the hypothesis that women with ED inhibit the expression of emotions perceived as threatening, by examining the relation between emotional expression and perceptions of threat from emotion, while partialling out the effects of depression; and (c) to determine whether, amongst women with ED, perceptions of threat from anger are uniquely associated with emotional inhibition, when the effects of depression and body dissatisfaction are controlled for. Results demonstrated that (a) emotional expression was negatively related with the three Eating Disorders Inventory-3 subscales (drive for thinness, bulimia and body dissatisfaction); (b) perceived threat from emotion, particularly anger, was negatively correlated with emotional expression, when depression was partialled out in the analysis; and (c) perceived threat from anger significantly and uniquely predicted emotional inhibition, over and above the effects of body dissatisfaction and depression, in a sample of women with ED symptomatology. It is suggested that anger may be perceived as particularly threatening amongst women with ED, and play a significant role in the emotional expression difficulties that this population experiences. The implications of the current findings are discussed in line with relevant theory and research, with particular reference to the new Schematic Propositional Analogical Associative Representation System for Eating Disorders (SPAARS-ED) model.

[Demography of aging in Spain].

PubMed

Rubio Herrera, R

1994-01-01

In this article, the demography of the elderly in Spain is scrutinized. The older population from 1960 to 1991 and their presumed development for the period from 2001-2020 is analyzed. According to these data, we attempt to determine the influence on life situation of older people according to several factors, such as changes of family structures and intergenerational relations as well as changes in social stereotypes, expected political and economical developments, and new concepts in medical care. In closing, we raise questions about the necessary future living structures in Spain.

Personality prototype as a risk factor for eating disorders.

PubMed

Sanchez-Guarnido, Antonio J; Pino-Osuna, Maria J; Herruzo-Cabrera, Francisco J

2015-01-01

To establish whether the risk of suffering from an eating disorder (ED) is associated with the high-functioning, undercontrolled, or overcontrolled personality prototype groups. The Revised NEO Personality Inventory (NEO-PI-R) and the Eating Disorder Inventory 2 (EDI-2) were administered to 69 patients diagnosed as suffering from EDs (cases) and 89 people free of any ED symptoms (control group). A cluster analysis was carried out to divide the participants into three groups based on their scores in the Big Five personality dimensions. A logistic regression model was then created. Participants in the undercontrolled group had a risk of suffering from an ED 6.517 times higher than those in the high-functioning group (p = 0.019; odds ratio [OR] = 6.517), while those in the overcontrolled subgroup had a risk of ED 15.972 times higher than those in the high-functioning group. Two personality subtypes were identified in which the risk of EDs was six times higher (the undercontrolled group) and almost 16 times higher (the overcontrolled group). Prevention and treatment programs for ED could benefit from focusing on the abovementioned personality profiles.

Individualized Inservice Teacher Education (Project In-Step). Evaluation Report. Phase III.

ERIC Educational Resources Information Center

Thurber, John C.

This is a report on the third phase of Project IN-STEP, which was intended to develop a viable model for individualized, multi-media in-service teacher education programs. (Phase I and II are reported in ED 033 905, and ED 042 709). The rationale for Phase III was to see if the model could be successfully transferred to an area other than teaching…

Revisiting dark energy models using differential ages of galaxies

NASA Astrophysics Data System (ADS)

Rani, Nisha; Jain, Deepak; Mahajan, Shobhit; Mukherjee, Amitabha; Biesiada, Marek

2017-03-01

In this work, we use a test based on the differential ages of galaxies for distinguishing the dark energy models. As proposed by Jimenez and Loeb in [1], relative ages of galaxies can be used to put constraints on various cosmological parameters. In the same vein, we reconstruct H0dt/dz and its derivative (H0d2t/dz2) using a model independent technique called non-parametric smoothing. Basically, dt/dz is the change in the age of the object as a function of redshift which is directly linked with the Hubble parameter. Hence for reconstruction of this quantity, we use the most recent H(z) data. Further, we calculate H0dt/dz and its derivative for several models like Phantom, Einstein de Sitter (EdS), ΛCDM, Chevallier-Polarski-Linder (CPL) parametrization, Jassal-Bagla-Padmanabhan (JBP) parametrization and Feng-Shen-Li-Li (FSLL) parametrization. We check the consistency of these models with the results of reconstruction obtained in a model independent way from the data. It is observed that H0dt/dz as a tool is not able to distinguish between the ΛCDM, CPL, JBP and FSLL parametrizations but, as expected, EdS and Phantom models show noticeable deviation from the reconstructed results. Further, the derivative of H0dt/dz for various dark energy models is more sensitive at low redshift. It is found that the FSLL model is not consistent with the reconstructed results, however, the ΛCDM model is in concordance with the 3σ region of the reconstruction at redshift z>= 0.3.

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

Wang, C; Nguyen, G; Chung, Y

Purpose: Ureteroscopy involves fluoroscopy which potentially results in considerable amount of radiation dose to the patient. Purpose of this study was two-fold: (a) to develop the effective dose computational model for obese and non-obese patients undergoing left and right ureteroscopy, and (b) to evaluate the utility of a commercial Monte Carlo software for dose assessment in ureteroscopy. Methods: Organ dose measurements were performed on an adult male anthropomorphic phantom, representing the non-obese patients, with 20 high-sensitivity MOSFET detectors and two 0.18cc ionization chambers placed in selected organs. Fat-equivalent paddings were placed around the abdominal region to simulate for obese patients.more » Effective dose (ED) was calculated using ICRP 103 tissue weighting factors and normalized to the effective dose rate in miliSivert per second (mSv/s). In addition, a commercial Monte Carlo (MC) dose estimation program was used to estimate ED for the non-obese model, with table attenuation correction applied to simulate clinical procedure. Results: For the equipment and protocols involved in this study, the MOSFETderived ED rates for the obese patient model (‘Left’: 0.0092±0.0004 mSv/s; ‘Right’: 0.0086±0.0004 mSv/s) was found to be more than twice as much as that to the non-obese patient model (‘Left’: 0.0041±0.0003 mSv/s; ‘Right’: 0.0036±0.0007 mSv/s). The MC-derived ED rates for the non-obese patient model (‘Left’: 0.0041 mSv/s; ‘Right’: 0.0036 mSv/s; with statistical uncertainty of 1%) showed a good agreement with the MOSFET method. Conclusion: The significant difference in ED rate between the obese and non-obese patient models shows the limitation of directly applying commercial softwares for obese patients and leading to considerable underestimation of ED. Although commercial softwares offer a convenient means of dose estimation, but the utility may be limited to standard-man geometry as the software does not account for table attenuation, obese patient geometry, and differences between the anthropomorphic phantom and MC mathematical phantom.« less

Modelling Ferroelectric Nanoparticles in Nematic Liquid Crystals (FERNANO)

DTIC Science & Technology

2015-02-26

DIPARTIMENTO DI CHIMICA FISICA ED INORGANICA VIALE DEL RISORGIMENTO 4 BOLOGNA, 40136 ITALY EOARD GRANT #FA8655-11-1-3046 Report...AND ADDRESS(ES) DIPARTIMENTO DI CHIMICA FISICA ED INORGANICA VIALE DEL RISORGIMENTO 4 BOLOGNA, 40136 ITALY 8. PERFORMING ORGANIZATION

Is Low Health Literacy Associated with Increased Emergency Department Utilization and Recidivism?

PubMed Central

Griffey, Richard T.; Kennedy, Sarah K.; McGownan, Lucy; Goodman, Melody; Kaphingst, Kimberly A.

2015-01-01

Objectives To determine whether patients with low health literacy have higher ED utilization and higher ED recidivism than patients with adequate health literacy. Methods The study was conducted at an urban academic ED with over 95,000 annual visits that is part of a 13-hospital health system, using electronic records that are captured in a central data repository. As part of a larger, cross sectional, convenience sample study, health literacy testing was performed using the short test of functional health literacy in adults (STOFHLA), and standard test thresholds identifying those with inadequate, marginal, and adequate health literacy. The authors collected patients' demographic and clinical data, including items known to affect recidivism. This was a structured electronic record review directed at determining 1) the median number of total ED visits in this health system within a 2-year period, and 2) the proportion of patients with each level of health literacy who had return visits within 3, 7, and 14 days of index visits. Descriptive data for demographics and ED returns are reported, stratified by health literacy level. The Mantel-Haenszel chi-square was used to test whether there is an association between health literacy and ED recidivism. A negative binomial multivariable model was performed to examine whether health literacy affects ED use, including variables significant at the 0.1 alpha level on bivariate analysis, and retaining those significant at an alpha of 0.05 in the final model. Results Among 431 patients evaluated, 13.2% had inadequate, 10% had marginal, and 76.3% had adequate health literacy as identified by S-TOFHLA. Patients with inadequate health literacy had higher ED utilization compared to those with adequate health literacy (p = 0.03). Variables retained in the final model included S-TOFHLA score, number of medications, having a personal doctor, being a property owner, race, insurance, age, and simple comorbidity score. During the study period, 118 unique patients each made at least one return ED visit within a 14-day period. The proportion of patients with inadequate health literacy making at least one return visit was higher than that of patients with adequate health literacy at 14 days, but was not significantly higher within 3 or 7 days. Conclusions In this single-center study, higher utilization of the ED by patients with inadequate health literacy when compared to those with adequate health literacy was observed. Patients with inadequate health literacy made a higher number of return visits at 14 days but not at 3 or 7 days. PMID:25308133

Improved porcine model for Shiga toxin-producing Escherichia coli infection by deprivation of colostrum feeding in newborn piglets.

PubMed

Sato, Toshio; Hamabata, Takashi; Takita, Eiji; Matsui, Takeshi; Sawada, Kazutoshi; Imaoka, Taishi; Nakanishi, Nobuo; Nakayama, Keizo; Tsukahara, Takamitsu

2017-05-01

Porcine edema disease (ED) is a toxemia caused by enteric infection with Shiga toxin 2e (Stx2e)-producing Escherichia coli (STEC). ED occurs most frequently during the weaning period and is manifested as emaciation associated with high mortality. In our experimental infection with a specific STEC strain, we failed to cause the suppression of weight gain in piglets, which is a typical symptom of ED, in two consecutive experiments. Therefore, we examined the effects of deprivation of colostrum on the sensitivity of newborn piglets to STEC infection. Neonatal pigs were categorized into two groups: one fed artificial milk instead of colostrum in the first 24 h after birth and then returned to the care of their mother, the other breastfed by a surrogate mother until weaning. The oral challenge with 10 11  colony-forming units of virulent STEC strain on days 25, 26 and 27 caused suppression of weight gain and other ED symptoms in both groups, suggesting that colostrum deprivation from piglets was effective in enhancing susceptibility to STEC. Two successive STEC infection experiments using colostrum-deprived piglets reproduced this result, leading us to conclude that this improved ED piglet model is more sensitive to STEC infection than the previously established models. © 2017 Japanese Society of Animal Science.

Predictive factors for erectile dysfunction in men with prostate cancer after brachytherapy: Is dose to the penile bulb important?

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

Macdonald, A. Graham; Keyes, Mira; Kruk, Alexandra

2005-09-01

Purpose: To determine predictive factors for postimplant erectile dysfunction (ED) in a cohort of patients, according to prospectively collected data; specifically, to assess the impact of penile bulb volume and D50 and D95 (dose covering 50% and 95% of the penile bulb volume, respectively) on ED. Methods and Materials: Three hundred forty-two patients were identified who were potent before implant and who had at least 2 years' follow-up. Patient, tumor, treatment, and dosimetric data were collected on all patients. Postimplant ED was defined according to both physician-documented and patient-documented outcome data. Binary logistic regression analysis was used to create multivariablemore » models of predictors for ED at 1, 2, and 3 years after implant. Results: Physician-documented rates of ED were 57%, 48%, and 38% at 1, 2, and 3 years after implant, respectively. Patient-documented rates of ED were 70% and 66% at 1 and 2 years, respectively. Multivariable analyses revealed age and degree of preimplant erectile function to be consistently significant predictors of ED. Use of hormones was significant at the 1-year physician-documented ED endpoint but not thereafter, in keeping with the time course of testosterone recovery. Penile bulb volume, D50, and D95 were not found to be predictive for ED at any time point, in contrast to previous studies. In addition, planning ultrasound target volume, number of needles, and institutional case sequence number were significant predictors of ED at various time points, consistent with a traumatic etiology of ED. Conclusions: We found no evidence to support penile bulb dosimetry as an independent predictive factor for ED after implant, using physician-documented or patient-documented outcomes.« less

Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction.

PubMed

Williams, Nancy I; Leidy, Heather J; Hill, Brenna R; Lieberman, Jay L; Legro, Richard S; De Souza, Mary Jane

2015-01-01

We assessed the impact of energy deficiency on menstrual function using controlled feeding and supervised exercise over four menstrual cycles (1 baseline and 3 intervention cycles) in untrained, eumenorrheic women aged 18-30 yr. Subjects were randomized to either an exercising control (EXCON) or one of three exercising energy deficit (ED) groups, i.e., mild (ED1; -8 ± 2%), moderate (ED2; -22 ± 3%), or severe (ED3; -42 ± 3%). Menstrual cycle length and changes in urinary concentrations of estrone-1-glucuronide, pregnanediol glucuronide, and midcycle luteinizing hormone were assessed. Thirty-four subjects completed the study. Weight loss occurred in ED1 (-3.8 ± 0.2 kg), ED2 (-2.8 ± 0.6 kg), and ED3 (-2.6 ± 1.1 kg) but was minimal in EXCON (-0.9 ± 0.7 kg). The overall sum of disturbances (luteal phase defects, anovulation, and oligomenorrhea) was greater in ED2 compared with EXCON and greater in ED3 compared with EXCON AND ED1. The average percent energy deficit was the main predictor of the frequency of menstrual disturbances (f = 10.1, β = -0.48, r(2) = 0.23, P = 0.003) even when weight loss was included in the model. The estimates of the magnitude of energy deficiency associated with menstrual disturbances ranged from -22 (ED2) to -42% (ED3), reflecting an energy deficit of -470 to -810 kcal/day, respectively. This is the first study to demonstrate a dose-response relationship between the magnitude of energy deficiency and the frequency of exercise-related menstrual disturbances; however, the severity of menstrual disturbances was not dependent on the magnitude of energy deficiency. Copyright © 2015 the American Physiological Society.

Trends in diabetes-related visits to US EDs from 1997 to 2007.

PubMed

Menchine, Michael D; Wiechmann, Warren; Peters, Anne L; Arora, Sanjay

2012-06-01

The aims of the study were to describe temporal trends in the number, proportion, and per capita use of diabetes-related emergency department (ED) visits and to examine any racial/ethnic disparity in ED use for diabetes-related reasons. We analyzed the ED portion of the National Hospital Ambulatory Medical Care Survey from 1997 through 2007. Diabetes-related ED visits were identified by International Classification of Diseases, Ninth Revision codes. Descriptive statistics were developed. Weighted linear and logistic regression models were used to determine significance of temporal trends, and multivariate logistic regression was used to examine racial/ethnic disparities. A total of 20.2 million (1.69%; 95% confidence interval [CI], 1.59%-1.78%) ED visits were diabetes-related during the study period. We observed significant increases in the number and proportion of diabetes-related ED visits. Overall, there was a 5.6% relative annual increase in the proportion of ED visits that were diabetes-related during the study period. However, the per capita ED use among the population with diabetes did not change over time (P>.05 for trend). On multivariate analysis, black race (odds ratio, 1.8; 95% CI, 1.7-2.0), Hispanic ethnicity (odds ratio, 1.6; 95% CI, 1.4-1.8), and advancing age were associated with significantly higher odds of having a diabetes-related visit. Despite a marked increase in number and proportion of diabetes-related ED visits during the study period, the per capita use of ED services for diabetes-related visits among the diabetic population remained stable. Copyright © 2012 Elsevier Inc. All rights reserved.

Emergency Department Use in the US-Mexico Border Region and Violence in Mexico: Is There a Relationship?

PubMed

Geissler, Kimberley H; Holmes, George M

2015-01-01

This study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US-Mexico border region. The border region is largely rural and underserved, making the identification and correction of potential barriers to access crucial. We used secondary data from state inpatient and ED discharge databases for California and Arizona for 2005-2010. A retrospective observational analysis using generalized linear models was used to determine whether the probability that an ED encounter was potentially avoidable was associated with homicide rates in the nearest Mexican municipality. To conduct the analysis, the location of ED encounters were identified and matched with homicide rates in the nearest Mexican municipality and regional characteristics. The probability that an ED encounter was potentially avoidable was calculated using the Billings ED algorithm. We found that 77% of ED encounters were potentially avoidable, with a higher percentage in border counties. There was no statistically significant relationship between homicide rates and the probability that an ED encounter was for a potentially avoidable condition for the full analytic sample (n = 24,859,273) and the uninsured and underinsured in the sample (n = 11,700,123). A substantial majority of ED encounters in the US-Mexico border region were potentially avoidable. However, there was not a strong relationship between homicide rates in northern Mexico and the distribution of ED discharges in Arizona and California. Given the large percentage of potentially avoidable ED encounters and the ongoing violence in Mexico, continuing to monitor this relationship is important. © 2015 National Rural Health Association.

Testing the Model: A Phase 1/2 Randomized Double Blind Placebo Control Trial of Targeted Therapeutics: Liposomal Glutathione and Curcumin

DTIC Science & Technology

2016-10-01

Syndrome, P. Goodnik and N.G. Klimas, eds., American Psychiatric Press, Washington, D.C., 1993. 4 2. Clinical Management of Chronic...Klimas, N. and Fletcher, M.A. Stress Management Interventions and psychosocial predictors of progression in HIV-1 infection. in K.Goodkin, ed...Fletcher, M.A. Psychoimmunology and Stress Management in HIV-1 Infection. in Update in Psychoneuroimmunology, Gorman, J.M. and Kertzner, R.M., eds

Satisfaction of health professionals after implementation of a primary care hospital emergency centre in Switzerland: A prospective before-after study.

PubMed

Hess, Sascha; Sidler, Patrick; Chmiel, Corinne; Bögli, Karin; Senn, Oliver; Eichler, Klaus

2015-10-01

The increasing number of patients requiring emergency care is a challenge and leads to decreased satisfaction of health professionals at emergency departments (EDs). Thus, a Swiss hospital implemented a hospital-associated primary care centre at the ED. The study aim was to investigate changes in job satisfaction of ED staff before and after the implementation of this new service model and to measure hospital GPs' (HGPs) satisfaction at the hospital-associated primary care centre. This study was embedded in a large prospective before-after study over two years. We examined changes in job satisfaction with a questionnaire followed by selected interviews approaching all of the involved 25 ED staff members and 38 HGPs. The new emergency care model increased job satisfaction of ED staff and HGPs in all measured dimensions. The overall job satisfaction of ED employees improved from 76.5 to 83.9 points (visual analogue scale 0-100; difference 7.4 points [95% CI: 1.3 to 13.5, p = 0.02]). 86% of 29 HGPs preferred to provide their out-of-hours service at the new hospital-associated primary care centre. The hospital-associated primary care centre is a promising option to improve job satisfaction of different health professionals in emergency care. Copyright © 2015 Elsevier Ltd. All rights reserved.

Redesigned geriatric emergency care may have helped reduce admissions of older adults to intensive care units.

PubMed

Grudzen, Corita; Richardson, Lynne D; Baumlin, Kevin M; Winkel, Gary; Davila, Carine; Ng, Kristen; Hwang, Ula

2015-05-01

Charged with transforming geriatric emergency care by applying palliative care principles, a process improvement team at New York City's Mount Sinai Medical Center developed the GEDI WISE (Geriatric Emergency Department Innovations in Care through Workforce, Informatics, and Structural Enhancements) model. The model introduced workforce enhancements for emergency department (ED) and adjunct staff, including role redefinition, retraining, and education in palliative care principles. Existing ED triage nurses screened patients ages sixty-five and older to identify those at high risk of ED revisit and hospital readmission. Once fully trained, these nurses screened all but 6 percent of ED visitors meeting the screening criteria. Newly hired ED nurse practitioners identified high-risk patients suitable for and desiring palliative and hospice care, then expedited referrals. Between January 2011 and May 2013 the percentage of geriatric ED admissions to the intensive care unit fell significantly, from 2.3 percent to 0.9 percent, generating an estimated savings of more than $3 million to Medicare. The decline in these admissions cannot be confidently attributed to the GEDI WISE program because other geriatric care innovations were implemented during the study period. GEDI WISE programs are now running at Mount Sinai and two partner sites, and their potential to affect the quality and value of geriatric emergency care continues to be examined. Project HOPE—The People-to-People Health Foundation, Inc.

Demography of a breeding population of whimbrel (Numenius phaeopus) near Churchill, Manitoba, Canada

NASA Astrophysics Data System (ADS)

Perz, Johanna

I used a GIS raster layer of an area in the Churchill, Manitoba region to investigate the effect of breeding habitat on demography and density of Whimbrel from 2010 through 2013. Program MARK was used to quantify adult and daily nest survival. Apparent annual survival of 0.73 +/- 0.06 SE (95% CI = 0.60-0.83) did not significantly differ between sexes or habitats and was lower than expected based on longevity records and estimates for other large-bodied shorebirds. Nest success, corrected for exposure days, was highly variable, ranging from a low of 3% (95% CI = 0-12%) in 2011 to a high of 71% (95% CI = 54-83%) in 2013. The highest rate of nest survival occurred in the spring with the warmest mean temperature. I developed a generalized linear model (GLM) with a negative-binomial distribution from random plots that were surveyed for abundance to extrapolate a local breeding population size of 410 +/- 230 SE and density of 3.2 birds per square km +/- 1.8 SE. The result of my study suggests that other aspects of habitat not captured by the land cover categories may be more important to population dynamics.

The Role of Demography and Markets in Determining Deforestation Rates Near Ranomafana National Park, Madagascar

PubMed Central

Brooks, Christopher P.; Holmes, Christopher; Kramer, Karen; Barnett, Barry; Keitt, Timothy H.

2009-01-01

The highland forests of Madagascar are home to some of the world's most unique and diverse flora and fauna and to some of its poorest people. This juxtaposition of poverty and biodiversity is continually reinforced by rapid population growth, which results in increasing pressure on the remaining forest habitat in the highland region, and the biodiversity therein. Here we derive a mathematical expression for the subsistence of households to assess the role of markets and household demography on deforestation near Ranomafana National Park. In villages closest to urban rice markets, households were likely to clear less land than our model predicted, presumably because they were purchasing food at market. This effect was offset by the large number of migrant households who cleared significantly more land between 1989–2003 than did residents throughout the region. Deforestation by migrant households typically occurred after a mean time lag of 9 years. Analyses suggest that while local conservation efforts in Madagascar have been successful at reducing the footprint of individual households, large-scale conservation must rely on policies that can reduce the establishment of new households in remaining forested areas. PMID:19536282

Predicting evolutionary rescue via evolving plasticity in stochastic environments

PubMed Central

Baskett, Marissa L.

2016-01-01

Phenotypic plasticity and its evolution may help evolutionary rescue in a novel and stressful environment, especially if environmental novelty reveals cryptic genetic variation that enables the evolution of increased plasticity. However, the environmental stochasticity ubiquitous in natural systems may alter these predictions, because high plasticity may amplify phenotype–environment mismatches. Although previous studies have highlighted this potential detrimental effect of plasticity in stochastic environments, they have not investigated how it affects extinction risk in the context of evolutionary rescue and with evolving plasticity. We investigate this question here by integrating stochastic demography with quantitative genetic theory in a model with simultaneous change in the mean and predictability (temporal autocorrelation) of the environment. We develop an approximate prediction of long-term persistence under the new pattern of environmental fluctuations, and compare it with numerical simulations for short- and long-term extinction risk. We find that reduced predictability increases extinction risk and reduces persistence because it increases stochastic load during rescue. This understanding of how stochastic demography, phenotypic plasticity, and evolution interact when evolution acts on cryptic genetic variation revealed in a novel environment can inform expectations for invasions, extinctions, or the emergence of chemical resistance in pests. PMID:27655762

King penguin demography since the last glaciation inferred from genome-wide data.

PubMed

Trucchi, Emiliano; Gratton, Paolo; Whittington, Jason D; Cristofari, Robin; Le Maho, Yvon; Stenseth, Nils Chr; Le Bohec, Céline

2014-07-22

How natural climate cycles, such as past glacial/interglacial patterns, have shaped species distributions at the high-latitude regions of the Southern Hemisphere is still largely unclear. Here, we show how the post-glacial warming following the Last Glacial Maximum (ca 18 000 years ago), allowed the (re)colonization of the fragmented sub-Antarctic habitat by an upper-level marine predator, the king penguin Aptenodytes patagonicus. Using restriction site-associated DNA sequencing and standard mitochondrial data, we tested the behaviour of subsets of anonymous nuclear loci in inferring past demography through coalescent-based and allele frequency spectrum analyses. Our results show that the king penguin population breeding on Crozet archipelago steeply increased in size, closely following the Holocene warming recorded in the Epica Dome C ice core. The following population growth can be explained by a threshold model in which the ecological requirements of this species (year-round ice-free habitat for breeding and access to a major source of food such as the Antarctic Polar Front) were met on Crozet soon after the Pleistocene/Holocene climatic transition. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Persistence and diversification of the Holarctic shrew, Sorex tundrensis (Family Soricidae), in response to climate change

USGS Publications Warehouse

Hope, Andrew G.; Waltari, Eric; Fedorov, Vadim B.; Goropashnaya, Anna V.; Talbot, Sandra; Cook, Joseph A.

2011-01-01

Environmental processes govern demography, species movements, community turnover and diversification and yet in many respects these dynamics are still poorly understood at high latitudes. We investigate the combined effects of climate change and geography through time for a widespread Holarctic shrew, Sorex tundrensis. We include a comprehensive suite of closely related outgroup taxa and three independent loci to explore phylogeographic structure and historical demography. We then explore the implications of these findings for other members of boreal communities. The tundra shrew and its sister species, the Tien Shan shrew (Sorex asper), exhibit strong geographic population structure across Siberia and into Beringia illustrating local centres of endemism that correspond to Late Pleistocene refugia. Ecological niche predictions for both current and historical distributions indicate a model of persistence through time despite dramatic climate change. Species tree estimation under a coalescent process suggests that isolation between populations has been maintained across timeframes deeper than the periodicity of Pleistocene glacial cycling. That some species such as the tundra shrew have a history of persistence largely independent of changing climate, whereas other boreal species shifted their ranges in response to climate change, highlights the dynamic processes of community assembly at high latitudes.

Persistence and diversification of the Holarctic shrew, Sorex tundrensis (Family Soricidae), in response to climate change

USGS Publications Warehouse

Hope, Andrew G.; Waltari, Eric; Fedorov, V.B.; Goropashnaya, A.V.; Talbot, Sandra; Cook, Joseph A.

2014-01-01

Environmental processes govern demography, species movements, community turnover and diversification and yet in many respects these dynamics are still poorly understood at high latitudes. We investigate the combined effects of climate change and geography through time for a widespread Holarctic shrew, Sorex tundrensis. We include a comprehensive suite of closely related outgroup taxa and three independent loci to explore phylogeographic structure and historical demography. We then explore the implications of these findings for other members of boreal communities. The tundra shrew and its sister species, the Tien Shan shrew (Sorex asper), exhibit strong geographic population structure across Siberia and into Beringia illustrating local centres of endemism that correspond to Late Pleistocene refugia. Ecological niche predictions for both current and historical distributions indicate a model of persistence through time despite dramatic climate change. Species tree estimation under a coalescent process suggests that isolation between populations has been maintained across timeframes deeper than the periodicity of Pleistocene glacial cycling. That some species such as the tundra shrew have a history of persistence largely independent of changing climate, whereas other boreal species shifted their ranges in response to climate change, highlights the dynamic processes of community assembly at high latitudes.

When high pressure, system constraints, and a social justice mission collide: A socio-structural analysis of emergency department social work services.

PubMed

Moore, Megan; Cristofalo, Margaret; Dotolo, Danae; Torres, Nicole; Lahdya, Alexandra; Ho, Leyna; Vogel, Mia; Forrester, Mollie; Conley, Bonnie; Fouts, Susan

2017-04-01

The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10). Eight major social work roles were identified: investigator, gatekeeper, resource broker, care coordinator, problem solver, crisis manager, advocate, discharge planner. Analyses revealed a complex interplay between ED social work services and multi-layered contexts. Using a social-ecological framework, we identified the interactions between micro or individual level factors, mezzo or local system level factors and macro environmental and systemic factors that play a role in ED interactions and patient services. Macro-level contextual influences were socio-structural forces including socioeconomic barriers to health, social hierarchies that reflected power differentials between providers and patients, and distrust or bias. Mezzo-level forces were limited resources, lack of healthcare system coordination, a challenging hierarchy within the medical model and the pressure to discharge patients quickly. Micro-level factors included characteristics of patients and social workers, complexity of patient stressors, empathic strain, lack of closure and compassion. All of these forces were at play in patient-social worker interactions and impacted service provision. Social workers were at times able to successfully navigate these forces, yet at other times these challenges were insurmountable. A conceptual model of ED social work and the influences on the patient-social worker interactions was developed to assist in guiding innovative research and practice models to improve services and outcomes in the complex, fast-paced ED. Copyright © 2017 Elsevier Ltd. All rights reserved.

When high pressure, system constraints, and a social justice mission collide: a socio-structural analysis of emergency department social work services

PubMed Central

Cristofalo, Margaret; Dotolo, Danae; Torres, Nicole; Lahdya, Alexandra; Ho, Leyna; Vogel, Mia; Forrester, Mollie; Conley, Bonnie; Fouts, Susan

2017-01-01

The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N=1,509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N=10). Eight major social work roles were identified: investigator, gatekeeper, resource broker, care coordinator, problem solver, crisis manager, advocate, discharge planner. Analyses revealed a complex interplay between ED social work services and multi-layered contexts. Using a social-ecological framework, we identified the interactions between micro or individual level factors, mezzo or local system level factors and macro environmental and systemic factors that play a role in ED interactions and patient services. Macro-level contextual influences were socio-structural forces including socioeconomic barriers to health, social hierarchies that reflected power differentials between providers and patients, and distrust or bias. Mezzo-level forces were limited resources, lack of healthcare system coordination, a challenging hierarchy within the medical model and the pressure to discharge patients quickly. Micro-level factors included characteristics of patients and social workers, complexity of patient stressors, empathic strain, lack of closure and compassion. All of these forces were at play in patient-social worker interactions and impacted service provision. Social workers were at times able to successfully navigate these forces, yet at other times these challenges were insurmountable. A conceptual model of ED social work and the influences on the patient-social worker interactions was developed to assist in guiding innovative research and practice models to improve services and outcomes in the complex, fast-paced ED. PMID:28214722

Integrating Population Health Data on Violence Into the Emergency Department: A Feasibility and Implementation Study.

PubMed

Levas, Michael N; Hernandez-Meier, Jennifer L; Kohlbeck, Sara; Piotrowski, Nancy; Hargarten, Stephen

Geocoded emergency department (ED) data have allowed for the development and evaluation of novel interventions for the prevention of violence in cities outside of the United States. First implemented in Cardiff, United Kingdom, collection of these data provides public health agencies, community organizations, and law enforcement with place-based information on assaults. The purpose of this study was to assess the feasibility of translating this model within the electronic medical record (EMR) in the United States. A new EMR module based on the Cardiff Model was developed and integrated into the existing ED EMR. Data were collected for all patients reporting an assaultive injury upon arrival to the ED. Emergency department nurses were subsequently recruited to participate in 2 surveys and a focus group to evaluate the implementation and to provide qualitative feedback to enhance integration. Nurses completed EMR questions in 98.2% of patients reporting to the ED over the study period. More than 90% of survey respondents were satisfied with their participation, and most felt that the questions were useful for clinical care (79/70%), were integrated well into workflow (89/90%), and were congruent with the ED and hospital goals and mission (93/98%). Focus group themes centered on ED culture, external factors, and internal workflow. It is feasible to implement place-based, assault-related injury-specific questions into the EMR with minimal disruption of workflow and triage times. Nurses, as key members of the ED team, are receptive to participating in the collection of population health data that may inform community violence prevention activities.

Identifying causes of laboratory turnaround time delay in the emergency department.

PubMed

Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

2012-12-01

Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol

PubMed Central

Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

2014-01-01

Background Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. Methods A descriptive, comparative (6 months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Results Over the 12 -month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS–EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6 min from 35 to 29 min), admission rate (decreased 6% from 14.5% to 8.5%), increase in β-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). Conclusions The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. PMID:24136123

Exploring the association of urban or rural county status and environmental, nutrition- and lifestyle-related resources with the efficacy of SNAP-Ed (Supplemental Nutrition Assistance Program-Education) to improve food security.

PubMed

Rivera, Rebecca L; Dunne, Jennifer; Maulding, Melissa K; Wang, Qi; Savaiano, Dennis A; Nickols-Richardson, Sharon M; Eicher-Miller, Heather A

2018-04-01

To investigate the association of policy, systems and environmental factors with improvement in household food security among low-income Indiana households with children after a Supplemental Nutrition Assistance Program-Education (SNAP-Ed) direct nutrition education intervention. Household food security scores measured by the eighteen-item US Household Food Security Survey Module in a longitudinal randomized and controlled SNAP-Ed intervention study conducted from August 2013 to April 2015 were the response variable. Metrics to quantify environmental factors including classification of urban or rural county status; the number of SNAP-authorized stores, food pantries and recreational facilities; average fair market housing rental price; and natural amenity rank were collected from government websites and data sets covering the years 2012-2016 and used as covariates in mixed multiple linear regression modelling. Thirty-seven Indiana counties, USA, 2012-2016. SNAP-Ed eligible adults from households with children (n 328). None of the environmental factors investigated were significantly associated with changes in household food security in this exploratory study. SNAP-Ed improves food security regardless of urban or rural location or the environmental factors investigated. Expansion of SNAP-Ed in rural areas may support food access among the low-income population and reduce the prevalence of food insecurity in rural compared with urban areas. Further investigation into policy, systems and environmental factors of the Social Ecological Model are warranted to better understand their relationship with direct SNAP-Ed and their impact on diet-related behaviours and food security.

Brain response to images of food varying in energy density is associated with body composition in 7- to 10-year-old children: Results of an exploratory study.

PubMed

Fearnbach, S Nicole; English, Laural K; Lasschuijt, Marlou; Wilson, Stephen J; Savage, Jennifer S; Fisher, Jennifer O; Rolls, Barbara J; Keller, Kathleen L

2016-08-01

Energy balance is regulated by a multifaceted system of physiological signals that influence energy intake and expenditure. Therefore, variability in the brain's response to food may be partially explained by differences in levels of metabolically active tissues throughout the body, including fat-free mass (FFM) and fat mass (FM). The purpose of this study was to test the hypothesis that children's body composition would be related to their brain response to food images varying in energy density (ED), a measure of energy content per weight of food. Functional magnetic resonance imaging (fMRI) was used to measure brain response to High (>1.5kcal/g) and Low (<1.5kcal/g) ED food images, and Control images, in 36 children ages 7-10years. Body composition was measured using bioelectrical impedance analysis. Multi-subject random effects general linear model (GLM) and two-factor repeated measures analysis of variance (ANOVA) were used to test for main effects of ED (High ED vs. Low ED) in a priori defined brain regions of interest previously implicated in energy homeostasis and reward processing. Pearson's correlations were then calculated between activation in these regions for various contrasts (High ED-Low ED, High ED-Control, Low ED-Control) and child body composition (FFM index, FM index, % body fat). Relative to Low ED foods, High ED foods elicited greater BOLD activation in the left thalamus. In the right substantia nigra, BOLD activation for the contrast of High ED-Low ED foods was positively associated with child FFM. There were no significant results for the High ED-Control or Low ED-Control contrasts. Our findings support literature on FFM as an appetitive driver, such that greater amounts of lean mass were associated with greater activation for High ED foods in an area of the brain associated with dopamine signaling and reward (substantia nigra). These results confirm our hypothesis that brain response to foods varying in energy content is related to measures of child body composition. Copyright © 2016 Elsevier Inc. All rights reserved.

Predicting emergency department volume using forecasting methods to create a "surge response" for noncrisis events.

PubMed

Chase, Valerie J; Cohn, Amy E M; Peterson, Timothy A; Lavieri, Mariel S

2012-05-01

This study investigated whether emergency department (ED) variables could be used in mathematical models to predict a future surge in ED volume based on recent levels of use of physician capacity. The models may be used to guide decisions related to on-call staffing in non-crisis-related surges of patient volume. A retrospective analysis was conducted using information spanning July 2009 through June 2010 from a large urban teaching hospital with a Level I trauma center. A comparison of significance was used to assess the impact of multiple patient-specific variables on the state of the ED. Physician capacity was modeled based on historical physician treatment capacity and productivity. Binary logistic regression analysis was used to determine the probability that the available physician capacity would be sufficient to treat all patients forecasted to arrive in the next time period. The prediction horizons used were 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, 8 hours, and 12 hours. Five consecutive months of patient data from July 2010 through November 2010, similar to the data used to generate the models, was used to validate the models. Positive predictive values, Type I and Type II errors, and real-time accuracy in predicting noncrisis surge events were used to evaluate the forecast accuracy of the models. The ratio of new patients requiring treatment over total physician capacity (termed the care utilization ratio [CUR]) was deemed a robust predictor of the state of the ED (with a CUR greater than 1 indicating that the physician capacity would not be sufficient to treat all patients forecasted to arrive). Prediction intervals of 30 minutes, 8 hours, and 12 hours performed best of all models analyzed, with deviances of 1.000, 0.951, and 0.864, respectively. A 95% significance was used to validate the models against the July 2010 through November 2010 data set. Positive predictive values ranged from 0.738 to 0.872, true positives ranged from 74% to 94%, and true negatives ranged from 70% to 90% depending on the threshold used to determine the state of the ED with the 30-minute prediction model. The CUR is a new and robust indicator of an ED system's performance. The study was able to model the tradeoff of longer time to response versus shorter but more accurate predictions, by investigating different prediction intervals. Current practice would have been improved by using the proposed models and would have identified the surge in patient volume earlier on noncrisis days. © 2012 by the Society for Academic Emergency Medicine.

A systematic review and qualitative analysis to inform the development of a new emergency department-based geriatric case management model.

PubMed

Sinha, Samir K; Bessman, Edward S; Flomenbaum, Neal; Leff, Bruce

2011-06-01

We inform the future development of a new geriatric emergency management practice model. We perform a systematic review of the existing evidence for emergency department (ED)-based case management models designed to improve the health, social, and health service utilization outcomes for noninstitutionalized older patients within the context of an index ED visit. This was a systematic review of English-language articles indexed in MEDLINE and CINAHL (1966 to 2010), describing ED-based case management models for older adults. Bibliographies of the retrieved articles were reviewed to identify additional references. A systematic qualitative case study analytic approach was used to identify the core operational components and outcome measures of the described clinical interventions. The authors of the included studies were also invited to verify our interpretations of their work. The determined patterns of component adherence were then used to postulate the relative importance and effect of the presence or absence of a particular component in influencing the overall effectiveness of their respective interventions. Eighteen of 352 studies (reported in 20 articles) met study criteria. Qualitative analyses identified 28 outcome measures and 8 distinct model characteristic components that included having an evidence-based practice model, nursing clinical involvement or leadership, high-risk screening processes, focused geriatric assessments, the initiation of care and disposition planning in the ED, interprofessional and capacity-building work practices, post-ED discharge follow-up with patients, and evaluation and monitoring processes. Of the 15 positive study results, 6 had all 8 characteristic components and 9 were found to be lacking at least 1 component. Two studies with positive results lacked 2 characteristic components and none lacked more than 2 components. Of the 3 studies with negative results demonstrating no positive effects based on any outcome tested, one lacked 2, one lacked 3, and one lacked 4 of the 8 model components. Successful models of ED-based case management models for older adults share certain key characteristics. This study builds on the emerging literature in this area and leverages the differences in these models and their associated outcomes to support the development of an evidence-based normative and effective geriatric emergency management practice model designed to address the special care needs and thereby improve the health and health service utilization outcomes of older patients. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

A General Population Genetic Framework for Antagonistic Selection That Accounts for Demography and Recurrent Mutation

PubMed Central

Connallon, Tim; Clark, Andrew G.

2012-01-01

Antagonistic selection—where alleles at a locus have opposing effects on male and female fitness (“sexual antagonism”) or between components of fitness (“antagonistic pleiotropy”)—might play an important role in maintaining population genetic variation and in driving phylogenetic and genomic patterns of sexual dimorphism and life-history evolution. While prior theory has thoroughly characterized the conditions necessary for antagonistic balancing selection to operate, we currently know little about the evolutionary interactions between antagonistic selection, recurrent mutation, and genetic drift, which should collectively shape empirical patterns of genetic variation. To fill this void, we developed and analyzed a series of population genetic models that simultaneously incorporate these processes. Our models identify two general properties of antagonistically selected loci. First, antagonistic selection inflates heterozygosity and fitness variance across a broad parameter range—a result that applies to alleles maintained by balancing selection and by recurrent mutation. Second, effective population size and genetic drift profoundly affect the statistical frequency distributions of antagonistically selected alleles. The “efficacy” of antagonistic selection (i.e., its tendency to dominate over genetic drift) is extremely weak relative to classical models, such as directional selection and overdominance. Alleles meeting traditional criteria for strong selection (Nes >> 1, where Ne is the effective population size, and s is a selection coefficient for a given sex or fitness component) may nevertheless evolve as if neutral. The effects of mutation and demography may generate population differences in overall levels of antagonistic fitness variation, as well as molecular population genetic signatures of balancing selection. PMID:22298707

A general population genetic framework for antagonistic selection that accounts for demography and recurrent mutation.

PubMed

Connallon, Tim; Clark, Andrew G

2012-04-01

Antagonistic selection--where alleles at a locus have opposing effects on male and female fitness ("sexual antagonism") or between components of fitness ("antagonistic pleiotropy")--might play an important role in maintaining population genetic variation and in driving phylogenetic and genomic patterns of sexual dimorphism and life-history evolution. While prior theory has thoroughly characterized the conditions necessary for antagonistic balancing selection to operate, we currently know little about the evolutionary interactions between antagonistic selection, recurrent mutation, and genetic drift, which should collectively shape empirical patterns of genetic variation. To fill this void, we developed and analyzed a series of population genetic models that simultaneously incorporate these processes. Our models identify two general properties of antagonistically selected loci. First, antagonistic selection inflates heterozygosity and fitness variance across a broad parameter range--a result that applies to alleles maintained by balancing selection and by recurrent mutation. Second, effective population size and genetic drift profoundly affect the statistical frequency distributions of antagonistically selected alleles. The "efficacy" of antagonistic selection (i.e., its tendency to dominate over genetic drift) is extremely weak relative to classical models, such as directional selection and overdominance. Alleles meeting traditional criteria for strong selection (N(e)s > 1, where N(e) is the effective population size, and s is a selection coefficient for a given sex or fitness component) may nevertheless evolve as if neutral. The effects of mutation and demography may generate population differences in overall levels of antagonistic fitness variation, as well as molecular population genetic signatures of balancing selection.

Madeiran Arabidopsis thaliana Reveals Ancient Long-Range Colonization and Clarifies Demography in Eurasia

PubMed Central

Fulgione, Andrea; Koornneef, Maarten; Roux, Fabrice; Hermisson, Joachim; Hancock, Angela M

2018-01-01

Abstract The study of model organisms on islands may shed light on rare long-range dispersal events, uncover signatures of local evolutionary processes, and inform demographic inference on the mainland. Here, we sequenced the genomes of Arabidopsis thaliana samples from the oceanic island of Madeira. These samples include the most diverged worldwide, likely a result of long isolation on the island. We infer that colonization of Madeira happened between 70 and 85 ka, consistent with a propagule dispersal model (of size ≥10), or with an ecological window of opportunity. This represents a clear example of a natural long-range dispersal event in A. thaliana. Long-term effective population size on the island, rather than the founder effect, had the greatest impact on levels of diversity, and rates of coalescence. Our results uncover a selective sweep signature on the ancestral haplotype of a known translocation in Eurasia, as well as the possible importance of the low phosphorous availability in volcanic soils, and altitude, in shaping early adaptations to the island conditions. Madeiran genomes, sheltered from the complexities of continental demography, help illuminate ancient demographic events in Eurasia. Our data support a model in which two separate lineages of A. thaliana, one originating in Africa and the other from the Caucasus expanded and met in Iberia, resulting in a secondary contact zone there. Although previous studies inferred that the westward expansion of A. thaliana coincided with the spread of human agriculture, our results suggest that it happened much earlier (20–40 ka). PMID:29216397

Childbearing and Economic Work: The Health Balance of Women in Accra, Ghana.

PubMed

Waterhouse, Philippa; Hill, Allan G; Hinde, Andrew

2016-02-01

This study aims to investigate (1) whether the health of working women with young children differs from that of working women without young children, and (2) which social factors mediate the relationship between economic and maternal role performance and health among mothers with young children. The analyses uses panel data from 697 women present in both waves of the Women's Health Study for Accra (WHSA-I and WHSA-II); a community based study of women aged 18 years and older in the Accra Metropolitan Area of Ghana conducted in 2003 and 2008-2009. Change in physical and mental health between the survey waves is compared between women with a biological child alive at WHSA-II and born since WHSA-I and women without a living biological child at WHSA-II born in the interval. To account for attrition between the two survey waves selection models were used with unconditional change score models being used as the outcome model. We found in our sample of working women that those who had a child born between WHSA-I and WHSA-II who was still alive at WHSA-II did not experience a change in mental or physical health different from other women. Among working women with young children, educational status, relationship to the household head and household demography were associated with change in mental health at the 5 % level, whilst migration status and household demography was associated with change in physical health scores. The results suggest there are no health penalties of combining work and childbearing among women with young children in Accra, Ghana.

Learning from Accident and Error: Avoiding the Hazards of Workload, Stress, and Routine Interruptions in the Emergency Department

PubMed Central

Morrison, J. Bradley; Rudolph, Jenny W.

2012-01-01

This article presents a model of how a build-up of interruptions can shift the dynamics of the emergency department (ED) from an adaptive, self-regulating system into a fragile, crisis-prone one. Drawing on case studies of organizational disasters and insights from the theory of high-reliability organizations, the authors use computer simulations to show how the accumulation of small interruptions could have disproportionately large effects in the ED. In the face of a mounting workload created by interruptions, EDs, like other organizational systems, have tipping points, thresholds beyond which a vicious cycle can lead rather quickly to the collapse of normal operating routines and in the extreme to a crisis of organizational paralysis. The authors discuss some possible implications for emergency medicine, emphasizing the potential threat from routine, non-novel demands on EDs and raising the concern that EDs are operating closer to the precipitous edge of crisis as ED crowding exacerbates the problem. PMID:22168187

New 'patent accelerated care environment' aims to facilitate work flow, free up ED for acute care needs.

PubMed

2012-02-01

Faced with rising acuity levels and surging demand, Virginia Mason Medical Center modified the Clinical Decision Unit concept used in many EDs, and developed a new Patient Accelerated Care Environment (PACE) to care for observation patients, process patients for discharge, and to prepare patients for admission.The approach is designed to utilize ED beds for initial processing of patients, allowing resuscitative care if needed, and treating and releasing the patients with quick care needs. Using the Virginia Mason Production System, a methodology that is modeled after Toyota production techniques, developers designed an optimal work flow pattern and then built infrastructure to facilitate that process. All patients who present to the ED for care are seen by the ED team through a "team greet" approach. Approximately 35% to 40% of patients who come to the ED for care are transferred to the PACE unit. Patients assigned to the PACE unit typically remain there for 4 to 48 hours, depending on their care needs.

Dietary energy density and body weight changes after 3 years in the PREDIMED study.

PubMed

Razquin, Cristina; Sanchez-Tainta, Ana; Salas-Salvadó, Jordi; Buil-Cosiales, Pilar; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Estruch, Ramón; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Serra-Majem, Luis; Pinto, Xavier; Schröder, Helmut; Tur, Josep; Sorlí, José V; Lamuela-Raventós, Rosa M; Bulló, Mónica; Bes-Rastrollo, Maira; Martinez-Gonzalez, Miguel A

2017-11-01

The association of dietary energy density (ED) and overweight is not clear in the literature. Our aim was to study in 4259 of the PREDIMED trial whether an increase in dietary ED based on a higher adherence to a Mediterranean dietary pattern was associated with 3-year weight gain. A validated 137-item food-frequency questionnaire was administered. Multivariable-adjusted models were used to analyze the association between 3-year ED change and the subsequent 3-year body weight change. The most important weight reduction after 3-year follow-up was observed in the two lowest quintiles and the highest quintile of ED change. The highest ED increase was characterized by an increased intake of extra virgin olive oil (EVOO) and nuts and a decreased intake of other oils, vegetable and fruit consumption (p < .001). In conclusion, increased 3-year ED in the PREDIMED study, associated with a higher EVOO and nuts consumption, was not associated with weight gain.

Understanding ED performance after the implementation of activity-based funding.

PubMed

Toloo, Ghasem-Sam; Burke, John; Crilly, Julia; Williams, Ged; McCann, Bridie; FitzGerald, Gerry; Bell, Anthony

2017-11-29

The aim of this study was to describe emergency department (ED) activities and staffing after the introduction of activity-based funding (ABF) to highlight the challenges of new funding arrangements and their implementation. A retrospective study of public hospital EDs in Queensland, Australia, was undertaken for 2013-2014. The ED and hospital characteristics are described to evaluate the alignment between activity and resourcing levels and their impact on performance. Twenty EDs participated (74% response rate). Weighted activity units (WAUs) and nursing staff varied based on hospital type and size. Larger hospital EDs had on average 9076 WAUs and 13 full time equivalent (FTE) nursing staff per 1000 WAUs; smaller EDs had on average 4587 WAUs and 10.3 FTE nursing staff per 1000 WAUs. Medical staff was relatively consistent (8.1-8.7 FTE per 1000 WAUs). The proportion of patients admitted, discharged, or transferred within 4 hours ranged from 73% to 79%. The ED medical and nursing staffing numbers did not correlate with the 4-hour performance. Substantial variation exists across Queensland EDs when resourcing service delivery in an activity-based funding environment. Historical inequity persists in the staffing profiles for regional and outer metropolitan departments. The lack of association between resourcing and performance metrics provides opportunity for further investigation of efficient models of care. Copyright © 2017 John Wiley & Sons, Ltd.

Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample.

PubMed

Diemer, Elizabeth W; White Hughto, Jaclyn M; Gordon, Allegra R; Guss, Carly; Austin, S Bryn; Reisner, Sari L

2018-01-01

Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18-75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants ( p =0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding ( p =0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity.

Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample

PubMed Central

Diemer, Elizabeth W.; White Hughto, Jaclyn M.; Gordon, Allegra R.; Guss, Carly; Austin, S. Bryn; Reisner, Sari L.

2018-01-01

Abstract Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18–75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants (p=0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding (p=0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity. PMID:29359198

Historical demography of common carp estimated from individuals collected from various parts of the world using the pairwise sequentially markovian coalescent approach.

PubMed

Yuan, Zihao; Huang, Wei; Liu, Shikai; Xu, Peng; Dunham, Rex; Liu, Zhanjiang

2018-04-01

The inference of historical demography of a species is helpful for understanding species' differentiation and its population dynamics. However, such inference has been previously difficult due to the lack of proper analytical methods and availability of genetic data. A recently developed method called Pairwise Sequentially Markovian Coalescent (PSMC) offers the capability for estimation of the trajectories of historical populations over considerable time periods using genomic sequences. In this study, we applied this approach to infer the historical demography of the common carp using samples collected from Europe, Asia and the Americas. Comparison between Asian and European common carp populations showed that the last glacial period starting 100 ka BP likely caused a significant decline in population size of the wild common carp in Europe, while it did not have much of an impact on its counterparts in Asia. This was probably caused by differences in glacial activities in East Asia and Europe, and suggesting a separation of the European and Asian clades before the last glacial maximum. The North American clade which is an invasive population shared a similar demographic history as those from Europe, consistent with the idea that the North American common carp probably had European ancestral origins. Our analysis represents the first reconstruction of the historical population demography of the common carp, which is important to elucidate the separation of European and Asian common carp clades during the Quaternary glaciation, as well as the dispersal of common carp across the world.

The big challenges in modeling human and environmental well-being.

PubMed

Tuljapurkar, Shripad

2016-01-01

This article is a selective review of quantitative research, historical and prospective, that is needed to inform sustainable development policy. I start with a simple framework to highlight how demography and productivity shape human well-being. I use that to discuss three sets of issues and corresponding challenges to modeling: first, population prehistory and early human development and their implications for the future; second, the multiple distinct dimensions of human and environmental well-being and the meaning of sustainability; and, third, inequality as a phenomenon triggered by development and models to examine changing inequality and its consequences. I conclude with a few words about other important factors: political, institutional, and cultural.

Fine particulate matter (PM2.5 ) exposure during a prolonged wildfire period and emergency department visits for asthma.

PubMed

Haikerwal, Anjali; Akram, Muhammad; Sim, Malcolm R; Meyer, Mick; Abramson, Michael J; Dennekamp, Martine

2016-01-01

The 2006-2007 wildfire period was one of the most extensive and long lasting fires in Australian history with high levels of fine particulate matter (PM2.5 ). Large populations were exposed to smoke for over 2 months. The study aimed to investigate the association between wildfire-related PM2.5 exposure and emergency department (ED) visits for asthma. A time-stratified case-crossover design was used to investigate associations between daily average PM2.5 and ED attendances for asthma from December 2006 to January 2007. ED data were obtained from the Victorian Emergency Minimum Dataset. Smoke dispersion during the wildfire event was modelled using a validated chemical transport model. Exposure data (daily average PM2.5 , temperature and relative humidity) were modelled for the study period. Various lag periods were investigated. There were 2047 ED attendances for asthma during the study period. After adjusting for temperature and relative humidity, an interquartile range increase in PM2.5 levels of 8.6 μg/m(3) was associated with an increase in ED attendances for asthma by 1.96% (95%CI: 0.02, 3.94) on the day of exposure. Lag periods up to 2 days prior did not show any association. A strong association was observed among women 20 years and older (5.08% 95%CI: 1.76, 8.51). Wildfire-related PM2.5 was associated with increased risk of ED attendance for asthma during the wildfire event. It is important to understand the role of wildfire PM2.5 as a trigger for asthma presentations. © 2015 Asian Pacific Society of Respirology.

Factors Associated With the Likelihood of Hospitalization Following Emergency Department Visits for Behavioral Health Conditions.

PubMed

Hamilton, Jane E; Desai, Pratikkumar V; Hoot, Nathan R; Gearing, Robin E; Jeong, Shin; Meyer, Thomas D; Soares, Jair C; Begley, Charles E

2016-11-01

Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources, and a longer length of stay (LOS) due in part to patients being admitted to the hospital but waiting for an inpatient bed. This study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States. Using Andersen's Behavioral Model of Health Service Use for guidance, the study examined the relationship between predisposing (characteristics of the individual, i.e., age, sex, race/ethnicity), enabling (system or structural factors affecting healthcare access), and need (clinical) factors and the likelihood of hospitalization following ED visits for behavioral health conditions (n = 28,716 ED visits). In the adjusted analysis, a logistic fixed-effects model with blockwise entry was used to estimate the relative importance of predisposing, enabling, and need variables added separately as blocks while controlling for variation in unobserved hospital-specific practices across hospitals and time in years. Significant predisposing factors associated with an increased likelihood of hospitalization following an ED visit included increasing age, while African American race was associated with a lower likelihood of hospitalization. Among enabling factors, arrival by emergency transport and a longer ED LOS were associated with a greater likelihood of hospitalization while being uninsured and the availability of community-based behavioral health services within 5 miles of the ED were associated with lower odds. Among need factors, having a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, dementia, or an impulse control disorder as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization following an ED visit. The block of enabling factors was the strongest predictor of hospitalization following an ED visit compared to predisposing and need factors. Our findings also provide evidence of disparities in hospitalization of the uninsured and racial and ethnic minority patients with ED visits for behavioral health conditions. Thus, improved access to community-based behavioral health services and an increased capacity for inpatient psychiatric hospitals for treating indigent patients may be needed to improve the efficiency of ED services in our region for patients with behavioral health conditions. Among need factors, a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, an impulse control disorder, or dementia as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization following an ED visit, also suggesting an opportunity for improving the efficiency of ED care through the provision of psychiatric services to stabilize and treat patients with serious mental illness. © 2016 by the Society for Academic Emergency Medicine.

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

PubMed Central

Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

2016-01-01

Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. Methods: This is a cross-sectional study in which simulation software (Arena, version 14) was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Results: Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity). The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the “bed area” server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the number waiting to 586 patients. Conclusion: Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution. PMID:26793727

Presentations to Emergency Departments for COPD: A Time Series Analysis.

PubMed

Rosychuk, Rhonda J; Youngson, Erik; Rowe, Brian H

2016-01-01

Background. Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by progressive dyspnea and acute exacerbations which may result in emergency department (ED) presentations. This study examines monthly rates of presentations to EDs in one Canadian province. Methods. Presentations for COPD made by individuals aged ≥55 years during April 1999 to March 2011 were extracted from provincial databases. Data included age, sex, and health zone of residence (North, Central, South, and urban). Crude rates were calculated. Seasonal autoregressive integrated moving average (SARIMA) time series models were developed. Results. ED presentations for COPD totalled 188,824 and the monthly rate of presentation remained relatively stable (from 197.7 to 232.6 per 100,000). Males and seniors (≥65 years) comprised 52.2% and 73.7% of presentations, respectively. The ARIMA(1,0, 0) × (1,0, 1)12 model was appropriate for the overall rate of presentations and for each sex and seniors. Zone specific models showed relatively stable or decreasing rates; the North zone had an increasing trend. Conclusions. ED presentation rates for COPD have been relatively stable in Alberta during the past decade. However, their increases in northern regions deserve further exploration. The SARIMA models quantified the temporal patterns and can help planning future health care service needs.

Psychological determinants of erectile dysfunction among middle-aged men.

PubMed

Aghighi, A; Grigoryan, V H; Delavar, A

2015-01-01

We describe psychological determinants of erectile dysfunction (ED) among middle-aged men with no identifiable medical risk factors and compare them with a sample of young individuals. Two groups of young (⩽ 30 years, n = 59) and middle-aged men (⩾ 40 years, n = 63) who scored ⩽ 25 on the erectile functioning domain of the International Index of Erectile Functioning were enrolled. Patients were included if they had no metabolic diseases, prostate problems or external genitalia abnormalities. Patients were not included if they were smokers, excessive drinkers or took medications known to cause ED. To assess psychopathology, symptom check list 90-revised (SCL-90-R) was administered. Structural equation modeling was performed to assess the relationship between psychopathology and ED. One in five men had severe ED, and the proportion was not different between the two groups. Middle-aged men had lower scores on different SCL-90-R domains. In both age groups, somatization and interpersonal sensitivity contributed to ED. Among younger individuals, anxiety and psychosis-related domains were also associated with ED. Unique contributors to ED in middle-aged men were depression and additional questions. In conclusion, among middle-aged men, psychological factors significantly contribute to ED when no medical risk factors are present. The pattern and composition of distress depicts distinct features, not seen in young age.

Enhanced risk prediction model for emergency department use and hospitalizations in patients in a primary care medical home.

PubMed

Takahashi, Paul Y; Heien, Herbert C; Sangaralingham, Lindsey R; Shah, Nilay D; Naessens, James M

2016-07-01

With the advent of healthcare payment reform, identifying high-risk populations has become more important to providers. Existing risk-prediction models often focus on chronic conditions. This study sought to better understand other factors to improve identification of the highest risk population. A retrospective cohort study of a paneled primary care population utilizing 2010 data to calibrate a risk prediction model of hospital and emergency department (ED) use in 2011. Data were randomly split into development and validation data sets. We compared the enhanced model containing the additional risk predictors with the Minnesota medical tiering model. The study was conducted in the primary care practice of an integrated delivery system at an academic medical center in Rochester, Minnesota. The study focus was primary care medical home patients in 2010 and 2011 (n = 84,752), with the primary outcome of subsequent hospitalization or ED visit. A total of 42,384 individuals derived the enhanced risk-prediction model and 42,368 individuals validated the model. Predictors included Adjusted Clinical Groups-based Minnesota medical tiering, patient demographics, insurance status, and prior year healthcare utilization. Additional variables included specific mental and medical conditions, use of high-risk medications, and body mass index. The area under the curve in the enhanced model was 0.705 (95% CI, 0.698-0.712) compared with 0.662 (95% CI, 0.656-0.669) in the Minnesota medical tiering-only model. New high-risk patients in the enhanced model were more likely to have lack of health insurance, presence of Medicaid, diagnosed depression, and prior ED utilization. An enhanced model including additional healthcare-related factors improved the prediction of risk of hospitalization or ED visit.

Genital image, sexual anxiety, and erectile dysfunction among young male military personnel.

PubMed

Wilcox, Sherrie L; Redmond, Sarah; Davis, Teaniese L

2015-06-01

More than a third of young military personnel report experiencing some level of erectile dysfunction (ED). Preoccupation with body image, particularly genitals, is a distraction that can influence sexual anxiety (SA) and sexual functioning problems (SFPs), particularly ED. This study assessed the relationships between male genital self-image (MGSI), SA, and ED in a sample of male military personnel age 40 or younger. Data were from a larger study on SFPs in military populations. This sample consisted of 367 male military personnel age 40 or younger. Hierarchical regression analyses and process modeling using mediation analysis were performed to examine the effects of MGSI on ED with SA as an intermediate variable. We predicted that SA would mediate the relationship between MGSI and ED. ED severity was assessed with the International Index of Erectile Function. MGSI was assessed using the MGSI Scale. SA was assessed with the SA subscale of the Sexual Needs Scale. As hypothesized, greater satisfaction with MGSI was predictive of significantly lower SA (F[8, 352] = 4.07, P = 0.001) and lower ED (F[8, 352] = 13.20, P = 0.001). Lower levels of SA were predictive of lower levels of ED (F[8, 354] = 21.35, P < 0.001). Additionally, results also revealed a significant indirect effect of MGSI on ED through SA (b = -0.07, standard error = 0.03, confidence interval = [-0.14,-0.02], P < 0.05), indicating mediation of MGSI on ED via SA. This study underscores the complex etiologic basis of SFPs, particularly ED, and highlights the importance of considering psychologic contributors to ED, such as SA and MGSI. Strategies aimed at reducing SA may be useful in improving ED in young military populations and are worth considering as complements to strategies that improve SFPs. © 2015 International Society for Sexual Medicine.

Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.

PubMed

Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn

2016-02-01

This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort.

PubMed

Hartman, Terryl J; Gapstur, Susan M; Gaudet, Mia M; Shah, Roma; Flanders, W Dana; Wang, Ying; McCullough, Marjorie L

2016-10-01

Dietary energy density (ED) is a measure of diet quality that estimates the amount of energy per unit of food (kilocalories per gram) consumed. Low-ED diets are generally high in fiber and fruits and vegetables and low in fat. Dietary ED has been positively associated with body mass index (BMI) and other risk factors for postmenopausal breast cancer. We evaluated the associations of total dietary ED and energy-dense (high-ED) foods with postmenopausal breast cancer incidence. Analyses included 56,795 postmenopausal women from the Cancer Prevention Study II Nutrition Cohort with no previous history of breast or other cancers and who provided information on diet, lifestyle, and medical history in 1999. Multivariable-adjusted breast cancer incidence rate ratios (RRs and 95% CIs) were estimated for quintiles of total dietary ED and for the consumption of high-ED foods in Cox proportional hazards regression models. During a median follow-up of 11.7 y, 2509 invasive breast cancer cases were identified, including 1857 estrogen receptor-positive and 277 estrogen receptor-negative tumors. Median dietary ED was 1.5 kcal/g (IQR: 1.3-1.7 kcal/g). After adjusting for age, race, education, reproductive characteristics, and family history, high compared with low dietary ED was associated with a statistically significantly higher risk of breast cancer (RR for fifth quintile compared with first quintile: 1.20; 95% CI: 1.05, 1.36; P-trend = 0.03). The association between the amount of high-ED foods consumed and breast cancer risk was not statistically significant. We observed no differences by estrogen receptor status or effect modification by BMI, age, or physical activity. These results suggest a modest positive association between total dietary ED and risk of postmenopausal breast cancer. © 2016 American Society for Nutrition.

Clinical and Economic Burden of Emergency Department Presentations for Neutropenia Following Outpatient Chemotherapy for Cancer in Victoria, Australia

PubMed Central

Craike, Melinda; Slavin, Monica

2012-01-01

Objective. To examine the clinical characteristics and financial charges associated with treating adult cancer patients receiving chemotherapy in outpatient clinics who presented to the emergency department (ED) with neutropenia. Design and Setting. A retrospective audit was conducted across two health services involving ED episodes and subsequent hospital admissions of patients who received chemotherapy through day oncology from January 1 to December 31, 2007 and presented to the ED with neutropenia. ED data were collected from the Victorian Emergency Minimum Dataset and charges were collected from Health Information Services. Descriptive and bivariate statistics were used to describe the patient and clinical characteristics and financial outcomes, and to explore associations between these factors. Results. In total, 200 neutropenic episodes in 159 outpatients were seen in the ED over the survey period. The mean patient age was 56.6 years (standard deviation, 13.2 years) and 47.2% were male. Overall, 70.0% of ED episodes were triaged as Australasian Triage Scale 2 (emergency). The median ED wait time was 10 minutes and the median ED length of stay was 6.8 hours. The median charge for each ED episode was $764.08 Australian dollars. The total combined ED and inpatient charge per episode was in the range of $144.27–$174,732.68, with a median charge of $5,640.87. Conclusions. This study provides important insights into the clinical and economic burden of neutropenia from both the ED and inpatient perspectives. Alternative treatment models, such as outpatient treatment, early discharge programs or prophylactic interventions to reduce the clinical and economic burden of neutropenia on our health system, must be explored. PMID:22707511

[Case mix analysis of patients who can be referred from emergency department triage to primary care].

PubMed

Gómez-Jiménez, Josep; Becerra, Oscar; Boneu, Francisco; Burgués, Lluís; Pàmies, Salvador

2006-01-01

Structured emergency department (ED) triage scales can be used to develop patient referral strategies from the ED to primary care. The objectives of the present study were to evaluate the percentage of patients who could potentially be referred from triage to primary care and to describe their clinical characteristics. We analyzed all patients with low acuity (triage levels IV and V) and low complexity (patients discharged from the ED) triaged during 2003 with the Andorran Triage Model in the ED and estimated the percentage of patients who could potentially be referred on the basis of three primary care models: A, centers unable to deal with emergencies or perform complementary investigations; B, centers able to deal with emergencies and perform complementary investigations, and C, centers able to deal with emergencies but unable to perform complementary investigations. Of the 25,319 patients included in the study, 5.63% could be referred to model A, 75.22% to model B and 33.36% to model C. A total of 81.04% of these model C patients were classified in seven symptomatic categories: wounds and traumatisms, inflammation or fever, pediatric problems, rhinolaryngological infection or alterations, ocular symptoms, pain and cutaneous allergy or reactions. Casemix analysis, based on the level of acuity and discharge criteria, can be used to establish the percentage of patients that could potentially be referred to primary care. Analysis of their clinical profile is useful to design referral protocols.

Toward a gender politics of aging.

PubMed

Carney, Gemma M

2018-01-01

The article proposes a Gender Politics of Aging approach to the study of aging societies. The approach recognizes the feminization of old age, ageism's roots in sexist discourse, and the need to recognize the role of politics in driving demographic debates. Drawing together arguments from feminist gerontology and political demography, the article argues that the intersection of politics and gender must be considered if appropriate responses to an older, feminized demography are to be produced. I conclude that the work of aging feminists provides a rich vein of research and praxis from which a gender politics of aging approach can draw.

Predation risk affects reproductive physiology and demography of elk.

PubMed

Creel, Scott; Christianson, David; Liley, Stewart; Winnie, John A

2007-02-16

Elk (Cervus elaphus) in the Greater Yellowstone Ecosystem alter patterns of aggregation, habitat selection, vigilance, and foraging in the presence of wolves (Canis lupus). Antipredator behaviors like these can reduce predation risk but are also likely to carry costs. Data from five elk populations studied for 16 site years showed that progesterone concentrations (from 1489 fecal samples) declined with the ratio of elk to wolves. In turn, progesterone concentrations were a good predictor of calf recruitment in the subsequent year. Together, these data suggest that wolves indirectly affect the reproductive physiology and the demography of elk through the costs of antipredator behavior.

LATE PLEISTOCENE ENVIRONMENTAL CHANGES LEAD TO UNSTABLE DEMOGRAPHY AND POPULATION DIVERGENCE OF ANOPHELES ALBIMANUS IN THE NORTHERN NEOTROPICS

PubMed Central

Loaiza, Jose R.; Scott, Marilyn E.; Bermingham, Eldredge; Sanjur, Oris I.; Wilkerson, Richard; Rovira, Jose; Gutiérrez, Lina A.; Correa, Margarita M.; Grijalva, Mario; Birnberg, Lotty; Bickersmith, Sara; Conn, Jan E.

2011-01-01

We investigated the historical demography of Anopheles albimanus using mosquitoes from five countries and three different DNA regions, the mitochondrial cytochrome oxidase subunit I gene (COI), the single copy nuclear white gene and the ribosomal internal transcribed spacer two (ITS2). All the molecular markers supported the taxonomic status of a single species of An. albimanus. Furthermore, agreement between the COI and the white genes suggested a scenario of Pleistocene geographic fragmentation (i.e., population contraction) and subsequent range expansion across southern Central America. PMID:20888924

The Fifteenth International Congress on Hygiene and Demography Held in Washington, D. C. from September 16 to October 5. 1912. I. Some Lessons and Suggestions from the Exhibition; II. Digests of Some of the Papers Presented at the Congress. Bulletin, 1913, No. 18. Whole Number 528

ERIC Educational Resources Information Center

Dresslar, Fletcher B.

1913-01-01

The Fifteenth International Congress on Hygiene and Demography, held in Washington City in the autumn of 1912, was a notable event in the history of sanitation and in the discussion of the conditions of the physical and mental health of the people. The exhibition held in connection with the congress was instructive in many ways, and contained much…

Revisiting dark energy models using differential ages of galaxies

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

Rani, Nisha; Mahajan, Shobhit; Mukherjee, Amitabha

In this work, we use a test based on the differential ages of galaxies for distinguishing the dark energy models. As proposed by Jimenez and Loeb in [1], relative ages of galaxies can be used to put constraints on various cosmological parameters. In the same vein, we reconstruct H {sub 0} {sub dt} / dz and its derivative ( H {sub 0} {sub d} {sup 2} {sup t} / dz {sup 2}) using a model independent technique called non-parametric smoothing . Basically, dt / dz is the change in the age of the object as a function of redshift whichmore » is directly linked with the Hubble parameter. Hence for reconstruction of this quantity, we use the most recent H ( z ) data. Further, we calculate H {sub 0} {sub dt} / dz and its derivative for several models like Phantom, Einstein de Sitter (EdS), ΛCDM, Chevallier-Polarski-Linder (CPL) parametrization, Jassal-Bagla-Padmanabhan (JBP) parametrization and Feng-Shen-Li-Li (FSLL) parametrization. We check the consistency of these models with the results of reconstruction obtained in a model independent way from the data. It is observed that H {sub 0} {sub dt} / dz as a tool is not able to distinguish between the ΛCDM, CPL, JBP and FSLL parametrizations but, as expected, EdS and Phantom models show noticeable deviation from the reconstructed results. Further, the derivative of H {sub 0} {sub dt} / dz for various dark energy models is more sensitive at low redshift. It is found that the FSLL model is not consistent with the reconstructed results, however, the ΛCDM model is in concordance with the 3σ region of the reconstruction at redshift z ≥ 0.3.« less

Evolution of spherical over-densities in tachyon scalar field model

NASA Astrophysics Data System (ADS)

Setare, M. R.; Felegary, F.; Darabi, F.

2017-09-01

We study the tachyon scalar field model in flat FRW cosmology with the particular potential ϕ-2 and the scale factor behavior a (t) =tn. We consider the spherical collapse model and investigate the effects of the tachyon scalar field on the structure formation in flat FRW universe. We calculate δc (zc), λ (zc), ξ (zc), ΔV (zc), log ⁡ [ νf (ν) ] and log ⁡ [ n (k) ] for the tachyon scalar field model and compare the results with the results of EdS model and ΛCDM model. It is shown that in the tachyon scalar field model the structure formation may occur earlier, in comparison to the other models.

FACTORIAL VALIDITY OF THE KOREAN VERSION OF THE EXERCISE DEPENDENCE SCALE-REVISED.

PubMed

Shin, Kyulee; You, Sukkyung

2015-12-01

This study evaluated the psychometric properties of the Korean version of the 21-item Exercise Dependence Scale-Revised (EDS-R). The EDS-R was designed to measure the multidimensional aspects of exercise dependence symptoms such as withdrawal, continuance, tolerance, lack of control, reductions, time, and intention. Although the EDS-R has demonstrated sound psychometric properties, it has only been validated in Western samples. Cross-cultural validations of the instrument may increase the knowledge of exercise dependence. Therefore, this study aimed to contribute to the file by investigating the validity and utility of the construct of the EDS-R, using a non-Western sample. 402 adult participants who were over 18 years of age and who reported exercising at least once a week were asked to complete the EDS-R. The results from factor analyses supported that the seven-factor model of exercise dependence symptoms showed an adequate fit for both men and women. The EDS-R scores differentiated between samples, with varying amounts of exercise; 15.4% of the sample was classified as being at risk for exercise dependence. In sum, the results indicated that the EDS-R is a psychometrically reliable assessment tool for exercise dependence symptoms in Korea.

Cooperativity in Molecular Dynamics Structural Models and the Dielectric Spectra of 1,2-Ethanediol

NASA Astrophysics Data System (ADS)

Usacheva, T. M.

2018-05-01

Linear relationships are established between the experimental equilibrium correlation factor and the molecular dynamics (MD) mean value of the O-H···O bond angle and the longitudinal component of the unit vector of the mean statistical dipole moment of the cluster in liquid 1,2-ethanediol (12ED). The achievements of modern MD models in describing the experimental dispersion of the permittivity of 12ED by both continuous and discrete relaxation time spectra are analyzed. The advantage computer MD experiments have over dielectric spectroscopy for calculating relaxation time and determining the molecular diffusion mechanisms of the rearrangement of the network 12ED structure, which is more complex than water, is demonstrated.

Decision-Making in Agent-Based Models of Migration: State of the Art and Challenges.

PubMed

Klabunde, Anna; Willekens, Frans

We review agent-based models (ABM) of human migration with respect to their decision-making rules. The most prominent behavioural theories used as decision rules are the random utility theory, as implemented in the discrete choice model, and the theory of planned behaviour. We identify the critical choices that must be made in developing an ABM, namely the modelling of decision processes and social networks. We also discuss two challenges that hamper the widespread use of ABM in the study of migration and, more broadly, demography and the social sciences: (a) the choice and the operationalisation of a behavioural theory (decision-making and social interaction) and (b) the selection of empirical evidence to validate the model. We offer advice on how these challenges might be overcome.

Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder.

PubMed

Stiekema, Annemarie P M; Islam, Md Atiqul; Liemburg, Edith J; Castelein, Stynke; van den Heuvel, Edwin R; van Weeghel, Jaap; Aleman, André; Bruggeman, Richard; van der Meer, Lisette

2018-03-01

The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes. Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses. SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (±60%), increased (±15%) and decreased course (±15%). Within SA only, a higher level decreased course (±6%) and within ED only, a course with relatively stable high ED scores (±6%) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups. In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60%) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels. Copyright © 2017 Elsevier B.V. All rights reserved.

Impact of Standardizing Management of Atrial Fibrillation with Rapid Heart Rate in the Emergency Department

PubMed Central

de Leon, Ernesto; Duan, Lewei; Rippenberger, Ellen; Sharp, Adam L

2018-01-01

Context There is substantial variation in the emergency treatment of atrial fibrillation with tachycardia. A standardized treatment approach at an academic center decreased admissions without adverse outcomes, but this approach has not been evaluated in a community Emergency Department (ED). Objective To evaluate the implementation of a standardized treatment guideline for patients with atrial fibrillation and a rapid heart rate in a community ED. Design An observational pre-/postimplementation (August 2013 to July 2014 and August 2014 to July 2015, respectively) study at a community ED. The standardized treatment guideline encouraged early oral treatment with rate control medication, outpatient echocardiogram, and early follow-up. A multiple logistic regression model adjusting for patient characteristics was generated to investigate the association between the intervention and ED discharge rate. Main Outcome Measures The primary measure was ED discharge. Secondary measures included stroke or death, ED return visit, hospital readmission, length of stay, and use of oral rate control medications. Results A total of 199 (104 pre/95 post) ED encounters were evaluated. The ED discharge rate increased 14% after intervention (57.7% to 71.6%, p = 0.04), and use of rate control medications increased by 19.4% (p < 0.01). Adjusted multivariate results showed a nearly 2-fold likelihood of ED discharge after guideline implementation (odds ratio = 1.97, 95%confidence interval = 1.07–3.63). Length of stay, return visits, and hospital readmissionswere similar. Conclusion A standardized approach to ED patients with atrial fibrillation and tachycardia is associated with a decrease in hospital admissions without adversely affecting patient safety. PMID:29401054

Older veterans and emergency department discharge information.

PubMed

Hastings, Susan; Stechuchak, Karen; Oddone, Eugene; Weinberger, Morris; Tucker, Dana; Knaack, William; Schmader, Kenneth

2012-10-01

Study goals were to assess older veterans' understanding of their emergency department (ED) discharge information and to determine the association between understanding discharge information and patient assessment of overall quality of care. Telephone interviews were conducted with 305 patients aged 65 or older (or their proxies) within 48 h of discharge from a Veterans Affairs Medical Center ED. Patients were asked about their perceived understanding (at the time of ED discharge) of information about their ED diagnosis, expected course of illness, contingency plan (ie, return precautions, who to call if it got worse, potential medication side effects) and follow-up care. Overall quality of ED care was rated on a four-point scale of poor, fair, good or excellent. Patients or their proxies reported not understanding information about their ED diagnosis (21%), expected course of illness (50%), contingency plan (43%), and how soon they needed to follow-up with their primary care provider (25%). In models adjusted for age and race, a positive association was observed between perceived understanding of the cause of the problem (OR 2.3; 95% CI 1.3 to 4.0), expected duration of symptoms (OR 1.6; 95% CI 1.0 to 2.5) and the contingency plan (OR 2.2; CI 1.3 to 3.4), and rating overall ED care as excellent. Older veterans may not understand key items of information at the time ED discharge, and this may have an impact on how they view the quality of ED care. Strategies are needed to improve communication of ED discharge information to older veterans and their families.

Emergency department knowledge management in the age of Web 2.0: evaluation of a new concept.

PubMed

Dinh, Michael; Tan, Timothy; Bein, Kendall; Hayman, Jon; Wong, Yuk Kuen; Dinh, David

2011-02-01

The objective of the present study was to describe the implementation of an organizational learning model and evaluate the effectiveness and usability of an application used to facilitate it in an ED setting. This was an implementation case study and technology evaluation. The organizational learning model was implemented using an online Web 2.0 collaborative learning application developed by the investigating team. Online use was tracked over a 9-month period. At the end of the study period, a usability assessment was conducted as well as a semistructured interview of participants to assess perceptions of usefulness and effect on learning capacity in the ED. Over a period of 9 months, a total of 54 individual sites from 74 eligible staff members were created within a specific web domain. There were 251 registered users including users outside the ED, who accessed learning materials within these sites 7494 times. The majority of staff members interviewed agreed or strongly agreed that the collaborative learning application had improved learning capacity within this ED (88%, 95% CI 74-94%). We demonstrate the implementation of an organizational learning model based on independent online sites networking together within an organization. This appears to be both usable and acceptable to staff members working in a large ED as a means of knowledge management. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Spatial and temporal dynamics of fucoid populations (Ascophyllum nodosum and Fucus serratus): a comparison between central and range edge populations.

PubMed

Araújo, Rita M; Serrão, Ester A; Sousa-Pinto, Isabel; Åberg, Per

2014-01-01

Persistence of populations at range edges relies on local population dynamics and fitness, in the case of geographically isolated populations of species with low dispersal potential. Focusing on spatial variations in demography helps to predict the long-term capability for persistence of populations across the geographical range of species' distribution. The demography of two ecological and phylogenetically close macroalgal species with different life history characteristics was investigated by using stochastic, stage-based matrix models. Populations of Ascophyllum nodosum and Fucus serratus were sampled for up to 4 years at central locations in France and at their southern range limits in Portugal. The stochastic population growth rate (λ(s)) of A. nodosum was lower and more variable in central than in southern sites whilst for F. serratus this trend was reversed with λ(s) much lower and more variable in southern than in central populations. Individuals were larger in central than in southern populations for both species, which was reflected in the lower transition probabilities of individuals to larger size classes and higher probability of shrinkage in the southern populations. In both central and southern populations elasticity analysis (proportional sensitivity) of population growth rate showed that fertility elements had a small contribution to λ(s) that was more sensitive to changes in matrix transitions corresponding to survival. The highest elasticities were found for loop transitions in A. nodosum and for growth to larger size classes in F. serratus. Sensitivity analysis showed high selective pressure on individual growth for both species at both locations. The results of this study highlight the deterministic role of species-specific life-history traits in population demography across the geographical range of species. Additionally, this study demonstrates that individuals' life-transitions differ in vulnerability to environmental variability and shows the importance of vegetative compared to reproductive stages for the long-term persistence of populations.

Alternative glacial-interglacial refugia demographic hypotheses tested on Cephalocereus columna-trajani (Cactaceae) in the intertropical Mexican drylands

PubMed Central

Cornejo-Romero, Amelia; Aguilar-Martínez, Gustavo F.; Medina-Sánchez, Javier; Rendón-Aguilar, Beatriz; Valverde, Pedro Luis; Zavala-Hurtado, Jose Alejandro; Serrato, Alejandra; Rivas-Arancibia, Sombra; Pérez-Hernández, Marco Aurelio; López-Ortega, Gerardo; Jiménez-Sierra, Cecilia

2017-01-01

Historic demography changes of plant species adapted to New World arid environments could be consistent with either the Glacial Refugium Hypothesis (GRH), which posits that populations contracted to refuges during the cold-dry glacial and expanded in warm-humid interglacial periods, or with the Interglacial Refugium Hypothesis (IRH), which suggests that populations contracted during interglacials and expanded in glacial times. These contrasting hypotheses are developed in the present study for the giant columnar cactus Cephalocereus columna-trajani in the intertropical Mexican drylands where the effects of Late Quaternary climatic changes on phylogeography of cacti remain largely unknown. In order to determine if the historic demography and phylogeographic structure of the species are consistent with either hypothesis, sequences of the chloroplast regions psbA-trnH and trnT-trnL from 110 individuals from 10 populations comprising the full distribution range of this species were analysed. Standard estimators of genetic diversity and structure were calculated. The historic demography was analysed using a Bayesian approach and the palaeodistribution was derived from ecological niche modelling to determine if, in the arid environments of south-central Mexico, glacial-interglacial cycles drove the genetic divergence and diversification of this species. Results reveal low but statistically significant population differentiation (FST = 0.124, P < 0.001), although very clear geographic clusters are not formed. Genetic diversity, haplotype network and Approximate Bayesian Computation (ABC) demographic analyses suggest a population expansion estimated to have taken place in the Last Interglacial (123.04 kya, 95% CI 115.3–130.03). The species palaeodistribution is consistent with the ABC analyses and indicates that the potential area of palaedistribution and climatic suitability were larger during the Last Interglacial and Holocene than in the Last Glacial Maximum. Overall, these results suggest that C. columna-trajani experienced an expansion following the warm conditions of interglacials, in accordance with the GRH. PMID:28426818

Alternative glacial-interglacial refugia demographic hypotheses tested on Cephalocereus columna-trajani (Cactaceae) in the intertropical Mexican drylands.

PubMed

Cornejo-Romero, Amelia; Vargas-Mendoza, Carlos Fabián; Aguilar-Martínez, Gustavo F; Medina-Sánchez, Javier; Rendón-Aguilar, Beatriz; Valverde, Pedro Luis; Zavala-Hurtado, Jose Alejandro; Serrato, Alejandra; Rivas-Arancibia, Sombra; Pérez-Hernández, Marco Aurelio; López-Ortega, Gerardo; Jiménez-Sierra, Cecilia

2017-01-01

Historic demography changes of plant species adapted to New World arid environments could be consistent with either the Glacial Refugium Hypothesis (GRH), which posits that populations contracted to refuges during the cold-dry glacial and expanded in warm-humid interglacial periods, or with the Interglacial Refugium Hypothesis (IRH), which suggests that populations contracted during interglacials and expanded in glacial times. These contrasting hypotheses are developed in the present study for the giant columnar cactus Cephalocereus columna-trajani in the intertropical Mexican drylands where the effects of Late Quaternary climatic changes on phylogeography of cacti remain largely unknown. In order to determine if the historic demography and phylogeographic structure of the species are consistent with either hypothesis, sequences of the chloroplast regions psbA-trnH and trnT-trnL from 110 individuals from 10 populations comprising the full distribution range of this species were analysed. Standard estimators of genetic diversity and structure were calculated. The historic demography was analysed using a Bayesian approach and the palaeodistribution was derived from ecological niche modelling to determine if, in the arid environments of south-central Mexico, glacial-interglacial cycles drove the genetic divergence and diversification of this species. Results reveal low but statistically significant population differentiation (FST = 0.124, P < 0.001), although very clear geographic clusters are not formed. Genetic diversity, haplotype network and Approximate Bayesian Computation (ABC) demographic analyses suggest a population expansion estimated to have taken place in the Last Interglacial (123.04 kya, 95% CI 115.3-130.03). The species palaeodistribution is consistent with the ABC analyses and indicates that the potential area of palaedistribution and climatic suitability were larger during the Last Interglacial and Holocene than in the Last Glacial Maximum. Overall, these results suggest that C. columna-trajani experienced an expansion following the warm conditions of interglacials, in accordance with the GRH.

Influence of appearance-related TV commercials on body image state.

PubMed

Legenbauer, Tanja; Rühl, Ilka; Vocks, Silja

2008-05-01

This study investigates the influence of media exposure on body image state in eating-disordered (ED) patients. The attitudinal and perceptual components of body image are assessed, as well as any associations with dysfunctional cognitions and behavioral consequences. Twenty-five ED patients and 25 non-ED controls (ND) viewed commercials either featuring appearance (AC; 5 min) or not featuring appearance (NC; 5 min). Both perceptual and attitudinal body image components changed markedly after the AC condition for ED patients, compared with the ND group and NC condition. Cognitions referring to dietary restraint and internalization/social comparison also changed significantly in ED patients depending on the experimental manipulation, whereas thoughts about body and self-esteem did not. The results suggest that media exposure acts as a stimulus that triggers body-related schemas. Partial support is given to cognitive-behavioral models of eating disorders, which postulate an association between cognitive bias, body image disturbances, and compensatory behavioral consequences.

Ways to reduce patient turnaround time and improve service quality in emergency departments.

PubMed

Sinreich, David; Marmor, Yariv

2005-01-01

Recent years have witnessed a fundamental change in the function of emergency departments (EDs). The emphasis of the ED shifts from triage to saving the lives of shock-trauma rooms equipped with state-of-the-art equipment. At the same time walk-in clinics are being set up to treat ambulatory type patients. Simultaneously ED overcrowding has become a common sight in many large urban hospitals. This paper recognises that in order to provide quality treatment to all these patient types, ED process operations have to be flexible and efficient. The paper aims to examine one major benchmark for measuring service quality--patient turnaround time, claiming that in order to provide the quality treatment to which EDs aspire, this time needs to be reduced. This study starts by separating the process each patient type goes through when treated at the ED into unique components. Next, using a simple model, the impact each of these components has on the total patient turnaround time is determined. This in turn, identifies the components that need to be addressed if patient turnaround time is to be streamlined. The model was tested using data that were gathered through a comprehensive time study in six major hospitals. The analysis reveals that waiting time comprises 51-63 per cent of total patient turnaround time in the ED. Its major components are: time away for an x-ray examination; waiting time for the first physician's examination; and waiting time for blood work. The study covers several hospitals and analyses over 20,000 process components; as such the common findings may serve as guidelines to other hospitals when addressing this issue.

Association between ozone and asthma emergency department visits in Saint John, New Brunswick, Canada.

PubMed Central

Stieb, D M; Burnett, R T; Beveridge, R C; Brook, J R

1996-01-01

This study examines the relationship of asthma emergency department (ED) visits to daily concentrations of ozone and other air pollutants in Saint John, New Brunswick, Canada. Data on ED visits with a presenting complaint of asthma (n = 1987) were abstracted for the period 1984-1992 (May-September). Air pollution variables included ozone, sulfur dioxide, nitrogen dioxide, sulfate, and total suspended particulate (TSP); weather variables included temperature, humidex, dewpoint, and relative humidity. Daily ED visit frequencies were filtered to remove day of the week and long wave trends, and filtered values were regressed on air pollution and weather variables for the same day and the 3 previous days. The mean daily 1-hr maximum ozone concentration during the study period was 41.6 ppb. A positive, statistically significant (p < 0.05) association was observed between ozone and asthma ED visits 2 days later, and the strength of the association was greater in nonlinear models. The frequency of asthma ED visits was 33% higher (95% CI, 10-56%) when the daily 1-hr maximum ozone concentration exceeded 75 ppb (the 95th percentile). The ozone effect was not significantly influenced by the addition of weather or other pollutant variables into the model or by the exclusion of repeat ED visits. However, given the limited number of sampling days for sulfate and TSP, a particulate effect could not be ruled out. We detected a significant association between ozone and asthma ED visits, despite the vast majority of sampling days being below current U.S. and Canadian standards. Images Figure 1. A Figure 1. B Figure 2. Figure 3. PMID:9118879

Decreasing troponin turnaround time in the emergency department using the central laboratory: A process improvement study.

PubMed

Boelstler, Arlene M; Rowland, Ralph; Theoret, Jennifer; Takla, Robert B; Szpunar, Susan; Patel, Shraddha P; Lowry, Andrew M; Pena, Margarita E

2015-03-01

To implement collaborative process improvement measures to reduce emergency department (ED) troponin turnaround time (TAT) to less than 60min using central laboratory. This was an observational, retrospective data study. A multidisciplinary team from the ED and laboratory identified opportunities and developed a new workflow model. Process changes were implemented in ED patient triage, staffing, lab collection and processing. Data collected included TAT of door-to-order, order-to-collect, collect-to-received, received-to-result, door-to-result, ED length of stay, and hemolysis rate before (January-August, 2011) and after (September 2011-June 2013) process improvement. After process improvement and implementation of the new workflow model, decreased median TAT (in min) was seen in door-to-order (54 [IQR43] vs. 11 [IQR20]), order-to-collect (15 [IQR 23] vs. 10 [IQR12]), collect-to-received (6 [IQR8] vs. 5 [IQR5]), received-to-result (30 [IQR12] vs. 24 [IQR11]), and overall door-to-result (117 [IQR60] vs. 60 [IQR40]). A troponin TAT of <60min was realized beginning in May 2012 (59 [IQR39]). Hemolysis rates decreased (14.63±0.74 vs. 3.36±1.99, p<0.0001), as did ED length of stay (5.87±2.73h vs. 5.15±2.34h, p<0.0001). Conclusion Troponin TAT of <60min using a central laboratory was achieved with collaboration between the ED and the laboratory; additional findings include a decreased ED length of stay. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

What do we need to measure, how much, and where? A quantitative assessment of terrestrial data needs across North American biomes through data-model fusion and sampling optimization

NASA Astrophysics Data System (ADS)

Dietze, M. C.; Davidson, C. D.; Desai, A. R.; Feng, X.; Kelly, R.; Kooper, R.; LeBauer, D. S.; Mantooth, J.; McHenry, K.; Serbin, S. P.; Wang, D.

2012-12-01

Ecosystem models are designed to synthesize our current understanding of how ecosystems function and to predict responses to novel conditions, such as climate change. Reducing uncertainties in such models can thus improve both basic scientific understanding and our predictive capacity, but rarely have the models themselves been employed in the design of field campaigns. In the first part of this paper we provide a synthesis of uncertainty analyses conducted using the Predictive Ecosystem Analyzer (PEcAn) ecoinformatics workflow on the Ecosystem Demography model v2 (ED2). This work spans a number of projects synthesizing trait databases and using Bayesian data assimilation techniques to incorporate field data across temperate forests, grasslands, agriculture, short rotation forestry, boreal forests, and tundra. We report on a number of data needs that span a wide array diverse biomes, such as the need for better constraint on growth respiration. We also identify other data needs that are biome specific, such as reproductive allocation in tundra, leaf dark respiration in forestry and early-successional trees, and root allocation and turnover in mid- and late-successional trees. Future data collection needs to balance the unequal distribution of past measurements across biomes (temperate biased) and processes (aboveground biased) with the sensitivities of different processes. In the second part we present the development of a power analysis and sampling optimization module for the the PEcAn system. This module uses the results of variance decomposition analyses to estimate the further reduction in model predictive uncertainty for different sample sizes of different variables. By assigning a cost to each measurement type, we apply basic economic theory to optimize the reduction in model uncertainty for any total expenditure, or to determine the cost required to reduce uncertainty to a given threshold. Using this system we find that sampling switches among multiple measurement types but favors those with no prior measurements due to the need integrate over prior uncertainty in within and among site variability. When starting from scratch in a new system, the optimal design favors initial measurements of SLA due to high sensitivity and low cost. The value of many data types, such as photosynthetic response curves, depends strongly on whether one includes initial equipment costs or just per-sample costs. Similarly, sampling at previously measured locations is favored when infrastructure costs are high, otherwise across-site sampling is favored over intensive sampling except when within-site variability strongly dominates.

Effect of ambient temperature on emergency department visits in Shanghai, China: a time series study.

PubMed

Zhang, Yue; Yan, Chenyang; Kan, Haidong; Cao, Junshan; Peng, Li; Xu, Jianming; Wang, Weibing

2014-11-25

Many studies have examined the association between ambient temperature and mortality. However, less evidence is available on the temperature effects on gender- and age-specific emergency department visits, especially in developing countries. In this study, we examined the short-term effects of daily ambient temperature on emergency department visits (ED visits) in Shanghai. Daily ED visits and daily ambient temperatures between January 2006 and December 2011 were analyzed. After controlling for secular and seasonal trends, weather, air pollution and other confounding factors, a Poisson generalized additive model (GAM) was used to examine the associations between ambient temperature and gender- and age-specific ED visits. A moving average lag model was used to evaluate the lag effects of temperature on ED visits. Low temperature was associated with an overall 2.76% (95% confidence interval (CI): 1.73 to 3.80) increase in ED visits per 1°C decrease in temperature at Lag1 day, 2.03% (95% CI: 1.04 to 3.03) and 2.45% (95% CI: 1.40 to 3.52) for males and females. High temperature resulted in an overall 1.78% (95% CI: 1.05 to 2.51) increase in ED visits per 1°C increase in temperature on the same day, 1.81% (95% CI: 1.08 to 2.54) among males and 1.75% (95% CI: 1.03 to 2.49) among females. The cold effect appeared to be more acute among younger people aged <45 years, whereas the effects were consistent on individuals aged ≥65 years. In contrast, the effects of high temperature were relatively consistent over all age groups. These findings suggest a significant association between ambient temperature and ED visits in Shanghai. Both cold and hot temperatures increased the relative risk of ED visits. This knowledge has the potential to advance prevention efforts targeting weather-sensitive conditions.

[Synergistic analgesic effect of choline and parecoxib sodium in mice and the mechanism].

PubMed

Zhang, Na; Feng, Ze-Guo; Wang, Ru-Huan; Zhang, Wei-Dong; Yu, Jun; DU, Chun-Yan; Wang, Hai

2016-11-20

To investigate the synergistic analgesic effect of choline and parecoxib sodium and study its mechanism. In male Kunming mice with acetic acid-induced writhing, the ED 50 of choline and parecoxib sodium (administered via the tail vein at 2 h and 30 min before modeling, respectively) and their combined use were determined. In saline (control) group, ED 50 choline (C) group, ED 50 parecoxib sodium (P) group, and 1/2ED 50 choline and parecoxib sodium (1/2[C+P]) group, blood samples were collected from the eyeball 10 min after intraperitoneal administration of acetic acid to detect the levels of IL-1, TNF-α, PGE2, NF-κB, and I-κB levels using ELISA kits. In the acetic acid-induced writhing model, the ED 50 of choline and parecoxib sodium was 8.64 and 6.33 mg/kg, and when combined, their ED50 was 2.13 and 1.56 mg/kg, respectively. The isobolograms of parecoxib sodium and choline showed that the measured ED 50 of the two drugs combined was below the theoretical ED 50 value (P<0.05) with a combination index (CI) of <0.9. Compared with the control group, C group, P group, and 1/2 (C+P) group all showed significantly lowered IL-1 and TNF-α levels (P<0.05), especially in 1/2 (C+P) group (P<0.05). PGE2 level was significantly lower in P group and 1/2 (C+P) group compared with the control group (P<0.05). NF-κB and I-κB levels were significantly lowered in C, P, and 1/2 (C+P) groups (P<0.05), and the reduction was the most obvious in 1/2 (C+P) group (P<0.05). Choline and parecoxib sodium has a synergistic analgesic effect, and their interactions may involve the in vivo expression of NF-κB.

Modified Regge calculus as an explanation of dark energy

NASA Astrophysics Data System (ADS)

Stuckey, W. M.; McDevitt, T. J.; Silberstein, M.

2012-03-01

Using the Regge calculus, we construct a Regge differential equation for the time evolution of the scale factor a(t) in the Einstein-de Sitter cosmology model (EdS). We propose two modifications to the Regge calculus approach: (1) we allow the graphical links on spatial hypersurfaces to be large, as in direct particle interaction when the interacting particles reside in different galaxies, and (2) we assume that luminosity distance DL is related to graphical proper distance Dp by the equation D_L = (1+z)\\sqrt{\\overrightarrow{D_p}\\cdot \\overrightarrow{D_p}}, where the inner product can differ from its usual trivial form. The modified Regge calculus model (MORC), EdS and ΛCDM are compared using the data from the Union2 Compilation, i.e. distance moduli and redshifts for type Ia supernovae. We find that a best fit line through log {\\big(\\frac{D_L}{{Gpc}}\\big)} versus log z gives a correlation of 0.9955 and a sum of squares error (SSE) of 1.95. By comparison, the best fit ΛCDM gives SSE = 1.79 using Ho = 69.2 km s-1 Mpc, ΩM = 0.29 and ΩΛ = 0.71. The best fit EdS gives SSE = 2.68 using Ho = 60.9 km s-1 Mpc. The best-fit MORC gives SSE = 1.77 and Ho = 73.9 km s-1 Mpc using R = A-1 = 8.38 Gcy and m = 1.71 × 1052 kg, where R is the current graphical proper distance between nodes, A-1 is the scaling factor from our non-trivial inner product, and m is the nodal mass. Thus, the MORC improves the EdS as well as ΛCDM in accounting for distance moduli and redshifts for type Ia supernovae without having to invoke accelerated expansion, i.e. there is no dark energy and the universe is always decelerating.

Using the Hendrich II Inpatient Fall Risk Screen to Predict Outpatient Falls After Emergency Department Visits.

PubMed

Patterson, Brian W; Repplinger, Michael D; Pulia, Michael S; Batt, Robert J; Svenson, James E; Trinh, Alex; Mendonça, Eneida A; Smith, Maureen A; Hamedani, Azita G; Shah, Manish N

2018-04-01

To evaluate the utility of routinely collected Hendrich II fall scores in predicting returns to the emergency department (ED) for falls within 6 months. Retrospective electronic record review. Academic medical center ED. Individuals aged 65 and older seen in the ED from January 1, 2013, through September 30, 2015. We evaluated the utility of routinely collected Hendrich II fall risk scores in predicting ED visits for a fall within 6 months of an all-cause index ED visit. For in-network patient visits resulting in discharge with a completed Hendrich II score (N = 4,366), the return rate for a fall within 6 months was 8.3%. When applying the score alone to predict revisit for falls among the study population the resultant receiver operating characteristic (ROC) plot had an area under the curve (AUC) of 0.64. In a univariate model, the odds of returning to the ED for a fall in 6 months were 1.23 times as high for every 1-point increase in Hendrich II score (odds ratio (OR)=1.23 (95% confidence interval (CI)=1.19-1.28). When included in a model with other potential confounders or predictors of falls, the Hendrich II score is a significant predictor of a return ED visit for fall (adjusted OR=1.15, 95% CI=1.10-1.20, AUC=0.75). Routinely collected Hendrich II scores were correlated with outpatient falls, but it is likely that they would have little utility as a stand-alone fall risk screen. When combined with easily extractable covariates, the screen performs much better. These results highlight the potential for secondary use of electronic health record data for risk stratification of individuals in the ED. Using data already routinely collected, individuals at high risk of falls after discharge could be identified for referral without requiring additional screening resources. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Cyber Selection Test Research Effort for U.S. Army New Accessions

DTIC Science & Technology

2017-10-12

assessment game 3. Develop an operational version of the STA game which incorporates assessments from phase 1 and (through game -play) examines...3 more STA abilities •5 STA behaviors 4. Validate the system thinking assessment game in an operational setting C O M PL ET ED PL AN N ED Research...Information Identifies Elements of Systems Models Relationships Understands System Dynamics Evaluates & Revises Model Applies Understanding to Problem STA Game

Endemic chronic wasting disease causes mule deer population decline in Wyoming.

PubMed

DeVivo, Melia T; Edmunds, David R; Kauffman, Matthew J; Schumaker, Brant A; Binfet, Justin; Kreeger, Terry J; Richards, Bryan J; Schätzl, Hermann M; Cornish, Todd E

2017-01-01

Chronic wasting disease (CWD) is a fatal transmissible spongiform encephalopathy affecting white-tailed deer (Odocoileus virginianus), mule deer (Odocoileus hemionus), Rocky Mountain elk (Cervus elaphus nelsoni), and moose (Alces alces shirasi) in North America. In southeastern Wyoming average annual CWD prevalence in mule deer exceeds 20% and appears to contribute to regional population declines. We determined the effect of CWD on mule deer demography using age-specific, female-only, CWD transition matrix models to estimate the population growth rate (λ). Mule deer were captured from 2010-2014 in southern Converse County Wyoming, USA. Captured adult (≥ 1.5 years old) deer were tested ante-mortem for CWD using tonsil biopsies and monitored using radio telemetry. Mean annual survival rates of CWD-negative and CWD-positive deer were 0.76 and 0.32, respectively. Pregnancy and fawn recruitment were not observed to be influenced by CWD. We estimated λ = 0.79, indicating an annual population decline of 21% under current CWD prevalence levels. A model derived from the demography of only CWD-negative individuals yielded; λ = 1.00, indicating a stable population if CWD were absent. These findings support CWD as a significant contributor to mule deer population decline. Chronic wasting disease is difficult or impossible to eradicate with current tools, given significant environmental contamination, and at present our best recommendation for control of this disease is to minimize spread to new areas and naïve cervid populations.

Endemic chronic wasting disease causes mule deer population decline in Wyoming

PubMed Central

DeVivo, Melia T.; Edmunds, David R.; Kauffman, Matthew J.; Schumaker, Brant A.; Binfet, Justin; Kreeger, Terry J.; Richards, Bryan J.; Schätzl, Hermann M.; Cornish, Todd E.

2017-01-01

Chronic wasting disease (CWD) is a fatal transmissible spongiform encephalopathy affecting white-tailed deer (Odocoileus virginianus), mule deer (Odocoileus hemionus), Rocky Mountain elk (Cervus elaphus nelsoni), and moose (Alces alces shirasi) in North America. In southeastern Wyoming average annual CWD prevalence in mule deer exceeds 20% and appears to contribute to regional population declines. We determined the effect of CWD on mule deer demography using age-specific, female-only, CWD transition matrix models to estimate the population growth rate (λ). Mule deer were captured from 2010–2014 in southern Converse County Wyoming, USA. Captured adult (≥ 1.5 years old) deer were tested ante-mortem for CWD using tonsil biopsies and monitored using radio telemetry. Mean annual survival rates of CWD-negative and CWD-positive deer were 0.76 and 0.32, respectively. Pregnancy and fawn recruitment were not observed to be influenced by CWD. We estimated λ = 0.79, indicating an annual population decline of 21% under current CWD prevalence levels. A model derived from the demography of only CWD-negative individuals yielded; λ = 1.00, indicating a stable population if CWD were absent. These findings support CWD as a significant contributor to mule deer population decline. Chronic wasting disease is difficult or impossible to eradicate with current tools, given significant environmental contamination, and at present our best recommendation for control of this disease is to minimize spread to new areas and naïve cervid populations. PMID:29049389

Endemic chronic wasting disease causes mule deer population decline in Wyoming

USGS Publications Warehouse

DeVivo, Melia T.; Edmunds, David R.; Kauffman, Matthew J.; Schumaker, Brant A.; Binfet, Justin; Kreeger, Terry J.; Richards, Bryan J.; Schatzl, Hermann M.; Cornish, Todd

2017-01-01

Chronic wasting disease (CWD) is a fatal transmissible spongiform encephalopathy affecting white-tailed deer (Odocoileus virginianus), mule deer (Odocoileus hemionus), Rocky Mountain elk (Cervus elaphus nelsoni), and moose (Alces alces shirasi) in North America. In southeastern Wyoming average annual CWD prevalence in mule deer exceeds 20% and appears to contribute to regional population declines. We determined the effect of CWD on mule deer demography using age-specific, female-only, CWD transition matrix models to estimate the population growth rate (λ). Mule deer were captured from 2010–2014 in southern Converse County Wyoming, USA. Captured adult (≥ 1.5 years old) deer were tested ante-mortem for CWD using tonsil biopsies and monitored using radio telemetry. Mean annual survival rates of CWD-negative and CWD-positive deer were 0.76 and 0.32, respectively. Pregnancy and fawn recruitment were not observed to be influenced by CWD. We estimated λ= 0.79, indicating an annual population decline of 21% under current CWD prevalence levels. A model derived from the demography of only CWD-negative individuals yielded; λ = 1.00, indicating a stable population if CWD were absent. These findings support CWD as a significant contributor to mule deer population decline. Chronic wasting disease is difficult or impossible to eradicate with current tools, given significant environmental contamination, and at present our best recommendation for control of this disease is to minimize spread to new areas and naïve cervid populations.

Predictors of orthorexic behaviours in patients with eating disorders: a preliminary study.

PubMed

Brytek-Matera, Anna; Rogoza, Radosław; Gramaglia, Carla; Zeppegno, Patrizia

2015-10-15

The construct of orthorexia in eating disorders (EDs) has received very little attention despite clinical observations of a possible overlap between the two. The aim of this study was: 1) to assess orthorexic behaviours, eating disorder pathology and attitudinal body image in ED patients; 2) to identify possible predictors of orthorexia nervosa among ED patients. Fifty-two women diagnosed with EDs were recruited. Patients' assessment included the following: the ORTO-15 test (Polish version) for orthorexic behaviours; the Eating Attitude Test-26 (EAT-26) to identify ED symptoms; the Multidimensional Body-Self Relations Questionnaire (Polish version) to assess body image. A latent class analysis was performed and differences between identified classes were assessed. The main differences concerned weight, ED pathology and orthorexic behaviours within the same group of ED patients. In order to examine predictors of orthorexia nervosa, we investigated a structural equation model, which excellently fitted to the data (χ(2)(17) = 23.05; p = .148; CFI = .962; RMSEA = .08; p = .25; SRMR = .05). In ED patients, orthorexic behaviour was negatively predicted by eating pathology, weight concern, health orientation and appearance orientation. The assessment of the orthorexia construct in EDs may add to the paucity of studies about this issue and may help to clarify the relationship between the two. Differences and similarities seem to exist between these disorders, and may benefit from specific treatment approaches. Moreover, these preliminary findings open tracks for future research in the field of the psychology of eating.

Impact of Federal Tax Policy on Utility-Scale Solar Deployment Given Financing Interactions

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

Mai, Trieu; Cole, Wesley; Krishnan, Venkat

In this study, the authors conducted a literature review of approaches and assumptions used by other modeling teams and consultants with respect to solar project financing; developed and incorporated an ability to model the likely financing shift away from more expensive sources of capital and toward cheaper sources as the investment tax credit declines in the ReEDS model; and used the 'before and after' versions of the ReEDS model to isolate and analyze the deployment impact of the financing shift under a range of conditions. Using ReEDS scenarios with this improved capability, we find that this 'financing' shift would softenmore » the blow of the ITC reversion; however, the overall impacts of such a shift in capital structure are estimated to be small and near-term utility-scale PV deployment is found to be much more sensitive to other factors that might drive down utility-scale PV prices.« less

Review article: Emergency department models of care in the context of care quality and cost: a systematic review.

PubMed

Wylie, Kate; Crilly, Julia; Toloo, Ghasem Sam; FitzGerald, Gerry; Burke, John; Williams, Ged; Bell, Anthony

2015-04-01

To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost-effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost-effectiveness. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Acetaminophen and non-steroidal anti-inflammatory drugs interact with morphine and tramadol analgesia for the treatment of neuropathic pain in rats.

PubMed

Shinozaki, Tomonari; Yamada, Toshihiko; Nonaka, Takahiro; Yamamoto, Tatsuo

2015-06-01

Although non-steroidal anti-inflammatory drugs and acetaminophen have no proven efficacy against neuropathic pain, they are frequently prescribed for neuropathic pain patients. We examined whether the combination of opioids (tramadol and morphine) with indomethacin or acetaminophen produce favorable effects on neuropathic pain and compared the efficacy for neuropathic pain with that for inflammatory pain. The carrageenan model was used as the inflammatory pain model while the tibial neuroma transposition (TNT) model was used as the neuropathic pain model. The tibial nerve is transected in the TNT model, with the tibial nerve stump then transpositioned to the lateral aspect of the hindlimb. Neuropathic pain (mechanical allodynia and neuroma pain) is observed after TNT injury. Drugs were administered orally. In the carrageenan model, all drugs produced anti-allodynic effects and all drug combinations, but not tramadol + indomethacin combination, produced synergistic anti-allodynic effects. In the TNT model, tramadol and morphine, but not acetaminophen and indomethacin, produced anti-neuropathic pain effects. In the combination, with the exception of morphine + acetaminophen combination, both acetaminophen and indomethacin reduced the 50% effective dose (ED50) of tramadol and morphine as compared with the ED50s for the single drug study in the TNT model. The ED50s of tramadol and morphine in the carrageenan combination test were not statistically significantly different from the ED50s in the TNT model combination study. The combination of opioids with indomethacin or acetaminophen produced a synergistic analgesic effect both in inflammatory and neuropathic pain with some exceptions. The efficacy of these combinations for neuropathic pain was not different from that for inflammatory pain.

Moving Average Models with Bivariate Exponential and Geometric Distributions.

DTIC Science & Technology

1985-03-01

ordinary time series and of point processes. Developments in Statistics, Vol. 1, P.R. Krishnaiah , ed. Academic Press, New York. [9] Esary, J.D. and...valued and discrete - valued time series with ARMA correlation structure. Multivariate Analysis V, P.R. Krishnaiah , ed. North-Holland. 151-166. [28

Data Analysis and Modeling to Support NOWCAST and Forecast Activities at the Fallon Naval Air Station

DTIC Science & Technology

2008-09-30

Remagnino, A. Nefian, G. Meenakshisundaram, V. Pascucci, J. Zara , J. Molineros, H. Thiesel, and T. Malzbender, Eds., 2006: Advances in Visual...Nefian, G. Meenakshisundaram, V. Pascucci, J. Zara , J. Molineros, H. Thiesel, and T. Malzbender, Eds., 2006: Advances in Visual Computing. Lecture Notes

Modelling Conceptual Development: A computational Account of Conservation Learning

DTIC Science & Technology

1990-02-28

6 year-old age range are unable to obtain specific quantitative values for larger sets of objects e.g. (Gelman & Gallistel , 1978). 3. Children who...Piagetian concepts. In J.H. Flavell & E.M. Markman (Eds.), Handbook of Child Psychology(Fourth ed.). New York: Wiley. Gelman, R. & Gallistel , R.C. (1978

Discrimination and Romani health: a validation study of discrimination scales among Romani women in Macedonia and Serbia.

PubMed

Janevic, T; Gundersen, D; Stojanovski, K; Jankovic, J; Nikolic, Z; Kasapinov, B

2015-09-01

Scales used to assess discrimination in public health research have rarely been validated outside of high income countries. Our objective was to validate the Experiences of Discrimination (EOD) scale and the Everyday Discrimination Scale (EDS) among 410 Romani women in Macedonia and Serbia. Romani female interviewers conducted interviews in 2012-2013. We used a multiple indicator multiple cause approach to test a one-factor model for each scale and to assess differential item functioning (DIF) by age, wealth, country, and education. We also measured associations between the EOD and EDS with smoking in the past year and psychological distress. Three items of the EOD were conceptually irrelevant. Two items of the EDS were not conditionally independent. DIF was found by country for one item in each scale. After excluding these items, all scales exhibited good model fit and were associated with smoking (EOD beta = 0.40, 95% CI = 0.18, 0.63; EDS beta = 0.33, 95% CI = 0.12, 0.54) and psychological distress (EOD beta = 0.26, 95% CI = 0.15, 0.37; EDS beta = 0.26, 95% CI = 0.04, 0.47). Discrimination scales can be adapted for use among Romani women and are associated with both smoking and psychological distress.

Safety and efficacy of antihypertensive prescription at emergency department discharge.

PubMed

Brody, Aaron; Rahman, Tahsin; Reed, Brian; Millis, Scott; Ference, Brian; Flack, John M; Levy, Phillip D

2015-05-01

Poor blood pressure (BP) control is a primary risk factor for target organ damage in the heart, brain, and kidney. Uncontrolled hypertension is common among emergency department (ED) patients, particularly in underresourced settings, but it is unclear what role ED providers should play in the management of chronic antihypertensive therapy. The objective was to evaluate the safety and efficacy of prescribing antihypertensive therapy from the ED. This was a retrospective study of data pooled from two prospective, longitudinal, randomized controlled trials, both of which enrolled ED patients with asymptomatic hypertension. Antihypertensives were prescribed at emergency physician discretion, and this was not related to randomization arm. Demographic data, BP at screening and randomization visit, and data on adverse effects potentially related to antihypertensive therapy were compiled. Means were compared using Student's t-tests, and proportions were compared using chi-square tests. The effect of antihypertensive therapy on BP control was further analyzed using multivariable regression modeling controlling for age, race, sex, hypertension history, study cohort, and ED BP. Data were abstracted for 217 subjects. The median interval from ED visit to randomization was 12 days. Seventy-six subjects (35%) received one or more prescriptions for antihypertensive therapy. Age, sex, race, hypertension history, and mean duration of hypertension were equivalent between groups. Although mean ED BP was higher among those who received prescriptions, the mean systolic BP (sBP) reduction from ED to randomization was significantly greater (difference = 19 mm Hg, 95% confidence interval = 12 to 26 mm Hg). No patient in either group had an sBP less than 100 mm Hg at randomization. On multiple regression modeling, randomization sBP reduction was independently associated with antihypertensive prescription (p = 0.001). The incidence of adverse effects was equivalent and low in both groups. No new neurological deficits, ischemic events, or life-threatening anaphylactic reactions were reported in either group. Prescription of antihypertensive medication from the ED is associated with significantly lower sBP at short-term outpatient follow-up. Antihypertensive therapy was not associated with an increased incidence of adverse events, and BP reduction did not exceed potentially harmful levels. Initiation of chronic antihypertensive therapy in the ED is safe and effective and may be a reasonable consideration for at-risk populations. © 2015 by the Society for Academic Emergency Medicine.

Predictive score for mortality in patients with COPD exacerbations attending hospital emergency departments

PubMed Central

2014-01-01

Background Limited information is available about predictors of short-term outcomes in patients with exacerbation of chronic obstructive pulmonary disease (eCOPD) attending an emergency department (ED). Such information could help stratify these patients and guide medical decision-making. The aim of this study was to develop a clinical prediction rule for short-term mortality during hospital admission or within a week after the index ED visit. Methods This was a prospective cohort study of patients with eCOPD attending the EDs of 16 participating hospitals. Recruitment started in June 2008 and ended in September 2010. Information on possible predictor variables was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up. Main short-term outcomes were death during hospital admission or within 1 week of discharge to home from the ED, as well as at death within 1 month of the index ED visit. Multivariate logistic regression models were developed in a derivation sample and validated in a validation sample. The score was compared with other published prediction rules for patients with stable COPD. Results In total, 2,487 patients were included in the study. Predictors of death during hospital admission, or within 1 week of discharge to home from the ED were patient age, baseline dyspnea, previous need for long-term home oxygen therapy or non-invasive mechanical ventilation, altered mental status, and use of inspiratory accessory muscles or paradoxical breathing upon ED arrival (area under the curve (AUC) = 0.85). Addition of arterial blood gas parameters (oxygen and carbon dioxide partial pressures (PO2 and PCO2)) and pH) did not improve the model. The same variables were predictors of death at 1 month (AUC = 0.85). Compared with other commonly used tools for predicting the severity of COPD in stable patients, our rule was significantly better. Conclusions Five clinical predictors easily available in the ED, and also in the primary care setting, can be used to create a simple and easily obtained score that allows clinicians to stratify patients with eCOPD upon ED arrival and guide the medical decision-making process. PMID:24758312

Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction

PubMed Central

Leidy, Heather J.; Hill, Brenna R.; Lieberman, Jay L.; Legro, Richard S.; Souza, Mary Jane De

2014-01-01

We assessed the impact of energy deficiency on menstrual function using controlled feeding and supervised exercise over four menstrual cycles (1 baseline and 3 intervention cycles) in untrained, eumenorrheic women aged 18–30 yr. Subjects were randomized to either an exercising control (EXCON) or one of three exercising energy deficit (ED) groups, i.e., mild (ED1; −8 ± 2%), moderate (ED2; −22 ± 3%), or severe (ED3; −42 ± 3%). Menstrual cycle length and changes in urinary concentrations of estrone-1-glucuronide, pregnanediol glucuronide, and midcycle luteinizing hormone were assessed. Thirty-four subjects completed the study. Weight loss occurred in ED1 (−3.8 ± 0.2 kg), ED2 (−2.8 ± 0.6 kg), and ED3 (−2.6 ± 1.1 kg) but was minimal in EXCON (−0.9 ± 0.7 kg). The overall sum of disturbances (luteal phase defects, anovulation, and oligomenorrhea) was greater in ED2 compared with EXCON and greater in ED3 compared with EXCON AND ED1. The average percent energy deficit was the main predictor of the frequency of menstrual disturbances (f = 10.1, β = −0.48, r2 = 0.23, P = 0.003) even when weight loss was included in the model. The estimates of the magnitude of energy deficiency associated with menstrual disturbances ranged from −22 (ED2) to −42% (ED3), reflecting an energy deficit of −470 to −810 kcal/day, respectively. This is the first study to demonstrate a dose-response relationship between the magnitude of energy deficiency and the frequency of exercise-related menstrual disturbances; however, the severity of menstrual disturbances was not dependent on the magnitude of energy deficiency. PMID:25352438

Association of emergency department and hospital characteristics with elopements and length of stay.

PubMed

Handel, Daniel A; Fu, Rongwei; Vu, Eugene; Augustine, James J; Hsia, Renee Y; Shufflebarger, Charles M; Sun, Benjamin

2014-06-01

As the Centers for Medicare & Medicaid Services (CMS) core measures in 2013 compare Emergency Department (ED) treatment time intervals, it is important to identify ED and hospital characteristics associated with these metrics to facilitate accurate comparisons. The objective of this study is to assess differences in operational metrics by ED and hospital characteristics. ED-level characteristics included annual ED volume, percentage of patients admitted, percentage of patients presenting by ambulance, and percentage of pediatric patients. Hospital-level characteristics included teaching hospital status, trauma center status, hospital ownership (nonprofit or for-profit), inpatient bed capacity, critical access status, inpatient bed occupancy, and rural vs. urban location area. Data from the ED Benchmarking Alliance from 2004 to 2009 were merged with the American Hospital Association's Annual Survey Database to include hospital characteristics that may impact ED throughput. Overall median length of stay (LOS) and left before treatment is complete (LBTC) were the primary outcome variables, and a linear mixed model was used to assess the association between outcome variables and ED and hospital characteristics, while accounting for correlations among multiple observations within each hospital. All data were at the hospital level on a yearly basis. There were 445 EDs included in the analysis, from 2004 to 2009, with 850 observations over 6 years. Higher-volume EDs were associated with higher rates of LBTC and LOS. For-profit hospitals had lower LBTC and LOS. Higher inpatient bed occupancies were associated with a higher LOS. Increasing admission percentages were positively associated with overall LOS for EDs, but not with rates of LBTC. Higher-volume EDs are associated with higher LBTC and LOS, and for-profit hospitals appear more favorably in these metrics compared with their nonprofit counterparts. It is important to appreciate that hospitals have different baselines for performance that may be more tied to volume and capacity, and less to quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.

Patterns of Emergency Department Use Among Long-Stay Nursing Home Residents With Differing Levels of Dementia Severity.

PubMed

LaMantia, Michael A; Lane, Kathleen A; Tu, Wanzhu; Carnahan, Jennifer L; Messina, Frank; Unroe, Kathleen T

2016-06-01

To describe emergency department (ED) utilization among long-stay nursing home residents with different levels of dementia severity. Retrospective cohort study. Public Health System. A total of 4491 older adults (age 65 years and older) who were long-stay nursing home residents. Patient demographics, dementia severity, comorbidities, ED visits, ED disposition decisions, and discharge diagnoses. Forty-seven percent of all long-stay nursing home residents experienced at least 1 transfer to the ED over the course of a year. At their first ED transfer, 36.4% of the participants were admitted to the hospital, whereas 63.1% of those who visited the ED were not. The median time to first ED visit for the participants with advanced stage dementia was 258 days, whereas it was 250 days for the participants with early to moderate stage dementia and 202 days for the participants with no dementia (P = .0034). Multivariate proportional hazard modeling showed that age, race, number of comorbidities, number of hospitalizations in the year prior, and do not resuscitate status all significantly influenced participants' time to first ED visit (P < .05 for all). After accounting for these effects, dementia severity (P = .66), years in nursing home before qualification (P = .46), and gender (P = .36) lost their significance. This study confirms high rates of transfer of long-stay nursing home residents, with nearly one-half of the participants experiencing at least 1 ED visit over the course of a year. Although dementia severity is not a predictor of time to ED use in our analyses, other factors that influence ED use are readily identifiable. Nursing home providers should be aware of these factors when developing strategies that meet patient care goals and avoid transfer from the nursing home to the ED. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Stress and body condition are associated with climate and demography in Asian elephants.

PubMed

Mumby, Hannah S; Mar, Khyne U; Thitaram, Chatchote; Courtiol, Alexandre; Towiboon, Patcharapa; Min-Oo, Zaw; Htut-Aung, Ye; Brown, Janine L; Lummaa, Virpi

2015-01-01

Establishing links between ecological variation, physiological markers of stress and demography is crucial for understanding how and why changes in environmental conditions affect population dynamics, and may also play a key role for conservation efforts of endangered species. However, detailed longitudinal studies of long-lived species are rarely available. We test how two markers of stress and body condition vary through the year and are associated with climatic conditions and large-scale mortality and fertility variation in the world's largest semi-captive population of Asian elephants employed in the timber industry in Myanmar. Glucocorticoid metabolites (used as a proxy for stress levels in 75 elephants) and body weight (used as a proxy for condition in 116 elephants) were monitored monthly across a typical monsoon cycle and compared with birth and death patterns of the entire elephant population over half a century (n = 2350). Our results show seasonal variation in both markers of stress and condition. In addition, this variation is correlated with population-level demographic variables. Weight is inversely correlated with population mortality rates 1 month later, and glucocorticoid metabolites are negatively associated with birth rates. Weight shows a highly positive correlation with rainfall 1 month earlier. Determining the factors associated with demography may be key to species conservation by providing information about the correlates of mortality and fertility patterns. The unsustainability of the studied captive population has meant that wild elephants have been captured and tamed for work. By elucidating the correlates of demography in captive elephants, our results offer management solutions that could reduce the pressure on the wild elephant population in Myanmar.

Sociocultural behavior, sex-biased admixture, and effective population sizes in Central African Pygmies and non-Pygmies.

PubMed

Verdu, Paul; Becker, Noémie S A; Froment, Alain; Georges, Myriam; Grugni, Viola; Quintana-Murci, Lluis; Hombert, Jean-Marie; Van der Veen, Lolke; Le Bomin, Sylvie; Bahuchet, Serge; Heyer, Evelyne; Austerlitz, Frédéric

2013-04-01

Sociocultural phenomena, such as exogamy or phylopatry, can largely determine human sex-specific demography. In Central Africa, diverging patterns of sex-specific genetic variation have been observed between mobile hunter-gatherer Pygmies and sedentary agricultural non-Pygmies. However, their sex-specific demography remains largely unknown. Using population genetics and approximate Bayesian computation approaches, we inferred male and female effective population sizes, sex-specific migration, and admixture rates in 23 Central African Pygmy and non-Pygmy populations, genotyped for autosomal, X-linked, Y-linked, and mitochondrial markers. We found much larger effective population sizes and migration rates among non-Pygmy populations than among Pygmies, in agreement with the recent expansions and migrations of non-Pygmies and, conversely, the isolation and stationary demography of Pygmy groups. We found larger effective sizes and migration rates for males than for females for Pygmies, and vice versa for non-Pygmies. Thus, although most Pygmy populations have patrilocal customs, their sex-specific genetic patterns resemble those of matrilocal populations. In fact, our results are consistent with a lower prevalence of polygyny and patrilocality in Pygmies compared with non-Pygmies and a potential female transmission of reproductive success in Pygmies. Finally, Pygmy populations showed variable admixture levels with the non-Pygmies, with often much larger introgression from male than from female lineages. Social discrimination against Pygmies triggering complex movements of spouses in intermarriages can explain these male-biased admixture patterns in a patrilocal context. We show how gender-related sociocultural phenomena can determine highly variable sex-specific demography among populations, and how population genetic approaches contrasting chromosomal types allow inferring detailed human sex-specific demographic history.

Sociocultural Behavior, Sex-Biased Admixture, and Effective Population Sizes in Central African Pygmies and Non-Pygmies

PubMed Central

Verdu, Paul; Becker, Noémie S.A.; Froment, Alain; Georges, Myriam; Grugni, Viola; Quintana-Murci, Lluis; Hombert, Jean-Marie; Van der Veen, Lolke; Le Bomin, Sylvie; Bahuchet, Serge; Heyer, Evelyne; Austerlitz, Frédéric

2013-01-01

Sociocultural phenomena, such as exogamy or phylopatry, can largely determine human sex-specific demography. In Central Africa, diverging patterns of sex-specific genetic variation have been observed between mobile hunter–gatherer Pygmies and sedentary agricultural non-Pygmies. However, their sex-specific demography remains largely unknown. Using population genetics and approximate Bayesian computation approaches, we inferred male and female effective population sizes, sex-specific migration, and admixture rates in 23 Central African Pygmy and non-Pygmy populations, genotyped for autosomal, X-linked, Y-linked, and mitochondrial markers. We found much larger effective population sizes and migration rates among non-Pygmy populations than among Pygmies, in agreement with the recent expansions and migrations of non-Pygmies and, conversely, the isolation and stationary demography of Pygmy groups. We found larger effective sizes and migration rates for males than for females for Pygmies, and vice versa for non-Pygmies. Thus, although most Pygmy populations have patrilocal customs, their sex-specific genetic patterns resemble those of matrilocal populations. In fact, our results are consistent with a lower prevalence of polygyny and patrilocality in Pygmies compared with non-Pygmies and a potential female transmission of reproductive success in Pygmies. Finally, Pygmy populations showed variable admixture levels with the non-Pygmies, with often much larger introgression from male than from female lineages. Social discrimination against Pygmies triggering complex movements of spouses in intermarriages can explain these male-biased admixture patterns in a patrilocal context. We show how gender-related sociocultural phenomena can determine highly variable sex-specific demography among populations, and how population genetic approaches contrasting chromosomal types allow inferring detailed human sex-specific demographic history. PMID:23300254

The impacts of climate, land use, and demography on fires during the 21st century simulated by CLM-CN

NASA Astrophysics Data System (ADS)

Kloster, S.; Mahowald, N. M.; Randerson, J. T.; Lawrence, P. J.

2012-01-01

Landscape fires during the 21st century are expected to change in response to multiple agents of global change. Important controlling factors include climate controls on the length and intensity of the fire season, fuel availability, and fire management, which are already anthropogenically perturbed today and are predicted to change further in the future. An improved understanding of future fires will contribute to an improved ability to project future anthropogenic climate change, as changes in fire activity will in turn impact climate. In the present study we used a coupled-carbon-fire model to investigate how changes in climate, demography, and land use may alter fire emissions. We used climate projections following the SRES A1B scenario from two different climate models (ECHAM5/MPI-OM and CCSM) and changes in population. Land use and harvest rates were prescribed according to the RCP 45 scenario. In response to the combined effect of all these drivers, our model estimated, depending on our choice of climate projection, an increase in future (2075-2099) fire carbon emissions by 17 and 62% compared to present day (1985-2009). The largest increase in fire emissions was predicted for Southern Hemisphere South America for both climate projections. For Northern Hemisphere Africa, a region that contributed significantly to the global total fire carbon emissions, the response varied between a decrease and an increase depending on the climate projection. We disentangled the contribution of the single forcing factors to the overall response by conducting an additional set of simulations in which each factor was individually held constant at pre-industrial levels. The two different projections of future climate change evaluated in this study led to increases in global fire carbon emissions by 22% (CCSM) and 66% (ECHAM5/MPI-OM). The RCP 45 projection of harvest and land use led to a decrease in fire carbon emissions by -5%. The RCP 26 and RCP 60 harvest and landuse projections caused decreases around -20%. Changes in human ignition led to an increase of 20%. When we also included changes in fire management efforts to suppress fires in densely populated areas, global fire carbon emission decreased by -6% in response to changes in population density. We concluded from this study that changes in fire emissions in the future are controlled by multiple interacting factors. Although changes in climate led to an increase in future fire emissions this could be globally counterbalanced by coupled changes in land use, harvest, and demography.