Analysis of 2009-10 WCPSS SAT Scores. Measuring Up. E&R Report No. 10.25

ERIC Educational Resources Information Center

Holdzkom, David; Gilleland, Kevin

2010-01-01

Wake County Public School System (WCPSS) students continue to fare well on the SAT test as compared with students in the state and nation. While there was a decline in average test scores in 2009-10 as compared with the prior year, the posted scores continue a trend of measurable improvement over time. Over the past 20 years, the average SAT…

Clinical Quality Performance in U.S. Health Centers

PubMed Central

Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen

2012-01-01

Objective To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. Data Sources National data from the 2009 Uniform Data System. Data Collection/Extraction Methods Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Study Design Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Principal Findings Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Conclusions Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. PMID:22594465

Regional Child Care Trends: Comparing Georgia to Its Neighbors.

ERIC Educational Resources Information Center

Waits, Lauren; Monaco, Malina; Beck, Lisa; Edwards, Jennifer

As child care becomes an increasingly important public policy issue on the national level, there is emerging concern about Georgia's readiness to meet the needs of its children in care. This study documented the state of child care in Georgia in comparison to other states, to national averages, and to national standards. A group of 12 comparison…

Delayed increase in male suicide rates in tsunami disaster-stricken areas following the great east japan earthquake: a three-year follow-up study in Miyagi Prefecture.

PubMed

Orui, Masatsugu; Sato, Yasuhiro; Tazaki, Kanako; Kawamura, Ikuko; Harada, Shuichiro; Hayashi, Mizuho

2015-03-01

Devastating natural disasters and their aftermath are known to cause psychological distress. However, little information is available regarding suicide rates following tsunami disasters that destroy regional social services and networks. The aim of the present study was to determine whether the tsunami disaster following the Great East Japan Earthquake in March 2011 has influenced suicide rates. The study period was from March 2009 to February 2014. Tsunami disaster-stricken areas were defined as the 16 municipalities facing the Pacific Ocean in Miyagi Prefecture. Inland areas were defined as other municipalities in Miyagi that were damaged by the earthquake. Suicide rates in the tsunami disaster-stricken areas were compared to national averages, using a time-series analysis and the Poisson distribution test. In tsunami disaster-stricken areas, male suicide rates were significantly lower than the national average during the initial post-disaster period and began to increase after two years. Likewise, male suicide rates in the inland areas decreased for seven months, and then increased to exceed the national average. In contrast, female post-disaster suicide rates did not change in both areas compared to the national average. Importantly, the male suicide rates in the inland areas started to increase earlier compared to the tsunami-stricken areas, which may reflect the relative deficiency of mental healthcare services in the inland areas. Considering the present status that many survivors from the tsunami disaster still live in temporary housing and face various challenges to rebuild their lives, we should continue intensive, long-term mental healthcare services in the tsunami-stricken areas.

75 FR 23667 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... Agricultural Cooperative Marketing Association on behalf of apple producers in Michigan. A public hearing to... determine within 40 days whether or not increasing imports of apple juice contributed to a greater than 15 percent decrease in the national average price of apples compared to the average of the 3 preceding...

Aging driver and pedestrian safety : parking lot hazards study [summary].

DOT National Transportation Integrated Search

2012-01-01

In 2009, Florida reported the highest rate of pedestrian fatalities in the nation. At 2.51 deaths per 100,000 residents, Floridas rate was nearly twice the national average. These deaths occurred in all age groups, but compared to other age groups...

Status of North Carolina Science Education, Grades 4-8

ERIC Educational Resources Information Center

Williams, Malcolm L.; And Others

1974-01-01

Reports the results of a study which compared the science achievement of North Carolina students in grades four through eight with that of a national sample. North Carolina students averaged five percent less than the national norm, although their ability (measured by the Lorge-Thorndike IQ test) was equivalent. (JR)

State of equity: childhood immunization in the World Health Organization African Region

PubMed Central

Casey, Rebecca Mary; Hampton, Lee McCalla; Anya, Blanche-philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron Stuart

2017-01-01

Introduction In 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category. Methods We compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015. Results DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%. Conclusion Disparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these disparities is essential for meeting global immunization targets. PMID:29296140

Estimating Gestational Age With Sonography: Regression-Derived Formula Versus the Fetal Biometric Average.

PubMed

Cawyer, Chase R; Anderson, Sarah B; Szychowski, Jeff M; Neely, Cherry; Owen, John

2018-03-01

To compare the accuracy of a new regression-derived formula developed from the National Fetal Growth Studies data to the common alternative method that uses the average of the gestational ages (GAs) calculated for each fetal biometric measurement (biparietal diameter, head circumference, abdominal circumference, and femur length). This retrospective cross-sectional study identified nonanomalous singleton pregnancies that had a crown-rump length plus at least 1 additional sonographic examination with complete fetal biometric measurements. With the use of the crown-rump length to establish the referent estimated date of delivery, each method's (National Institute of Child Health and Human Development regression versus Hadlock average [Radiology 1984; 152:497-501]), error at every examination was computed. Error, defined as the difference between the crown-rump length-derived GA and each method's predicted GA (weeks), was compared in 3 GA intervals: 1 (14 weeks-20 weeks 6 days), 2 (21 weeks-28 weeks 6 days), and 3 (≥29 weeks). In addition, the proportion of each method's examinations that had errors outside prespecified (±) day ranges was computed by using odds ratios. A total of 16,904 sonograms were identified. The overall and prespecified GA range subset mean errors were significantly smaller for the regression compared to the average (P < .01), and the regression had significantly lower odds of observing examinations outside the specified range of error in GA intervals 2 (odds ratio, 1.15; 95% confidence interval, 1.01-1.31) and 3 (odds ratio, 1.24; 95% confidence interval, 1.17-1.32) than the average method. In a contemporary unselected population of women dated by a crown-rump length-derived GA, the National Institute of Child Health and Human Development regression formula produced fewer estimates outside a prespecified margin of error than the commonly used Hadlock average; the differences were most pronounced for GA estimates at 29 weeks and later. © 2017 by the American Institute of Ultrasound in Medicine.

Knowledge of the Military Retirement System Among Naval Postgraduate School Officers and Analysis of Associated Retirement Information Sources

DTIC Science & Technology

2009-06-01

exchanges are tax free, an average additional saving of 4.9 percent when compared to the national average sales tax. 4. Other Non-Cash Components a...civilian job hunters/corporate HR personnel of potential future employers 82 recording on iTunes 68 83 increase in Transition Assistance Program type

African Americans and Mathematics Outcomes on National Assessment of Educational Progress: Parental and Individual Influences

ERIC Educational Resources Information Center

Noble, Richard, III; Morton, Crystal Hill

2013-01-01

This study investigated within group differences between African American female and male students who participated in the 2009 National Assessment of Educational Progress mathematics assessment. Using results from participating states, we compare average scale scores of African American students based on home regulatory environment and interest…

Comparison of food consumption in Indian adults between national and sub-national dietary data sources.

PubMed

Aleksandrowicz, Lukasz; Tak, Mehroosh; Green, Rosemary; Kinra, Sanjay; Haines, Andy

2017-04-01

Accurate data on dietary intake are important for public health, nutrition and agricultural policy. The National Sample Survey is widely used by policymakers in India to estimate nutritional outcomes in the country, but has not been compared with other dietary data sources. To assess relative differences across available Indian dietary data sources, we compare intake of food groups across six national and sub-national surveys between 2004 and 2012, representing various dietary intake estimation methodologies, including Household Consumption Expenditure Surveys (HCES), FFQ, food balance sheets (FBS), and 24-h recall (24HR) surveys. We matched data for relevant years, regions and economic groups, for ages 16-59. One set of national HCES and the 24HR showed a decline in food intake in India between 2004-2005 and 2011-2012, whereas another HCES and FBS showed an increase. Differences in intake were smallest between the two HCES (1 % relative difference). Relative to these, FFQ and FBS had higher intake (13 and 35 %), and the 24HR lower intake (-9 %). Cereal consumption had high agreement across comparisons (average 5 % difference), whereas fruit and nuts, eggs, meat and fish and sugar had the least (120, 119, 56 and 50 % average differences, respectively). Spearman's coefficients showed high correlation of ranked food group intake across surveys. The underlying methods of the compared data highlight possible sources of under- or over-estimation, and influence their relevance for addressing various research questions and programmatic needs.

Patterns of Recent National Institutes of Health (NIH) Funding to Diagnostic Radiology Departments: Analysis Using the NIH RePORTER System.

PubMed

Franceschi, Ana M; Rosenkrantz, Andrew B

2017-09-01

This study aimed to characterize recent National Institutes of Health (NIH) funding for diagnostic radiology departments at US medical schools. This retrospective study did not use private identifiable information and thus did not constitute human subjects research. The public NIH Research Portfolio Online Reporting Tools Expenditure and Results system was used to extract information regarding 887 NIH awards in 2015 to departments of "Radiation-Diagnostic/Oncology." Internet searches were conducted to identify each primary investigator (PI)'s university web page, which was used to identify the PI's departmental affiliation, gender, degree, and academic rank. A total of 649 awards to diagnostic radiology departments, based on these web searches, were included; awards to radiation oncology departments were excluded. Characteristics were summarized descriptively. A total of 61 unique institutions received awards. The top five funded institutions represented 33.6% of all funding. The most common institutes administering these awards were the National Cancer Institute (29.0%) and the National Institute of Biomedical Imaging and Bioengineering (21.6%). Women received 15.9% of awards and 13.3% of funding, with average funding per award of $353,512 compared to $434,572 for men. PhDs received 77.7% of all awards, with average funding per award of $457,413 compared to $505,516 for MDs. Full professors received 51.2% of awards (average funding per award of $532,668), compared to assistant professors who received 18.4% of awards ($260,177). Average funding was $499,859 for multiple-PI awards vs. $397,932 for single-PI awards. Common spending categories included "neurosciences," "cancer," "prevention," and "aging." NIH funding for diagnostic radiology departments has largely been awarded to senior-ranking male PhD investigators, commonly at large major academic medical centers. Initiatives are warranted to address such disparities and promote greater diversity in NIH funding among diagnostic radiology investigators. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

National Hospital Input Price Index

PubMed Central

Freeland, Mark S.; Anderson, Gerard; Schendler, Carol Ellen

1979-01-01

The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 percent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies. PMID:10309052

National hospital input price index.

PubMed

Freeland, M S; Anderson, G; Schendler, C E

1979-01-01

The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 per cent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies.

National-scale exposure prediction for long-term concentrations of particulate matter and nitrogen dioxide in South Korea.

PubMed

Kim, Sun-Young; Song, Insang

2017-07-01

The limited spatial coverage of the air pollution data available from regulatory air quality monitoring networks hampers national-scale epidemiological studies of air pollution. The present study aimed to develop a national-scale exposure prediction model for estimating annual average concentrations of PM 10 and NO 2 at residences in South Korea using regulatory monitoring data for 2010. Using hourly measurements of PM 10 and NO 2 at 277 regulatory monitoring sites, we calculated the annual average concentrations at each site. We also computed 322 geographic variables in order to represent plausible local and regional pollution sources. Using these data, we developed universal kriging models, including three summary predictors estimated by partial least squares (PLS). The model performance was evaluated with fivefold cross-validation. In sensitivity analyses, we compared our approach with two alternative approaches, which added regional interactions and replaced the PLS predictors with up to ten selected variables. Finally, we predicted the annual average concentrations of PM 10 and NO 2 at 83,463 centroids of residential census output areas in South Korea to investigate the population exposure to these pollutants and to compare the exposure levels between monitored and unmonitored areas. The means of the annual average concentrations of PM 10 and NO 2 for 2010, across regulatory monitoring sites in South Korea, were 51.63 μg/m3 (SD = 8.58) and 25.64 ppb (11.05), respectively. The universal kriging exposure prediction models yielded cross-validated R 2 s of 0.45 and 0.82 for PM 10 and NO 2 , respectively. Compared to our model, the two alternative approaches gave consistent or worse performances. Population exposure levels in unmonitored areas were lower than in monitored areas. This is the first study that focused on developing a national-scale point wise exposure prediction approach in South Korea, which will allow national exposure assessments and epidemiological research to answer policy-related questions and to draw comparisons among different countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Forest resources of the Hoosier National Forest, 2005

Treesearch

Christoper W. Woodall; Judith A. Perez; Thomas R. Thake

2007-01-01

The first annual inventory of the Hoosier National Forest reports more than 200,000 forest land acres dominated by oaks, maples, and hickories with annual growth exceeding annual mortality by a factor of seven. When compared to forests in the rest of Indiana, the Hoosier's forests are on average older, have greater biomass per acre, and possess a greater...

Predictors of body mass index in female parents whose children participate in a competitive, creative, problem-solving program

PubMed Central

Moustaid-Moussa, Naima; Costello, Carol A.; Greer, Betty P.; Spence, Marsha; Fitzhugh, Eugene; Muenchen, Robert; Kalupahana, Nishan S.

2012-01-01

Background Recent findings from our research indicate that children participating in a creative afterschool program exhibit overall healthier lifestyle practices compared to the average US pediatric population. This observation led us to investigate the prevalence of overweight/obesity and lifestyle practices of their parents. Objective To determine the strongest predictors of weight status for female parents whose children were participating in such creative afterschool program. Design Surveyed subjects were parents of children who competed in the 2008 and 2009 Destination ImagiNation® Global Finals in Knoxville, Tennessee. A total of 4,608 children participated in data collection, with parental consent. For the combined 2 years, 1,118 parents, 87% of whom were females (n=1,032) completed online questionnaires, which were based on the Behavioral Risk Factor Surveillance System and included self-reported height, weight, dietary intake, physical activity, and socioeconomic status. The majority of this population was white, and less than 5% were African American or Hispanic. Results We report here results obtained for the female parents. Only 45.2% of these female parents were overweight/obese, compared to a national average of 64.1% reported by the National Health Nutrition Examination Surveys for 2007—2008. Furthermore, this population was significantly more physically active compared to national average. Most parents (76%) had completed a college degree and reported high incomes. Parents with the lowest income were the most obese in this population. Finally, we found a significant association between parent and child weight status. Conclusions These studies demonstrate that female parents of children who have healthy lifestyles were physically active, which likely accounts for the parents’ lower overweight/obesity rates. In addition to physical activity, income and percentage of calories from fat were all predictors of weight status. PMID:22912600

Predictors of body mass index in female parents whose children participate in a competitive, creative, problem-solving program.

PubMed

Moustaid-Moussa, Naima; Costello, Carol A; Greer, Betty P; Spence, Marsha; Fitzhugh, Eugene; Muenchen, Robert; Kalupahana, Nishan S

2012-01-01

Recent findings from our research indicate that children participating in a creative afterschool program exhibit overall healthier lifestyle practices compared to the average US pediatric population. This observation led us to investigate the prevalence of overweight/obesity and lifestyle practices of their parents. To determine the strongest predictors of weight status for female parents whose children were participating in such creative afterschool program. Surveyed subjects were parents of children who competed in the 2008 and 2009 Destination ImagiNation(®) Global Finals in Knoxville, Tennessee. A total of 4,608 children participated in data collection, with parental consent. For the combined 2 years, 1,118 parents, 87% of whom were females (n=1,032) completed online questionnaires, which were based on the Behavioral Risk Factor Surveillance System and included self-reported height, weight, dietary intake, physical activity, and socioeconomic status. The majority of this population was white, and less than 5% were African American or Hispanic. We report here results obtained for the female parents. Only 45.2% of these female parents were overweight/obese, compared to a national average of 64.1% reported by the National Health Nutrition Examination Surveys for 2007-2008. Furthermore, this population was significantly more physically active compared to national average. Most parents (76%) had completed a college degree and reported high incomes. Parents with the lowest income were the most obese in this population. Finally, we found a significant association between parent and child weight status. These studies demonstrate that female parents of children who have healthy lifestyles were physically active, which likely accounts for the parents' lower overweight/obesity rates. In addition to physical activity, income and percentage of calories from fat were all predictors of weight status.

Racial and Ethnic Minority Populations

MedlinePlus

... American adults ages 18 and older had a past-year mental illness and a substance use disorder, while ... national average for any mental illness in the past year for adults was 18.1%, compared to 16. ...

Naturalistic Bicycling Behavior Pilot Study.

DOT National Transportation Integrated Search

2017-11-01

Bicyclists experience disproportionate rates of injuries and fatalities compared to other road users. The safety for bicyclists is of particular concern in Florida, where bicyclist fatality rates were nearly triple the national average in 2015. This ...

7 CFR 760.640 - National average market price.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false National average market price. 760.640 Section 760.640....640 National average market price. (a) The Deputy Administrator will establish the National Average Market Price (NAMP) using the best sources available, as determined by the Deputy Administrator, which...

1954 midsummer fuel moistures in Oregon and Washington national forests compared with other years.

Treesearch

Owen P. Cramer

1955-01-01

For the third successive year mid-fire-season fuel moistures on national forests of Oregon and Washington averaged higher than in the preceding year, and forest flammability was correspondingly lower. Generally high fuel-moisture conditions during 1954 are reflected in fire occurrence, which approached an all-time low. Fuel-moisture ratings are based on the 25 lowest...

1951 midsummer fuel moistures in Oregon and Washington national forests compared with other years.

Treesearch

Owen P. Cramer

1952-01-01

During the past four years on most Oregon and Washington national forests average midsummer fuel moisture has shown a general downward trend. Conversely, the lowering fuel moistures have caused a rising trend in midsummer forest inflammability. These trends have been brought to light by an analysis of readings from fuel moisture indicator sticks during the midsummer...

Local and national trends in general surgery residents' operative experience: do work hour limitations negatively affect case volume in small community-based programs?

PubMed

Markelov, Alexey; Sakharpe, Aniket; Kohli, Harjeet; Livert, David

2011-12-01

The goals of this study were to analyze the impact of work hour restrictions on the operative case volume at a small community-based general surgery residency training program and compare changes with the national level. Annual national resident case log data from Accreditation Council for Graduate Medical Education (ACGME) website and case logs of graduating Easton Hospital residents (years 2002-2009) were used for analysis. Weighted average change in total number of cases in our institution was -1.20 (P = 0.52) vs 1.78 (P = 0.07) for the national program average with statistically significant difference on comparison (P = 0.027). We also found significant difference in case volume changes at the national level compared with our institution for the following ACGME defined subcategories: alimentary tract [8.19 (P < 0.01) vs -1.08 (P = 0.54)], abdomen [8.48 (P < 0.01) vs -6.29 (P < 0.01)], breast [1.91 (P = 0.89) vs -3.6 (P = 0.02)], and vascular [4.03 (P = 0.02) vs -3.98 (P = 0.01)]. Comparing the national trend to the community hospital we see that there is total increase in cases at the national level whereas there is a decrease in case volume at the community hospital. These trends can also be followed in ACGME defined subcategories which form the major case load for a general surgical training such as alimentary tract, abdominal, breast, and vascular procedures. We hypothesize that work hour restrictions have been favorable for the larger programs, as these programs were able to better integrate the night float system, restructure their call schedule, and implement institutional modifications which are too resource demanding for smaller training programs.

Focus on Teacher Salaries: Update for 1998-99.

ERIC Educational Resources Information Center

Gaines, Gale F.

For the third consecutive year, Southern Regional Education Board (SREB) states narrowed the gap between national average teacher salaries and the region's average. The regional average for 1998-99 was 88.2 percent of the national average. A year earlier, it was 87.3 percent of the national average. The average increase for SREB states was 4…

Tropospheric ozone in the Nisqually River Drainage, Mount Rainier National Park

USGS Publications Warehouse

Peterson, D.L.; Bowers, Darci

1999-01-01

We quantified the summertime distribution of tropospheric ozone in the topographically complex Nisqually River drainage of Mount Rainier National Park from 1994 to 1997. Passive ozone samplers were used along an elevational transect to measure weekly average ozone concentrations ranging from 570 m to 2040 m elevation. Weekly average ozone concentrations were positively correlated with elevation, with the highest concentrations consistently measured at the highest sampling site (Panorama Point). Weekly average ozone concentrations at Mount Rainier National Park are considerably higher than those in the Seattle-Tacoma metropolitan area to the west. The anthropogenic contribution to ozone within the Nisqually drainage was evaluated by comparing measurements at this location with measurements from a 'reference' site in the western Olympic Mountains. The comparison suggests there is a significant anthropogenic source of ozone reaching the Cascade Range via atmospheric transport from urban areas to the west. In addition. temporal (week to week) variation in ozone distribution is synchronous within the Nisqually drainage, which indicates that subregional patterns are detectable with weekly averages. The Nisqually drainage is likely the 'hot spot' for air pollution in Mount Rainier National Park. By using passive ozone samplers in this drainage in conjunction with a limited number of continuous analyzers, the park will have a robust monitoring approach for measuring tropospheric ozone over time and protecting vegetative and human health.

National Character Does Not Reflect Mean Personality Trait Levels in 49 Cultures

PubMed Central

Abdel-Khalek, A. M.; Ádám, N.; Adamovová, L.; Ahn, C.-k.; Ahn, H.-n.; Alansari, B. M.; Alcalay, L.; Allik, J.; Angleitner, A.; Avia, A.; Ayearst, L. E.; Barbaranelli, C.; Beer, A.; Borg-Cunen, M. A.; Bratko, D.; Brunner-Sciarra, M.; Budzinski, L.; Camart, N.; Dahourou, D.; De Fruyt, F.; de Lima, M. P.; del Pilar, G. E. H.; Diener, E.; Falzon, R.; Fernando, K.; Ficková, E.; Fischer, R.; Flores-Mendoza, C.; Ghayur, M. A.; Gülgöz, S.; Hagberg, B.; Halberstadt, J.; Halim, M. S.; Hřebíčková, M.; Humrichouse, J.; Jensen, H. H.; Jocic, D. D.; Jónsson, F. H.; Khoury, B.; Klinkosz, W.; Knežević, G.; Lauri, M. A.; Leibovich, N.; Martin, T. A.; Marušić, I.; Mastor, K. A.; Matsumoto, D.; McRorie, M.; Meshcheriakov, B.; Mortensen, E. L.; Munyae, M.; Nagy, J.; Nakazato, K.; Nansubuga, F.; Oishi, S.; Ojedokun, A. O.; Ostendorf, F.; Paulhus, D. L.; Pelevin, S.; Petot, J.-M.; Podobnik, N.; Porrata, J. L.; Pramila, V. S.; Prentice, G.; Realo, A.; Reátegui, N.; Rolland, J.-P.; Rossier, J.; Ruch, W.; Rus, V. S.; Sánchez-Bernardos, M. L.; Schmidt, V.; Sciculna-Calleja, S.; Sekowski, A.; Shakespeare-Finch, J.; Shimonaka, Y.; Simonetti, F.; Sineshaw, T.; Siuta, J.; Smith, P. B.; Trapnell, P. D.; Trobst, K. K.; Wang, L.; Yik, M.; Zupančič, A.

2009-01-01

Most people hold beliefs about personality characteristics typical of members of their own and others' cultures. These perceptions of national character may be generalizations from personal experience, stereotypes with a “kernel of truth,” or inaccurate stereotypes. We obtained national character ratings (N = 3,989) from 49 cultures and compared them to the average personality scores of culture members assessed by observer ratings and self-reports. National character ratings were reliable, but did not converge with assessed traits (Mdn r = .04). Perceptions of national character thus appear to be unfounded stereotypes that may serve the function of maintaining a national identity. PMID:16210536

Demographic characteristics, social competence, and behavior problems in children with gender identity disorder: a cross-national, cross-clinic comparative analysis.

PubMed

Cohen-Kettenis, Peggy T; Owen, Allison; Kaijser, Vanessa G; Bradley, Susan J; Zucker, Kenneth J

2003-02-01

This study examined demographic characteristics, social competence, and behavior problems in clinic-referred children with gender identity problems in Toronto, Canada (N = 358), and Utrecht, The Netherlands (N = 130). The Toronto sample was, on average, about a year younger than the Utrecht sample at referral, had a higher percentage of boys, had a higher mean IQ, and was less likely to be living with both parents. On the Child Behavior Checklist (CBCL), both groups showed, on average, clinical range scores in both social competence and behavior problems. A CBCL-derived measure of poor peer relations showed that boys in both clinics had worse ratings than did the girls. A multiple regression analysis showed that poor peer relations were the strongest predictor of behavior problems in both samples. This study-the first cross-national, cross-clinic comparative analysis of children with gender identity disorder-found far more similarities than differences in both social competence and behavior problems. The most salient demographic difference was age at referral. Cross-national differences in factors that might influence referral patterns are discussed.

Conifer regeneration on burned and unburned clearcuts on granitic soils of the Klamath National Forest

Treesearch

Danny Heavilan

1977-01-01

Regeneration was studied on a mixed conifer stand on granitic soils on the Klamath National Forest. Six years after logging and hand planting with Douglas-fir, stocking and growth on cutblocks where slash had been broadcast burned was compared with that on similar unburned cutblocks. Conifers were seven times more plentiful on the unburned areas, the average height of...

Using length of stay data from a hospital to evaluate whether limiting elective surgery at the hospital is an inappropriate decision.

PubMed

Dexter, Franklin; Lubarsky, David A

2004-09-01

At hospitals without detailed managerial accounting data but with overall longer than average diagnosis-related groups (DRG)-adjusted lengths of stays (LOS), some administrators do not aggressively hire the nurses needed to maintain surgical hospital capacity. The consequence of this (long-term) decision is that day-of-surgery admit cases are delayed or cancelled from a lack of beds. The anesthesiologists suffer financially. In this paper, we show how publicly released national LOS data can be applied specifically to these cases. We applied the method to 1 year of data from two academic hospitals. Each case's LOS was compared to the United States national average LOS for cases with the same DRG. A total of 8,050 and 10,099 hospitalizations, respectively. Among all surgical admissions, mean LOS was 2.5 days longer than the national average for Hospital #1 (95% confidence interval [CI], 2.1 to 2.8) and 3.1 days longer for Hospital #2 (95% CI, 2.8 to 3.4). Among patients undergoing elective, scheduled surgery with day of surgery admission, mean LOS was 0.7 days less than average for Hospital #1 (0.6 to 0.9) and 1.2 days less than average for Hospital #2 (1.1 to 1.4). This method can be used by anesthesiologists to show that LOS are not longer than average among patients whose surgeries may be cancelled or delayed for a lack of hospital ward staff.

Wealth, intelligence, politics and global fertility differentials.

PubMed

Meisenberg, Gerhard

2009-07-01

Demographic trends in today's world are dominated by large fertility differentials between nations, with 'less developed' nations having higher fertility than the more advanced nations. The present study investigates whether these fertility differences are related primarily to indicators of economic development, the intellectual level of the population, or political modernity in the form of liberal democracy. Results obtained with multiple regression, path models and latent variable models are compared. Both log-transformed GDP and measures of intelligence independently reduce fertility across all methods, whereas the effects of liberal democracy are weak and inconsistent. At present rates of fertility and mortality and in the absence of changes within countries, the average IQ of the young world population would decline by 1.34 points per decade and the average per capita income would decline by 0.79% per year.

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

PubMed

Jaafar, Nasruddin; Hakim, Hina; Mohd Nor, Nor Azlida; Mohamed, Asma; Saub, Roslan; Esa, Rashidah; Doss, Jennifer; Mohd Yusof, Zamros Yuzadi; Ab-Murat, Norintan; Abu Kassim, Noor Lide; Majid, Hazreen Abdul

2014-01-01

The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group.

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

PubMed Central

2014-01-01

Background The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. Methods A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). Results The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. Conclusions The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group. PMID:25438162

Determinants of psychogeriatric inpatient length of stay and direct medical costs: a 6-year longitudinal study using a national database in Taiwan.

PubMed

Liu, Chin-Ming; Li, Chu-Shiu; Liu, Chwen-Chi; Tu, Chu-Chin

2012-08-01

This research examined factors related to the average length of hospital stay (LOS) and average direct medical costs (DMC) for 2291 psychogeriatric inpatients (aged 65 and over) admitted for the first time to a psychiatric ward in 2002. Hospitalization claim data of these inpatients were traced for the subsequent 6 years (2002-2007) from the dataset of Taiwan's National Health Insurance program. Analysis was carried out using the t-test, χ(2) -test and zero truncated Tobit regression. Mean LOS and mean DMC were significantly different according to sex, psychiatric diagnosis, institution type, ownership type, and number of hospitalizations, but age was the exception. Both LOS and DMC exhibited downward U-shape for the number of hospitalizations. Factors significantly associated with longer LOS and higher DMC were: male sex; schizophrenic and delusional disorders (compared with dementia); and public institution (compared with private hospital). Compared with dementia, organic mental and anxiety disorders had significantly shorter LOS, and affective disorders had shorter LOS but higher DMC. Community and psychiatric hospitals (compared with general hospital) significantly influenced LOS but not DMC. Our results can be used as a reference for providers and policymakers to improve psychiatric care efficiency and carry out National Health Insurance financial reform for psychogeriatric inpatients. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries.

PubMed

Shmueli, Amir; Israeli, Avi

2013-02-20

Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.

Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries

PubMed Central

2013-01-01

Background Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. Objectives To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. Methods We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. Results While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Conclusions Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps. PMID:23425013

Dental establishment business activity in California counties at the start of the millennium.

PubMed

Waldman, H Barry

2006-05-01

The Bureau of the Census reports for 2002 were used to develop business data for "average" dental establishments in each of the counties in California. On average, between 1997 and 2002, when compared to national information, the number of California statewide dental establishments increased at a greater rate, had a smaller resident population per establishment, reported lower gross receipts, had fewer employees, and paid lower salaries to employees.

Responses of Chinese University Students to the Thematic Apperception Test

ERIC Educational Resources Information Center

Han, Elizabeth Yeo-hsien

1974-01-01

Murray's original Thematic Apperception Test (TAT), Cards I to XX, was administered in two sessions to 80 Chinese male and female undergraduate students at the National Taiwan Normal University. The results are compared with American averages. (Author/JH)

Statewide heavy-truck crash assessment.

DOT National Transportation Integrated Search

2014-09-01

In 2010, 16.5 percent of all fatal vehicle crashes in Iowa involved large trucks compared to the national average of 7.8 percent. Only : about 16 percent of these fatalities involved the occupants of the heavy vehicles, meaning that a majority of the...

Incremental Value of Repeated Risk Factor Measurements for Cardiovascular Disease Prediction in Middle-Aged Korean Adults: Results From the NHIS-HEALS (National Health Insurance System-National Health Screening Cohort).

PubMed

Cho, In-Jeong; Sung, Ji Min; Chang, Hyuk-Jae; Chung, Namsik; Kim, Hyeon Chang

2017-11-01

Increasing evidence suggests that repeatedly measured cardiovascular disease (CVD) risk factors may have an additive predictive value compared with single measured levels. Thus, we evaluated the incremental predictive value of incorporating periodic health screening data for CVD prediction in a large nationwide cohort with periodic health screening tests. A total of 467 708 persons aged 40 to 79 years and free from CVD were randomly divided into development (70%) and validation subcohorts (30%). We developed 3 different CVD prediction models: a single measure model using single time point screening data; a longitudinal average model using average risk factor values from periodic screening data; and a longitudinal summary model using average values and the variability of risk factors. The development subcohort included 327 396 persons who had 3.2 health screenings on average and 25 765 cases of CVD over 12 years. The C statistics (95% confidence interval [CI]) for the single measure, longitudinal average, and longitudinal summary models were 0.690 (95% CI, 0.682-0.698), 0.695 (95% CI, 0.687-0.703), and 0.752 (95% CI, 0.744-0.760) in men and 0.732 (95% CI, 0.722-0.742), 0.735 (95% CI, 0.725-0.745), and 0.790 (95% CI, 0.780-0.800) in women, respectively. The net reclassification index from the single measure model to the longitudinal average model was 1.78% in men and 1.33% in women, and the index from the longitudinal average model to the longitudinal summary model was 32.71% in men and 34.98% in women. Using averages of repeatedly measured risk factor values modestly improves CVD predictability compared with single measurement values. Incorporating the average and variability information of repeated measurements can lead to great improvements in disease prediction. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02931500. © 2017 American Heart Association, Inc.

10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center

PubMed Central

Chen, Jenny T.; Nayar, Harry S.

2017-01-01

Background: In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. Methods: Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included. Data are compared to nationally published reports. Results: Nearly 3,500 cosmetic surgeries and 10,000 minimally invasive procedures were performed. Compared with national averages, surgical volume in abdominoplasty is high, whereas rhinoplasty and breast augmentation is low. Regarding trend data, breast augmentation volume has decreased by 25%, whereas minimally invasive procedural volume continues to grow and is comparable with national reports. Similarly, where surgical revenue remains steady, minimally invasive revenue has increased significantly. The majority of surgical cases (70%) are reconstructive in nature and insurance-based. Payer mix is 71% private insurance, 18% Medicare and Medicaid, and 11% self-pay. Despite year-over-year revenue increases, net profit in 2015 was $6,120. Rent and anesthesia costs exceed national averages, and employee salary and wages are the highest expenditure. Conclusion: Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream. PMID:29062640

National assessment of shoreline change—Summary statistics for updated vector shorelines and associated shoreline change data for the north coast of Alaska, U.S.-Canadian Border to Icy Cape

USGS Publications Warehouse

Gibbs, Ann E.; Richmond, Bruce M.

2017-09-25

Long-term rates of shoreline change for the north coast of Alaska, from the U.S.-Canadian border to the Icy Cape region of northern Alaska, have been updated as part of the U.S. Geological Survey’s National Assessment of Shoreline Change Project. Short-term shoreline change rates are reported for the first time. Additional shoreline position data were used to compute rates where the previous rate-of-change assessment only included two shoreline positions at a given location. The calculation of uncertainty associated with the long-term average rates has also been updated to match refined methods used in other study regions of the National Assessment of Shoreline Change Project. The average rates of this report have a reduced amount of uncertainty compared to those presented in the first assessment for this region.

Dental establishment business activity in New York State counties at start of the millennium.

PubMed

Waldman, H Barry

2006-01-01

Bureau of the Census reports for 2002 were used to develop business data for "average" dental establishments in each of the counties in New York State. On average, between 1997 and 2002, when compared to national information, the number of New York State dental establishments increased at a slower rate, had a smaller resident population per establishment, reported lower gross receipts, had fewer employees and paid lower salaries to employees.

Universality, correlations, and rankings in the Brazilian universities national admission examinations

NASA Astrophysics Data System (ADS)

da Silva, Roberto; Lamb, Luis C.; Barbosa, Marcia C.

2016-09-01

We analyze the scores obtained by students who have taken the ENEM examination, The Brazilian High School National Examination which is used in the admission process at Brazilian universities. The average high schools scores from different disciplines are compared through the Pearson correlation coefficient. The results show a very large correlation between the performance in the different school subjects. Even though the students' scores in the ENEM form a Gaussian due to the standardization, we show that the high schools' scores form a bimodal distribution that cannot be used to evaluate and compare students performance over time. We also show that this high schools distribution reflects the correlation between school performance and the economic level (based on the average family income) of the students. The ENEM scores are compared with a Brazilian non standardized exam, the entrance examination from the Universidade Federal do Rio Grande do Sul. The analysis of the performance of the same individuals in both tests shows that the two tests not only select different abilities, but also lead to the admission of different sets of individuals. Our results indicate that standardized tests might be an interesting tool to compare performance of individuals over the years, but not of institutions.

Cigarette consumption per adult of each sex in various countries.

PubMed Central

Todd, G F

1978-01-01

Estimates of cigarette consumption per adult male and female available from surveys in eight countries are examined and the figures of national consumption per adult implied by the surveys are compared with national averages obtained from government data and other sources. The errors likely to be found in the surveys are considered and corrected figures are calculated. Estimates are also made of cigarette consumption per woman of childbearing age. PMID:744820

Vegetable and Fruit Intakes of On-Reserve First Nations Schoolchildren Compared to Canadian Averages and Current Recommendations

PubMed Central

Gates, Allison; Hanning, Rhona M.; Gates, Michelle; Skinner, Kelly; Martin, Ian D.; Tsuji, Leonard J. S.

2012-01-01

This study investigated, in on-reserve First Nations (FN) youth in Ontario, Canada, the following: (a) the intakes of vegetable and fruit, “other” foods and relevant nutrients as compared to current recommendations and national averages, (b) current prevalence rates of overweight and obesity and (c) the relationship between latitude and dietary intakes. Twenty-four-hour diet recalls were collected via the Waterloo Web-Based Eating Behaviour Questionnaire (WEB-Q) (n = 443). Heights and weights of participants were self reported using measured values and Body Mass Index was categorized using the International Obesity Task Force cutoffs. Food group and nutrient intakes were compared to current standards, Southern Ontario Food Behaviour data and the Canadian Community Health Survey, Cycle 2.2, using descriptive statistics. Mean vegetable and fruit, fibre and folate intakes were less than current recommendations. Girls aged 14–18 years had mean intakes of vitamin A below current recommendations for this sub-group; for all sub-groups, mean intakes of vegetables and fruit were below Canadian averages. All sub-groups also had intakes of all nutrients and food groups investigated that were less than those observed in non-FN youth from Southern Ontario, with the exception of “other” foods in boys 12–18 years. Prevalence rates of overweight and obesity were 31.8% and 19.6%, respectively, exceeding rates in the general population. Dietary intakes did not vary consistently by latitude (n = 248), as revealed by ANOVA. This study provided a unique investigation of the dietary intakes of on-reserve FN youth in Ontario and revealed poor intakes of vegetables and fruit and related nutrients and high intakes of “other” foods. Prevalence rates of overweight and obesity exceed those of the general population. PMID:22690200

Accreditation status of U.S. military graduate medical education programs.

PubMed

De Lorenzo, Robert A

2008-07-01

Military graduate medical education (GME) comprises a substantial fraction of U.S. physician training capacity. The wars in Iraq and Afghanistan have placed substantial stress on military medicine, and lay and professional press accounts have raised awareness of the effects on military GME. To date, however, objective data on military GME quality remains sparse. Determine the accreditation status of U.S. military GME programs. Additionally, military GME program data will be compared to national (U.S.) accreditation lengths. Retrospective review of Accreditation Council for Graduate Medical Education (ACGME) data. All military-sponsored core programs in specialties with at least three residencies were included. Military-affiliated but civilian-sponsored programs were excluded. The current and past cycle data were used for the study. For each specialty, the current mean accreditation length and the net change in cycle was calculated. National mean accreditation lengths by specialty for 2005 to 2006 were obtained from the ACGME. Comparison between the overall mean national and military accreditation lengths was performed with a z test. All other comparisons employed descriptive statistics. Ninety-nine military programs in 15 specialties were included in the analysis. During the study period, 1 program was newly accredited, and 6 programs had accreditation withdrawn or were closed. The mean accreditation length of the military programs was 4.0 years. The overall national mean for the same specialties is 3.5 years (p < 0.01). In previous cycles, 68% of programs had accreditation of 4 years or longer, compared to 70% in the current cycle, while 13% had accreditation of 2 years or less in the previous cycle compared to 14% in the current cycle. Ten (68%) of the military specialties had mean accreditation lengths greater than the national average, while 5 (33%) were below it. Ten (68%) specialties had stable or improving cycle lengths when compared to previous cycles. Military GME accreditation cycle lengths are, overall, longer than national averages. Trends show many military programs are experiencing either stable or slightly lengthening accreditation compared to previous cycles. A few specialties show a declining trend. There has been a modest 5% decline in the number of military core residency programs since 2000.

Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey.

PubMed

Zhang, Yiyi; Post, Wendy S; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F; Guallar, Eliseo

2011-02-28

Abnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration. We studied 7795 men and women from the Third National Health and Nutrition Survey (NHANES III, 1988-1994). Baseline QT interval was measured from the standard 12-lead electrocardiogram. Coffee and tea intake, alcohol consumption, leisure-time physical activities over the past month, and lifetime smoking habits were determined using validated questionnaires during the home interview. In the fully adjusted model, the average differences in QT interval comparing participants drinking ≥6 cups/day to those who did not drink any were -1.2 ms (95% CI -4.4 to 2.0) for coffee, and -2.0 ms (-11.2 to 7.3) for tea, respectively. The average differences in QT interval duration comparing current to never smokers was 1.2 ms (-0.6 to 2.9) while the average difference in QT interval duration comparing participants drinking ≥7 drinks/week to non-drinkers was 1.8 ms (-0.5 to 4.0). The age, race/ethnicity, and RR-interval adjusted differences in average QT interval duration comparing men with binge drinking episodes to non-drinkers or drinkers without binge drinking were 2.8 ms (0.4 to 5.3) and 4.0 ms (1.6 to 6.4), respectively. The corresponding differences in women were 1.1 (-2.9 to 5.2) and 1.7 ms (-2.3 to 5.7). Finally, the average differences in QT interval comparing the highest vs. the lowest categories of total physical activity was -0.8 ms (-3.0 to 1.4). Binge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors including coffee and tea intake, smoking, and physical activity.

Coffee, Alcohol, Smoking, Physical Activity and QT Interval Duration: Results from the Third National Health and Nutrition Examination Survey

PubMed Central

Zhang, Yiyi; Post, Wendy S.; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F.; Guallar, Eliseo

2011-01-01

Background Abnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration. Methods We studied 7795 men and women from the Third National Health and Nutrition Survey (NHANES III, 1988–1994). Baseline QT interval was measured from the standard 12-lead electrocardiogram. Coffee and tea intake, alcohol consumption, leisure-time physical activities over the past month, and lifetime smoking habits were determined using validated questionnaires during the home interview. Results In the fully adjusted model, the average differences in QT interval comparing participants drinking ≥6 cups/day to those who did not drink any were −1.2 ms (95% CI −4.4 to 2.0) for coffee, and −2.0 ms (−11.2 to 7.3) for tea, respectively. The average differences in QT interval duration comparing current to never smokers was 1.2 ms (−0.6 to 2.9) while the average difference in QT interval duration comparing participants drinking ≥7 drinks/week to non-drinkers was 1.8 ms (−0.5 to 4.0). The age, race/ethnicity, and RR-interval adjusted differences in average QT interval duration comparing men with binge drinking episodes to non-drinkers or drinkers without binge drinking were 2.8 ms (0.4 to 5.3) and 4.0 ms (1.6 to 6.4), respectively. The corresponding differences in women were 1.1 (−2.9 to 5.2) and 1.7 ms (−2.3 to 5.7). Finally, the average differences in QT interval comparing the highest vs. the lowest categories of total physical activity was −0.8 ms (−3.0 to 1.4). Conclusion Binge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors including coffee and tea intake, smoking, and physical activity. PMID:21386989

23 CFR Appendix D to Part 1240 - Determination of National Average Seat Belt Use Rate

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Determination of National Average Seat Belt Use Rate D Appendix D to Part 1240 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY... BASED ON SEAT BELT USE RATES Pt. 1240, App. D Appendix D to Part 1240—Determination of National Average...

Tennessee advanced practice nurse compensation survey results 2006-2007.

PubMed

Arnold, Kimberly

2007-01-01

In 2006, representatives from Middle Tennessee Advanced Practice Nurses (MTAPN), Greater Memphis Area Advanced Practice Nurses (GMAAPN), and Northeast Tennessee Nurse Practitioners Association (NETNPA) decided to poll APNs in Tennessee to compare data with the most recent results from the Advance for Nurse Practitioners national NP survey. Every other year, Advance for Nurse Practitioners publishes salary survey results from their survey. Most recently, in January 2006, an average nationwide salary for all APNs was reported at $74,812, with Tennessee's average at $71,068.

42 CFR 423.286 - Rules regarding premiums.

Code of Federal Regulations, 2011 CFR

2011-10-01

... section for the difference between the bid and the national average monthly bid amount, any supplemental... percentage as specified in paragraph (b) of this section; and (2) National average monthly bid amount... reflect difference between bid and national average bid. If the amount of the standardized bid amount...

The Stock Performance of C. Everett Koop Award Winners Compared With the Standard & Poor's 500 Index.

PubMed

Goetzel, Ron Z; Fabius, Raymond; Fabius, Dan; Roemer, Enid C; Thornton, Nicole; Kelly, Rebecca K; Pelletier, Kenneth R

2016-01-01

To explore the link between companies investing in the health and well-being programs of their employees and stock market performance. Stock performance of C. Everett Koop National Health Award winners (n = 26) was measured over time and compared with the average performance of companies comprising the Standard and Poor's (S&P) 500 Index. The Koop Award portfolio outperformed the S&P 500 Index. In the 14-year period tracked (2000-2014), Koop Award winners' stock values appreciated by 325% compared with the market average appreciation of 105%. This study supports prior and ongoing research demonstrating a higher market valuation--an affirmation of business success by Wall Street investors--of socially responsible companies that invest in the health and well-being of their workers when compared with other publicly traded firms.

16 CFR 305.20 - Paper catalogs and websites.

Code of Federal Regulations, 2012 CFR

2012-01-01

...] national average electricity cost of [ ___ cents per kWh]. For more information, visit www.ftc.gov... estimated operating cost is based on a [Year] national average [electricity, natural gas, propane, or oil... washers] and a [Year] national average cost of ___ cents per kWh for electricity and $ ___ per therm for...

16 CFR 305.20 - Paper catalogs and websites.

Code of Federal Regulations, 2013 CFR

2013-01-01

...] national average electricity cost of [ ___ cents per kWh]. For more information, visit www.ftc.gov... estimated operating cost is based on a [Year] national average [electricity, natural gas, propane, or oil... washers] and a [Year] national average cost of ___ cents per kWh for electricity and $ ___ per therm for...

42 CFR 433.10 - Rates of FFP for program services.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) of the Act. Under the formula, if a State's per capita income is equal to the national average per... income is lower than the national average, the Federal share is increased, with a statutory maximum of 83... both the State and national average per capita incomes; this procedure magnifies any difference between...

42 CFR 433.10 - Rates of FFP for program services.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) of the Act. Under the formula, if a State's per capita income is equal to the national average per... income is lower than the national average, the Federal share is increased, with a statutory maximum of 83... both the State and national average per capita incomes; this procedure magnifies any difference between...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2011-10-01 2011-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2010-10-01 2010-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

16 CFR 305.20 - Paper catalogs and Web sites.

Code of Federal Regulations, 2014 CFR

2014-01-01

... based on a [Year] national average electricity cost of [ ___ cents per kWh]. For more information, visit... estimated operating cost is based on a [Year] national average [electricity, natural gas, propane, or oil... washers] and a [Year] national average cost of ___ cents per kWh for electricity and $ ___ per therm for...

Quantifying the association between obesity, automobile travel, and caloric intake.

PubMed

Behzad, Banafsheh; King, Douglas M; Jacobson, Sheldon H

2013-02-01

The objective of this study is to assess the association between average adult body mass index (BMI), automobile travel, and caloric intake in the US in order to predict future trends of adult obesity. Annual BMI data (1984-2010) from the Behavioral Risk Factor Surveillance System (BRFSS), vehicle miles traveled data (1970-2009) from the Federal Highway Administration, licensed drivers data (1970-2009) from the Federal Highway Administration, and adult average daily caloric intake data (1970-2009) from the US Department of Agriculture were collected. A statistical model is proposed to capture multicollinearity across the independent variables. The proposed statistical model provides an estimate of changes in the average adult BMI associated with changes in automobile travel and caloric intake. According to this model, reducing daily automobile travel by one mile per driver would be associated with a 0.21 kg/m(2) reduction in the national average BMI after six years. Reducing daily caloric intake by 100 calories per person would be associated with a 0.16 kg/m(2) reduction in the national average BMI after three years. Making small changes in travel or diet choices may lead to comparable obesity interventions, implying that travel-based interventions may be as effective as dietary interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

75 FR 79000 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... States submit pricing information for the 50 most widely prescribed drugs so that the States' prices can be compared to the national average prices obtained from the survey. The States pricing information... health care payment and remittance advices, transmit health plan premium payments, determine health care...

Tax Wealth in Fifty States.

ERIC Educational Resources Information Center

Halstead, D. Kent

This study presents a scheme for yearly, comparative, computation of state and local government tax capacity and effort. Figures for all states for fiscal year 1975 are presented in extensive tables. The system used is a simplified version of the Representative Tax System, which identifies tax bases, determines national average tax rates for those…

Accountability, utilization and providers for diabetes management in Taiwan, 2000-2009: an analysis of the National Health Insurance database.

PubMed

Chang, Tien-Jyun; Jiang, Yi-Der; Chang, Chia-Hsiun; Chung, Ching-Hu; Yu, Neng-Chun; Chuang, Lee-Ming

2012-11-01

The prevalence of diabetes has increased worldwide. To obtain nationwide data on accountability and utilization of health resources among diabetes patients in Taiwan, an analysis of the claims data for the National Health Insurance (NHI) from 2000 to 2009 was conducted. One-third of the NHI claims database was randomly sampled from 2000 to 2009. Diabetes was defined by three or more outpatient visits with diagnostic codes [International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM): 250 or A code: A181] within 1 year, or one inpatient discharge diagnosis. Accountability items and NHI codes of various metabolic parameters and examinations were identified. Medical utilization was measured by the frequency and cost of care associated with ambulatory visits, hospitalizations, and emergency care within each year. The annual check-up frequency for various examinations significantly increased from 2000 to 2009. Both the average outpatient department (OPD) cost per diabetes patient/year and the average inpatient department (IPD) cost per time increased 1.34-fold in the past decade. The average OPD cost per diabetes patient and average IPD cost of each admission for diabetes patients was four times and 1.4 times compare with the general population, respectively. The annual average medical cost of each diabetes patient affected with both micro- and macrovascular complications was four times compared with those without vascular complications. There was an increasing trend for diabetes patients to visit regional hospital for OPD and IPD, whereas visits to the local hospital decreased in the past decade. Due to the increased frequency of annual check-ups after various examinations, the quality of diabetes management has improved in the past decade in Taiwan. As diabetes patients affected with both micro- and macrovascular complications incurred costs four times compared with those without complications, it is worth screening high-risk individuals to ensure earlier intervention and thus reduce diabetic complications and healthcare expenditure. Copyright © 2012. Published by Elsevier B.V.

Geographical trends in infant mortality: England and Wales, 1970-2006.

PubMed

Norman, Paul; Gregory, Ian; Dorling, Danny; Baker, Allan

2008-01-01

At national level in England and Wales, infant mortality rates fell rapidly from the early 1970s and into the 1980s. Subnational areas have also experienced a reduction in levels of infant mortality. While rates continued to fall to 2006, the rate of reduction has slowed. Although the Government Office Regions Yorkshire and The Humber, the North West and the West Midlands and the Office for National Statistics local authority types Cities and Services and London Cosmopolitan have experienced relatively large absolute reductions in infant mortality, their rates remained high compared with the national average. Within all regions and local authority types, a strong relationship was found between ward level deprivation and infant mortality rates. Nevertheless, levels of infant mortality declined over time even in the most deprived areas with a narrowing of absolute differences in rates between areas. Areas in which the level of deprivation eased have experienced greater than average reductions in levels of infant mortality.

The Stock Performance of C. Everett Koop Award Winners Compared With the Standard & Poor's 500 Index

PubMed Central

Goetzel, Ron Z.; Fabius, Raymond; Fabius, Dan; Roemer, Enid C.; Thornton, Nicole; Kelly, Rebecca K.; Pelletier, Kenneth R.

2016-01-01

Objective: To explore the link between companies investing in the health and well-being programs of their employees and stock market performance. Methods: Stock performance of C. Everett Koop National Health Award winners (n = 26) was measured over time and compared with the average performance of companies comprising the Standard and Poor's (S&P) 500 Index. Results: The Koop Award portfolio outperformed the S&P 500 Index. In the 14-year period tracked (2000–2014), Koop Award winners’ stock values appreciated by 325% compared with the market average appreciation of 105%. Conclusions: This study supports prior and ongoing research demonstrating a higher market valuation—an affirmation of business success by Wall Street investors—of socially responsible companies that invest in the health and well-being of their workers when compared with other publicly traded firms. PMID:26716843

An Analysis and Comparative Study of Job Characteristics Levels and Job Redesign Potential within the Strategic Air Command Maintenance Officer and Navigator Career Fields.

DTIC Science & Technology

1985-09-01

Job Diagnostic Survey National Norms Managerial Workers ... 40 5 . Comparison of Mean Scores of Affective Outcomes With Norms For Navigators...VV cis cda r-4 * 14 to 0 0 0 m V4 E- 0 ta a 7 27 Issue #2: Feasibility of job redesigni. As mentioned earlier, two questions we:!? answered in...C. Satisfaction with co-workers. Average items #4, #7, and #12 of Section Four. D. Satisfaction with supervision. Average items # 5 , #8, and # 14 of

The contribution of trees outside forests to national tree biomass and carbon stocks--a comparative study across three continents.

PubMed

Schnell, Sebastian; Altrell, Dan; Ståhl, Göran; Kleinn, Christoph

2015-01-01

In contrast to forest trees, trees outside forests (TOF) often are not included in the national monitoring of tree resources. Consequently, data about this particular resource is rare, and available information is typically fragmented across the different institutions and stakeholders that deal with one or more of the various TOF types. Thus, even if information is available, it is difficult to aggregate data into overall national statistics. However, the National Forest Monitoring and Assessment (NFMA) programme of FAO offers a unique possibility to study TOF resources because TOF are integrated by default into the NFMA inventory design. We have analysed NFMA data from 11 countries across three continents. For six countries, we found that more than 10% of the national above-ground tree biomass was actually accumulated outside forests. The highest value (73%) was observed for Bangladesh (total forest cover 8.1%, average biomass per hectare in forest 33.4 t ha(-1)) and the lowest (3%) was observed for Zambia (total forest cover 63.9%, average biomass per hectare in forest 32 t ha(-1)). Average TOF biomass stocks were estimated to be smaller than 10 t ha(-1). However, given the large extent of non-forest areas, these stocks sum up to considerable quantities in many countries. There are good reasons to overcome sectoral boundaries and to extend national forest monitoring programmes on a more systematic basis that includes TOF. Such an approach, for example, would generate a more complete picture of the national tree biomass. In the context of climate change mitigation and adaptation, international climate mitigation programmes (e.g. Clean Development Mechanism and Reduced Emission from Deforestation and Degradation) focus on forest trees without considering the impact of TOF, a consideration this study finds crucial if accurate measurements of national tree biomass and carbon pools are required.

Evaluating the environmental impacts of dietary recommendations.

PubMed

Behrens, Paul; Kiefte-de Jong, Jessica C; Bosker, Thijs; Rodrigues, João F D; de Koning, Arjan; Tukker, Arnold

2017-12-19

Dietary choices drive both health and environmental outcomes. Information on diets come from many sources, with nationally recommended diets (NRDs) by governmental or similar advisory bodies the most authoritative. Little or no attention is placed on the environmental impacts within NRDs. Here we quantify the impact of nation-specific NRDs, compared with an average diet in 37 nations, representing 64% of global population. We focus on greenhouse gases (GHGs), eutrophication, and land use because these have impacts reaching or exceeding planetary boundaries. We show that compared with average diets, NRDs in high-income nations are associated with reductions in GHG, eutrophication, and land use from 13.0 to 24.8%, 9.8 to 21.3%, and 5.7 to 17.6%, respectively. In upper-middle-income nations, NRDs are associated with slight decrease in impacts of 0.8-12.2%, 7.7-19.4%, and 7.2-18.6%. In poorer middle-income nations, impacts increase by 12.4-17.0%, 24.5-31.9%, and 8.8-14.8%. The reduced environmental impact in high-income countries is driven by reductions in calories (∼54% of effect) and a change in composition (∼46%). The increased environmental impacts of NRDs in low- and middle-income nations are associated with increased intake in animal products. Uniform adoption of NRDs across these nations would result in reductions of 0.19-0.53 Gt CO 2 eq⋅a -1 , 4.32-10.6 Gt [Formula: see text] eq⋅a -1 , and 1.5-2.8 million km 2 , while providing the health cobenefits of adopting an NRD. As a small number of dietary guidelines are beginning to incorporate more general environmental concerns, we anticipate that this work will provide a standardized baseline for future work to optimize recommended diets further. Copyright © 2017 the Author(s). Published by PNAS.

Evaluating the environmental impacts of dietary recommendations

PubMed Central

Kiefte-de Jong, Jessica C.; Bosker, Thijs; Rodrigues, João F. D.; de Koning, Arjan; Tukker, Arnold

2017-01-01

Dietary choices drive both health and environmental outcomes. Information on diets come from many sources, with nationally recommended diets (NRDs) by governmental or similar advisory bodies the most authoritative. Little or no attention is placed on the environmental impacts within NRDs. Here we quantify the impact of nation-specific NRDs, compared with an average diet in 37 nations, representing 64% of global population. We focus on greenhouse gases (GHGs), eutrophication, and land use because these have impacts reaching or exceeding planetary boundaries. We show that compared with average diets, NRDs in high-income nations are associated with reductions in GHG, eutrophication, and land use from 13.0 to 24.8%, 9.8 to 21.3%, and 5.7 to 17.6%, respectively. In upper-middle–income nations, NRDs are associated with slight decrease in impacts of 0.8–12.2%, 7.7–19.4%, and 7.2–18.6%. In poorer middle-income nations, impacts increase by 12.4–17.0%, 24.5–31.9%, and 8.8–14.8%. The reduced environmental impact in high-income countries is driven by reductions in calories (∼54% of effect) and a change in composition (∼46%). The increased environmental impacts of NRDs in low- and middle-income nations are associated with increased intake in animal products. Uniform adoption of NRDs across these nations would result in reductions of 0.19–0.53 Gt CO2 eq⋅a−1, 4.32–10.6 Gt PO43− eq⋅a−1, and 1.5–2.8 million km2, while providing the health cobenefits of adopting an NRD. As a small number of dietary guidelines are beginning to incorporate more general environmental concerns, we anticipate that this work will provide a standardized baseline for future work to optimize recommended diets further. PMID:29203655

Hospital Evaluations by Social Media: A Comparative Analysis of Facebook Ratings among Performance Outliers.

PubMed

Glover, McKinley; Khalilzadeh, Omid; Choy, Garry; Prabhakar, Anand M; Pandharipande, Pari V; Gazelle, G Scott

2015-10-01

An increasing number of hospitals and health systems utilize social media to allow users to provide feedback and ratings. The correlation between ratings on social media and more conventional hospital quality metrics remains largely unclear, raising concern that healthcare consumers may make decisions on inaccurate or inappropriate information regarding quality. The purpose of this study was to examine the extent to which hospitals utilize social media and whether user-generated metrics on Facebook(®) correlate with a Hospital Compare(®) metric, specifically 30-day all cause unplanned hospital readmission rates. This was a retrospective cross-sectional study conducted among all U.S. hospitals performing outside the confidence interval for the national average on 30-day hospital readmission rates as reported on Hospital Compare. Participants were 315 hospitals performing better than U.S. national rate on 30-day readmissions and 364 hospitals performing worse than the U.S. national rate. The study analyzed ratings of hospitals on Facebook's five-star rating scale, 30-day readmission rates, and hospital characteristics including beds, teaching status, urban vs. rural location, and ownership type. Hospitals performing better than the national average on 30-day readmissions were more likely to use Facebook than lower-performing hospitals (93.3 % vs. 83.5 %; p < 0.01). The average rating for hospitals with low readmission rates (4.15 ± 0.31) was higher than that for hospitals with higher readmission rates (4.05 ± 0.41, p < 0.01). Major teaching hospitals were 14.3 times more likely to be in the high readmission rate group. A one-star increase in Facebook rating was associated with increased odds of the hospital belonging to the low readmission rate group by a factor of 5.0 (CI: 2.6-10.3, p <  0.01), when controlling for hospital characteristics and Facebook-related variables. Hospitals with lower rates of 30-day hospital-wide unplanned readmissions have higher ratings on Facebook than hospitals with higher readmission rates. These findings add strength to the concept that aggregate measures of patient satisfaction on social media correlate with more traditionally accepted measures of hospital quality.

Update of Ireland's national average indoor radon concentration - Application of a new survey protocol.

PubMed

Dowdall, A; Murphy, P; Pollard, D; Fenton, D

2017-04-01

In 2002, a National Radon Survey (NRS) in Ireland established that the geographically weighted national average indoor radon concentration was 89 Bq m -3 . Since then a number of developments have taken place which are likely to have impacted on the national average radon level. Key among these was the introduction of amending Building Regulations in 1998 requiring radon preventive measures in new buildings in High Radon Areas (HRAs). In 2014, the Irish Government adopted the National Radon Control Strategy (NRCS) for Ireland. A knowledge gap identified in the NRCS was to update the national average for Ireland given the developments since 2002. The updated national average would also be used as a baseline metric to assess the effectiveness of the NRCS over time. A new national survey protocol was required that would measure radon in a sample of homes representative of radon risk and geographical location. The design of the survey protocol took into account that it is not feasible to repeat the 11,319 measurements carried out for the 2002 NRS due to time and resource constraints. However, the existence of that comprehensive survey allowed for a new protocol to be developed, involving measurements carried out in unbiased randomly selected volunteer homes. This paper sets out the development and application of that survey protocol. The results of the 2015 survey showed that the current national average indoor radon concentration for homes in Ireland is 77 Bq m -3 , a decrease from the 89 Bq m -3 reported in the 2002 NRS. Analysis of the results by build date demonstrate that the introduction of the amending Building Regulations in 1998 have led to a reduction in the average indoor radon level in Ireland. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparing Anesthesiology Residency Training Structure and Requirements in Seven Different Countries on Three Continents.

PubMed

Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias V; Macario, Alex

2017-02-26

Little has been published comparing the graduate medical education training structure and requirements across multiple countries. The goal of this study was to summarize and compare the characteristics of anesthesiology training programs in the USA, UK, Canada, Japan, Brazil, Denmark, and Switzerland as a way to better understand efforts to train anesthesiologists in different countries. Two physicians trained in each of the seven countries (convenience sample) were interviewed using a semi-structured approach. The interview was facilitated by use of a predetermined questionnaire that included, for example, the duration of post-medical school training and national requirements for certain rotations, a number of cases, faculty supervision, national in-training written exams, and duty hour limits. These data were augmented by review of each country's publicly available residency training documents as available on the internet. Post-medical school anesthesia residency duration varied: three years (Brazil), four years (USA), five years (Canada and Switzerland), six years (Japan and Denmark) to nine years (UK), as did the number of explicitly required clinical rotations of a defined duration: zero (Denmark), one (Switzerland and UK), four (Brazil), six (Canada), and 12 (USA). Minimum case requirements exist in the USA, Japan, and Brazil, but not in the other countries. National written exams taken during training exist for all countries studied except Japan and Denmark. The countries studied increasingly aim to have competency-based education with milestone assessments. Training duty hour limits also varied including for example 37 hours/week averaged over a one month with limitations on night duties (Denmark), a weekly average of 48 hours taken over a 17 week period (UK), 50 hours/week maximum (Switzerland), 60 hours/week maximum (Brazil), and 80 hours/week averaged over four weeks (USA). Some countries have highly structured training programs with multiple national requirements with training principally carried out at a home institution. Other countries have a more decentralized and unregulated approach with fewer (if any) specific case or rotation requirements, where the trainee creates his/her own customized training to meet broad objectives and goals. The countries studied have different national training requirements, unique duty hour rules and are at varying stages in transitioning to an outcome based model of residency.

Impact of Community-Based Approach as Policy Tool: World Health Organization-Designated Safe Communities of Korea and Health Action Zones of the United Kingdom.

PubMed

Kang, Changhyun; Shin, Jihyung; Matthews, Bob

2016-02-01

The aim of this study is to ascertain and identify the effectiveness of area-based initiatives as a policy tool mediated by societal and individual factors in the five World Health Organization (WHO)-designated Safe Communities of Korea and the Health Action Zones of the United Kingdom (UK). The Korean National Hospital discharge in-depth injury survey from the Korea Centers for Disease Control and Prevention and causes of death statistics by the Statistics Korea were used for all analyses. The trend and changes in injury rate and mortality by external causes were compared among the five WHO-designated Safe Communities in Korea. The injury incident rates decreased at a greater level in the Safe Communities compared with the national average. Similar results were shown for the changes in unintentional injury incident rates. In comparison of changes in mortality rate by external causes between 2005 and 2011, the rate increase in Safe Communities was higher than the national average except for Jeju, where the mortality rate by external causes decreased. When the Healthy Action Zones of the UK and the WHO Safe Communities of Korea were examined, the outcomes were interpreted differently among the compared index, regions, and time periods. Therefore, qualitative outcomes, such as bringing the residents' attention to the safety of the communities and promoting participation and coordination of stakeholders, should also be considered as important impacts of the community-based initiatives.

Implications of uncertainty on regional CO2 mitigation policies for the U.S. onroad sector based on a high-resolution emissions estimate

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

Mendoza, D.; Gurney, Kevin R.; Geethakumar, Sarath

2013-04-01

In this study we present onroad fossil fuel CO2 emissions estimated by the Vulcan Project, an effort quantifying fossil fuel CO2 emissions for the U.S. in high spatial and temporal resolution. This high-resolution data, aggregated at the state-level and classified in broad road and vehicle type categories, is compared to a commonly used national-average approach. We find that the use of national averages incurs state-level biases for road groupings that are almost twice as large as for vehicle groupings. The uncertainty for all groups exceeds the bias, and both quantities are positively correlated with total state emissions. States with themore » largest emissions totals are typically similar to one another in terms of emissions fraction distribution across road and vehicle groups, while smaller-emitting states have a wider range of variation in all groups. Errors in reduction estimates as large as ±60% corresponding to ±0.2 MtC are found for a national-average emissions mitigation strategy focused on a 10% emissions reduction from a single vehicle class, such as passenger gas vehicles or heavy diesel trucks. Recommendations are made for reducing CO2 emissions uncertainty by addressing its main drivers: VMT and fuel efficiency uncertainty.« less

Does a surgical career affect a woman's childbearing and fertility? A report on pregnancy and fertility trends among female surgeons.

PubMed

Phillips, Elizabeth A; Nimeh, Tony; Braga, Julie; Lerner, Lori B

2014-11-01

Increases in pregnancy complication rates and use of assisted reproductive technology (ART) have been demonstrated in female urologists and orthopaedic surgeons when compared with the general US population. To determine if childbearing differences exist across specialties, we evaluated female surgeons in all fields, particularly with regard to fertility. An anonymous, 199-item survey was distributed via specialty female surgeon interest groups and word of mouth to general surgery, gynecology, neurosurgery, ophthalmology, orthopaedics, otolaryngology, plastic surgery, podiatry, and urology. The 1,021 responses were analyzed and compared with Centers for Disease Control National Survey for Family Growth and National Institute of Health data to identify differences between populations. Of women surgeons, 32% reported fertility difficulty; 84% of whom underwent infertility workup. Seventy-six percent of these women used ART to attempt pregnancy. In comparison, only 10.9% of women in the general US population report infertility, and 11% seek infertility services. Of all babies born to female surgeons, at least 13% were conceived using ART. Surgeons had 1.4 biological children, less than the national average. Age at first pregnancy was 33 years, compared with a national average of 23. If ART was implemented, surgeon age at first birth increased to 35.4 years. Highest rates of infertility existed in otolaryngology (29%), general surgery (22%), and orthopaedics (18%). Female surgeons have first pregnancies later in life, fewer children, and report more issues with infertility. Assisted reproductive technology is implemented more often by female surgeons than the general population. Differences in fertility exist between specialties and warrant additional study. Copyright © 2014 American College of Surgeons. All rights reserved.

Global fund financing to the 34 malaria-eliminating countries under the new funding model 2014-2017: an analysis of national allocations and regional grants.

PubMed

Zelman, Brittany; Melgar, Melissa; Larson, Erika; Phillips, Allison; Shretta, Rima

2016-02-25

The Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM) has been the largest financial supporter of malaria since 2002. In 2011, the GFATM transitioned to a new funding model (NFM), which prioritizes grants to high burden, lower income countries. This shift raises concerns that some low endemic countries, dependent on GFATM financing to achieve their malaria elimination goals, would receive less funding under the NFM. This study aims to understand the projected increase or decrease in national and regional funding from the GFATM's NFM to the 34 malaria-eliminating countries. Average annual disbursements under the old funding model were compared to average annual national allocations for all eligible 34 malaria-eliminating countries for the period of 2014-2017. Regional grant funding to countries that are due to receive additional support was then included in the comparison and analysed. Estimated funding ranges for the countries under the NFM were calculated using the proposed national allocation plus the possible adjustments and additional funding. Finally, the minimum and maximum funding estimates were compared to average annual disbursements under the old funding model. A cumulative 31 % decrease in national financing from the GFATM is expected for the countries included in this analysis. Regional grants augment funding for almost half of the eliminating countries, and increase the cumulative percent change in GTFAM funding to 32 %, though proposed activities may not be funded directly through national malaria programmes. However, if countries receive the maximum possible funding, 46 % of the countries included in this analysis would receive less than they received under the previous funding model. Many malaria-eliminating countries have projected national declines in funding from the GFATM under the NFM. While regional grants enhance funding for eliminating countries, they may not be able to fill country-level funding gaps for local commodities and implementation. If the GFATM is able to nuance its allocation methodology to mitigate drastic funding declines for malaria investments in low transmission countries, the GFATM can ensure previous investments are not lost. By aligning with WHO's Global Technical Strategy for Malaria and investing in both high- and low-endemic countries, the Global Fund can tip the scale on a global health threat and contribute toward the goal of eventual malaria eradication.

Simple versus composite indicators of socioeconomic status in resource allocation formulae: the case of the district resource allocation formula in Malawi

PubMed Central

2010-01-01

Background The district resource allocation formula in Malawi was recently reviewed to include stunting as a proxy measure of socioeconomic status. In many countries where the concept of need has been incorporated in resource allocation, composite indicators of socioeconomic status have been used. In the Malawi case, it is important to ascertain whether there are differences between using single variable or composite indicators of socioeconomic status in allocations made to districts, holding all other factors in the resource allocation formula constant. Methods Principal components analysis was used to calculate asset indices for all districts from variables that capture living standards using data from the Malawi Multiple Indicator Cluster Survey 2006. These were normalized and used to weight district populations. District proportions of national population weighted by both the simple and composite indicators were then calculated for all districts and compared. District allocations were also calculated using the two approaches and compared. Results The two types of indicators are highly correlated, with a spearman rank correlation coefficient of 0.97 at the 1% level of significance. For 21 out of the 26 districts included in the study, proportions of national population weighted by the simple indicator are higher by an average of 0.6 percentage points. For the remaining 5 districts, district proportions of national population weighted by the composite indicator are higher by an average of 2 percentage points. Though the average percentage point differences are low and the actual allocations using both approaches highly correlated (ρ of 0.96), differences in actual allocations exceed 10% for 8 districts and have an average of 4.2% for the remaining 17. For 21 districts allocations based on the single variable indicator are higher. Conclusions Variations in district allocations made using either the simple or composite indicators of socioeconomic status are not statistically different to recommend one over the other. However, the single variable indicator is favourable for its ease of computation. PMID:20053274

Petroleum taxation: a comparison between Russia and Kazakhstan

NASA Astrophysics Data System (ADS)

Tsibulnikova, M. R.; Salata, D. V.; Drebot, V. V.; Vorozheykina, E. A.

2016-09-01

The paper compares mineral resource recovery taxes for oil to be paid in Kazakhstan and the RF. It provides a case study on an average Kazakh oil and gas company and presents tax calculations as an example. To compare the taxation systems in Kazakhstan and the RF, the situation is modelled as if the field was located in the RF and the relevant calculations are carried out in compliance with national laws and regulations.

Aerobic Capacities of Early College High School Students

ERIC Educational Resources Information Center

Loflin, Jerry W.

2014-01-01

The Early College High School Initiative (ECHSI) was introduced in 2002. Since 2002, limited data, especially student physical activity data, have been published pertaining to the ECHSI. The purpose of this study was to examine the aerobic capacities of early college students and compare them to state and national averages. Early college students…

CognitiveGenesis (CG): Assessing Academic Achievement and Cognitive Ability in Adventist Schools

ERIC Educational Resources Information Center

Thayer, Jerome; Kido, Elissa

2012-01-01

CognitiveGenesis collected achievement and ability test data from 2006-2009 for all students in Seventh-day Adventist schools in North America. Students were above average in achievement compared to national norms and achieved above that predicted by their ability scores. The more years students attended Adventist schools, the higher they…

Sleep Trends and College Students: Does it Connect to Obesity?

ERIC Educational Resources Information Center

Melton, Bridget F.; Langdon, Jody; McDaniel, Tyler

2013-01-01

Purpose: The objective of this study was to investigate and compare local to national averages in college-aged students' sleep disturbances, as well as further investigate key demographics (obesity classification, gender, race, year in college) among sleep issues. Methods: This study investigated 636 undergraduate students (333 males, 303 Females,…

A Survey of Professional Licensure Examinations in Texas.

ERIC Educational Resources Information Center

Texas Coll. and Univ. System, Austin. Coordinating Board.

A determination was made of how graduates of Texas professional education programs perform on licensure examinations in comparison with their counterparts in other states. Test scores of Texas graduates were compared with national norms and averages in other states, when available, as well as with scores of graduates of out-of-state programs who…

[Nutritional evaluation of adolescent students from Extremadura based on anthropometric measurements].

PubMed

Fernández Cabrera, Jacinta; Aranda Medina, Emilio; Córdoba Ramos, María de Guía; Hernández León, Alejandro; Rodríguez Bernabé, José Antonio; Pérez-Nevado, Francisco

2014-03-01

Nutrition is one of the pillars for proper body development and optimal nutritional status. Anthropometric methods are most commonly used for body composition analysis and are an essential part in the assessment of the nutritional status of individuals and population groups. This study aims to assess the nutritional status of adolescents from Extremadura (Spain); to determine variations in body composition according to the percentiles obtained; and to propose these values as a reference to the nutritional status of the adolescent population in Extremadura. A cross sectional study in the community of Extremadura was performed, including a total of 816 students of Secondary School Education of both sexes; and of all ages in the adolescence stage. The selected secondary schools belonged to populations of different sizes (less than 5,000 to more than 60,000 inhabitants). From the measurements taken, different anthropometric indices were determined and the percentiles 3, 10, 25, 50, 75, 90, 95 and 97 for weight, height and complexion were found. There were significant gender differences for height, weight, triceps skinfold, arm muscle area and arm fat area. Boys showed greater figures for height, weight and arm muscle area; however, the triceps skinfold and arm fat area was higher in girls. When compared to other national studies, the average height of our population was lower by about 3 cm in both sexes; the average weight was similar, but our adolescents had a higher proportion of fat in the arm. Extremadura girls seem to have a faster growth, reaching final height at an earlier age than the national average, although this height is below average. The boys had a continuous growth in all ages, maintaining national averages. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Collegiate ACL Injury Rates Across 15 Sports: National Collegiate Athletic Association Injury Surveillance System Data Update (2004-2005 Through 2012-2013).

PubMed

Agel, Julie; Rockwood, Todd; Klossner, David

2016-11-01

To present data on the rate of anterior cruciate ligament (ACL) injury in 15 collegiate sports from 2004 to 2005 through 2012 to 2013 updating the 1988-1989 to 2003-2004 data. Prospectively designed descriptive epidemiology study. National Collegiate Athletic Association Schools. National Collegiate Athletic Association School athletes. Injury rate by year and sport. Most ACL injuries to women occurred by a noncontact mechanism (60%) versus a contact mechanism for men (59%). The highest average annual rate of ACL injury for men was found in football (0.17 per 1000 athlete-exposure [A-E]). The highest average annual rate of ACL injury for women was found in lacrosse (0.23 per 1000 A-E). There were statistically significant increases in average annual injury rate for men's (P = 0.04) and women's soccer (P = 0.01) and a statistically significant decrease in women's gymnastics over the 9 years (=0.009). Controlling for exposures, there were statistically significant increases in the average annual number of injuries for men's and women's basketball, ice hockey, field hockey, football, and volleyball and a decrease in the average annual number of injuries for baseball and women's gymnastics. Women continue to sustain ACL injuries at higher rates than men in the comparable sports of soccer, basketball, and lacrosse. Anterior cruciate ligament injury rates continue to rise in men's and women's soccer. Some sports have shown absolute increases in ACL rates, which persist even after exposure rates are taken into account. Despite extensive research and development of prevention programs before and during the time of this study, very few sports showed a reduction in ACL injury rates in this data set.

Evidence from the national health account: the case of Dubai

PubMed Central

Hamidi, Samer

2014-01-01

Introduction National health accounts (NHAs) provide useful information to aid in understanding the health care financing system. This article aims to present a profile of health system financing in Dubai using data from the NHA. We also aim to compare the provider structure of financing schemes in Dubai with those of the State of Qatar and selected Organization for Economic Cooperation and Development (OECD) countries. Methods The author analyzed secondary data published in NHAs for Dubai and Qatar, and data collected by the OECD countries and publicly available from the Statistical Office of the European Union (Eurostat), for 25 OECD countries for comparative analysis. All health financing measures used are as defined in the international System of Health Accounts (SHA). Results In Dubai, only 33% of current health expenditure (CHE) is funded by the government. However, the public sector is the main source of health funding in Qatar and most OECD countries, with an average of 79% and 72%, respectively. Households in Dubai spent about 22% of CHE, equivalent to an average US$187 per capita, ranking the highest among Gulf Cooperation Council (GCC) countries, and compared with 20% of CHE across OECD countries. Hospitals in Dubai accounted for 48% of CHE, which is much higher than Qatar (40%) and the OECD average (36%). Conclusion The Dubai health care financing system differs substantially from that in OECD countries, as it is more private oriented. The findings point to several potential opportunities for growth and improvement. Policy areas that may be addressed using the information presented in this article are broad and include the following: shift from hospital care to ambulatory and day care, sustainability of health finance, shift the cost of health care to the private sector, introduce cost-containment measures, revise payment systems for health providers, and produce subnational accounts for non-communicable diseases. More investment in the translation of national health account data into policy is suggested for future researchers. PMID:25285027

Impact of the 80-hour workweek on surgical exposure and national in-training examination scores in an orthopedic residency program.

PubMed

Froelich, John; Milbrandt, Joseph C; Allan, D Gordon

2009-01-01

This study examines the impact of the 80-hour workweek on the number of surgical cases performed by PGY-2 through PGY-5 orthopedic residents. We also evaluated orthopedic in-training examination (OITE) scores during the same time period. Data were collected from the Accreditation Council for Graduate Medical Education (ACGME) national database for 3 academic years before and 5 years after July 1, 2003. CPT surgical procedure codes logged by all residents 3 years before and 5 years after implementation of the 80-hour workweek were compared. The average raw OITE scores for each class obtained during the same time period were also evaluated. Data were reported as the mean +/- standard deviation (SD), and group means were compared using independent t-tests. No statistical difference was noted in the number of surgical procedure codes logged before or after the institution of the 80-hour week during any single year of training. However, an increase in the number of CPT codes logged in the PGY-3 years after 2003 did approach significance (457.7 vs 551.9, p = 0.057). Overall, the average number of cases performed per resident increased each year after implementation of the work-hour restriction (464.4 vs 515.5 cases). No statistically significant difference was noted in the raw OITE scores before or after work-hour restrictions for our residents or nationally. We found no statistical difference for each residency class in the average number of cases performed or OITE scores, although the total number of cases performed has increased after implementation of the work-hour restrictions. We also found no statistical difference in the national OITE scores. Our data suggest that the impact of the 80-hour workweek has not had a detrimental effect on these 2 resident training measurements.

Differences across payors in charges for agency-based home health services: evidence from the National Home and Hospice Care Survey.

PubMed Central

Freedman, V A; Reschovsky, J D

1997-01-01

OBJECTIVE: To investigate charge and payment differentials for home health services across different payors. DATA SOURCES: The 1992 National Home and Hospice Care Survey, a nationally representative survey of home and hospice care agencies and their patients, collected by the National Center for Health Statistics. STUDY DESIGN: We compare the average charge for a Medicare home health visit to the average charge for patients with other sources of payment. In making such comparisons, we control for differences across payors in service mix and agency characteristics. PRINCIPAL FINDINGS: Agencies charge various payors different amounts for similar services, and Medicare is consistently charged more than other payors. CONCLUSIONS: Findings imply the potential existence of payment differentials across payors for home health services, with Medicare and privately insured patients likely to be paying more than others for similar services. Such conclusions raise the possibility that, as in other segments of the healthcare market, cost-shifting and price discrimination might exist within the home health industry. Future research should explore these issues, along with the question of whether Medicare is paying too much for home health services. PMID:9327812

Assessment of bias in US waterfowl harvest estimates

USGS Publications Warehouse

Padding, Paul I.; Royle, J. Andrew

2012-01-01

Context. North American waterfowl managers have long suspected that waterfowl harvest estimates derived from national harvest surveys in the USA are biased high. Survey bias can be evaluated by comparing survey results with like estimates from independent sources. Aims. We used band-recovery data to assess the magnitude of apparent bias in duck and goose harvest estimates, using mallards (Anas platyrhynchos) and Canada geese (Branta canadensis) as representatives of ducks and geese, respectively. Methods. We compared the number of reported mallard and Canada goose band recoveries, adjusted for band reporting rates, with the estimated harvests of banded mallards and Canada geese from the national harvest surveys. Weused the results of those comparisons to develop correction factors that can be applied to annual duck and goose harvest estimates of the national harvest survey. Key results. National harvest survey estimates of banded mallards harvested annually averaged 1.37 times greater than those calculated from band-recovery data, whereas Canada goose harvest estimates averaged 1.50 or 1.63 times greater than comparable band-recovery estimates, depending on the harvest survey methodology used. Conclusions. Duck harvest estimates produced by the national harvest survey from 1971 to 2010 should be reduced by a factor of 0.73 (95% CI = 0.71–0.75) to correct for apparent bias. Survey-specific correction factors of 0.67 (95% CI = 0.65–0.69) and 0.61 (95% CI = 0.59–0.64) should be applied to the goose harvest estimates for 1971–2001 (duck stamp-based survey) and 1999–2010 (HIP-based survey), respectively. Implications. Although this apparent bias likely has not influenced waterfowl harvest management policy in the USA, it does have negative impacts on some applications of harvest estimates, such as indirect estimation of population size. For those types of analyses, we recommend applying the appropriate correction factor to harvest estimates.

The social class gradient in health in Spain and the health status of the Spanish Roma.

PubMed

La Parra Casado, Daniel; Gil González, Diana; de la Torre Esteve, María

2016-10-01

To determine the social class gradient in health in general Spain population and the health status of the Spanish Roma. The National Health Survey of Spanish Roma 2006 (sample size = 993 people; average age: 33.6 years; 53.1% women) and the National Health Surveys for Spain 2003 (sample size: 21,650 people; average age: 45.5 years; 51.2% women) and 2006 (sample size: 29,478 people; average age: 46 years; 50.7% women) are compared. Several indicators were chosen: self-perceived health, activity limitation, chronic diseases, hearing and sight problems, caries, and obesity. Analysis was based on age-standardised rates and logistic regression models. According to most indicators, Roma's health is worse than that of social class IV-V (manual workers). Some indicators show a remarkable difference between Roma and social class IV-V: experiencing three or more health problems, sight problems, and caries, in both sexes, and hearing problems and obesity, in women. Roma people are placed on an extreme position on the social gradient in health, a situation of extreme health inequality.

A comparison of average wages with age-specific wages for assessing indirect productivity losses: analytic simplicity versus analytic precision.

PubMed

Connolly, Mark P; Tashjian, Cole; Kotsopoulos, Nikolaos; Bhatt, Aomesh; Postma, Maarten J

2017-07-01

Numerous approaches are used to estimate indirect productivity losses using various wage estimates applied to poor health in working aged adults. Considering the different wage estimation approaches observed in the published literature, we sought to assess variation in productivity loss estimates when using average wages compared with age-specific wages. Published estimates for average and age-specific wages for combined male/female wages were obtained from the UK Office of National Statistics. A polynomial interpolation was used to convert 5-year age-banded wage data into annual age-specific wages estimates. To compare indirect cost estimates, average wages and age-specific wages were used to project productivity losses at various stages of life based on the human capital approach. Discount rates of 0, 3, and 6 % were applied to projected age-specific and average wage losses. Using average wages was found to overestimate lifetime wages in conditions afflicting those aged 1-27 and 57-67, while underestimating lifetime wages in those aged 27-57. The difference was most significant for children where average wage overestimated wages by 15 % and for 40-year-olds where it underestimated wages by 14 %. Large differences in projecting productivity losses exist when using the average wage applied over a lifetime. Specifically, use of average wages overestimates productivity losses between 8 and 15 % for childhood illnesses. Furthermore, during prime working years, use of average wages will underestimate productivity losses by 14 %. We suggest that to achieve more precise estimates of productivity losses, age-specific wages should become the standard analytic approach.

Using School-Level Student Achievement to Engage in Formative Evaluation: Comparative School-Level Rates of Oral Reading Fluency Growth Conditioned by Initial Skill for Second Grade Students

ERIC Educational Resources Information Center

Cummings, Kelli D.; Stoolmiller, Michael L.; Baker, Scott K.; Fien, Hank; Kame'enui, Edward J.

2015-01-01

We present a method for data-based decision making at the school level using student achievement data. We demonstrate the potential of a national assessment database [i.e., the University of Oregon DIBELS Data System (DDS)] to provide comparative levels of school-level data on average student achievement gains. Through the DDS as a data source,…

78 FR 956 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

75 FR 2551 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

77 FR 801 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-06

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

76 FR 5180 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

Poverty Among Spanish Americans in Texas: Low-Income Families in a Minority Group.

ERIC Educational Resources Information Center

Upham, W. Kennedy; Wright, David E.

An analysis of 1960 census data for persons with Spanish surnames in Texas reveals a significantly high rate of poverty when compared with other ethnic groups and national averages. An analysis by county shows greater economic disadvantagement in the southern part of the state where the concentration of Mexican Americans is higher. Rural Mexican…

A Tax Increase Is Essential To Improve Illinois Schools.

ERIC Educational Resources Information Center

Lewis, James H.; Taylor, D. Garth

A tax increase is necessary to improve Illinois public schools, as this analysis demonstrates. When Illinois is compared to the rest of the United States, it has high wealth, low taxes, and low commitment to education. In fact, it has the financial capacity to have much better funded schools. Illinois ranked 12th nationally in average buying…

Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions.

PubMed

McCord, Gordon C; Liu, Anne; Singh, Prabhjot

2013-04-01

To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were calculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1 CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$ 6.86 per year per inhabitant covered by the CHW subsystem and into US$ 2.72 per year per inhabitant. Alternatively, it would take an annual average of US$ 3750 to train, equip and support each CHW. Comprehensive CHW subsystems can be deployed across sub-Saharan Africa at cost that is modest compared with the projected costs of the primary-health-care system. Given their documented successes, they offer a strong complement to facility-based care in rural African settings.

Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions

PubMed Central

McCord, Gordon C; Liu, Anne

2013-01-01

Abstract Objective To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. Methods The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were calculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1 CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. Findings The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$ 6.86 per year per inhabitant covered by the CHW subsystem and into US$ 2.72 per year per inhabitant. Alternatively, it would take an annual average of US$ 3750 to train, equip and support each CHW. Conclusion Comprehensive CHW subsystems can be deployed across sub-Saharan Africa at cost that is modest compared with the projected costs of the primary-health-care system. Given their documented successes, they offer a strong complement to facility-based care in rural African settings. PMID:23599547

Importing health conditions of expatriate workers into the United Arab Emirates.

PubMed

Newson-Smith, Mark S

2010-07-01

There are around 3.5 million workers in the United Arab Emirates, more than 80% of whom are expatriates. Among offshore workers, levels of obesity reflected the relative prevalence of the condition in their home countries and exceeded their respective national averages. Levels of hypertension and diabetes in these groups were lower than the national averages, probably because of the healthy worker effect. The level of obesity probably reflected the sedentary nature of their jobs. The presence of hepatitis C antibodies was almost exclusive to Egyptian workers. In a downstream oil and gas business, the prevalence of obesity also reflected the prevalences in the respective home countries, increasing greatly in existing employees when compared with those attending for preemployment health evaluations. Increases in the prevalence of hypertension and diabetes were also found in this group. One possible explanation is the impact of the changed environment on underlying susceptibility to these conditions.

Twenty Years of Progress on Maternal and Child Health in the Philippines: An Equity Lens.

PubMed

Bredenkamp, Caryn; Buisman, Leander R

2017-07-01

This article assesses trends and inequalities in maternal and child health in the Philippines between 1993 and 2013, using 6 national household surveys, and also compares the Philippines' performance to 15 other Asia-Pacific countries. Thirteen indicators of child health outcomes and maternal and child health interventions are examined. Two measures of inequality are used: the absolute difference between the poorest and wealthiest quintile, and the concentration index. Coverage of all indicators has improved, both on average and among the poorest quintile; however, increases are very small for child health interventions (especially immunization coverage). By the first measure of inequality, all indicators show narrowing inequalities. By the second measure, inequality has fallen only for maternal health interventions. Compared with other 15 other developing Asia-Pacific countries, the Philippines performs among the best on the child health outcomes examined and above average on maternal health interventions (except family planning), but only at or below average on child health interventions.

The economic consequences of irritable bowel syndrome: a US employer perspective.

PubMed

Leong, Stephanie A; Barghout, Victoria; Birnbaum, Howard G; Thibeault, Crystal E; Ben-Hamadi, Rym; Frech, Feride; Ofman, Joshua J

2003-04-28

The objective of this study was to measure the direct costs of treating irritable bowel syndrome (IBS) and the indirect costs in the workplace. This was accomplished through retrospective analysis of administrative claims data from a national Fortune 100 manufacturer, which includes all medical, pharmaceutical, and disability claims for the company's employees, spouses/dependents, and retirees. Patients with IBS were identified as individuals, aged 18 to 64 years, who received a primary code for IBS or a secondary code for IBS and a primary code for constipation or abdominal pain between January 1, 1996, and December 31, 1998. Of these patients with IBS, 93.7% were matched based on age, sex, employment status, and ZIP code to a control population of beneficiaries. Direct and indirect costs for patients with IBS were compared with those of matched controls. The average total cost (direct plus indirect) per patient with IBS was 4527 dollars in 1998 compared with 3276 dollars for a control beneficiary (P<.001). The average physician visit costs were 524 dollars and 345 dollars for patients with IBS and controls, respectively (P<.001). The average outpatient care costs to the employer were 1258 dollars and 742 dollars for patients with IBS and controls, respectively (P<.001). Medically related work absenteeism cost the employer 901 dollars on average per employee treated for IBS compared with 528 dollars on average per employee without IBS (P<.001). Irritable bowel syndrome is a significant financial burden on the employer that arises from an increase in direct and indirect costs compared with the control group.

Impact of Community-Based Approach as Policy Tool: World Health Organization-Designated Safe Communities of Korea and Health Action Zones of the United Kingdom

PubMed Central

Kang, Changhyun; Shin, Jihyung; Matthews, Bob

2015-01-01

Objectives The aim of this study is to ascertain and identify the effectiveness of area-based initiatives as a policy tool mediated by societal and individual factors in the five World Health Organization (WHO)-designated Safe Communities of Korea and the Health Action Zones of the United Kingdom (UK). Methods The Korean National Hospital discharge in-depth injury survey from the Korea Centers for Disease Control and Prevention and causes of death statistics by the Statistics Korea were used for all analyses. The trend and changes in injury rate and mortality by external causes were compared among the five WHO-designated Safe Communities in Korea. Results The injury incident rates decreased at a greater level in the Safe Communities compared with the national average. Similar results were shown for the changes in unintentional injury incident rates. In comparison of changes in mortality rate by external causes between 2005 and 2011, the rate increase in Safe Communities was higher than the national average except for Jeju, where the mortality rate by external causes decreased. Conclusion When the Healthy Action Zones of the UK and the WHO Safe Communities of Korea were examined, the outcomes were interpreted differently among the compared index, regions, and time periods. Therefore, qualitative outcomes, such as bringing the residents' attention to the safety of the communities and promoting participation and coordination of stakeholders, should also be considered as important impacts of the community-based initiatives. PMID:26981341

Focus on Teacher Salaries.

ERIC Educational Resources Information Center

Gaines, Gale F.

This report presents teacher salary data from the Southern Regional Education Board (SREB). There is a gap between SREB states' average teacher salaries and the national average. Over the last 5 years, SREB teacher salaries increased by an average of 14.4 percent; the national increase was nearly 2 percentage points lower. Georgia and North…

High Dengue Case Capture Rate in Four Years of a Cohort Study in Nicaragua Compared to National Surveillance Data

PubMed Central

Standish, Katherine; Kuan, Guillermina; Avilés, William; Balmaseda, Angel; Harris, Eva

2010-01-01

Dengue is a major public health problem in tropical and subtropical regions; however, under-reporting of cases to national surveillance systems hinders accurate knowledge of disease burden and costs. Laboratory-confirmed dengue cases identified through the Nicaraguan Pediatric Dengue Cohort Study (PDCS) were compared to those reported from other health facilities in Managua to the National Epidemiologic Surveillance (NES) program of the Nicaraguan Ministry of Health. Compared to reporting among similar pediatric populations in Managua, the PDCS identified 14 to 28 (average 21.3) times more dengue cases each year per 100,000 persons than were reported to the NES. Applying these annual expansion factors to national-level data, we estimate that the incidence of confirmed pediatric dengue throughout Nicaragua ranged from 300 to 1000 cases per 100,000 persons. We have estimated a much higher incidence of dengue than reported by the Ministry of Health. A country-specific expansion factor for dengue that allows for a more accurate estimate of incidence may aid governments and other institutions calculating disease burden, costs, resource needs for prevention and treatment, and the economic benefits of drug and vaccine development. PMID:20300515

75 FR 21155 - National Equal Pay Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... America A Proclamation Throughout our Nation's history, extraordinary women have broken barriers to... Equal Pay Day symbolizes the day when an average American woman's earnings finally match what an average... celebrate the strength and vibrancy women add to our economy. Our Nation's workforce includes more women...

Medical Malpractice Reform: Noneconomic Damages Caps Reduced Payments 15 Percent, With Varied Effects By Specialty

PubMed Central

Seabury, Seth A.; Helland, Eric; Jena, Anupam B.

2014-01-01

The impact of medical malpractice reforms on the average size of malpractice payments in specific physician specialties is unknown and subject to debate. We analyzed a national sample of 220,653 malpractice claims from 1985–2010 merged with information on state liability reforms. We estimated the impact of state noneconomic damage caps on average malpractice payment size for physicians overall and for 10 different specialties, and compared how the effects differed according to the restrictiveness of the cap ($250,000 vs. $500,000 cap). We found noneconomic damage caps reduced payments by $42,980 (15%; p<0.001), with a $250,000 cap reducuing average payments by $59,331 (20%; p<0.001), while a $500,000 cap had no significant effect. Effects varied according to specialty and were largest in specialties with high average payments, such as pediatrics. This suggests that the effect of noneconomic damage caps differs by specialty, and only more restrictive caps result in lower average payments. PMID:25339633

Athletic Performance at the National Basketball Association Combine After Anterior Cruciate Ligament Reconstruction

PubMed Central

Mehran, Nima; Williams, Phillip N.; Keller, Robert A.; Khalil, Lafi S.; Lombardo, Stephen J.; Kharrazi, F. Daniel

2016-01-01

Background: Anterior cruciate ligament (ACL) injuries are significant injuries in elite-level basketball players. In-game statistical performance after ACL reconstruction has been demonstrated; however, few studies have reviewed functional performance in National Basketball Association (NBA)–caliber athletes after ACL reconstruction. Purpose: To compare NBA Combine performance of athletes after ACL reconstruction with an age-, size-, and position-matched control group of players with no previous reported knee injury requiring surgery. We hypothesized that there is no difference between the 2 groups in functional performance. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 1092 NBA-caliber players who participated in the NBA Combine between 2000 and 2015 were reviewed. Twenty-one athletes were identified as having primary ACL reconstruction prior to participation in the combine. This study group was compared with an age-, size-, and position-matched control group in objective functional performance testing, including the shuttle run test, lane agility test, three-quarter court sprint, vertical jump (no step), and maximum vertical jump (running start). Results: With regard to quickness and agility, both ACL-reconstructed athletes and controls scored an average of 11.5 seconds in the lane agility test and 3.1 seconds in the shuttle run test (P = .745 and .346, respectively). Speed and acceleration was measured by the three-quarter court sprint, in which both the study group and the control group averaged 3.3 seconds (P = .516). In the maximum vertical jump, which demonstrates an athlete’s jumping ability with a running start, the ACL reconstruction group had an average height of 33.6 inches while the controls averaged 33.9 inches (P = .548). In the standing vertical jump, the ACL reconstruction group averaged 28.2 inches while the control group averaged 29.2 inches (P = .067). Conclusion: In athletes who are able to return to sport and compete at a high level such as the NBA Combine, there is no significant difference in any combine performance test between players who have had primary ACL reconstruction compared with an age-, size-, and position-matched control group. Clinical Relevance: Athletes with previous ACL reconstruction who are able to return to high-level professional basketball have equivalent performance measures with regard to speed, quickness, and jumping ability as those athletes who have not undergone knee surgery. PMID:27294169

Athletic Performance at the National Basketball Association Combine After Anterior Cruciate Ligament Reconstruction.

PubMed

Mehran, Nima; Williams, Phillip N; Keller, Robert A; Khalil, Lafi S; Lombardo, Stephen J; Kharrazi, F Daniel

2016-05-01

Anterior cruciate ligament (ACL) injuries are significant injuries in elite-level basketball players. In-game statistical performance after ACL reconstruction has been demonstrated; however, few studies have reviewed functional performance in National Basketball Association (NBA)-caliber athletes after ACL reconstruction. To compare NBA Combine performance of athletes after ACL reconstruction with an age-, size-, and position-matched control group of players with no previous reported knee injury requiring surgery. We hypothesized that there is no difference between the 2 groups in functional performance. Cross-sectional study; Level of evidence, 3. A total of 1092 NBA-caliber players who participated in the NBA Combine between 2000 and 2015 were reviewed. Twenty-one athletes were identified as having primary ACL reconstruction prior to participation in the combine. This study group was compared with an age-, size-, and position-matched control group in objective functional performance testing, including the shuttle run test, lane agility test, three-quarter court sprint, vertical jump (no step), and maximum vertical jump (running start). With regard to quickness and agility, both ACL-reconstructed athletes and controls scored an average of 11.5 seconds in the lane agility test and 3.1 seconds in the shuttle run test (P = .745 and .346, respectively). Speed and acceleration was measured by the three-quarter court sprint, in which both the study group and the control group averaged 3.3 seconds (P = .516). In the maximum vertical jump, which demonstrates an athlete's jumping ability with a running start, the ACL reconstruction group had an average height of 33.6 inches while the controls averaged 33.9 inches (P = .548). In the standing vertical jump, the ACL reconstruction group averaged 28.2 inches while the control group averaged 29.2 inches (P = .067). In athletes who are able to return to sport and compete at a high level such as the NBA Combine, there is no significant difference in any combine performance test between players who have had primary ACL reconstruction compared with an age-, size-, and position-matched control group. Athletes with previous ACL reconstruction who are able to return to high-level professional basketball have equivalent performance measures with regard to speed, quickness, and jumping ability as those athletes who have not undergone knee surgery.

The Impacts of Exposure to Environmental Risk on Physical and Mental Health in a Small Geographic Community in Houston, TX.

PubMed

Sansom, Garett; Parras, Juan; Parras, Ana; Nieto, Yudith; Arellano, Yvette; Berke, Philip; McDonald, Thomas; Shipp, Eva; Horney, Jennifer A

2017-08-01

Previous research has shown that communities with low average socioeconomic status (SES) and majority minority populations are more likely to be exposed to industrial buildings, waste facilities, and poor infrastructure compared to white communities with higher average SES. While some studies have demonstrated linkages between exposures to specific environmental contaminates within these communities and negative health outcomes, little research has analyzed the effects of environmental contaminants on the mental and physical health of these populations. A cross-sectional survey collected data from residents of Manchester, a small neighborhood in Houston, TX, that is characterized by industrial sites, unimproved infrastructure, nuisance flooding, and poor air quality. Our study (N = 109) utilized the 12 item Short Form Health Survey version 2 (SF12v2) to assess the general mental and physical health of the community. The community as a whole had reduced physical health scores compared to U.S. national averages. The time residents had lived in the neighborhood was also correlated with a reported reduction in physical health scores (r2 = 0.136; p-value <0.001). The association between time lived in the neighborhood and poorer health scores remained after adjusting for age, race, and gender (coef = -0.27, p-value <0.001). Mental health scores were within national averages and time spent living in the neighborhood did not appear to negatively impact respondent's mental health scores. These findings point to the need for more research to determine the potential for additive physical and mental health impacts in long-term residents in neighborhoods characterized by environmental justice issues.

Truth in Reporting: How Data Capture Methods Obfuscate Actual Surgical Site Infection Rates within a Health Care Network System.

PubMed

Bordeianou, Liliana; Cauley, Christy E; Antonelli, Donna; Bird, Sarah; Rattner, David; Hutter, Matthew; Mahmood, Sadiqa; Schnipper, Deborah; Rubin, Marc; Bleday, Ronald; Kenney, Pardon; Berger, David

2017-01-01

Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. This study aimed to compare database concordance. This is a multi-institution cohort study of systemwide Colorectal Surgery Collaborative. The National Surgical Quality Improvement Program requires rigorous, standardized data capture techniques; National Healthcare Safety Network allows 5 data capture techniques. Standardized surgical site infection rates were compared between databases. The Cohen κ-coefficient was calculated. This study was conducted at Boston-area hospitals. National Healthcare Safety Network or National Surgical Quality Improvement Program patients undergoing colorectal surgery were included. Standardized surgical site infection rates were the primary outcomes of interest. Thirty-day surgical site infection rates of 3547 (National Surgical Quality Improvement Program) vs 5179 (National Healthcare Safety Network) colorectal procedures (2012-2014). Discrepancies appeared: National Surgical Quality Improvement Program database of hospital 1 (N = 1480 patients) routinely found surgical site infection rates of approximately 10%, routinely deemed rate "exemplary" or "as expected" (100%). National Healthcare Safety Network data from the same hospital and time period (N = 1881) revealed a similar overall surgical site infection rate (10%), but standardized rates were deemed "worse than national average" 80% of the time. Overall, hospitals using less rigorous capture methods had improved surgical site infection rates for National Healthcare Safety Network compared with standardized National Surgical Quality Improvement Program reports. The correlation coefficient between standardized infection rates was 0.03 (p = 0.88). During 25 site-time period observations, National Surgical Quality Improvement Program and National Healthcare Safety Network data matched for 52% of observations (13/25). κ = 0.10 (95% CI, -0.1366 to 0.3402; p = 0.403), indicating poor agreement. This study investigated hospitals located in the Northeastern United States only. Variation in Centers for Medicare & Medicaid Services-mandated National Healthcare Safety Network infection surveillance methodology leads to unreliable results, which is apparent when these results are compared with standardized data. High-quality data would improve care quality and compare outcomes among institutions.

42 CFR 423.279 - National average monthly bid amount.

Code of Federal Regulations, 2010 CFR

2010-10-01

... bid amounts for each prescription drug plan (not including fallbacks) and for each MA-PD plan...(h) of the Act. (b) Calculation of weighted average. (1) The national average monthly bid amount is a....258(c)(1) of this chapter) and the denominator equal to the total number of Part D eligible...

42 CFR 423.279 - National average monthly bid amount.

Code of Federal Regulations, 2011 CFR

2011-10-01

... bid amounts for each prescription drug plan (not including fallbacks) and for each MA-PD plan...(h) of the Act. (b) Calculation of weighted average. (1) The national average monthly bid amount is a....258(c)(1) of this chapter) and the denominator equal to the total number of Part D eligible...

40 CFR Appendix N to Part 50 - Interpretation of the National Ambient Air Quality Standards for PM2.5

Code of Federal Regulations, 2012 CFR

2012-07-01

... midnight to midnight (local standard time) that are used in NAAQS computations. Designated monitors are... accordance with part 58 of this chapter. Design values are the metrics (i.e., statistics) that are compared... (referred to as the “annual standard design value”). If spatial averaging has been approved by EPA for a...

The Use of ICT Tools in Mathematics: A Case-Control Study of Best Practice in 9th Grade Classrooms

ERIC Educational Resources Information Center

Thorvaldsen, Steinar; Vavik, Lars; Salomon, Gavriel

2012-01-01

Results are reported from a study in which teachers' views of highly achieving ninth grade classes in Norway (KappAbel national competition winners) were compared with teachers' views of average achievement classes with regard to the use of information and communication technologies (ICT) and pedagogical practices. The main purpose of the study…

The Astronomy Diagnostic Test: Comparing Your Class to Others

NASA Astrophysics Data System (ADS)

Hufnagel, B.; Deming, G.

1999-05-01

A standard diagnostic test can be a powerful tool to assess the conceptual understanding of students, as has been proven for undergraduate physics instruction over the last ten years (e.g., E.F. Redish and R.N. Steinberg 1999, Physics Today, 52:1, 24). If you are now using, or are considering adopting, a more interactive teaching style such as that used by Eric Mazur (Peer Instruction: a User's Manual, [Prentice-Hall: 1997]) or Michael Zeilik and his collaborators (1997, AJP, 65:12, 987), you may want to use a standard diagnostic test designed for undergraduate astronomy classes. Details of the validation of the ADT are at Slater et al., also presented in this session. A comparative database of ADT scores, by class and by question, can help the instructor assess student preparedness and the effectiveness of alternative teaching methods. In the spring of 1999, 19 astronomy instructors at 7 state universities, 4 community colleges, 4 liberal arts schools, 1 woman's college and 1 technical university across the USA gave the ADT to their classes once at the beginning of the course, and again at the end of the course. The average pre-course ADT scores by class from these ~ 1000 students show two surprising results: the conceptual understanding of introductory classes is about the same (34%) regardless of type of school, geographic location, or average student age. However, there is a significant gender difference, with females scoring an average of 29% and males 39%, with the standard errors both less than 1%. The Astronomy Diagnostic Test (ADT) and its comparative by-class database will be available at the National Institute for Science Education (NISE) website after 1 June 1999. This research was supported by the National Science Foundation through Grant DGE-9714489, and by the generosity of the participating astronomy instructors.

Food Consumption According to the Days of the Week – National Food Survey, 2008-2009

PubMed Central

Monteiro, Luana Silva; Hassan, Bruna Kulik; Estima, Camilla Chermont Prochnik; Souza, Amanda de Moura; Verly, Eliseu; Sichieri, Rosely; Pereira, Rosangela Alves

2017-01-01

ABSTRACT OBJECTIVE Evaluate the variations in energy, nutrients, and food groups intake between days of the week and weekend days in the Brazilian population. METHODS We used data from the first National Food Survey (2008-2009) of a one-day food log of a representative sample of the Brazilian population aged 10 years or older (n = 34,003). For the analyses, we considered the sample weights and the effect of the study design. The mean (and standard deviations) and frequencies (%) of energy, nutrients, and food groups consumption were estimated for weekdays (Monday to Friday) and weekend (Saturday and Sunday), we then estimated the differences according to the days of the week for the population strata analyzed. RESULTS The average daily energy intake for the weekend was 8% higher than the one observed for weekdays. The average percentage contribution of carbohydrate to the daily energy intake was higher during the week compared to Saturday and Sunday (56.3% versus 54.1%, p < 0.01). The inverse was observed for averages of the contribution to the daily intake of energy from total fat (26.8% versus 28.4%), saturated fat (9.1% versus 9.9%) and trans fat (1.4% versus 1.6%). The most significant changes between weekdays and weekend days were observed for eggs, sugar-added beverages, puff snacks and chips, beans, and pasta. During weekends, the frequency of beverage with added sugar consumption increased by 34%, the amount consumed increased by 42%, and the contribution to energy intake increased by 62% when compared to weekdays. CONCLUSIONS The Brazilian population increases energy intake and unhealthy food markers on weekends compared to weekdays. PMID:29020121

Comparison of National Board of Chiropractic Examiners part I examination scores between tutors and tutees at a chiropractic college

PubMed Central

Kenya, Amilliah W.; Hart, John F.; Vuyiya, Charles K.

2016-01-01

Objective: This study compared National Board of Chiropractic Examiners part I test scores between students who did and did not serve as tutors on the subject matter. Methods: Students who had a prior grade point average of 3.45 or above on a 4.0 scale just before taking part I of the board exams were eligible to participate. A 2-sample t-test was used to ascertain the difference in the mean scores on part I between the tutor group (n = 28) and nontutor (n = 29) group. Results: Scores were higher in all subjects for the tutor group compared to the nontutor group and the differences were statistically significant (p < .01) with large effect sizes. Conclusion: The tutors in this study performed better on part I of the board examination compared to nontutors, suggesting that tutoring results in an academic benefit for tutors themselves. PMID:26998665

Measurements of methane emissions at natural gas production sites in the United States.

PubMed

Allen, David T; Torres, Vincent M; Thomas, James; Sullivan, David W; Harrison, Matthew; Hendler, Al; Herndon, Scott C; Kolb, Charles E; Fraser, Matthew P; Hill, A Daniel; Lamb, Brian K; Miskimins, Jennifer; Sawyer, Robert F; Seinfeld, John H

2013-10-29

Engineering estimates of methane emissions from natural gas production have led to varied projections of national emissions. This work reports direct measurements of methane emissions at 190 onshore natural gas sites in the United States (150 production sites, 27 well completion flowbacks, 9 well unloadings, and 4 workovers). For well completion flowbacks, which clear fractured wells of liquid to allow gas production, methane emissions ranged from 0.01 Mg to 17 Mg (mean = 1.7 Mg; 95% confidence bounds of 0.67-3.3 Mg), compared with an average of 81 Mg per event in the 2011 EPA national emission inventory from April 2013. Emission factors for pneumatic pumps and controllers as well as equipment leaks were both comparable to and higher than estimates in the national inventory. Overall, if emission factors from this work for completion flowbacks, equipment leaks, and pneumatic pumps and controllers are assumed to be representative of national populations and are used to estimate national emissions, total annual emissions from these source categories are calculated to be 957 Gg of methane (with sampling and measurement uncertainties estimated at ± 200 Gg). The estimate for comparable source categories in the EPA national inventory is ~1,200 Gg. Additional measurements of unloadings and workovers are needed to produce national emission estimates for these source categories. The 957 Gg in emissions for completion flowbacks, pneumatics, and equipment leaks, coupled with EPA national inventory estimates for other categories, leads to an estimated 2,300 Gg of methane emissions from natural gas production (0.42% of gross gas production).

Measurements of methane emissions at natural gas production sites in the United States

PubMed Central

Allen, David T.; Torres, Vincent M.; Thomas, James; Sullivan, David W.; Harrison, Matthew; Hendler, Al; Herndon, Scott C.; Kolb, Charles E.; Fraser, Matthew P.; Hill, A. Daniel; Lamb, Brian K.; Miskimins, Jennifer; Sawyer, Robert F.; Seinfeld, John H.

2013-01-01

Engineering estimates of methane emissions from natural gas production have led to varied projections of national emissions. This work reports direct measurements of methane emissions at 190 onshore natural gas sites in the United States (150 production sites, 27 well completion flowbacks, 9 well unloadings, and 4 workovers). For well completion flowbacks, which clear fractured wells of liquid to allow gas production, methane emissions ranged from 0.01 Mg to 17 Mg (mean = 1.7 Mg; 95% confidence bounds of 0.67–3.3 Mg), compared with an average of 81 Mg per event in the 2011 EPA national emission inventory from April 2013. Emission factors for pneumatic pumps and controllers as well as equipment leaks were both comparable to and higher than estimates in the national inventory. Overall, if emission factors from this work for completion flowbacks, equipment leaks, and pneumatic pumps and controllers are assumed to be representative of national populations and are used to estimate national emissions, total annual emissions from these source categories are calculated to be 957 Gg of methane (with sampling and measurement uncertainties estimated at ±200 Gg). The estimate for comparable source categories in the EPA national inventory is ∼1,200 Gg. Additional measurements of unloadings and workovers are needed to produce national emission estimates for these source categories. The 957 Gg in emissions for completion flowbacks, pneumatics, and equipment leaks, coupled with EPA national inventory estimates for other categories, leads to an estimated 2,300 Gg of methane emissions from natural gas production (0.42% of gross gas production). PMID:24043804

Methane and nitrous oxide emissions from livestock agriculture in 16 local administrative districts of Korea.

PubMed

Ji, Eun Sook; Park, Kyu-Hyun

2012-12-01

This study was conducted to evaluate methane (CH4) and nitrous oxide (N2O) emissions from livestock agriculture in 16 local administrative districts of Korea from 1990 to 2030. National Inventory Report used 3 yr averaged livestock population but this study used 1 yr livestock population to find yearly emission fluctuations. Extrapolation of the livestock population from 1990 to 2009 was used to forecast future livestock population from 2010 to 2030. Past (yr 1990 to 2009) and forecasted (yr 2010 to 2030) averaged enteric CH4 emissions and CH4 and N2O emissions from manure treatment were estimated. In the section of enteric fermentation, forecasted average CH4 emissions from 16 local administrative districts were estimated to increase by 4%-114% compared to that of the past except for Daejeon (-63%), Seoul (-36%) and Gyeonggi (-7%). As for manure treatment, forecasted average CH4 emissions from the 16 local administrative districts were estimated to increase by 3%-124% compared to past average except for Daejeon (-77%), Busan (-60%), Gwangju (-48%) and Seoul (-8%). For manure treatment, forecasted average N2O emissions from the 16 local administrative districts were estimated to increase by 10%-153% compared to past average CH4 emissions except for Daejeon (-60%), Seoul (-4.0%), and Gwangju (-0.2%). With the carbon dioxide equivalent emissions (CO2-Eq), forecasted average CO2-Eq from the 16 local administrative districts were estimated to increase by 31%-120% compared to past average CH4 emissions except Daejeon (-65%), Seoul (-24%), Busan (-18%), Gwangju (-8%) and Gyeonggi (-1%). The decreased CO2-Eq from 5 local administrative districts was only 34 kt, which was insignificantly small compared to increase of 2,809 kt from other 11 local administrative districts. Annual growth rates of enteric CH4 emissions, CH4 and N2O emissions from manure management in Korea from 1990 to 2009 were 1.7%, 2.6%, and 3.2%, respectively. The annual growth rate of total CO2-Eq was 2.2%. Efforts by the local administrative offices to improve the accuracy of activity data are essential to improve GHG inventories. Direct measurements of GHG emissions from enteric fermentation and manure treatment systems will further enhance the accuracy of the GHG data. (Key Words: Greenhouse Gas, Methane, Nitrous Oxide, Carbon Dioxide Equivalent Emission, Climate Change).

The Status of White Spruce Plantations on Lake States National Forests

Treesearch

Glen W. Erickson; H. Michael Rauscher

1985-01-01

Summarizes information about white spruce plantations as of 1982. Based on average site index, the Superior National Forest in Minnesota and the Hiawatha and Huron-Manistee in Michigan contain climate-soil-seed source complexes that are, on the average, less productive for white spruce than on the other National Forests

77 FR 43232 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... ``national average payments,'' the amount of money the Federal Government provides States for lunches... with pricing programs that elect to serve milk free to eligible children continue to receive the... during the second preceding school year were served free or at a reduced price. The higher payment level...

24 CFR Appendix B to Part 1000 - IHBG Block Grant Formula Mechanisms

Code of Federal Regulations, 2011 CFR

2011-04-01

... weighted average for AEL (NAEL). The FMR factor is also defined in § 1000.302 as the relative difference between a local area Fair Market Rent (FMR) and the national weighted average for FMR. OPSUB = [LR * LRSUB... FMR Factor weighted by national average of AEL Factor and FRM Factor. AEL FACTOR = AEL/NAEL. AEL...

Quantifying sources of bias in National Healthcare Safety Network laboratory-identified Clostridium difficile infection rates.

PubMed

Haley, Valerie B; DiRienzo, A Gregory; Lutterloh, Emily C; Stricof, Rachel L

2014-01-01

To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates. Sensitivity analysis. A total of 124 New York hospitals in 2010. New York NHSN CDI events from audited hospitals were matched to New York hospital discharge billing records to obtain additional information on patient age, length of stay, and previous hospital discharges. "Corrected" hospital-onset (HO) CDI rates were calculated after (1) correcting inaccurate case reporting found during audits, (2) incorporating knowledge of laboratory results from outside hospitals, (3) excluding days when patients were not at risk from the denominator of the rates, and (4) adjusting for patient age. Data sets were simulated with each of these sources of bias reintroduced individually and combined. The simulated rates were compared with the corrected rates. Performance (ie, better, worse, or average compared with the state average) was categorized, and misclassification compared with the corrected data set was measured. Counting days patients were not at risk in the denominator reduced the state HO rate by 45% and resulted in 8% misclassification. Age adjustment and reporting errors also shifted rates (7% and 6% misclassification, respectively). Changing the NHSN protocol to require reporting of age-stratified patient-days and adjusting for patient-days at risk would improve comparability of rates across hospitals. Further research is needed to validate the risk-adjustment model before these data should be used as hospital performance measures.

Racial Differences in Outcomes after Acute Ischemic Stroke Hospitalization in the United States.

PubMed

Kumar, Nilay; Khera, Rohan; Pandey, Ambarish; Garg, Neetika

2016-08-01

Racial differences in stroke outcomes have major health policy implications. There is paucity of contemporary data on racial differences in clinical outcomes and resource utilization in acute ischemic stroke hospitalizations in the United States. We used the 2011-2012 National Inpatient Sample to identify hospitalizations with a primary diagnosis of acute ischemic stroke. Primary outcomes were in-hospital mortality, utilization of thrombolysis, and endovascular mechanical thrombectomy (EMT). Secondary outcomes were length of stay (LOS) and average inflation-adjusted charges. A total of 173,910 hospitalizations representing 835,811 hospitalizations nationwide were included in the study. Mean age was 70.9 years and 52.3% were women. Blacks (adjusted OR .71, 95% CI .64-.78, P < .001) and Asian or Pacific Islanders (adjusted OR .80, 95% CI .66-.97, P = .02) had a lower in-hospital mortality compared to Whites. Blacks were less likely to be treated with thrombolysis (adjusted OR .84, 95% CI .76-.92, P < .001) and EMT (OR .73, 95% CI .58-.91, P = .01). Average LOS and inflation-adjusted charges were significantly higher for racial minorities compared to Whites. Blacks and Asians hospitalized for ischemic stroke are less likely to die in the hospital compared to Whites. Hospitalization for stroke in Blacks is associated with lower rates of reperfusion therapy, longer lengths of stay, and higher costs compared to Whites. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

High-tech rural clinics and hospitals in Japan: a comparison to the Japanese average.

PubMed

Matsumoto, Masatoshi; Okayama, Masanobu; Inoue, Kazuo; Kajii, Eiji

2004-10-01

Japanese medical facilities are noted for being heavily equipped with high-tech equipment compared to other industrialised countries. Rural facilities are anecdotally said to be better equipped than facilities in other areas due to egalitarian health resource diffusion policies by public sectors whose goal is to secure fair access to modern medical technologies among the entire population. To show the technology status of rural practice and compare it to the national level. Nationwide postal survey. Questionnaires were sent to the directors of 1362 public hospitals and clinics (of the 1723 municipalities defined as 'rural' by four national laws). Information was collected about the technologies they possessed. The data were compared with figures from a national census of all hospitals and clinics. A total of 766 facilities responded (an effective response rate of 56%). Rural facilities showed higher possession rates in most comparable technologies than the national level. It is noted that almost all rural hospitals had gastroscopes and colonoscopes and their possession rates of bronchoscopes and dialysis equipment were twice as high as the national level. The discrepancy in possession rates between rural and national was even more remarkable in clinics than in hospitals. Rural clinics owned twice as many abdominal ultrasonographs, and three times as many gastroscopes, colonoscopes, defibrillators and computed tomography scanners as the national level. Rural facilities are equipped with more technology than urban ones. Government-led, tax based, technology diffusion in the entire country seems to have attained its goal. What is already known on this subject: As a general tendency in both developing and developed countries, rural medical facilities are technologically less equipped than their urban counterparts. What does this paper add?: In Japan, rural medical facilities are technologically better equipped than urban facilities.

The Family Health Project: psychosocial adjustment of children whose mothers are HIV infected.

PubMed

Forehand, R; Steele, R; Armistead, L; Morse, E; Simon, P; Clark, L

1998-06-01

The psychosocial adjustment of 87 inner-city African American children 6-11 years old whose mothers were HIV infected was compared with that of 149 children from a similar sociodemographic background whose mothers did not report being HIV infected. Children were not identified as being HIV infected. Mother reports, child reports, and standardized reading achievement scores were used to assess 4 domains of adjustment: externalizing problems, internalizing problems, cognitive competence, and prosocial competence. The results indicated that, on average, children from both groups had elevated levels of behavior problem scores and low reading achievement scores when compared with national averages. Relative to children whose mothers were not infected, those whose mothers were HIV infected were reported to have more difficulties in all domains of psychosocial adjustment. Potential family processes that may explain the findings are discussed.

The Quality vs. the Quantity of Schooling: What Drives Economic Growth?

ERIC Educational Resources Information Center

Breton, Theodore R.

2011-01-01

This paper challenges Hanushek and Woessmann's (2008) contention that the quality and not the quantity of schooling determines a nation's rate of economic growth. I first show that their statistical analysis is flawed. I then show that when a nation's average test scores and average schooling attainment are included in a national income model,…

78 FR 45178 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-26

... ``national average payments,'' the amount of money the Federal Government provides States for lunches... institutions with pricing programs that elect to serve milk free to eligible children continue to receive the... during the second preceding school year were served free or at a reduced price. The higher payment level...

76 FR 43256 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... ``national average payments,'' the amount of money the Federal Government provides States for lunches... institutions with pricing programs that elect to serve milk free to eligible children continue to receive the... during the second preceding school year were served free or at a reduced price. The higher payment level...

Preliminary Final Environmental Impact Statement

DTIC Science & Technology

2000-12-01

Suitabilities - Brooks AFB .................................................................... 3-49 3.5-2 National and Texas Ambient Air Quality...night average sound level NAAQS = National Ambient Air Quality Standards NPDES = National Pollutant Discharge Elimination System ROI = region of...Dos Rios, and Medio Creek plants. These plants treat an average of 130 MG of wastewater per day, with a total capacity (including an excess margin

Beyond Horse Race Comparisons of National Performance Averages: Math Performance Variation within and between Classrooms in 38 Countries

ERIC Educational Resources Information Center

Huang, Min-Hsiung

2009-01-01

Reports of international studies of student achievement often receive public attention worldwide. However, this attention overly focuses on the national rankings of average student performance. To move beyond the simplistic comparison of national mean scores, this study investigates (a) country differences in the measures of variability as well as…

Fractures in Individuals with and without a History of Infantile Autism. A Danish Register Study Based on Hospital Discharge Diagnoses

ERIC Educational Resources Information Center

Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

2012-01-01

We compared the prevalence and types of fractures in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average observation time was 30.3 years (range 27.3-30.4…

JPRS Report, China.

DTIC Science & Technology

1989-11-04

short-term behavior and act only for immediate benefit. This atti- tude is conducive to the growth of deceitful behaviors. China’s revolution and...having a power shortage. Objectively, the construction of the power generation industry has fallen behind the growth of the national economic...increased by 22.2 percent when compared to the previous year, which exceeded the average growth rate of the whole province. After entering into

Change in First Leaf Date Between 1951-1960 and 2006-2015

EPA Pesticide Factsheets

This figure shows modeled trends in lilac and honeysuckle first leaf dates at weather stations across the contiguous 48 states. This map compares the average first leaf date during two 10-year periods, developed using data from the USA National Phenology Network. Blue circles represent later leaf dates, and red circles represent earlier. For more information: www.epa.gov/climatechange/science/indicators

SAT Scores, 2012-13: Wake County Public School System (WCPSS). Measuring Up. D&A Report No. 13.22

ERIC Educational Resources Information Center

Muli, Juliana; Gilleland, Kevin; McMillen, Brad

2014-01-01

As the ACT has become part of North Carolina's mandatory testing program, SAT participation in Wake County Public School System (WCPSS) and North Carolina has declined in recent years. However, SAT performance in WCPSS remains high compared to state and national averages. In 2012-13, students in WCPSS continued to score 50-60 points higher on the…

HEaDS-UP Phase IV Assessment: Headgear Effects on Auditory Perception

DTIC Science & Technology

2015-02-01

8 Fig. 6 Average attenuation measured for the CIPHER and INTERCPT helmets as a function of noise level, mandible/ eyewear ...impulsive noise consistent with the US Occupational Safety and Health Administration (OSHA 1981), the National Institute for Occupational Safety and... eyewear , or HPDs) (Fig. 5) show that the CIPHER and INTERCPT compared favorably with the currently fielded advanced combat helmet (ACH). Figure 6

Talented Athletes and Academic Achievements: A Comparison over 14 Years

ERIC Educational Resources Information Center

Jonker, Laura; Elferink-Gemser, Marije T.; Visscher, Chris

2009-01-01

The purpose of this study was to gain insight into the academic achievements of 200 talented athletes in 1992/1993 and 200 in 2006/2007, aged 14-16 years. When compared with the national average, the athletes in 2006/2007 attended pre-university classes more often (X[superscript 2] = 57.001, p less than 0.05). Of the 2006/2007 athletes, a higher…

A Multifaceted Intervention to Improve the Quality of Care of Children in District Hospitals in Kenya: A Cost-Effectiveness Analysis

PubMed Central

Barasa, Edwine W.; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

Background To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Methods and Findings Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26–67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67–47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19–2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A “what-if” analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Conclusion Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be cost-effective when compared to incremental cost-effectiveness ratios of other priority child health interventions. Please see later in the article for the Editors' Summary PMID:22719233

A multifaceted intervention to improve the quality of care of children in district hospitals in Kenya: a cost-effectiveness analysis.

PubMed

Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26-67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67-47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19-2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A "what-if" analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be cost-effective when compared to incremental cost-effectiveness ratios of other priority child health interventions.

"Inclusive Working Life" in Norway--experience from "Models of Good Practice" enterprises.

PubMed

Lie, Arve

2008-08-01

To determine whether enterprises belonging to the Bank of Models of Good Practice were more successful than average Norwegian enterprises in the reduction of sickness absence, promotion of early return to work, and prevention of early retirement. In 2004 we selected 86 enterprises with a total of approximately 90000 employees from the Inclusive Working Life (IWL) Bank of Models of Good Practice. One representative of workers and one of management from each enterprise received a questionnaire on the aims, organization, and the results of the IWL program by mail. Data on sickness absence, use of early retirement, and disability retirement in the 2000-2004 period were collected from the National Insurance Registry. Data on comparable enterprises were obtained from the National Bureau of Statistics. The response rate was 65%. Although the IWL campaign was directed at reducing sickness absence, preventing early retirement, and promoting employment of the functionally impaired, most attention was paid to reducing sickness absence. Sickness absence rate in Models of Good Practice enterprises (8.2%) was higher than in comparable enterprises that were not part of the Models of Good Practice (6.9%). Implementation of many IWL activities, empowerment and involvement of employees, and good cooperation with the occupational health service were associated with a lower rate of sickness absence. On average, 0.7% new employees per year received disability pension, which is a significantly lower percentage than expected on the basis of the rate of 1.3% per year in comparable enterprises. Frequent use of disability pensioning was associated with high rate of sickness absence and having many employees older than 50 years. On average, 0.4% employees per year received early retirement compensation, which was expected on the basis of national estimates. Frequent use of early retirement was associated with having many employees older than 50 years. Models of Good Practice enterprises had a higher than expected sickness absence rate. This indicates that it is difficult to identify Models of Good Practice enterprises and that they cannot be treated as role model enterprises. Good cooperation with the occupational health service and the empowerment and involvement of the employees is associated with a low sickness absence rate.

Results of external quality-assurance program for the National Atmospheric Deposition Program and National Trends Network during 1985

USGS Publications Warehouse

Brooks, M.H.; Schroder, L.J.; Willoughby, T.C.

1988-01-01

External quality assurance monitoring of the National Atmospheric Deposition Program (NADP) and National Trends Network (NTN) was performed by the U.S. Geological Survey during 1985. The monitoring consisted of three primary programs: (1) an intersite comparison program designed to assess the precision and accuracy of onsite pH and specific conductance measurements made by NADP and NTN site operators; (2) a blind audit sample program designed to assess the effect of routine field handling on the precision and bias of NADP and NTN wet deposition data; and (3) an interlaboratory comparison program designed to compare analytical data from the laboratory processing NADP and NTN samples with data produced by other laboratories routinely analyzing wet deposition samples and to provide estimates of individual laboratory precision. An average of 94% of the site operators participated in the four voluntary intersite comparisons during 1985. A larger percentage of participating site operators met the accuracy goal for specific conductance measurements (average, 87%) than for pH measurements (average, 67%). Overall precision was dependent on the actual specific conductance of the test solution and independent of the pH of the test solution. Data for the blind audit sample program indicated slight positive biases resulting from routine field handling for all analytes except specific conductance. These biases were not large enough to be significant for most data users. Data for the blind audit sample program also indicated that decreases in hydrogen ion concentration were accompanied by decreases in specific conductance. Precision estimates derived from the blind audit sample program indicate that the major source of uncertainty in wet deposition data is the routine field handling that each wet deposition sample receives. Results of the interlaboratory comparison program were similar to results of previous years ' evaluations, indicating that the participating laboratories produced comparable data when they analyzed identical wet deposition samples, and that the laboratory processing NADP and NTN samples achieved the best analyte precision of the participating laboratories. (Author 's abstract)

Health, social and economic consequences of dementias: a comparative national cohort study.

PubMed

Frahm-Falkenberg, S; Ibsen, R; Kjellberg, J; Jennum, P

2016-09-01

Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register based cohort study. Using records from the Danish National Patient Registry (1997-2009) all patients with a diagnosis of Alzheimer's disease, vascular dementia or dementia not otherwise specified and their partners were identified and compared with randomly chosen controls matched for age, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period - before and after diagnosis. In all, 78 715 patients were identified and compared with 312 813 matched controls. Patients' partners were also identified and matched with a control group. Patients had lower income and higher mortality and morbidity rates and greater use of medication. Social- and health-related vulnerability was identified years prior to diagnosis. The average annual additional cost of direct healthcare costs and lost productivity in the years before diagnosis was 2082 euros per patient over and above that of matched controls, and 4544 euros per patient after the time of diagnosis. Dementias cause significant morbidity and mortality, consequently generating significant socioeconomic costs. © 2016 EAN.

42 CFR 423.279 - National average monthly bid amount.

Code of Federal Regulations, 2014 CFR

2014-10-01

... each MA-PD plan described in section 1851(a)(2)(A)(i) of the Act. The calculation does not include bids... section 1876(h) of the Act. (b) Calculation of weighted average. (1) The national average monthly bid... defined in § 422.258(c)(1) of this chapter) and the denominator equal to the total number of Part D...

42 CFR 423.279 - National average monthly bid amount.

Code of Federal Regulations, 2013 CFR

2013-10-01

... each MA-PD plan described in section 1851(a)(2)(A)(i) of the Act. The calculation does not include bids... section 1876(h) of the Act. (b) Calculation of weighted average. (1) The national average monthly bid... defined in § 422.258(c)(1) of this chapter) and the denominator equal to the total number of Part D...

42 CFR 423.279 - National average monthly bid amount.

Code of Federal Regulations, 2012 CFR

2012-10-01

... each MA-PD plan described in section 1851(a)(2)(A)(i) of the Act. The calculation does not include bids... section 1876(h) of the Act. (b) Calculation of weighted average. (1) The national average monthly bid... defined in § 422.258(c)(1) of this chapter) and the denominator equal to the total number of Part D...

Reforming maternity services in Australia: Outcomes of a private practice midwifery service.

PubMed

Wilkes, E; Gamble, J; Adam, Ghazala; Creedy, D K

2015-10-01

recent legislative changes in Australia have enabled eligible midwives to provide private primary maternity care with fee rebates through Medicare. This paper (1) discusses these changes affecting midwifery practice; (2) describes Australia's first private midwifery service with visiting rights to hospital for labour and birth care since Medicare funding for midwives was introduced in 2010; and (3) compares outcomes with National Core Maternity Indicators. an audit of all client records (n=323) for the survey period from September 2012 to February 2014 was undertaken. Data were extracted and compared with the 10 perinatal indicators using Chi square statistics. this convenience sample of all-risk women was similar to the national birthing population for age and parity. Compared to national indicators, women were significantly more likely to have spontaneous commencement of labour (79.6% versus 54.8%) (χ(2)=79.88, p<.001), lower rates of induction (10.2% versus 26%) (χ(2)=79.88, p<.001), and not require pharmacological pain relief (54.8% versus 23.9%) (χ(2)=152.2, p<.001). The majority of women had a normal vaginal birth (70.3% versus 55.1%) (χ(2)=28.13, p<.001). The caesarean section rate (22% versus 32.3%) was significantly lower (χ(2)=15.64, p<.001) than the national rate. Average gestation of neonates was 39.3 weeks; average birth weight was 3525 gms, and fewer required transfer to the special care nursery (8.4% versus 15.3%) (χ(2)=11.89, p<.001). this is the first report of maternal and neonatal outcomes for a private midwifery service in Australia since the introduction of access to Medicare for midwives. Maternal and newborn outcomes were statistically better than national rates. Routinely reporting and publishing clinical outcomes needs to become the norm for private maternity care. this private midwifery caseload model has been instrumental in the ground-breaking change to primary maternity services that extends women׳s access to safe midwifery care in Australia. The potential impact of private practicing midwives to align maternity care with the best available evidence is significant. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluating Siebens Domain Management Model for inpatient rehabilitation to increase functional independence and discharge rate to home in geriatric patients.

PubMed

Kushner, David S; Peters, Kenneth M; Johnson-Greene, Doug

2015-07-01

To evaluate the Siebens Domain Management Model (SDMM) for geriatric inpatient rehabilitation (IR) to increase functional independence and dispositions to home. Before and after study. IR facility. During 2010 (preintervention), 429 patients aged ≥75 years who were on average admitted to IR 8.2 days postacute care, and during 2012 (postintervention), 524 patients aged ≥75 years who were on average admitted to IR 5.5 days postacute care. Case-mix group (CMG) comorbidity tier severity, preadmission living setting, and living support were similar in both groups. The SDMM involving weekly adjustments of IR care focused on potential barriers to discharge home. FIM efficiency, length of stay (LOS), and disposition rates to community/home, acute care, and long-term care (LTC) to compare pre-/postintervention facility data and comparison of facility to national CMG-adjusted data from the Uniform Data System for Medical Rehabilitation for both years (2010/2012). Pre-/postintervention group admission FIM scores were similar (t=2.96, P<.003), but the preintervention group had on average 2.6 days greater LOS during IR and greater time to onset of IR (8.2 vs 5.5d) from acute care. Preintervention FIM efficiency was 2.1, whereas postintervention FIM efficiency was 2.76, a significant difference (t=4.1, P<.0001). There were significantly more discharges to the community in the postintervention group (74.4%) than the preintervention group (58.5%, χ(2)=26.2, P<.0001). There were significantly fewer patients discharged to LTC in the postintervention group (χ(2)=30.47, P<.0001). The preintervention group did not significantly differ from the 2010 national data, but the postintervention group significantly differed from the 2012 national data for both greater FIM efficiency (t=-5.5, P<.0001) and greater discharge to community (χ(2)=34, P<.0001). LOS decreased by 2.6 days in the postintervention group compared with the preintervention group, whereas LOS decreased by only 0.6 days nationally from 2010 to 2012, a significant difference with postintervention LOS lower than the national data (t=31.1, P<.0001). Use of the SDMM during IR in geriatric patients is associated with increased functional independence and discharges to home/community and reduced institutionalization. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Delivering an effective outpatient service in gynaecology. A randomised controlled trial analysing the cost of outpatient versus daycase hysteroscopy.

PubMed

Marsh, Fiona; Kremer, Christian; Duffy, Sean

2004-03-01

To examine the cost implications of outpatient versus daycase hysteroscopy to the National Health Service, the patient and their employer. Randomised controlled trial. The gynaecology clinic of a large teaching hospital. Ninety-seven women with abnormal uterine bleeding requiring investigation. Women were randomly allocated to either outpatient or daycase hysteroscopy. They were asked to complete diaries recording expenses and time off work. The National Health Service costs were calculated for a standard outpatient and daycase hysteroscopy. Costs to the National Health Service, costs to the employer, loss of income, childcare costs and travel expenses. The outpatient group required significantly less time off work compared with the daycase group (0.8 days vs 3.3 days), P < 0.001. Of those women who lost income due to the hysteroscopy, the average loss of income was twice as much in the daycase group ( pound 20.40 in the outpatient group vs pound 50.60 in the daycase group). The average cost of childcare required to cover the time spent in hospital undergoing the hysteroscopy was similar in both groups, however, the number of women requiring childcare was small. Travel costs incurred by the women were 74% more in the daycase group compared with the outpatient group-with an average cost of pound 3.46 in the outpatient group and pound 6.02 in the daycase group. Daycase hysteroscopy costs the National Health Service approximately pound 53.88 more per patient, than performing an outpatient hysteroscopy. Purchasing the hysteroscopes necessary to perform an outpatient hysteroscopy is a more expensive outlay than those required for daycase hysteroscopy. However, there are so many other savings that only 38 patients need to undergo outpatient hysteroscopy (even with a 4% failure rate) rather than daycase hysteroscopy in order to recoup the extra money required to set up an outpatient hysteroscopy service. Outpatient hysteroscopy offers many benefits over its traditional counterpart including faster recovery, less time away from work and home and cost savings to the woman and her employer and the National Health Service. Resources need to be made available to rapidly develop this service across the UK in order to better serve both patient and taxpayer.

Pharmacy curriculum outcomes assessment for individual student assessment and curricular evaluation.

PubMed

Scott, Day M; Bennett, Lunawati L; Ferrill, Mary J; Brown, Daniel L

2010-12-15

The Pharmacy Curriculum Outcomes Assessment (PCOA) is a standardized examination for assessing academic progress of pharmacy students. Although no other national benchmarking tool is available on a national level, the PCOA has not been adopted by all colleges and schools of pharmacy. Palm Beach Atlantic University (PBAU) compared 2008-2010 PCOA results of its P1, P2, and P3 students to their current grade point average (GPA) and to results of a national cohort. The reliability coefficient of PCOA was 0.91, 0.90, and 0.93 for the 3 years, respectively. PBAU results showed a positive correlation between GPA and PCOA scale score. A comparison of subtopic results helped to identify areas of strengths and weaknesses of the curriculum. PCOA provides useful comparative data that can facilitate individual student assessment as well as programmatic evaluation. There are no other standardized assessment tools available. Despite limitations, PCOA warrants consideration by colleges and schools of pharmacy. Expanded participation could enhance its utility as a meaningful benchmark.

Pharmacy Curriculum Outcomes Assessment for Individual Student Assessment and Curricular Evaluation

PubMed Central

Bennett, Lunawati L.; Ferrill, Mary J.; Brown, Daniel L.

2010-01-01

The Pharmacy Curriculum Outcomes Assessment (PCOA) is a standardized examination for assessing academic progress of pharmacy students. Although no other national benchmarking tool is available on a national level, the PCOA has not been adopted by all colleges and schools of pharmacy. Palm Beach Atlantic University (PBAU) compared 2008-2010 PCOA results of its P1, P2, and P3 students to their current grade point average (GPA) and to results of a national cohort. The reliability coefficient of PCOA was 0.91, 0.90, and 0.93 for the 3 years, respectively. PBAU results showed a positive correlation between GPA and PCOA scale score. A comparison of subtopic results helped to identify areas of strengths and weaknesses of the curriculum. PCOA provides useful comparative data that can facilitate individual student assessment as well as programmatic evaluation. There are no other standardized assessment tools available. Despite limitations, PCOA warrants consideration by colleges and schools of pharmacy. Expanded participation could enhance its utility as a meaningful benchmark. PMID:21436924

Using Item Response Theory to Evaluate LSCI Learning Gains

NASA Astrophysics Data System (ADS)

Schlingman, Wayne M.; Prather, E. E.; Collaboration of Astronomy Teaching Scholars CATS

2012-01-01

Analyzing the data from the recent national study using the Light and Spectroscopy Concept Inventory (LSCI), this project uses Item Response Theory (IRT) to investigate the learning gains of students as measured by the LSCI. IRT provides a theoretical model to generate parameters accounting for students’ abilities. We use IRT to measure changes in students’ abilities to reason about light from pre- to post-instruction. Changes in students’ abilities are compared by classroom to better understand the learning that is taking place in classrooms across the country. We compare the average change in ability for each classroom to the Interactivity Assessment Score (IAS) to provide further insight into the prior results presented from this data set. This material is based upon work supported by the National Science Foundation under Grant No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

Women's participation in developing west China.

PubMed

Huang, D

2000-06-01

In China, the underdeveloped economy of the west has limited women's employment opportunities compared with their counterparts in the eastern and central region. Most women workers are engaged in agricultural production offering few opportunities for career development. Education, awareness of participation, fertility level, and health conditions are the compounding factors that hindered women's employment. According to a 10% sampling survey of the 4th population census in 1990, a high percentage of illiterates and semi-illiterates and a high dropout rate among girl students are noted. Moreover, a survey of maternal mortality rates indicated that the rate in west China was still far higher than that in central and eastern areas. In the context of its fertility, it is evident that the average age at first marriages and childbirth for women are considerably lower than the national average, while the percentage of women having multiple children is markedly higher than the national level. The paper proposes the following: improve education for women, especially girls; promote gender equality; publicize and implement the family planning policy; and increase spending on improving young girls' nutrition and on acquisition of medical equipment in western China for a balanced national economic development.

Evaluating Heterogeneous Conservation Effects of Forest Protection in Indonesia

PubMed Central

Shah, Payal; Baylis, Kathy

2015-01-01

Establishing legal protection for forest areas is the most common policy used to limit forest loss. This article evaluates the effectiveness of seven Indonesian forest protected areas introduced between 1999 and 2012. Specifically, we explore how the effectiveness of these parks varies over space. Protected areas have mixed success in preserving forest, and it is important for conservationists to understand where they work and where they do not. Observed differences in the estimated treatment effect of protection may be driven by several factors. Indonesia is particularly diverse, with the landscape, forest and forest threats varying greatly from region to region, and this diversity may drive differences in the effectiveness of protected areas in conserving forest. However, the observed variation may also be spurious and arise from differing degrees of bias in the estimated treatment effect over space. In this paper, we use a difference-in-differences approach comparing treated observations and matched controls to estimate the effect of each protected area. We then distinguish the true variation in protected area effectiveness from spurious variation driven by several sources of estimation bias. Based on our most flexible method that allows the data generating process to vary across space, we find that the national average effect of protection preserves an additional 1.1% of forest cover; however the effect of individual parks range from a decrease of 3.4% to an increase of 5.3% and the effect of most parks differ from the national average. Potential biases may affect estimates in two parks, but results consistently show Sebangau National Park is more effective while two parks are substantially less able to protect forest cover than the national average. PMID:26039754

Evaluating heterogeneous conservation effects of forest protection in Indonesia.

PubMed

Shah, Payal; Baylis, Kathy

2015-01-01

Establishing legal protection for forest areas is the most common policy used to limit forest loss. This article evaluates the effectiveness of seven Indonesian forest protected areas introduced between 1999 and 2012. Specifically, we explore how the effectiveness of these parks varies over space. Protected areas have mixed success in preserving forest, and it is important for conservationists to understand where they work and where they do not. Observed differences in the estimated treatment effect of protection may be driven by several factors. Indonesia is particularly diverse, with the landscape, forest and forest threats varying greatly from region to region, and this diversity may drive differences in the effectiveness of protected areas in conserving forest. However, the observed variation may also be spurious and arise from differing degrees of bias in the estimated treatment effect over space. In this paper, we use a difference-in-differences approach comparing treated observations and matched controls to estimate the effect of each protected area. We then distinguish the true variation in protected area effectiveness from spurious variation driven by several sources of estimation bias. Based on our most flexible method that allows the data generating process to vary across space, we find that the national average effect of protection preserves an additional 1.1% of forest cover; however the effect of individual parks range from a decrease of 3.4% to an increase of 5.3% and the effect of most parks differ from the national average. Potential biases may affect estimates in two parks, but results consistently show Sebangau National Park is more effective while two parks are substantially less able to protect forest cover than the national average.

Basic language comprehension and production in >100,000 young children from sixteen developing nations

PubMed Central

BORNSTEIN, MARC H.; HENDRICKS, CHARLENE

2013-01-01

Using the Multiple Indicator Cluster Survey, language comprehension and production were compared in a sample of 101,250 children aged 2;00 to 9;11 and a focus subsample of 38,845 children aged 2;00 to 4;11 from sixteen under-researched developing nations. In the whole sample, comprehension slightly exceeded production; correlations between comprehension and production by country were positive and significant, but varied in size, and the average correlation was positive, significant, and small to medium. Mean comprehension and production varied with child age, reaching an asymptote at 5;00, and correlations between comprehension and production by age were positive, significant, and similar at each age. In the focus subsample, comprehension exceeded production; correlations between comprehension and production by country were positive and significant, but varied in size, and the average correlation was positive, significant, and medium in size. Children in countries with lower standards of living were less likely to demonstrate basic language comprehension or production. PMID:22129486

National Highway Traffic Safety Administration Corporate Average Fuel Economy (CAFE) Standards

DOT National Transportation Integrated Search

2003-01-01

The National Highway Traffic Safety Administration (NHTSA) must set Corporate Average Fuel Economy (CAFE) standards for light trucks. This was authorized by the Energy Policy and Conservation Act, which added Title V: Imporving Automotive Fuel Effici...

The effect of lactation length on greenhouse gas emissions from the national dairy herd.

PubMed

Wall, E; Coffey, M P; Pollott, G E

2012-11-01

Many governments have signed up to greenhouse gas emission (GHGE) reduction programmes under their national climate change obligations. Recently, it has been suggested that the use of extended lactations in dairy herds could result in reduced GHGE. Dairy GHGE were modelled on a national basis and the model was used to compare emissions from lactations of three different lengths (305, 370 and 440 days), and a current 'base' scenario on the basis of maintaining current milk production levels. In addition to comparing GHGE from the average 'National Herd' under these scenarios, results were used to investigate how accounting for lactations of different lengths might alter the estimation of emissions calculated from the National Inventory methodology currently recommended by Intergovernmental Panel on Climate Change. Data for the three lactation length scenarios were derived from nationally recorded dairy performance information and used in the GHGE model. Long lactations required fewer milking cows and replacements to maintain current milk yield levels than short ones, but GHGEs were found to rise from 1214 t of CO2 equivalent (CE)/farm per year for lactations of 305 days to 1371 t CE/farm per year for 440-day lactations. This apparent anomaly can be explained by the less efficient milk production (kg milk produced per kg cow weight) found in later lactation, a more pronounced effect in longer lactations. The sensitivity of the model to changes in replacement rate, persistency and level of milk yield was investigated. Changes in the replacement rate from 25% to 20% and in persistency by −10% to +20% resulted in very small changes in GHGE. Differences in GHGE due to the level of milk yield were much more dramatic with animals in the top 10% for yield, producing about 25% less GHGE/year than the average animal. National Inventory results were investigated using a more realistic spread of lactation lengths than recommended for such calculations using emissions calculated in the first part of the study. Current UK emission calculations based on the National Inventory were 329 Gg of methane per year from the dairy herd. Using the national distribution of lactation lengths, this was found to be an underestimate by about 10%. This work showed that the current rise in lactation length or a move towards calving every 18 months would increase GHGE by 7% to 14% compared with the current scenario, assuming the same milk yield in all models. Increased milk yield would have a much greater effect on reducing GHGE than changes to lactation length, replacement rate or persistency. National Inventory methodology appears to underestimate GHGE when the distribution of lactation lengths is considered and may need revising to provide more realistic figures.

Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study.

PubMed

Kerr, Zachary Y; Dompier, Thomas P; Dalton, Sara L; Miller, Sayers John; Hayden, Ross; Marshall, Stephen W

2015-12-01

Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting. To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports. Descriptive epidemiology study. Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states. High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011-2012 through 2013-2014 academic years. The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non-time-loss (NTL) injuries. Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 ± 6.52 ATR visits and 11.01 ± 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P < .001) and AT services (18.60 versus 9.56; P < .001) per injury. An average of 2.24 ± 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P < .001). These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services.

National Survey of Patients’ Bill of Rights Statutes

PubMed Central

Jacob, Dan M.; Hochhauser, Mark; Parker, Ruth M.

2009-01-01

BACKGROUND Despite vigorous national debate between 1999–2001 the federal patients’ bill of rights (PBOR) was not enacted. However, states have enacted legislation and the Joint Commission defined an accreditation standard to present patients with their rights. Because such initiatives can be undermined by overly complex language, we surveyed the readability of hospital PBOR documents as well as texts mandated by state law. METHODS State Web sites and codes were searched to identify PBOR statutes for general patient populations. The rights addressed were compared with the 12 themes presented in the American Hospital Association’s (AHA) PBOR text of 2002. In addition, we obtained PBOR texts from a sample of hospitals in each state. Readability was evaluated using Prose, a software program which reports an average of eight readability formulas. RESULTS Of 23 states with a PBOR statute for the general public, all establish a grievance policy, four protect a private right of action, and one stipulates fines for violations. These laws address an average of 7.4 of the 12 AHA themes. Nine states’ statutes specify PBOR text for distribution to patients. These documents have an average readability of 15th grade (range, 11.6, New York, to 17.0, Minnesota). PBOR documents from 240 US hospitals have an average readability of 14th grade (range, 8.2 to 17.0). CONCLUSIONS While the average U.S. adult reads at an 8th grade reading level, an advanced college reading level is routinely required to read PBOR documents. Patients are not likely to learn about their rights from documents they cannot read. PMID:19189192

Fit for the fight? Illnesses in the Norwegian team in the Vancouver Olympic Games.

PubMed

Hanstad, Dag Vidar; Rønsen, Ola; Andersen, Svein S; Steffen, Kathrin; Engebretsen, Lars

2011-06-01

The development of strategies to prevent illnesses before and during Olympic Games provides a basis for improved health and Olympic results. (1) To document the efficacy of a prevention programme on illness in a national Olympic team before and during the 2010 Vancouver Olympic Winter Games (OWG), (2) to compare the illness incidence in the Norwegian team with Norwegian incidence data during the Turin 2006 OWG and (3) to compare the illness incidence in the Norwegian team with illness rates of other nations in the Vancouver OWG. Information on prevention measures of illnesses in the Norwegian Olympic team was based on interviews with the Chief Medical Officer (CMO) and the Chief Nutrition and Sport Psychology Officers, and on a review of CMO reports before and after the 2010 OWG. The prevalence data on illness were obtained from the daily reports on injuries and illness to the International Olympic Committee. The illness rate was 5.1% (five of 99 athletes) compared with 17.3% (13 out of 75 athletes) in Turin (p=0.008). A total of four athletes missed one competition during the Vancouver Games owing to illness, compared with eight in Turin. The average illness rate for all nations in the Vancouver OWG was 7.2%. Conclusions Although no definite cause-and-effect link between the implementation of preventive measures and the prevalence of illness in the 2010 OWG could be established, the reduced illness rate compared with the 2006 OWG, and the low prevalence of illnesses compared with other nations in the Vancouver OWG suggest that the preparations were effective.

Can the national surgical quality improvement program provide surgeon-specific outcomes?

PubMed

Kuhnen, Angela H; Marcello, Peter W; Roberts, Patricia L; Read, Thomas E; Schoetz, David J; Rusin, Lawrence C; Hall, Jason F; Ricciardi, Rocco

2015-02-01

Efforts to improve the quality of surgical care and reduce morbidity and mortality have resulted in outcomes reporting at the service and institutional level. Surgeon-specific outcomes are not readily available. The aim of this study is to compare surgeon-specific outcomes from the National Surgical Quality Improvement Program and 100% capture institutional quality data. We conducted a cohort study evaluating institutional and surgeon-specific outcomes following colorectal surgery procedures at 1 institution over 5 years. All patients who underwent an operation by a colorectal surgeon at Lahey Hospital & Medical Center from January 1, 2008 through December 31, 2012 were identified. Thirty-day mortality, reoperation, urinary tract infection, deep vein thrombosis, pneumonia, superficial surgical site infection, and organ space infection were the primary outcomes measured. We compared annual and 5-year institutional and surgeon-specific adverse event rates between the data sets. In addition, we categorized individual surgeons as low-outlier, average, or high-outlier in relation to aggregate averages and determined the concordance between the data sets in identifying outliers. Concordance was designated if the 2 databases classified outlier status similarly for the same adverse event category. In the 100% capture institutional data, 6459 operative encounters were identified in comparison with 1786 National Surgical Quality Improvement Program encounters (28% sampled). Annual aggregate adverse event rates were similar between the institutional data and the National Surgical Quality Improvement Program. For annual surgeon-specific comparisons, concordance in identifying outliers between the 2 data sets was 51.4%, and gross discordance between outlier status was in 8.2%. Five-year surgeon-specific comparisons demonstrated 59% concordance in identifying outlier status with 8.2% gross discordance for the group. The inclusion of data from only 1 academic referral center is a limitation of this study. Each surgeon was identified as a "high outlier" in at least 1 adverse event category. Comparisons at the annual and 5-year points demonstrated poor concordance between our 100% capture institutional data and the National Surgical Quality Improvement Program data.

Projections of health care spending to 1990

PubMed Central

Arnett, Ross H.; McKusick, David R.; Sonnefeld, Sally T.; Cowell, Carol S.

1986-01-01

National health expenditures are projected to grow to $640 billion by 1990, 11.3 percent of the gross national product. Growth in health spending is expected to moderate to an 8.7 percent average annual rate from 1984 to 1990, compared with a 12.6 percent rate from 1978 to 1984. These projections assume lower estimates of overall economic price growth, lower use of hospital care, and increased use of less expensive types of care. A preliminary analysis of demographic factors reveals that the aging of the population has almost as great an impact as the growth in total population on projected expenditures for many types of health care services. PMID:10311492

Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002.

PubMed

Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas

2010-12-01

The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

Are occupational exposure limits becoming more alike within the European Union?

PubMed

Schenk, Linda; Hansson, Sven Ove; Rudén, Christina; Gilek, Michael

2008-10-01

The occupational exposure limits (OELs) established by seven different national regulatory agencies of EU member states are compared with those of the European Commission (EC). The comparison concerned: (1) what chemicals have been selected, (2) the average level of exposure limits for all chemicals, and (3) the similarity between the OELs of different EU member states and the OELs recommended by the European Commission. The average level of the exposure limits has declined during the past 10 years in four of the five countries in our study for which historical data were available to us. Poland has not changed its level noticeably and Germany has increased it. Since the first list of indicative OELs was established by the EC, a few of the EU exposure limits have been lowered. The similarity index indicates that the exposure limits of EU member states are converging towards the European Commission's recommended OELs. Still, the average level of OELs differs between organizations--the Estonian OELs are on average 35% higher than the Polish OELs.

Variation of wet deposition chemistry in Sequoia National Park, California

USGS Publications Warehouse

Stohlgren, Thomas J.; Parsons, David J.

1987-01-01

Sequoia National Park has monitored wet deposition chemistry in conjunction with the National Atmospheric Deposition Program and National Trends Network (NADP/NTN), on a weekly basis since July, 1980. Annual deposition of H, NO3 and SO4 (0.045, 3.6, and 3.9 kg ha−1 a−1, respectively) is relatively low compared to that measured in the eastern United States, or in the urban Los Angeles and San Francisco areas. Weekly ion concentrations are highly variable. Maximum concentrations of 324,162, and 156 μeq ol−1 of H, NO3 and SO4 have been recorded for one low volume summer storm (1.4 mm). Summer concentrations of NO3 and SO4 average two and five times higher, respectively, than concentrations reported for remote areas in the world. There is considerable variability in the ionic concentration of low volume samples, and much less variability in moderate and high volume samples.

Talking about health: correction employees' assessments of obstacles to healthy living.

PubMed

Morse, Tim; Dussetschleger, Jeffrey; Warren, Nicholas; Cherniack, Martin

2011-09-01

Describe health risks/obstacles to health among correctional employees. Mixed-methods approach combined results from four focus groups, 10 interviews, 335 surveys, and 197 physical assessments. Obesity levels were higher than national averages (40.7% overweight and 43.3% obese), with higher levels associated with job tenure, male gender, and working off-shift. Despite widespread concern about the lack of fitness, leisure exercise was higher than national norms. Respondents had higher levels of hypertension than national norms, with 31% of men and 25.8% of women hypertensive compared with 17.1% and 15.1% for national norms. Stress levels were elevated. Officers related their stress to concerns about security, administrative requirements, and work/family imbalance. High stress levels are reflected in elevated levels of hypertension. Correctional employees are at high risk for chronic disease, and environmental changes are needed to reduce risk factors. (C)2011The American College of Occupational and Environmental Medicine

Measuring Alcohol Consumption in Population Surveys: A Review of International Guidelines and Comparison with Surveys in England

PubMed Central

Nugawela, Manjula D.; Langley, Tessa; Szatkowski, Lisa; Lewis, Sarah

2016-01-01

Aims To review the international guidelines and recommendations on survey instruments for measurement of alcohol consumption in population surveys and to examine how national surveys in England meet the core recommendations. Methods A systematic search for international guidelines for measuring alcohol consumption in population surveys was undertaken. The common core recommendations for alcohol consumption measures and survey instruments were identified. Alcohol consumption questions in national surveys in England were compared with these recommendations for specific years and over time since 2000. Results Four sets of international guidelines and three core alcohol consumption measures (alcohol consumption status, average volume of consumption, frequency and volume of heavy episodic drinking) with another optional measure (drinking context) were identified. English national surveys have been inconsistent over time in including questions that provide information on average volume of consumption but have not included questions on another essential alcohol consumption measure, frequency of heavy episodic drinking. Instead, they have used questions that focus only on maximum volume of alcohol consumed on any day in the previous week. Conclusions International guidelines provide consistent recommendations for measuring alcohol consumption in population surveys. These recommendations have not been consistently applied in English national surveys, and this has contributed to the inadequacy of survey measurements for monitoring vital aspects of alcohol consumption in England over recent years. PMID:26115987

Sexual behaviour and sexual and reproductive health education: a cross-sectional study in Romania.

PubMed

Rada, Cornelia

2014-06-23

Up-to-date, genuine sexual and reproductive health (SRH) education programmes have been possible in Romania only since communism collapsed in 1990. Since 2006, Romania has had no national strategy in this field. Under current global circumstances (high labour mobility, internationally mixed marriages), issues previously considered solely national have become worldwide concerns. In 2011-2012, 1215 respondents homogeneously distributed on background, gender, educational level and age group (18-74) were sampled. This article uses a 96-item questionnaire about family and SRH, presenting results on nine items: first intercourse (FI), virginity, knowing first sexual partner, safe sex, number of sexual partners and sexual education. The data were analysed using Pearson chi-square tests and latent class analysis. Some participants (7.2%) engaged in FI at age 15 or earlier. The average age at FI was lower for men (18.08), for individuals with a lower education level (18.07) and for those in rural areas (18.27), compared with that for women, those with more education and those in urban areas, respectively. The average age at FI was over 2.5 years lower for people aged 18-24 (16.99) than for those aged 60-74 (p < 0.001). More than 60% were not married or partnered with their FI partner, and 17.8% engaged in FI less than a month after meeting their partner. Less than one-fourth practiced safe sex at FI, with higher proportions for the urban sample, those with an average level of education and those aged 18-35 (p < 0.001). Higher average numbers of sexual partners were found among men (6.56, compared with 2.37 among women), in urban areas (5.07, compared with 3.75 in rural areas) and among those with higher levels of education (p < 0.005). On average, subjects first received information on SRH at 15.39 years of age, with only 10% listing the school, doctors or medics as a source. Unsafe sex, early initiation of sexual activity and poor SRH education from schools, experts and parents require a multidisciplinary approach within prevention programmes, especially among the populations at risk: rural residents, those with low levels of education and youth.

Sexual behaviour and sexual and reproductive health education: a cross-sectional study in Romania

PubMed Central

2014-01-01

Background Up-to-date, genuine sexual and reproductive health (SRH) education programmes have been possible in Romania only since communism collapsed in 1990. Since 2006, Romania has had no national strategy in this field. Under current global circumstances (high labour mobility, internationally mixed marriages), issues previously considered solely national have become worldwide concerns. Methods In 2011–2012, 1215 respondents homogeneously distributed on background, gender, educational level and age group (18–74) were sampled. This article uses a 96-item questionnaire about family and SRH, presenting results on nine items: first intercourse (FI), virginity, knowing first sexual partner, safe sex, number of sexual partners and sexual education. The data were analysed using Pearson chi-square tests and latent class analysis. Results Some participants (7.2%) engaged in FI at age 15 or earlier. The average age at FI was lower for men (18.08), for individuals with a lower education level (18.07) and for those in rural areas (18.27), compared with that for women, those with more education and those in urban areas, respectively. The average age at FI was over 2.5 years lower for people aged 18–24 (16.99) than for those aged 60–74 (p < 0.001). More than 60% were not married or partnered with their FI partner, and 17.8% engaged in FI less than a month after meeting their partner. Less than one-fourth practiced safe sex at FI, with higher proportions for the urban sample, those with an average level of education and those aged 18–35 (p < 0.001). Higher average numbers of sexual partners were found among men (6.56, compared with 2.37 among women), in urban areas (5.07, compared with 3.75 in rural areas) and among those with higher levels of education (p < 0.005). On average, subjects first received information on SRH at 15.39 years of age, with only 10% listing the school, doctors or medics as a source. Conclusions Unsafe sex, early initiation of sexual activity and poor SRH education from schools, experts and parents require a multidisciplinary approach within prevention programmes, especially among the populations at risk: rural residents, those with low levels of education and youth. PMID:24957900

Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study

DTIC Science & Technology

2016-11-15

participants who were followed for the development of back pain for an average of 3.9 years. Methods. Descriptive statistics and longitudinal...health, military personnel, occupational health, outcome assessment, statistics, survey methodology . Level of Evidence: 3 Spine 2016;41:1754–1763ack...based on the National Health and Nutrition Examination Survey.21 Statistical Analysis Descriptive and univariate analyses compared character- istics

Vegetation response to fire and postburn seeding treatments in juniper woodlands of the Grand Staircase-Escalante National Monument, Utah

USGS Publications Warehouse

Evangelista, P.; Stohlgren, T.J.; Guenther, D.; Stewart, S.

2004-01-01

We compared 3 naturally ignited burns with unburned sites in the Grand Staircase-Escalante National Monument. Each burn site was restored with native and nonnative seed mixes, restored with native seeds only, or regenerated naturally. In general, burned sites had significantly lower native species richness (1.8 vs. 2.9 species), native species cover (11% vs. 22.5%), and soil crust cover (4.1% vs. 15%) than unburned sites. Most burned plots, seeded or not, had significantly higher average nonnative species richness and cover and lower average native species richness and cover than unburned sites. Regression tree analyses suggest site variation was equally important to rehabilitation results as seeding treatments. Low native species richness and cover, high soil C, and low cover of biological soil crusts may facilitate increased nonnative species richness and cover. Our study also found that unburned sites in the region had equally high cover of nonnative species compared with the rest of the Monument. Cheatgrass (Bromus tectorum) dominated both burned and unburned sites. Despite the invasion of cheatgrass, unburned sites still maintain higher native species richness; however, the high cover of cheatgrass may increase fire frequency, further reduce native species richness and cover, and ultimately change vegetation composition in juniper woodlands.

Temporal distribution of blood donations in three Brazilian blood centers and its repercussion on the blood supply

PubMed Central

Oliveira, Claudia Di Lorenzo; de Almeida-Neto, Cesar; Liu, Emily Jing; Sabino, Ester Cerdeira; Leão, Silvana Carneiro; Loureiro, Paula; Wright, David; Custer, Brian; Gonçalez, Thelma Therezinha; Capuani, Ligia; Busch, Michael; Proietti, Anna Bárbara de Freitas Carneiro

2013-01-01

Background Seasonal distribution of blood donation hinders efforts to provide a safe and adequate blood supply leading to chronic and persistent shortages. This study examined whether holidays, geographical area and donation type (community versus replacement) has any impact on the fluctuation of donations. Methods The numbers of blood donations from 2007 through 2010 in three Brazilian Retrovirus Epidemiological Donor Study II (REDS-II) participating centers were analyzed according to the week of donation. The weeks were classified as holiday or non-holiday. To compare donations performed during holiday versus non-holiday weeks, tabulations and descriptive statistics for weekly donations by blood center were examined and time series analysis was conducted. Results The average weekly number of donations varied according to the blood center and type of week. The average number of donations decreased significantly during Carnival and Christmas and increased during the Brazilian National Donor Week. The fluctuation was more pronounced in Recife and Belo Horizonte when compared to São Paulo and higher among community donors. Conclusion National bank holidays affect the blood supply by reducing available blood donations. Blood banks should take into account these oscillations in order to plan local campaigns, aiming at maintaining the blood supply at acceptable levels. PMID:24106441

Temporal distribution of blood donations in three Brazilian blood centers and its repercussion on the blood supply.

PubMed

Oliveira, Claudia Di Lorenzo; de Almeida-Neto, Cesar; Liu, Emily Jing; Sabino, Ester Cerdeira; Leão, Silvana Carneiro; Loureiro, Paula; Wright, David; Custer, Brian; Gonçalez, Thelma Therezinha; Capuani, Ligia; Busch, Michael; Proietti, Anna Bárbara de Freitas Carneiro

2013-01-01

Seasonal distribution of blood donation hinders efforts to provide a safe and adequate blood supply leading to chronic and persistent shortages. This study examined whether holidays, geographical area and donation type (community versus replacement) has any impact on the fluctuation of donations. The numbers of blood donations from 2007 through 2010 in three Brazilian Retrovirus Epidemiological Donor Study II (REDS-II) participating centers were analyzed according to the week of donation. The weeks were classified as holiday or non-holiday. To compare donations performed during holiday versus non-holiday weeks, tabulations and descriptive statistics for weekly donations by blood center were examined and time series analysis was conducted. The average weekly number of donations varied according to the blood center and type of week. The average number of donations decreased significantly during Carnival and Christmas and increased during the Brazilian National Donor Week. The fluctuation was more pronounced in Recife and Belo Horizonte when compared to São Paulo and higher among community donors. National bank holidays affect the blood supply by reducing available blood donations. Blood banks should take into account these oscillations in order to plan local campaigns, aiming at maintaining the blood supply at acceptable levels.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

PubMed

Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

2016-01-01

It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum-rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

PubMed Central

Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

2016-01-01

Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum–rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Conclusion Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities. PMID:27924741

The Nation's top 25 construction aggregates producers

USGS Publications Warehouse

Willett, Jason Christopher

2013-01-01

U.S. production of construction aggregates in 2011 was 2.17 billion short tons, valued at $17.2 billion, free on board (f.o.b.) at plant. Construction aggregates production decreased by 37 percent, and the associated value decreased by 25 percent, compared with the record highs reported in 2006. In 2011, construction aggregates production increased for the first time since 2006, owing to a very slight increase in the production of both construction sand and gravel and crushed stone. The average unit value, which is the f.o.b. at plant price of a ton of material, increased slightly, but is still less than the average unit value of two years prior.

Population-Based Surveillance of Amyotrophic Lateral Sclerosis in New Jersey, 2009–2011

PubMed Central

Jordan, Heather; Fagliano, Jerald; Rechtman, Lindsay; Lefkowitz, Daniel; Kaye, Wendy

2015-01-01

Background Limited epidemiological data exist about amyotrophic lateral sclerosis (ALS) in the United States (US). The Agency for Toxic Substances and Disease Registry maintains the National ALS Registry and funded state and metropolitan surveillance projects to obtain reliable, timely information about ALS in defined geographic areas. Methods Neurologists submitted case reports for ALS patients under their care between January 1, 2009 and December 31, 2011 who were New Jersey residents. A medical record verification form and electromyogram (EMG) report were requested for a sample of case reports. Incidence rates were standardized to the 2000 US Standard Population. Results The average crude annual incidence rate was 1.87 per 100,000 person-years, the average age-adjusted annual incidence rate was 1.67 per 100,000 person-years, and the point prevalence rate on December 31, 2011 was 4.40 per 100,000 persons. Average annual incidence rates and point prevalence rates were statistically higher for men compared with women; Whites compared with Blacks/African Americans and Asians; and non-Hispanics compared with Hispanics. Conclusions The project findings contribute new, population-based, state-specific information to epidemiological data regarding ALS. The findings are generally consistent with previously published surveillance studies conducted in the US and abroad. PMID:25323440

Conversion of National Health Insurance Service-National Sample Cohort (NHIS-NSC) Database into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM).

PubMed

You, Seng Chan; Lee, Seongwon; Cho, Soo-Yeon; Park, Hojun; Jung, Sungjae; Cho, Jaehyeong; Yoon, Dukyong; Park, Rae Woong

2017-01-01

It is increasingly necessary to generate medical evidence applicable to Asian people compared to those in Western countries. Observational Health Data Sciences a Informatics (OHDSI) is an international collaborative which aims to facilitate generating high-quality evidence via creating and applying open-source data analytic solutions to a large network of health databases across countries. We aimed to incorporate Korean nationwide cohort data into the OHDSI network by converting the national sample cohort into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM). The data of 1.13 million subjects was converted to OMOP-CDM, resulting in average 99.1% conversion rate. The ACHILLES, open-source OMOP-CDM-based data profiling tool, was conducted on the converted database to visualize data-driven characterization and access the quality of data. The OMOP-CDM version of National Health Insurance Service-National Sample Cohort (NHIS-NSC) can be a valuable tool for multiple aspects of medical research by incorporation into the OHDSI research network.

77 FR 36085 - Enterprise Underwriting Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... National Laboratory showed that homes with solar PV systems had an average $17,000 sales price premium... projects, such as solar panels, insulation, energy-efficient windows, and other technologies. Homeowners... Berkeley National Laboratory * * * showed an average $17,000 sales price premium for homes with solar P...

An international survey of the health economics of IVF and ICSI.

PubMed

Collins, JohnA

2002-01-01

The health economics of IVF and ICSI involve assessments of utilization, cost, cost-effectiveness and ability to pay. In 48 countries, utilization averaged 289 IVF/ICSI cycles per million of population per annum, ranging from two in Kazachstan, to 1657 in Israel. Higher national utilization of IVF/ICSI was associated with higher quality of health services, as indicated by lower infant mortality rates. IVF and ICSI are scientifically demanding and personnel-intensive, and are therefore expensive procedures. The average cost per IVF/ICSI cycle in 2002 would be US$9547 in the USA, and US$3518 in 25 other countries. Price elasticity estimates suggest that a 10% decrease in IVF/ICSI cost would generate a 30% increase in utilization. The average cost-effectiveness ratios in 2002 would be US$58,394 per live birth in the USA, and US$22,048 in other countries. In three randomized controlled trials, incremental costs per additional live birth with IVF compared with conventional therapy were US$ -26,586, $79,472 and $47,749. The national costs of IVF/ICSI treatment would be US$1.00 per capita in one current model, but the costs to individual couples range from 10% of annual household expenditures in European countries to 25% in Canada and the USA.

The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics.

PubMed

Ercolani, Marco G; Vohra, Ravinder S; Carmichael, Fiona; Mangat, Karanjit; Alderson, Derek

2015-04-21

To evaluate this impact on male and female English medical graduates by estimating the total time and amount repaid on loans taken out with the UK's Student Loans Company (SLC). UK. 4286 respondents with a medical degree in the Labour Force Surveys administered by the Office for National Statistics (ONS) between 1997 and 2014. Age-salary profiles were generated to estimate the repayment profiles for different levels of initial graduate debt. 2195 female and 2149 male medical graduates were interviewed by the ONS. Those working full-time (73.1% females and 96.1% males) were analysed in greater depth. Following standardisation to 2014 prices, average full-time male graduates earned up to 35% more than females by the age of 55. The initial graduate debt from tuition fees alone amounts to £39,945.69. Owing to interest charges on this debt the average full-time male graduate repays £57,303 over 20 years, while the average female earns less and so repays £61,809 over 26 years. When additional SLC loans are required for maintenance, the initial graduate debt can be as high as £81,916 and, as SLC debt is written off 30 years after graduation, the average female repays £75,786 while the average male repays £110,644. Medical graduates on an average salary are unlikely to repay their SLC debt in full. This is a consequence of higher university fees and as SLC debt is written off 30 years after graduation. This results in the average female graduate repaying more when debt is low, but a lower amount when debt is high compared to male graduates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics

PubMed Central

Ercolani, Marco G; Vohra, Ravinder S; Carmichael, Fiona; Mangat, Karanjit; Alderson, Derek

2015-01-01

Objective To evaluate this impact on male and female English medical graduates by estimating the total time and amount repaid on loans taken out with the UK's Student Loans Company (SLC). Setting UK. Participants 4286 respondents with a medical degree in the Labour Force Surveys administered by the Office for National Statistics (ONS) between 1997 and 2014. Outcomes Age-salary profiles were generated to estimate the repayment profiles for different levels of initial graduate debt. Results 2195 female and 2149 male medical graduates were interviewed by the ONS. Those working full-time (73.1% females and 96.1% males) were analysed in greater depth. Following standardisation to 2014 prices, average full-time male graduates earned up to 35% more than females by the age of 55. The initial graduate debt from tuition fees alone amounts to £39 945.69. Owing to interest charges on this debt the average full-time male graduate repays £57 303 over 20 years, while the average female earns less and so repays £61 809 over 26 years. When additional SLC loans are required for maintenance, the initial graduate debt can be as high as £81 916 and, as SLC debt is written off 30 years after graduation, the average female repays £75 786 while the average male repays £110 644. Conclusions Medical graduates on an average salary are unlikely to repay their SLC debt in full. This is a consequence of higher university fees and as SLC debt is written off 30 years after graduation. This results in the average female graduate repaying more when debt is low, but a lower amount when debt is high compared to male graduates. PMID:25900463

The impact of drought on the association between food security and mental health in a nationally representative Australian sample.

PubMed

Friel, Sharon; Berry, Helen; Dinh, Huong; O'Brien, Léan; Walls, Helen L

2014-10-24

The association between food insecurity and mental health is established. Increasingly, associations between drought and mental health and drought and food insecurity have been observed in a number of countries. The impact of drought on the association between food insecurity and mental health has received little attention. Population-based study using data from a nationally representative panel survey of Australian adults in which participants report behaviour, health, social, economic and demographic information annually. Exposure to drought was modelled using annual rainfall data during Australia's 'Big Dry'. Regression modelling examined associations between drought and three indicative measures of food insecurity and mental health, controlling for confounding factors. People who reported missing meals due to financial stress reported borderline moderate/high distress levels. People who consumed below-average levels of core foods reported more distress than those who consumed above the average level, while people consuming discretionary foods above the average level reported greater distress than those consuming below the threshold. In all drought exposure categories, people missing meals due to cost reported higher psychological distress than those not missing meals. Compared to drought-unadjusted psychological distress levels, in most drought categories, people consuming higher-than-average discretionary food levels reported higher levels of distress. Exposure to drought moderates the association between measures of food insecurity and psychological distress, generally increasing the distress level. Climate adaptation strategies that consider social, nutrition and health impacts are needed.

Systematic review of colorectal cancer screening guidelines for average-risk adults: Summarizing the current global recommendations.

PubMed

Bénard, Florence; Barkun, Alan N; Martel, Myriam; von Renteln, Daniel

2018-01-07

To summarize and compare worldwide colorectal cancer (CRC) screening recommendations in order to identify similarities and disparities. A systematic literature search was performed using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge identifying all average-risk CRC screening guideline publications within the last ten years and/or position statements published in the last 2 years. In addition, a hand-search of the webpages of National Gastroenterology Society websites, the National Guideline Clearinghouse, the BMJ Clinical Evidence website, Google and Google Scholar was performed. Fifteen guidelines were identified. Six guidelines were published in North America, four in Europe, four in Asia and one from the World Gastroenterology Organization. The majority of guidelines recommend screening average-risk individuals between ages 50 and 75 using colonoscopy (every 10 years), or flexible sigmoidoscopy (FS, every 5 years) or fecal occult blood test (FOBT, mainly the Fecal Immunochemical Test, annually or biennially). Disparities throughout the different guidelines are found relating to the use of colonoscopy, rank order between test, screening intervals and optimal age ranges for screening. Average risk individuals between 50 and 75 years should undergo CRC screening. Recommendations for optimal surveillance intervals, preferred tests/test cascade as well as the optimal timing when to start and stop screening differ regionally and should be considered for clinical decision making. Furthermore, local resource availability and patient preferences are important to increase CRC screening uptake, as any screening is better than none.

Calcium II K Line as a Measure of Activity: Meshing Sac Peak and Solis Measurements

NASA Astrophysics Data System (ADS)

Urbach, Elana; Earley, J.; Keil, S.

2012-05-01

The Calcium II K line is an important indicator of solar and stellar activity. Disk integrated Ca K measurements have been taken at the Evans Solar Facility at Sacramento Peak Observatory since 1976. This instrument will be shut down by the end of the year, and the observations will be continued by the Solis Integrated Sunlight Spectrometer (ISS), which has been taking measurements since 2006. We attempt to regress the measurements from Sacramento Peak and ISS. In addition, we compare the Ca K measurements with disk averaged line of sight magnetic field measurements, which will help us predict the magnetic field of other stars. We also compare the measurements with Lyman α, allowing us to use Ca K as an extreme ultraviolet (EUV) proxy. This work is carried out through the National Solar Observatory Research Experiences for Undergraduate (REU) [or Research Experiences for Teachers (RET)] site program, which is co-funded by the Department of Defense in partnership with the National Science Foundation REU/RET Program. The National Solar Observatory is operated by the Association of Universities for Research in Astronomy, Inc. (AURA) under cooperative agreement with the National Science Foundation.

Funding models for outreach ophthalmology services.

PubMed

Turner, Angus W; Mulholland, Will; Taylor, Hugh R

2011-01-01

This paper aims to describe funding models used and compare the effects of funding models for remuneration on clinical activity and cost-effectiveness in outreach eye services in Australia. Cross-sectional case study based in remote outreach ophthalmology services in Australia. Key stake-holders from eye services in nine outreach regions participated in the study. Semistructured interviews were conducted to perform a qualitative assessment of outreach eye services' funding mechanisms. Records of clinical activity were used to statistically compare funding models. Workforce availability (supply of ophthalmologists), costs of services, clinical activity (surgery and clinic consultation rates) and waiting times. The supply of ophthalmologists (full-time equivalence) to all remote regions was below the national average (up to 19 times lower). Cataract surgery rates were also below national averages (up to 10 times lower). Fee-for-service funding significantly increased clinical activity. There were also trends to shorter waiting times and lower costs per attendance. For outreach ophthalmology services, the funding model used for clinician reimbursement may influence the efficiency and costs of the services. Fee-for-service funding models, safety-net funding options or differential funding/incentives need further exploration to ensure isolated disadvantaged areas prone to poor patient attendance are not neglected. In order for outreach eye health services to be sustainable, remuneration rates need to be comparable to those for urban practice. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Alternatives to national average income data as eligibility criteria for international subsidies: a social justice perspective.

PubMed

Shebaya, Sirine; Sutherland, Andrea; Levine, Orin; Faden, Ruth

2010-12-01

Current strategies to address global inequities in access to life-saving vaccines use averaged national income data to determine eligibility. While largely successful in the lowest income countries, we argue that this approach could lead to significant inefficiencies from the standpoint of justice if applied to middle-income countries, where income inequalities are large and lead to national averages that obscure truly needy populations. Instead, we suggest alternative indicators more sensitive to social justice concerns that merit consideration by policy-makers developing new initiatives to redress health inequities in middle-income countries. © 2009 Blackwell Publishing Ltd.

National Trends in Demographics and Outcomes Following Cervical Fusion for Cervical Spondylotic Myelopathy

PubMed Central

Vonck, Caroline E.; Tanenbaum, Joseph E.; Smith, Gabriel A.; Benzel, Edward C.; Mroz, Thomas E.; Steinmetz, Michael P.

2017-01-01

Study Design: Retrospective trends analysis. Objectives: Cervical fusion is a common adjunctive surgical modality used in the treatment of cervical spondylotic myelopathy (CSM). The purpose of this study was to quantify national trends in patient demographics, hospital characteristics, and outcomes in the surgical management of CSM. Methods: This was a retrospective study that used the National Inpatient Sample. The sample included all patients over 18 years of age with a diagnosis of CSM who underwent cervical fusion from 2003 to 2013. The outcome measures were in-hospital mortality, length of stay, and hospital charges. Chi-square tests were performed to compare categorical variables. Independent t tests were performed to compare continuous variables. Results: We identified 62 970 patients with CSM who underwent cervical fusion from 2003 to 2013. The number of fusions performed per year in the treatment of CSM increased from 3879 to 8181. The average age of all fusion patients increased from 58.2 to 60.6 years (P < .001). Length of stay did not change significantly from a mean of 3.7 days. In-hospital mortality decreased from 0.6% to 0.3% (P < .01). Hospital charges increased from $49 445 to $92 040 (P < .001). Conclusions: This study showed a dramatic increase in cervical fusions to treat CSM from 2003 to 2013 concomitant with increasing age of the patient population. Despite increases in average age and number of comorbidities, length of stay remained constant and a decrease in mortality was seen across the study period. However, hospital charges increased dramatically.

Fast food intake in Canada: Differences among Canadians with diverse demographic, socio-economic and lifestyle characteristics.

PubMed

Black, Jennifer L; Billette, Jean-Michel

2015-02-03

To estimate the contribution of fast food to daily energy intake, and compare intake among Canadians with varied demographic, socioeconomic and lifestyle characteristics. Using the National Cancer Institute method, nationally representative estimates of mean usual daily caloric intake from fast food were derived from 24-hour dietary recall data from the Canadian Community Health Survey Cycle 2.2 (n = 17,509) among participants age ≥ 2 years. Mean daily intake and relative proportion of calories derived from fast food were compared among respondents with diverse demographic (age, sex, provincial and rural/urban residence), socio-economic (income, education, food security status) and health and lifestyle characteristics (physical activity, fruit/vegetable intake, vitamin/ mineral supplement use, smoking, binge drinking, body mass index (BMI), self-rated health and dietary quality). On average, Canadians reported consuming 146 kcal/day from fast food, contributing to 6.3% of usual energy intake. Intake was highest among male teenagers (248 kcal) and lowest among women ≥ 70 years of age (32 kcal). Fast food consumption was significantly higher among respondents who reported lower fruit and vegetable intake, poorer dietary quality, binge drinking, not taking vitamin/mineral supplements (adults only), and persons with higher BMI. Socio-economic status, physical activity, smoking and self-rated health were not significantly associated with fast food intake. While average Canadian fast food consumption is lower than national US estimates, intake was associated with lower dietary quality and higher BMI. Findings suggest that research and intervention strategies should focus on dietary practices of children and adolescents, whose fast food intakes are among the highest in Canada.

Theoretical and Experimental Triple Differential Cross Sections for Electron Impact Ionization of SF6

NASA Astrophysics Data System (ADS)

Chaluvadi, Hari; Nixon, Kate; Murray, Andrew; Ning, Chuangang; Colgan, James; Madison, Don

2014-10-01

Experimental and theoretical Triply Differential Cross Sections (TDCS) will be presented for electron-impact ionization of sulfur hexafluoride (SF6) for the molecular orbital 1t1g. M3DW (molecular 3-body distorted wave) results will be compared with experiment for coplanar geometry and for perpendicular plane geometry (a plane which is perpendicular to the incident beam direction). In both cases, the final state electron energies and observation angles are symmetric and the final state electron energies range from 5 eV to 40 eV. It will be shown that there is a large difference between using the OAMO (orientation averaged molecular orbital) approximation and the proper average over all orientations and also that the proper averaged results are in much better agreement with experiment. Work supported by NSF under Grant Number PHY-1068237. Computational work was performed with Institutional resources made available through Los Alamos National Laboratory.

7 CFR 1580.102 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of the United States. Marketing year means the marketing season or year as defined by National... Administrator. National average price means the average price paid to producers for an agricultural commodity in a marketing year as determined by the Administrator. Net farm income means net farm profit or loss...

Performance outcomes after repair of complete achilles tendon ruptures in national basketball association players.

PubMed

Amin, Nirav H; Old, Andrew B; Tabb, Loni P; Garg, Rohit; Toossi, Nader; Cerynik, Douglas L

2013-08-01

A complete rupture of the Achilles tendon is a devastating injury. Variables affecting return to competition and performance changes for National Basketball Association (NBA) players are not readily evident. Players in the NBA who ruptured their Achilles tendons and who underwent surgical repair would have more experience in the league, and the performance of those who were able to return to competition would be decreased when compared with their performance before injury and with their control-matched peers. Cohort study; Level of evidence, 3. Data for 18 basketball players with Achilles tendon repair over a 23-year period (1988-2011) were obtained from injury reports, press releases, and player profiles. Variables included age, body mass index (BMI), player position, and number of years playing in the league. Individual season statistics were obtained, and the NBA player efficiency rating (PER) was calculated for 2 seasons before and after injury. Controls were matched by playing position, number of seasons played, and performance statistics. Univariate and multivariate analyses were performed to assess the effect of each factor. At the time of injury, the average age was 29.7 years, average BMI was 25.6, and average playing experience was 7.6 years. Seven players never returned to play an NBA game, whereas 11 players returned to play 1 season, with 8 of those players returning for ≥2 seasons. Players who returned missed an average of 55.9 games. The PER was reduced by 4.57 (P = .003) in the first season and by 4.38 (P = .010) in the second season. When compared with controls, players demonstrated a significant decline in the PER the first season (P = .038) and second season (P = .081) after their return. The NBA players who returned to play after repair of complete Achilles tendon ruptures showed a significant decrease in playing time and performance. Thirty-nine percent of players never returned to play.

Building toward Completion: Five Years into President Obama's 2020 Completion Initiative, Some Community Colleges Find Ways to Move the Needle on Student Success

ERIC Educational Resources Information Center

Pierce, Dennis

2015-01-01

In 2009, President Barack Obama announced the 2020 College Completion initiative. The goal: By 2020, the United States will have the greatest proportion of citizens who are college graduates, compared with the rest of the world. On a national level, however, the average six-year completion rate hasn't changed much in the more than five years since…

El Nino, La Nina, ENSO | National Oceanic and Atmospheric Administration

Science.gov Websites

your local weather Enter your ZIP code GO Enter Search Terms El Nino, La Nina, ENSO Content La Nina is gone, for now May 10, 2018 More On El Nino, La Nina, ENSO Ocean surface temperatures in April 2018 compared to the 1981-2010 average. What's going on with La Niña? March 22, 2018 More On El Nino, La Nina

WCPSS Advanced Placement (AP) Results, 2011-12 and 2012-13. Measuring Up. D&A Report No. 13.17

ERIC Educational Resources Information Center

Muli, Juliana; McMillen, Brad

2014-01-01

Students in Wake County Public Schools (WCPSS) continue to score well on AP exams with an increased percentage of students enrolling in the courses. As in past years, in 2013 the district had higher average AP exam scores compared to the state and the nation. WCPSS had 76.6% of scores 3 or higher in 2013 (qualified and above). Again in both 2012…

Mortality on match days of the German national soccer team: a time series analysis from 1995 to 2009.

PubMed

Medenwald, D; Kuss, O

2014-09-01

There is inconsistent evidence on population mortality, especially cardiovascular disease mortality, on match days of national soccer teams during particular international tournaments. This study examines the number of deaths in Germany on match days of the national soccer team during a long-term period including several tournaments. We analysed all registered daily deaths in Germany from 1995 to 2009 (11 225 966 cases) using time series analysis methods. Following the Box/Jenkins approach, we applied a seasonal autoregressive integrated moving average model. To assess the effect of match days, we performed an intervention analysis by including a transfer function model representing match days of the national team in the statistical analyses. We conducted separate analyses for all matches and for matches during international tournaments (European and World Championships) only. Time series and results were stratified in terms of sex, age (<50 years, 50-70 years, >70 years) and cause of death (cardiovascular deaths, injuries, others). We performed a further independent analysis focusing only on the effect of match results (victory, loss, draw) and kind of tournament (international championships, qualifications, friendly matches). Most of the results did not indicate a distinct effect of matches of the national team on general mortality. Moreover, all null value deviations were small when compared with the average number of daily deaths (n=2270). There is no relevant increase or decrease in mortality on match days of the German national soccer team. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

24 CFR 92.50 - Formula allocation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... per rental unit basis, that amount is capped at twice the national average. (3) To determine the... of funds calculation) exceed twice the national average, on a per rental unit basis, each amount that... previous fiscal year, are metropolitan cities, urban counties, or consortia approved under § 92.101; and...

24 CFR 92.50 - Formula allocation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... per rental unit basis, that amount is capped at twice the national average. (3) To determine the... of funds calculation) exceed twice the national average, on a per rental unit basis, each amount that... previous fiscal year, are metropolitan cities, urban counties, or consortia approved under § 92.101; and...

24 CFR 92.50 - Formula allocation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... per rental unit basis, that amount is capped at twice the national average. (3) To determine the... of funds calculation) exceed twice the national average, on a per rental unit basis, each amount that... previous fiscal year, are metropolitan cities, urban counties, or consortia approved under § 92.101; and...

24 CFR 92.50 - Formula allocation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... per rental unit basis, that amount is capped at twice the national average. (3) To determine the... of funds calculation) exceed twice the national average, on a per rental unit basis, each amount that... previous fiscal year, are metropolitan cities, urban counties, or consortia approved under § 92.101; and...

7 CFR 1435.101 - Loan rates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Sugar Loan Program § 1435.101 Loan rates. (a) The national average loan rate for raw cane sugar produced from domestically grown sugarcane is: 18... for the 2012 crop year. (b) The national average loan rate for refined beet sugar from domestically...

7 CFR 1435.101 - Loan rates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Sugar Loan Program § 1435.101 Loan rates. (a) The national average loan rate for raw cane sugar produced from domestically grown sugarcane is: 18... for the 2012 crop year. (b) The national average loan rate for refined beet sugar from domestically...

7 CFR 1777.12 - Eligibility.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., on the date preapplication is received by the Agency, the: (1) Per capita income of the residents is not more than 70 percent of the most recent national average per capita income, as determined by the... recent national average unemployment rate, as determined by the Bureau of Labor Statistics. (b) Residents...

7 CFR 1777.12 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., on the date preapplication is received by the Agency, the: (1) Per capita income of the residents is not more than 70 percent of the most recent national average per capita income, as determined by the... recent national average unemployment rate, as determined by the Bureau of Labor Statistics. (b) Residents...

42 CFR 422.252 - Terminology.

Code of Federal Regulations, 2011 CFR

2011-10-01

... a nationally average risk profile for the factors described in § 422.308(c), and this amount is... risk profile for the risk factors CMS applies to payment calculations as set forth at § 422.308(c) of... eligible beneficiary with a nationally average risk profile for the risk factors CMS applies to payment...

7 CFR 1435.101 - Loan rates.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Sugar Loan Program § 1435.101 Loan rates. (a) The national average loan rate for raw cane sugar produced from domestically grown sugarcane is: 18... for the 2012 crop year. (b) The national average loan rate for refined beet sugar from domestically...

7 CFR 1435.101 - Loan rates.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Sugar Loan Program § 1435.101 Loan rates. (a) The national average loan rate for raw cane sugar produced from domestically grown sugarcane is: 18... for the 2012 crop year. (b) The national average loan rate for refined beet sugar from domestically...

7 CFR 1435.101 - Loan rates.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Sugar Loan Program § 1435.101 Loan rates. (a) The national average loan rate for raw cane sugar produced from domestically grown sugarcane is: 18... for the 2012 crop year. (b) The national average loan rate for refined beet sugar from domestically...

40 CFR 63.5710 - How do I demonstrate compliance using emissions averaging?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutants for Boat Manufacturing Standards for Open... section to compute the weighted-average MACT model point value for each open molding resin and gel coat...

Choose Wisely: the Quality of Massage Education in the United States

PubMed Central

Menard, Martha Brown

2014-01-01

Background Assessing the quality of postsecondary education remains a difficult task, despite many efforts to do so. No consensus or standard definition of educational quality has yet been agreed upon or developed. Purpose This study evaluated the quality of massage education in the United States using three closely-related questions to frame the evaluation: 1) Is accreditation improving the quality of education for massage therapy? If not, then what do we need to do to improve it? 2) Does accreditation by COMTA specifically improve quality of education compared to other vocational accrediting agencies that do not require curriculum competencies specific to massage? 3) Would adding competencies at an “advanced” level, or specific degree levels, be helpful in advancing massage therapy in the eyes of other health professions? Setting United States Participants Members of a national massage education organization, members affiliated with the educational arm of two national professional associations, and members of two national education organizations in complementary and integrative health care (CIHC). Research Design Mixed methods evaluation using three data sources: existing gainful employment data from the US Department of Education, analyzed by type of massage program and accreditation agency to determine average and relative value for cost; numbers of disciplinary actions against massage practitioners reported by state regulatory agencies, and a qualitatively developed survey administered to two different groups of educators. Results Average tuition cost across all reporting schools/programs was $13,605, with an average graduation rate of 71.9%. Of the schools and programs that reported student loan data, 84% of students received federal financial aid. Median loan amount was $8,052, with an average repayment rate of 43.4%. Programs in corporate-owned schools had the highest average cost, highest median loan amount, and lowest repayment rate, while community college programs had the lowest average cost, lowest graduation rate, and lowest median loan amount. Repayment rate data were not available for community colleges. Of the five states and the District of Columbia that require school accreditation, there were 208 disciplinary actions from 2009–2011. The remaining 28 regulated states that do not require school accreditation reported 1,702 disciplinary actions during the same period. Seventy-five percent of massage educators and 58% of CIHC educators stated that the current quality of massage education is inconsistent, with only 10% of massage educators and 8% of CIHC educators agreeing that current educational quality is adequate. Fifty-six percent of massage educators and 40% of CIHC educators agreed that educational quality needs to improve if massage therapists want to be considered comparable to other allied health professionals. Both groups suggested specific areas and means of improvement, including raising admission requirements and offering an academic degree. Conclusions Accreditation appears to improve the quality of massage education; however, more consistent methods for calculating tuition costs, educational outcomes, and classifying severity of disciplinary actions are needed. Both quantitative and qualitative evidence indicates that the current quality of massage education in the US is inconsistent and less than adequate. Specific areas of improvement needed for massage therapists to be perceived as comparable to other allied healthcare providers are described. PMID:25184011

Increasing Mercury in Yellow Perch at a Hotspot in Atlantic Canada, Kejimkujik National Park

PubMed Central

2010-01-01

In the mid-1990s, yellow perch (Perca flavescens) and common loons (Gavia immer) from Kejimkujik National Park and National Historic Site (KNPNHS), Nova Scotia, Canada, had among the highest mercury (Hg) concentrations across North America. In 2006 and 2007, we re-examined 16 lakes to determine whether there have been changes in Hg in the loon’s preferred prey, yellow perch. Total Hg concentrations were measured in up to nine perch in each of three size classes (5−10 cm, 10−15 cm, and 15−20 cm) consumed by loons. Between 1996/97 and 2006/07, polynomial regressions indicated that Hg in yellow perch increased an average of 29% in ten lakes, decreased an average of 21% in three, and were unchanged in the remaining three lakes. In 2006/07, perch in 75% of the study lakes had Hg concentrations (standardized to 12-cm fish length) equal to or above the concentration (0.21 μg·g−1 ww) associated with a 50% reduction in maximum productivity of loons, compared with only 56% of these lakes in 1996/97. Mercury contamination currently poses a greater threat to loon health than a decade ago, and further reductions in anthropogenic emissions should be considered to reduce its impacts on ecosystem health. PMID:21062071

Rapid core measure improvement through a "business case for quality".

PubMed

Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

2014-01-01

Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. © 2012 National Association for Healthcare Quality.

Autism and thimerosal-containing vaccines: lack of consistent evidence for an association.

PubMed

Stehr-Green, Paul; Tull, Peet; Stellfeld, Michael; Mortenson, Preben-Bo; Simpson, Diane

2003-08-01

In 1999, concerns were raised that vaccines containing the preservative Thimerosal might increase the risk of autism and/or other neurodevelopmental disorders. Between the mid-1980s through the late-1990s, we compared the prevalence/incidence of autism in California, Sweden, and Denmark with average exposures to Thimerosal-containing vaccines. Graphic ecologic analyses were used to examine population-based data from the United States (national immunization coverage surveys and counts of children diagnosed with autism-like disorders seeking special education services in California); Sweden (national inpatient data on autism cases, national vaccination coverage levels, and information on use of all vaccines and vaccine-specific amounts of Thimerosal); and Denmark (national registry of inpatient/outpatient-diagnosed autism cases, national vaccination coverage levels, and information on use of all vaccines and vaccine-specific amounts of Thimerosal). In all three countries, the incidence and prevalence of autism-like disorders began to rise in the 1985-1989 period, and the rate of increase accelerated in the early 1990s. However, in contrast to the situation in the United States, where the average Thimerosal dose from vaccines increased throughout the 1990s, Thimerosal exposures from vaccines in both Sweden and Denmark-already low throughout the 1970s and 1980s-began to decrease in the late 1980s and were eliminated in the early 1990s. The body of existing data, including the ecologic data presented herein, is not consistent with the hypothesis that increased exposure to Thimerosal-containing vaccines is responsible for the apparent increase in the rates of autism in young children being observed worldwide.

Readability of neurosurgery-related patient education materials provided by the American Association of Neurological Surgeons and the National Library of Medicine and National Institutes of Health.

PubMed

Schmitt, Paul J; Prestigiacomo, Charles J

2013-11-01

Most professional organizations now provide patient information material, and not all of this material is appropriate for the average American adult to comprehend. The National Institutes of Health (NIH) and the United States Department of Health and Human Services recommend that patient education materials be written at the sixth-grade level. Our aim was to assess the readability of neurosurgery-related patient education material and compare it with The American Medical Association, NIH, and United States Department of Health and Human Services recommendations. Materials provided by the American Association of Neurologic Surgeons (AANS) and the U.S. National Library of Medicine (NLM) and National Institutes of Health were assessed with the Flesch-Kincaid grade level and Flesch Reading Ease score with Microsoft Office Word software. None of the articles had Flesch-Kincaid grade levels at or below the sixth-grade level. All articles on the AANS Conditions and Treatments section were written at or above the ninth-grade level; three of the AANS Camera-Ready Fact Sheets and four of the NIH/NLM articles were written between the seventh- and eighth-grade levels. Current patient education material provided by the AANS is written well above the recommended level. Material from the NLM and NIH performed better, but was still above the recommended sixth-grade level. Education materials should contain information relevant to patients' conditions, be accurate in the information they present, and be written with the average patient in mind. Copyright © 2013 Elsevier Inc. All rights reserved.

A Comparison of Quality of Community Health Services Between Public and Private Community Health Centers in Urban China.

PubMed

Yin, Xiaoxv; Gong, Yanhong; Yang, Chen; Tu, Xiaochen; Liu, Wei; Cao, Shiyi; Yang, Huajie; Lu, Zuxun

2015-10-01

This study was the first of its kind to evaluate and compare the quality of private and public community health centers (CHCs) in urban China. A total of 2501 CHCs in 35 cities were chosen in 2011 using a multistage sampling method, and data on human resources, medical equipment and drug inventory were collected. A subset of 422 CHCs was randomly selected and 100 prescriptions from each CHCs were reviewed to evaluate prescribing practice. In total, 12,386 patients who visited the selected 422 CHCs were interviewed to assess patient satisfaction and payments. Controlling for population covered per CHC and geographic regions, private CHCs were higher than public CHCs in average building area (2310.96 vs. 2000.92 square meters), average number of medical equipment (6.42 vs. 6.14), average number of physicians and nurses per 10,000 population (4.86 vs. 3.81 and 3.38 vs. 2.62), and average number of medicines in stock (435.08 vs. 375.83), but lower in average percentage of medicines on the national essential medicines list (67.29% vs. 77.55%). Prescriptions from private CHCs had significantly higher number of drugs per prescription (2.38 vs. 2.24), higher percentage of prescriptions with injections (36.44% vs. 30.50%), and higher percentage of prescriptions with antibiotics (37.17% vs. 30.14%). Patient satisfaction was similar between the 2 groups, and patient payments per visit were lower in private CHCs after controlling for patients' sociodemographic characteristics. Private CHCs are better equipped and better staffed than public CHCs but are less compliant with national policy on essential medicines and have poorer prescribing quality in China, warranting more rigorous government supervision.

Financial modelling of femtosecond laser-assisted cataract surgery within the National Health Service using a 'hub and spoke' model for the delivery of high-volume cataract surgery.

PubMed

Roberts, H W; Ni, M Z; O'Brart, D P S

2017-03-16

To develop financial models which offset additional costs associated with femtosecond laser (FL)-assisted cataract surgery (FLACS) against improvements in productivity and to determine important factors relating to its implementation into the National Health Service (NHS). FL platforms are expensive, in initial purchase and running costs. The additional costs associated with FL technology might be offset by an increase in surgical efficiency. Using a 'hub and spoke' model to provide high-volume cataract surgery, we designed a financial model, comparing FLACS against conventional phacoemulsification surgery (CPS). The model was populated with averaged financial data from 4 NHS foundation trusts and 4 commercial organisations manufacturing FL platforms. We tested our model with sensitivity and threshold analyses to allow for variations or uncertainties. The averaged weekly workload for cataract surgery using our hub and spoke model required either 8 or 5.4 theatre sessions with CPS or FLACS, respectively. Despite reduced theatre utilisation, CPS (average £433/case) was still found to be 8.7% cheaper than FLACS (average £502/case). The greatest associated cost of FLACS was the patient interface (PI) (average £135/case). Sensitivity analyses demonstrated that FLACS could be less expensive than CPS, but only if increased efficiency, in terms of cataract procedures per theatre list, increased by over 100%, or if the cost of the PI was reduced by almost 70%. The financial viability of FLACS within the NHS is currently precluded by the cost of the PI and the lack of knowledge regarding any gains in operational efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Species richness and composition of epiphytic bryophytes in flooded forests of Caxiuanã National Forest, Eastern Amazon, Brazil.

PubMed

Cerqueira, Gabriela R; Ilkiu-Borges, Anna Luiza; Ferreira, Leandro V

2017-01-01

This study aimed to compare the richness and composition of the epiphytic bryoflora between várzea and igapó forests in Caxiuanã National Forest, Brazilian Amazon. Bryophytes were collected on 502 phorophytes of Virola surinamensis. Average richness per phorophyte and composition between forests and between dry and rainy periods was tested by two-way analysis and by cluster analysis, respectively. In total, 54 species of 13 families were identified. Richness was greater in igapó forest (44 species) compared to várzea forest (38 species). There was no significant difference in the number of species between the studied periods. Cluster analysis showed the bryoflora composition was different between várzea and igapó, but not between dry and rainy periods. Results did not corroborate the hypothesis that várzea forests harbor higher species richness than igapó forests.

Politics and population health: Testing the impact of electoral democracy.

PubMed

Patterson, Andrew C; Veenstra, Gerry

2016-07-01

This study addresses questions of whether and why electoral democracies have better health than other nations. After devising a replicable approach to missing data, we compare political, economic, and health-related data for 168 nations collected annually from 1960 through 2010. Regression models estimate that electoral democracies have 11 years of longer life expectancy on average and 62.5% lower rates of infant mortality. The association with life expectancy reduces markedly after controlling for GDP, while a combination of factors may explain the democratic advantage in infant health. Results suggest that income inequality associates independently with both health outcomes but does not mediate their associations with democracy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of historical medical spending patterns among the BRICS and G7.

PubMed

Jakovljevic, Mihajlo Michael

2016-01-01

The past few decades have been marked by a bold increase in national health spending across the globe. Rather successful health reforms in leading emerging markets such as BRICS reveal a reshaping of their medical care-related expenditures. There is a scarcity of evidence explaining differences in long-term medical spending patterns between top ranked G7 traditional welfare economies and the BRICS nations. A retrospective observational study was conducted on a longitudinal WHO Global Health Expenditure data-set based on the National Health Accounts (NHA) system. Data were presented in a simple descriptive manner, pointing out health expenditure dynamics and differences between the two country groups (BRICS and G7) and individual nations in a 1995-2013 time horizon. Average total per capita health spending still remains substantially higher among G7 (4747 Purchase Power Parity (PPP) $PPP in 2013) compared to the BRICS (1004 $PPP in 2013) nations. The percentage point share of G7 in global health expenditure (million current PPP international $US) has been falling constantly since 1995 (from 65% in 1995 to 53.2% in 2013), while in BRICS nations it grew (from 10.7% in 1995 to 20.2% in 2013). Chinese national level medical spending exceeded significantly that of all G7 members except the US in terms of current $PPP in 2013. Within a limited time horizon of only 19 years it appears that the share of global medical spending by the leading emerging markets has been growing steadily. Simultaneously, the world's richest countries' global share has been falling constantly, although it continues to dominate the landscape. If the contemporary global economic mainstream continues, the BRICS per capita will most likely reach or exceed the OECD average in future decades. Rising out-of-pocket expenses threatening affordability of medical care to poor citizens among the BRICS nations and a too low percentage of GDP in India remain the most notable setbacks of these developments.

The National Poisons Information Centre in Sri Lanka: the first ten years.

PubMed

Fernando, Ravindra

2002-01-01

Poisoning is a major health concern in Sri Lanka, which has a very high morbidity and mortality from pesticide poisoning. Poisoning, which continues to be in the first five leading causes of death, accounts for about 80,000 hospitalizations and over 3,000 deaths per year. The National Poisons Information Centre in Sri Lanka, thefirst such centre to be established in South Asia, completed 10 years service in 1997. The 4,070 calls received in thefirst 10 years are analyzed and compared with the national hospitalization pattern. The recorded data sheets of all enquiries received from 1988 to 1997 were analyzed retrospectively to study (1) purpose of enquiry, (2) category of enquirer, (3) circumstances of poisoning, (4) gender of victim, (5) age of victim, (6) type of poison, and (7) outcome. Items (6) and (7) were compared with the national hospital statistics for 1998. Of the 4,070 enquiries, 92% concerned specific patients and 6% were for information on poisons. Almost 90% of the enquiries were from medical or paramedical personnel, 5% from relatives or friends, and 3% from the victims. Nearly 38% of enquiries concerned pesticides compared to 27% of poisoning hospitalizations. Medicinal agents were the subject of 20% of enquiries compared to 13% of hospitalizations. The major discrepancy was for snake bites, accounting for only 6% of enquiries but 42% of hospitalizations. Sex distribution of enquiries showed more males than females. Thirty-seven percent of the victims were young adults-15-29years age group. Nearly 49% of the enquiries were for suicidal attempts. Seventy-one percent of the victims recovered. Although enquiries to the NPIC averaged only 0.5% of poisoning hospitalizations, they were sufficiently representative of the national pattern to predict that increasing utilization of the NPIC would offer a much needed service, both for

Analysis of Rainfall and PM2.5 Data Using Clustered Trajectory Analysis for National Park Sites in the Western U.S.

NASA Astrophysics Data System (ADS)

Solorzano, N. N.; Hafner, W.; Jaffe, D.

2005-12-01

We calculated daily kinematic back-trajectories using the NOAA-HYSPLIT model to analyze 7 years of PM2.5 data from National Park sites in the Western U.S. (Glacier N.P., Mount Rainier N.P., Sequoia N.P., Rocky Mountain N.P. and Denali N.P.) The back-trajectories were clustered using a k-means clustering algorithm to segregate the trajectories into 6 main transport patterns. We calculated trajectory clusters for 1, 5 and 10 days to represent short, medium and long-range flow patterns. Some trajectory types and clusters show marked seasonality. Generally faster flow patterns are more prevalent in winter and slower/stagnant patterns are more prevalent in summer. In addition, we found significant inter-annual variability that may be important for explaining variations in rainfall and/or pollutant concentrations. The 5 and 10-day analyses revealed that, for the 4 non-Alaskan sites, trajectories from Asia tend to be less frequent in the summer, compared to the rest of the year. The clusters of different duration show very different predictive power for rainfall and PM2.5. We found that the 1-day clusters are a better predictor for precipitation and PM2.5 concentrations, as compared to the 5 and 10-day clusters. At each of the sites, there is at least one cluster with an average PM2.5 concentration that is different than the average for the site, indicating distinctive transport patterns. The same is true for 5 and 10-day clusters. Interestingly, only one site, Mount Rainier N.P., shows seasonal differences in PM2.5 concentrations between the clusters that differ from the average.

Is the bang worth the buck? A RAID performance study

NASA Technical Reports Server (NTRS)

Hauser, Susan E.; Berman, Lewis E.; Thoma, George R.

1996-01-01

Expecting a high data delivery rate as well as data protection, the Lister Hill National Center for Biomedical Communications procured a RAID system to house image files for image delivery applications. A study was undertaken to determine the configuration of the RAID system that would provide for the fastest retrieval of image files. Average retrieval times with single and with concurrent users were measured for several stripe widths and several numbers of disks for RAID levels 0, 0+1 and 5. These are compared to each other and to average retrieval times for non-RAID configurations of the same hardware. Although the study in ongoing, a few conclusions have emerged regarding the tradeoffs among the different configurations with respect to file retrieval speed and cost.

What difference a decade? The costs of psychosis in Australia in 2000 and 2010: comparative results from the first and second Australian national surveys of psychosis.

PubMed

Neil, Amanda L; Carr, Vaughan J; Mihalopoulos, Cathrine; Mackinnon, Andrew; Lewin, Terry J; Morgan, Vera A

2014-03-01

To assess differences in costs of psychosis between the first and second Australian national surveys of psychosis and examine them in light of policy developments. Cost differences due to changes in resource use and/or real price rises were assessed by minimizing differences in recruitment and costing methodologies between the two surveys. For each survey, average annual societal costs of persons recruited through public specialized mental health services in the census month were assessed through prevalence-based, bottom-up cost-of-illness analyses. The first survey costing methodology was employed as the reference approach. Unit costs were specific to each time period (2000, 2010) and expressed in 2010 Australian dollars. There was minimal change in the average annual costs of psychosis between the surveys, although newly included resources in the second survey's analysis cost AUD$3183 per person. Among resources common to each analysis were significant increases in the average annual cost per person for ambulatory care of AUD$7380, non-government services AUD$2488 and pharmaceuticals AUD$1892, and an upward trend in supported accommodation costs. These increases were offset by over a halving of mental health inpatient costs of AUD$11,790 per person and a 84.6% (AUD$604) decrease in crisis accommodation costs. Productivity losses, the greatest component cost, changed minimally, reflecting the magnitude and constancy of reduced employment levels of individuals with psychosis across the surveys. Between 2000 and 2010 there was little change in total average annual costs of psychosis for individuals receiving treatment at public specialized mental health services. However, there was a significant redistribution of costs within and away from the health sector in line with government initiatives arising from the Second and Third National Mental Health Plans. Non-health sector costs are now a critical component of cost-of-illness analyses of mental illnesses reflecting, at least in part, a whole-of-government approach to care.

The Problem With Estimating Public Health Spending.

PubMed

Leider, Jonathon P

2016-01-01

Accurate information on how much the United States spends on public health is critical. These estimates affect planning efforts; reflect the value society places on the public health enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic public health finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national public health finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of public health activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on public health ($200 per capita on average, median $166). Census public health data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to meaningfully systematize reporting of public health spending and revenue.

A model of political voting behaviours across different countries

NASA Astrophysics Data System (ADS)

Rowden, Jessica; Lloyd, David J. B.; Gilbert, Nigel

2014-11-01

This paper analyses, models mathematically, and compares national voting behaviours across seven democratic countries that have a long term election history, focusing on re-election rates, leaders’ reputation with voters and the importance of friends’ and family influence. Based on the data, we build a Markov model to test and explore national voting behaviour, showing voters are only influenced by the most recent past election. The seven countries can be divided into those in which there is a high probability that leaders will be re-elected and those in which incumbents have relatively less success. A simple stochastic phenomenological dynamical model of electoral districts in which voters may be influenced by social neighbours, political parties and political leaders is then created to explore differences in voter behaviours in the countries. This model supports the thesis that an unsuccessful leader has a greater negative influence on individual voters than a successful leader, while also highlighting that increasing the influence on voters of social neighbours leads to a decrease in the average re-election rate of leaders, but raises the average amount of time the dominant party is in charge.

76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

IMPORTANT FACTORS CONCERNING HUMAN RESOURCES IN MISSISSIPPI. PRELIMINARY REPORT NUMBER 11.

ERIC Educational Resources Information Center

WALL, JAMES E.

THE MORE IMPORTANT CHARACTERISTICS OF THE STATE'S HUMAN RESOURCES AND INFORMATION CONCERNING VOCATIONAL EDUCATION PROGRAMS ARE PRESENTED. MISSISSIPPI'S POPULATION INCREASED 21.6 PERCENT BETWEEN 1920 AND 1960. CENSUS DATA INDICATED (1) BIRTH RATES ARE HIGHER THAN NATIONAL AVERAGE, (2) DEATH RATES ARE CLOSE TO THE NATIONAL AVERAGE, (3) THE SHIFT…

78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-26

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2013 Through June 30, 2014...

76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

Estimating the risks of cancer mortality and genetic defects resulting from exposures to low levels of ionizing radiation

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

Buhl, T.E.; Hansen, W.R.

1984-05-01

Estimators for calculating the risk of cancer and genetic disorders induced by exposure to ionizing radiation have been recommended by the US National Academy of Sciences Committee on the Biological Effects of Ionizing Radiations, the UN Scientific Committee on the Effects of Atomic Radiation, and the International Committee on Radiological Protection. These groups have also considered the risks of somatic effects other than cancer. The US National Council on Radiation Protection and Measurements has discussed risk estimate procedures for radiation-induced health effects. The recommendations of these national and international advisory committees are summarized and compared in this report. Based onmore » this review, two procedures for risk estimation are presented for use in radiological assessments performed by the US Department of Energy under the National Environmental Policy Act of 1969 (NEPA). In the first procedure, age- and sex-averaged risk estimators calculated with US average demographic statistics would be used with estimates of radiation dose to calculate the projected risk of cancer and genetic disorders that would result from the operation being reviewed under NEPA. If more site-specific risk estimators are needed, and the demographic information is available, a second procedure is described that would involve direct calculation of the risk estimators using recommended risk-rate factors. The computer program REPCAL has been written to perform this calculation and is described in this report. 25 references, 16 tables.« less

UK and Twenty Comparable Countries GDP-Expenditure-on-Health 1980-2013: The Historic and Continued Low Priority of UK Health-Related Expenditure.

PubMed

Harding, Andrew J E; Pritchard, Colin

2016-07-10

It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health-related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a 'crisis' point on account of low levels of funding. Indeed, many state that currently the NHS has a sizeable funding gap, in part due to its recently reduced GDP devoted to health but mainly the challenges around increases in longevity, expectation and new medical costs. The right level of health funding is a political value judgement. As the data in this paper outline, if the UK 'afforded' the same proportional level of funding as the mean average European country, total expenditure would currently increase by one-fifth. © 2016 by Kerman University of Medical Sciences.

Comparison of Children's Menu Items at Full- and Quick-Service Restaurants.

PubMed

Eissa, Mona A; Hearne, Katherine; Saavedra, Nora

2018-04-01

The proportion of food consumed by children from restaurants tripled during the last 4 decades and that coincided with the increased rate of obesity. Despite the presence of data linking quick-service (QS) food consumption to poor diet quality, studies comparing the nutrition content of the children's menu items at QS restaurants (QSRs) with those at full-service restaurants (FSRs) are limited. The objectives of this study were to examine the nutrition content of common children's menu items at both QSRs and FSRs and compare these data with recommendations reported by the Dietary Guidelines for Americans 2015-2020, Eighth Edition . Using the 2014 data of the MenuStat project, 10 food items that are on both QSR and FSR children's menus were selected. Data from each restaurant category were aggregated and the overall average of the nutritional content of each individual food item was calculated and compared between the two restaurant categories. The average of calories, fat, carbohydrates, and added sugar of most items on the children's menu of QSRs are lower than those of FSRs. Also, most food items on children's menus of FSRs, and to a lesser extent those of QSRs, exceeded the national recommended calories and fat content per meal. Although some children's menu items of QSRs have less fat and fewer calories compared with those of FSRs, most menu items in both FSRs and QSRs do not meet national dietary recommendations. Healthcare professionals may expand discussions with patients to include both restaurant categories when counseling them and their families on obesity prevention. Also, educating children and families about reading the nutritional content information of children's menu items when eating out to make an informed choice can be a tool in fighting childhood obesity.

Focus on Teacher Salaries: What Teacher Salary Averages Don't Show.

ERIC Educational Resources Information Center

Gaines, Gale

Traditional comparisons of teacher salary averages fail to consider factors beyond pay raises that affect those averages. Salary averages do not show: regional and national variations among states' average salaries; the variation of salaries within an individual state; variations in the cost of living; the highest degree earned by teachers and the…

Perinatal mortality among infants born during health user-fees (Cash & Carry) and the national health insurance scheme (NHIS) eras in Ghana: a cross-sectional study.

PubMed

Ibrahim, Abdallah; Maya, Ernest T; Donkor, Ernestina; Agyepong, Irene A; Adanu, Richard M

2016-12-08

This research determined the rates of perinatal mortality among infants delivered under Ghana's national health insurance scheme (NHIS) compared to infants delivered under the previous "Cash and Carry" system in Northern Region, especially as the country takes stock of its progress toward meeting the Millennium Development Goals (MDG) 4 and 5. The labor and maternity wards delivery records of infants delivered before and after the implementation of the NHIS in Northern Region were examined. Records of available daily deliveries during the two health systems were extracted. Fisher's exact tests of non-random association were used to examine the bivariate association between categorical independent variables and perinatal mortality. On average, 8% of infants delivered during the health user-fee (Cash & Carry) died compared to about 4% infant deaths during the NHIS delivery fee exemption period in Northern Region, Ghana. There were no remarkable difference in the rate of infant deaths among mothers in almost all age categories in both the Cash and Carry and the NHIS periods except in mothers age 35 years and older. Infants born to multiparous mothers were significantly more likely to die than those born to first time mothers. There were more twin deaths during the Cash and Carry system (p = 0.001) compared to the NHIS system. Deliveries by caesarean section increased from an average of 14% in the "Cash and Carry" era to an average of 20% in the NHIS era. The overall rate of perinatal mortality declined by half (50%) in infants born during the NHIS era compared to the Cash and Carry era. However, caesarean deliveries increased during the NHIS era. These findings suggest that pregnant women in the Northern Region of Ghana were able to access the opportunity to utilize the NHIS for antenatal visits and possibly utilized skilled care at delivery at no cost or very minimal cost to them, which therefore improved Ghana's progress towards meeting the MDG 4, (reducing under-five deaths by two-thirds).

Determining the prevalence of malnutrition in hospitalized paediatric patients.

PubMed

Marino, L V; Goddard, E; Workman, L

2006-09-01

To determine the prevalence of malnutrition in hospitalised paediatric patients at Red Cross War Memorial Children's Hospital. A 1-day cross-sectional survey was completed in all medical and surgical wards and some specialist outpatient clinics. A total of 227 children participated in the study. Thirty-five per cent of patients were moderately malnourished (< or = -2 z-score), of whom 70% had no road to health card with them. Thirty-four per cent of children under 60 months of age received supplements in addition to a normal ward diet, 7.8% were enterally fed and less than 1% were parenterally fed. Almost 14% of children were found to be overweight/obese, which is higher than the national average of 6%. The prevalence of HIV infection on the day of the audit was 18% across all age groups compared with the Western Cape antenatal prevalence of 15.7% (2005). The overall prevalence of undernutrition was 34%, which is comparable with similar studies. However, the proportion of overweight children (14%) was greater than the national average. In view of the level of malnutrition seen, a nutrition risk-screening tool, identifying risk factors for malnutrition such as food access and vulnerability, should be developed. The tool should be used to assess nutrition status and risk during the course of hospitalisation, in addition to planning appropriate nutrition care plan interventions for discharge.

Bald eagle winter roost characteristics in Lava Beds National Monument, California

USGS Publications Warehouse

Stohlgren, Thomas J.

1993-01-01

This study provided a survey of bald eagle (Haliaeetus leucocephalus) winter roost habitat (in 4 km2 of potential roost areas) in southern Lava Beds National Monument, California. A systematic-clustered sampling design (n=381 plots) was used to compare forest stand characteristics in two primary roost areas (Caldwell Butte and Eagle Nest Butte) and two potential roost areas (Hidden Valley and Island Butte). A 100 percent inventory of roost trees in Caldwell Butte (n=103 trees) and Eagle Nest Butte (n=44 trees) showed they were spatially clumped and restricted to 12.7 percent and 2.8 percent, respectively, of the study areas. Roost trees, primarily ponderosa pine (Pinus ponderosa), averaged 81.1 ± 1.3 cm dbh (mean ± 1 S.E.) compared to non-roost trees (>35 cm dbh) that averaged 52.2 ± 1.0 cm dbh. Roost trees were generally taller and more open-structured than non-roost trees. All four study sites had adequate numbers of mid-sized trees (10 to 50 cm dbh) to replace the current stock of older, larger roost trees. However, seedling and small trees (<10 cm dbh) in the roost areas were spatially clumped and few, suggesting that maintaining a continuous population of roost trees may be a problem in the distant future. Long-term studies of changing winter roost habitat and eagle use are essential to protect the bald eagle in the northwestern US.

Energetics of thermoregulation by an industrious endotherm.

PubMed

Meehan, Timothy D

2012-01-01

Thermoregulation by modern industrial humans is unique among endothermic animals, in that it is largely accomplished by controlling the temperature of our external environment. The objective of this study was to view the relationship between thermoregulatory energy use and environmental temperature in modern humans from the perspective of comparative physiology. Monthly residential energy use estimates from the US Energy Information Administration were divided by the annual number of American households from the US Census Bureau, giving average monthly energy consumption per American household for the years 2006 through 2010. Monthly energy consumption was then plotted against average monthly temperature across the United States from the National Climatic Data Center. The resulting graph bore a striking resemblance to a classic Scholander-Irving curve, exhibiting clear upper (22°C) and lower (15°C) critical temperatures, and an increase in energy use as temperatures extend above (90 W °C(-1) increase) or below (244 W °C(-1) decrease) those critical temperatures. Allometric equations from comparative physiology indicate that the energetic costs of our current thermoregulatory habits are ∼30 to 50 times those predicted for an endotherm of our size. Modern humans have redefined what it means to be a homeothermic endotherm, using large quantities of extrametabolic energy to regulate the temperature of our surroundings. Despite this sophistication, the signal of our individual physiology is readily discernible in national data on energy consumption. Copyright © 2012 Wiley Periodicals, Inc.

Modeling Soil Carbon Dynamics in Northern Forests: Effects of Spatial and Temporal Aggregation of Climatic Input Data.

PubMed

Dalsgaard, Lise; Astrup, Rasmus; Antón-Fernández, Clara; Borgen, Signe Kynding; Breidenbach, Johannes; Lange, Holger; Lehtonen, Aleksi; Liski, Jari

2016-01-01

Boreal forests contain 30% of the global forest carbon with the majority residing in soils. While challenging to quantify, soil carbon changes comprise a significant, and potentially increasing, part of the terrestrial carbon cycle. Thus, their estimation is important when designing forest-based climate change mitigation strategies and soil carbon change estimates are required for the reporting of greenhouse gas emissions. Organic matter decomposition varies with climate in complex nonlinear ways, rendering data aggregation nontrivial. Here, we explored the effects of temporal and spatial aggregation of climatic and litter input data on regional estimates of soil organic carbon stocks and changes for upland forests. We used the soil carbon and decomposition model Yasso07 with input from the Norwegian National Forest Inventory (11275 plots, 1960-2012). Estimates were produced at three spatial and three temporal scales. Results showed that a national level average soil carbon stock estimate varied by 10% depending on the applied spatial and temporal scale of aggregation. Higher stocks were found when applying plot-level input compared to country-level input and when long-term climate was used as compared to annual or 5-year mean values. A national level estimate for soil carbon change was similar across spatial scales, but was considerably (60-70%) lower when applying annual or 5-year mean climate compared to long-term mean climate reflecting the recent climatic changes in Norway. This was particularly evident for the forest-dominated districts in the southeastern and central parts of Norway and in the far north. We concluded that the sensitivity of model estimates to spatial aggregation will depend on the region of interest. Further, that using long-term climate averages during periods with strong climatic trends results in large differences in soil carbon estimates. The largest differences in this study were observed in central and northern regions with strongly increasing temperatures.

Impact of vaccination on influenza mortality in children <5years old in Mexico.

PubMed

Sánchez-Ramos, Evelyn L; Monárrez-Espino, Joel; Noyola, Daniel E

2017-03-01

Influenza is a leading cause of respiratory tract infections among children. In Mexico, influenza vaccination was included in the National Immunization Program since 2004. However, the population health effects of the vaccine on children have not been fully described. Thus, we estimated the impact of influenza immunization in terms of mortality associated with this virus among children younger than 5years of age in Mexico. Mortality rates and years of life lost associated with influenza were estimated using national mortality register data for the period 1998-2012. Age-stratified and cause-specific mortality rates were estimated for all-cause, respiratory and cardiovascular events. Influenza-associated mortality was compared between the period prior to introduction of the influenza vaccine as part of the National Immunization Program (1998-2004) and the period thereafter (2004-2012). During the 1998-2012 winter seasons, the average number of all-cause, respiratory and cardiovascular deaths attributable to influenza were 1186, 794 and 21, respectively. Influenza-associated mortality was higher prior to the vaccination period than after influenza was included in the immunization program for all-cause (mean 1660 vs. 780) and respiratory (mean 1063 vs. 563) mortality, but no reduction was seen for cardiovascular mortality. The proportion of all-cause and respiratory deaths attributable to influenza was significantly lower in the post-vaccine period compared with the pre-vaccine period (P<0.001), but no reduction was seen in the proportion of cardiovascular deaths. There was an average annual reduction of 66,558years of life lost in the post-vaccine compared with the pre-vaccine period. The introduction of influenza vaccination within the Mexican Immunization Program was associated with a reduction in mortality rates attributable to this virus among children younger than 5years of age. Copyright © 2017 Elsevier Ltd. All rights reserved.

Modeling Soil Carbon Dynamics in Northern Forests: Effects of Spatial and Temporal Aggregation of Climatic Input Data

PubMed Central

Dalsgaard, Lise; Astrup, Rasmus; Antón-Fernández, Clara; Borgen, Signe Kynding; Breidenbach, Johannes; Lange, Holger; Lehtonen, Aleksi; Liski, Jari

2016-01-01

Boreal forests contain 30% of the global forest carbon with the majority residing in soils. While challenging to quantify, soil carbon changes comprise a significant, and potentially increasing, part of the terrestrial carbon cycle. Thus, their estimation is important when designing forest-based climate change mitigation strategies and soil carbon change estimates are required for the reporting of greenhouse gas emissions. Organic matter decomposition varies with climate in complex nonlinear ways, rendering data aggregation nontrivial. Here, we explored the effects of temporal and spatial aggregation of climatic and litter input data on regional estimates of soil organic carbon stocks and changes for upland forests. We used the soil carbon and decomposition model Yasso07 with input from the Norwegian National Forest Inventory (11275 plots, 1960–2012). Estimates were produced at three spatial and three temporal scales. Results showed that a national level average soil carbon stock estimate varied by 10% depending on the applied spatial and temporal scale of aggregation. Higher stocks were found when applying plot-level input compared to country-level input and when long-term climate was used as compared to annual or 5-year mean values. A national level estimate for soil carbon change was similar across spatial scales, but was considerably (60–70%) lower when applying annual or 5-year mean climate compared to long-term mean climate reflecting the recent climatic changes in Norway. This was particularly evident for the forest-dominated districts in the southeastern and central parts of Norway and in the far north. We concluded that the sensitivity of model estimates to spatial aggregation will depend on the region of interest. Further, that using long-term climate averages during periods with strong climatic trends results in large differences in soil carbon estimates. The largest differences in this study were observed in central and northern regions with strongly increasing temperatures. PMID:26901763

Prospects for future climate change and the reasons for early action

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

MacCracken, Michael C.

2008-06-15

Combustion of coal, oil, and natural gas, and to a lesser extent deforestation, land-cover change, and emissions of halocarbons and other greenhouse gases, are rapidly increasing the atmospheric concentrations of climate-warming gases. The global average temperature is already approximately 0.8{sup o}C above its preindustrial level, and present atmospheric levels of greenhouse gases will contribute to further warming of 0.5-1{sup o}C as equilibrium is re-established. Warming has been and will be greater in mid and high latitudes compared with low latitudes, over land compared with oceans, and at night compared with day. As emissions continue to increase, both warming and themore » commitment to future warming are presently increasing at a rate of approximately 0.2{sup o}C per decade, with projections that the rate of warming will further increase if emission controls are not put in place. Such warming and the associated changes are likely to result in severe impacts on key societal and environmental support systems. Present estimates are that limiting the increase in global average surface temperature to no more than 2-2.5{sup o}C above its 1750 value of approximately 15{sup o}C will be required to avoid the most catastrophic, but certainly not all, consequences of climate change. Accomplishing this will require reducing emissions sharply by 2050 and to near zero by 2100. This can only be achieved if: (1) developed nations move rapidly to demonstrate that a modem society can function without reliance on technologies that release carbon dioxide (CO{sub 2}) and other non-CO{sub 2} greenhouse gases to the atmosphere; and (2) if developing nations act in the near-term to sharply limit their non-CO{sub 2} emissions while minimizing growth in CO{sub 2} emissions, and then in the long-term join with the developed nations to reduce all emissions as cost-effective technologies are developed. 183 refs., 13 figs., 5 tabs.« less

Comparability of ecological quality boundaries in the Mediterranean basin using freshwater benthic invertebrates. Statistical options and implications.

PubMed

Feio, M J; Ferreira, J; Buffagni, A; Erba, S; Dörflinger, G; Ferréol, M; Munné, A; Prat, N; Tziortzis, I; Urbanič, G

2014-04-01

Within the Mediterranean region each country has its own assessment method based on aquatic macroinvertebrates. However, independently of the classification system, quality assessments should be comparable across members of the European Commission, which means, among others, that the boundaries between classes should not deviate significantly. Here we check for comparability between High-Good and Good-Moderate classifications, through the use of a common metric. Additionally, we discuss the influence of the conceptual and statistical approaches used to calculate a common boundary within the Mediterranean countries participating in the Intercalibration Exercise (e.g., using individual national type-boundaries, one value for each common type or an average boundary by country; weighted average, median) in the overall outcome. All methods, except for the IBMWP (the Iberian BMWP) when applied to temporary rivers, were highly correlated (0.82

Are Emissions of Restricted Halocarbons in the USA and Canada Still Globally Significant?

NASA Astrophysics Data System (ADS)

Hurst, D. F.; Romashkin, P. A.; Hall, B. D.; Elkins, J. W.; Lin, J. C.; Gerbig, C.; Daube, B. C.; Wofsy, S. C.

2004-12-01

The global manufacture of halocarbons regulated by the Montreal Protocol has dropped substantially in response to the January 1, 1996, production phase-out deadline (1994 for halons) for developed (Article 5) countries like the United States and Canada. Contemporary emissions of these ozone-depleting substances (ODS) emanate from ongoing production in developing countries and releases of banked halocarbons world-wide. ODS emissions in developing nations can be appraised from reported production figures, but not so for developed nations where recent manufacture is negligible. Emissions in the United States and Canada are increasingly difficult to estimate because of limited information about bank sizes and release rates in the post-production era. In addition, regional- or national-scale emission estimates should no longer be derived wholly from localized measurements because of the potentially patchy spatial distributions of modern emissions. We estimate ODS emissions in the USA and Canada from >1000 simultaneous, in situ measurements each of CO and six restricted halocarbons (CFC-11, CFC-12, CFC-113, methyl chloroform, carbon tetrachloride, and halon-1211) in and above the planetary boundary layer during the 2003 CO2 Budget and Regional Airborne - North America (COBRA-NA 2003) study. The data obtained during 87 flight hours are geographically extensive (>30,000 km) including two 11,000 km flight circuits across both countries. More than 50 pollution "events" with statistically significant ODS:CO emission ratios were sampled, and for each event we have determined a flux footprint using the Stochastic Time-Inverted Lagrangian Transport (STILT) model. The model also calculates footprint-weighted average population densities and CO fluxes which we convert to footprint-weighted average ODS fluxes using the measured ODS:CO emission ratios. Statistically robust relationships between footprint-averaged ODS fluxes and population densities for several ODS indicate that population-based extrapolations of these relationships to national levels are warranted. Emission estimates for the USA and Canada in 2003 will be presented and compared to the magnitudes of global emissions.

Compliance with clinical pathways for inpatient care in Chinese public hospitals.

PubMed

He, Xiao Yan; Bundorf, M Kate; Gu, Jian Jun; Zhou, Ping; Xue, Di

2015-10-06

The National Health and Family Planning Commission of China has issued more than 400 clinical pathways to improve the effectiveness and efficiency of medical care delivered by public hospitals in China. The aim of our study is to determine whether patient care is compliant with national clinical pathways in public general hospitals of Pudong New Area in Shanghai. We identified the clinical pathways established by the National Health and Family Planning Commission of China for 5 common conditions (community-acquired pneumonia, acute myocardial infarction (AMI), heart failure, cesarean section, type-2 diabetes). We randomly selected patients with each condition admitted to one of 7 public general hospitals in Pudong New Area in China in January, 2013. We identified key process indicators (KPIs) for each pathway and, based on chart review for each patient, determined whether the patient's care was compliant for each indicator. We calculated the proportion of care which was compliant with clinical pathways for each indicator, the average proportion of indicators that were met for each patient, and the proportion of patients whose care was compliant for all measures. For selected indicators, we compared compliance rates among hospitals in our study with those from other countries. Average compliance rates across the KPIs for each condition ranged from 61 % for AMI to 89 % for pneumonia. The percent of patient receiving fully compliant care ranged from 0 for AMI and heart failure to 39 % for pneumonia. Compared to the compliance rate for process indicators in the hospitals of other countries, some rates in the hospitals that we audited were higher, but some were lower. Few patients received care that complied with all the pathways for each condition. The reasons for low compliance with national clinical pathways and how to improve clinical quality in public hospitals of China need to be further explored.

Adrenalectomy for adrenal-mediated hypertension: National Surgical Quality Improvement Program analysis of an institutional experience.

PubMed

Shada, Amber L; Stokes, Jayme B; Turrentine, Florence E; Simpson, Virginia B; Padia, Shetal H; Carey, Robert M; Hanks, John B; Smith, Philip W

2014-11-01

Adrenal-mediated hypertension (AMH) has been increasingly treated by laparoscopic adrenalectomy (LA). Metabolic derangements in patients with AMH could result in perioperative complications and mortality. Long-term operative and clinical outcomes after laparoscopic treatment of AMH have not been evaluated using large clinical databases. The institutional National Surgical Quality Improvement Program (NSQIP) data for patients undergoing adrenalectomy for AMH between 2002 and 2012 were reviewed. Patient demographics, perioperative variables, and outcomes were analyzed and compared with national NSQIP adrenalectomy data. Improvement in AMH was recorded when discontinuation or reduction of antihypertensive medication occurred or with a decrease of blood pressure on the preoperative antihypertensive regimen. Ninety-four patients underwent adrenalectomy. There were 48 patients with pheochromocytoma (PHE) and 46 patients with aldosterone-producing adenoma (APA). Eighty-five patients (90%) were taking antihypertensive medications preoperatively compared with 36 patients (38%) postoperatively (P < 0.0001). Patients with PHE were more likely to discontinue all medications compared with the patients with APA (80 vs 20%, respectively, P < 0.0001). Patients with PHE and APA, respectively, took an average of 2.0 and 3.2 antihypertensive medications preoperatively compared with 0.3 and 1.2 postoperatively. There were no conversions to open procedures or 30-day mortality. Our results were 0 per cent for cerebral vascular accident, 0 per cent for myocardial infarction, and 0.5 per cent for transfusions compared with the national NSQIP data of 0.2, 0, and 6.7 per cent, respectively. Patients presenting with significant AMH including PHE and APA can be effectively and safely treated with LA with minimal complications and with a significant number of patients eliminating or decreasing their need for antihypertensive medications.

Work Hours and Self rated Health of Hospital Doctors in Norway and Germany. A comparative study on national samples

PubMed Central

2011-01-01

Background The relationship between extended work hours and health is well documented among hospital doctors, but the effect of national differences in work hours on health is unexplored. The study examines the relationship between work hours and self rated health in two national samples of hospital doctors. Methods The study population consisted of representative samples of 1,260 German and 562 Norwegian hospital doctors aged 25-65 years (N = 1,822) who received postal questionnaires in 2006 (Germany) and 2008 (Norway). The questionnaires contained items on demography, work hours (number of hours per workday and on-call per month) and self rated subjective health on a five point scale - dichotomized into "good" (above average) and "average or below". Results Compared to Norway, a significantly higher proportion of German doctors exceeded a 9 hour work day (58.8% vs. 26.7%) and 60 hours on-call per month (63.4% vs. 18.3%). Every third (32.2%) hospital doctor in Germany worked more than this, while this pattern was rare in Norway (2.9%). In a logistic regression model, working in Norway (OR 4.17; 95% CI 3.02-5.73), age 25-44 years (OR 1.66; 95% CI 1.29-2.14) and not exceeding 9 hour work day and 60 hours on-call per month (OR 1.35; 95% CI 1.03-1.77) were all independent significant predictors of good self reported health. Conclusion A lower percentage of German hospital doctors reported self rated health as "good", which is partly explained by the differences in work time pattern. Initiatives to increase doctors' control over their work time are recommended. PMID:21338494

Financial expectations of first-year veterinary students.

PubMed

Lim, Christine C; Schulhofer-Wohl, Sam; Root Kustritz, Margaret V; Molgaard, Laura K; Lee, David

2015-07-15

To assess student awareness of the financial costs of pursuing a veterinary education, to determine student expectations for financial returns of a veterinary career, and to identify associations between student debt and factors such as future career plans or personality type. Survey. First-year veterinary students at the University of Minnesota College of Veterinary Medicine. In 2013, prior to the first day of class, all incoming first-year students received an email invitation to complete an online survey. The survey contained questions about demographics, current financial situation, current debt, expected debt at graduation, expected annual income following graduation, intent to pursue specialty training, and Myers-Briggs personality type. 72 of 102 (71%) students completed the survey; 65 respondents answered all relevant questions and provided usable data. Student responses for expected debt at graduation were comparable to national averages for veterinary college graduates; responses for expected annual income following graduation were lower than averages for University of Minnesota veterinary college graduates and national averages. However, students predicted even lower annual income if they did not attend veterinary college. Expected debt and expected annual income were not correlated with factors such as personality type or future career plans. Results indicated that first-year veterinary students were aware of the financial costs of their veterinary education and had realistic expectations for future salaries. For typical veterinary students, attending veterinary college appeared to be financially worthwhile, given lower expected earnings otherwise.

The Nation's Report Card Reading 2011 State Snapshot Report. Oregon. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Oregon. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Oregon. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Oregon. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. Minnesota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Minnesota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Minnesota. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. Minnesota. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

A climatic handbook for Glacier National Park-with data for Waterton Lakes National Park

Treesearch

Arnold I. Finklin

1986-01-01

A climatic description of the Glacier-Waterton Lakes Park area; mainly covers Glacier. Contains numerous tables, graphs, and maps showing the year-round pattern of climatic elements and 10-day details during fire season. Data analysis includes frequency distributions in addition to average values. Examines relationship of averages to topography, weather correlations...

The Nation's Report Card Mathematics 2011 State Snapshot Report. West Virginia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. West Virginia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. West Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. West Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. West Virginia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. West Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

Creep and Creep Recovery Response of Load Cells Tested According to U.S. and International Evaluation Procedures

PubMed Central

Bartel, Thomas W.; Yaniv, Simone L.

1997-01-01

The 60 min creep data from National Type Evaluation Procedure (NTEP) tests performed at the National Institute of Standards and Technology (NIST) on 65 load cells have been analyzed in order to compare their creep and creep recovery responses, and to compare the 60 min creep with creep over shorter time periods. To facilitate this comparison the data were fitted to a multiple-term exponential equation, which adequately describes the creep and creep recovery responses of load cells. The use of such a curve fit reduces the effect of the random error in the indicator readings on the calculated values of the load cell creep. Examination of the fitted curves show that the creep recovery responses, after inversion by a change in sign, are generally similar in shape to the creep response, but smaller in magnitude. The average ratio of the absolute value of the maximum creep recovery to the maximum creep is 0.86; however, no reliable correlation between creep and creep recovery can be drawn from the data. The fitted curves were also used to compare the 60 min creep of the NTEP analysis with the 30 min creep and other parameters calculated according to the Organization Internationale de Métrologie Légale (OIML) R 60 analysis. The average ratio of the 30 min creep value to the 60 min value is 0.84. The OIML class C creep tolerance is less than 0.5 of the NTEP tolerance for classes III and III L. PMID:27805151

Water quality in the St. Croix National Scenic Riverway, Wisconsin

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

Graczyk, D.J.

1986-01-01

A water quality study of the St. Croix National Scenic Riverway, was conducted during the period 1975-83. Concentrations of most constituents analyzed, and constituent loads and yields were lower in the Scenic Riverway than in other Wisconsin streams. Water quality samples were collected at 10 stations throughout the study area and were compared to analyses of samples from selected National Stream Quality Accounting Network stations (NASWAN) and the Hydrologic Bench-Mark Network (HBMN) station in Wisconsin. The average suspended sediment (SS) concentration for 9 of the 10 stations in this study was 7.7 mg/L. The concentrations of major cations and anionsmore » at two of the stations were similar to concentrations at the HBMN station Popple River near Fence. Mean total phosphorus concentrations ranged from 0.02 to 0.08 mg/L at the study stations and from 0.03 to 0.16 mg/L at selected NASQAN stations. Concentrations of trace metals were below safe drinking water standards at all the study sites, except for iron and manganese which exceeded drinking water standards at some of the study sites. Pesticides were sampled at the St. Croix River at St. Croix Falls and above and below cranberry bogs that drain into the Namekagon River. Average annual loads of SS, total phosphorus, total nitrogen, and dissolved solids were calculated by a flow duration curve method. Suspended sediment yields ranged from 1.9 to 13.3 tons/sq mi. The average SS yield for Wisconsin is 80 tons/sq mi. total phosphorus and other constituents exhibited the same trend. 26 refs., 10 figs., 12 tabs.« less

Dengue in Thailand and Cambodia: An Assessment of the Degree of Underrecognized Disease Burden Based on Reported Cases

PubMed Central

Wichmann, Ole; Yoon, In-Kyu; Vong, Sirenda; Limkittikul, Kriengsak; Gibbons, Robert V.; Mammen, Mammen P.; Ly, Sowath; Buchy, Philippe; Sirivichayakul, Chukiat; Buathong, Rome; Huy, Rekol; Letson, G. William; Sabchareon, Arunee

2011-01-01

Background Disease incidence data are needed to guide decision-making for public health interventions. Although dengue is a reportable disease in Thailand and Cambodia, the degree that reported incidence underrecognizes true disease burden is unknown. We utilized dengue incidence calculated from laboratory-confirmed outpatient and inpatient cases in prospective cohort studies to estimate the magnitude of dengue underrecognition and to establish more accurate disease burden estimates for these countries. Methods and Findings Cohort studies were conducted among children aged <15 years by members of a dengue field site consortium over at least 2 dengue seasons. Age-group specific multiplication factors (MFs) were computed by comparing data from three cohort studies to national surveillance data in the same province and year. In Thailand, 14,627 person-years of prospective cohort data were obtained in two provinces and 14,493 person-years from one province in Cambodia. Average annual incidence of laboratory-confirmed dengue was 23/1,000 and 25/1,000 in Thailand, and 41/1,000 in Cambodia. Calculated MFs in these provinces varied by age-group and year (range 0.4–29). Average age-group specific MFs were then applied to country-level reporting data and indicated that in Thailand a median 229,886 (range 210,612–331,236) dengue cases occurred annually during 2003–2007 and a median 111,178 (range 80,452–357,135) cases occurred in Cambodia in children <15 years of age. Average underrecognition of total and inpatient dengue cases was 8.7 and 2.6-fold in Thailand, and 9.1 and 1.4-fold in Cambodia, respectively. During the high-incidence year 2007, >95,000 children in Thailand and >58,000 children in Cambodia were estimated to be hospitalized due to dengue. Conclusion Calculating MFs by comparing prospective cohort study data to locally-reported national surveillance data is one approach to more accurately assess disease burden. These data indicate that although dengue is regularly reported in many countries, national surveillance data significantly underrecognize the true burden of disease. PMID:21468308

Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study

PubMed Central

Kerr, Zachary Y.; Dompier, Thomas P.; Dalton, Sara L.; Miller, Sayers John; Hayden, Ross; Marshall, Stephen W.

2015-01-01

Context Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting. Objective To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports. Design Descriptive epidemiology study. Setting Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states. Patients or Other Participants High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011−2012 through 2013−2014 academic years. Main Outcome Measure(s) The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non–time-loss (NTL) injuries. Results Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 ± 6.52 ATR visits and 11.01 ± 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P < .001) and AT services (18.60 versus 9.56; P < .001) per injury. An average of 2.24 ± 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P < .001). Conclusions These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services. PMID:26678290

How robust is the pre-1931 National Climatic Data Center—climate divisional dataset? Examples from Georgia and Louisiana

NASA Astrophysics Data System (ADS)

Allard, Jason; Thompson, Clint; Keim, Barry D.

2015-04-01

The National Climatic Data Center's climate divisional dataset (CDD) is commonly used in climate change analyses. This dataset is a spatially continuous dataset for the conterminous USA from 1895 to the present. The CDD since 1931 is computed by averaging all available representative cooperative weather station data into a single monthly value for each of the 344 climate divisions of the conterminous USA, while pre-1931 data for climate divisions are derived from statewide averages using regression equations. This study examines the veracity of these pre-1931 data. All available Cooperative Observer Program (COOP) stations within each climate division in Georgia and Louisiana were averaged into a single monthly value for each month and each climate division from 1897 to 1930 to generate a divisional dataset (COOP DD), using similar methods to those used by the National Climatic Data Center to generate the post-1931 CDD. The reliability of the official CDD—derived from statewide averages—to produce temperature and precipitation means and trends prior to 1931 are then evaluated by comparing that dataset with the COOP DD with difference-of-means tests, correlations, and linear regression techniques. The CDD and the COOP DD are also compared to a divisional dataset derived from the United States Historical Climatology Network (USHCN) data (USHCN DD), with difference of means and correlation techniques, to demonstrate potential impacts of inhomogeneities within the CDD and the COOP DD. The statistical results, taken as a whole, not only indicate broad similarities between the CDD and COOP DD but also show that the CDD does not adequately portray pre-1931 temperature and precipitation in certain climate divisions within Georgia and Louisiana. In comparison with the USHCN DD, both the CDD and the COOP DD appear to be subject to biases that probably result from changing stations within climate divisions. As such, the CDD should be used judiciously for long-term studies of climate change, and past studies using the CDD should be evaluated in the context of these new findings.

Comparison of 368 patients undergoing surgery for lumbar degenerative spondylolisthesis from the SPORT trial with 955 from the NSQIP database.

PubMed

Golinvaux, Nicholas S; Basques, Bryce A; Bohl, Daniel D; Yacob, Alem; Grauer, Jonathan N

2015-03-01

Retrospective cohort. To compare demographics and perioperative outcomes between the Spine Patient Outcomes Research Trial (SPORT) lumbar degenerative spondylolisthesis arm and a similar population from the National Surgical Quality Improvement Program (NSQIP) database. SPORT is a well-known surgical trial that investigated the benefits of surgical versus nonsurgical treatment in patients with various lumbar pathologies. However, the external validity of SPORT demographics and outcomes has not been fully established. Surgical degenerative spondylolisthesis cases were identified from NSQIP between 2010 and 2012. This population was then compared with the SPORT degenerative spondylolisthesis study. These comparisons were based on published data from SPORT and included analyses of demographics, perioperative factors, and complications. The 368 surgical patients with degenerative spondylolisthesis in SPORT were compared with 955 patients identified in NSQIP. Demographic comparisons were as follows: average age and race (no difference; P > 0.05 for each), sex (9.1% more female patients in SPORT; P = 0.002), smoking status (6.6% more smokers in NSQIP; P = 0.002), and average body mass index (1.1 kg/m greater in NSQIP; P = 0.005). Larger differences were noted in what surgical procedure was performed (P < 0.001), with the most notable difference being that the NSQIP population was much more likely to include interbody fusion than the SPORT population (52.4% vs. 12.5%). Most perioperative factors and complication rates were similar, including average operative time, wound infection, wound dehiscence, postoperative transfusion, and postoperative mortality (no differences; P > 0.05 for each). Average length of stay was shorter in NSQIP compared with SPORT (3.7 vs. 5.8 d; P = 0.042). Though important differences in the distribution of surgical procedures were identified, this study supports the greater generalizability of the surgical SPORT degenerative spondylolisthesis study based on similar demographics and perioperative outcomes when compared with patients from the NSQIP database. 3.

Targeting smoking cessation to high prevalence communities: outcomes from a pilot intervention for gay men.

PubMed

Harding, Richard; Bensley, James; Corrigan, Nick

2004-09-30

Cigarette smoking prevalence among gay men is twice that of population levels. A pilot community-level intervention was developed and evaluated aiming to meet UK Government cessation and cancer prevention targets. Four 7-week withdrawal-oriented treatment groups combined nicotine replacement therapy with peer support. Self-report and carbon monoxide register data were collected at baseline and 7 weeks. N = 98 gay men were recruited through community newspapers and organisations in London UK. At 7 weeks, n = 44 (76%) were confirmed as quit using standard UK Government National Health Service monitoring forms. In multivariate analysis the single significant baseline variable associated with cessation was previous number of attempts at quitting (OR 1.48, p = 0.04). This tailored community-level intervention successfully recruited a high-prevalence group, and the outcome data compares very favourably to national monitoring data (which reports an average of 53% success). Implications for national targeted services are considered.

--No Title--

Science.gov Websites

2008073000 2008072900 2008072800 Background information bias reduction = ( | domain-averaged ensemble mean bias | - | domain-averaged bias-corrected ensemble mean bias | / | domain-averaged bias-corrected ensemble mean bias | NAEFS Products | NAEFS | EMC Ensemble Products EMC | NCEP | National Weather Service

Nutritional habits in Italian university students.

PubMed

Teleman, Adele Anna; de Waure, Chiara; Soffiani, Valentina; Poscia, Andrea; Di Pietro, Maria Luisa

2015-01-01

Dietary habits have been indicated by research as key elements in both disease pathogenesis and prevention and health promotion. We analyzed data collected from Italian university students regarding consumption of fruits, vegetables, fast-foods, sweets, energizing drinks, and coffee, average number of eating episodes per day and regularity of breakfast habits. 44% of the university student population eats in average at least 1 portion of fruit per day. 22.5% eats at least 2 portions of vegetables per day. 8.5% eats in average 5 times per day with 48.6% declaring an average of 3 eating episodes per day. 11.3% consumes eccessive amounts of caffeine. 49.1% of the females reaches the recommended consumption of fruit, compared to only 33.8% of males (p < 0.05). 27.7% of females eats at least 2 portions of vegetables per day, compared to 12.0% of males (p < 0.05). Eccessive coffee drinkers pass from 8.9% in the 18-21 age group to 16% in the 25-30 year old age group (p < 0.05). This study showed that the eating habits of young adults do not follow national recommendations. Less than 50% of university students eats at least 1 portion of fruit per day and less than 1 out of 4 eats at least 2 portions of vegetables per day. Less than 10% of the students eats in average 5 times per day and more than 1 out of 3 does not have breakfast regularly every morning. Interventions targeting university students are required in order to increase their knowledge on healthy eating habits and to ameliorate their dietary behaviours.

DOD Civilian and Contractor Workforces: Additional Cost Savings Data and Efficiencies Plan are Needed

DTIC Science & Technology

2016-10-01

reductions reported in average strength bNumber of reductions reported in full-time equivalents Note: DOD costs savings provided for the prior FY are...comparing costs from FY 2012 to FY 2017, and not each year in between. Further, officials stated that DOD did not include full- time equivalents ...Application FTE Full-time Equivalent NDAA National Defense Authorization Act This is a work of the U.S. government and is not subject to copyright

COPA (Committee on Professional Activities) Colloquium on Selected Topics in Behavioral Science Basic Research held at Alexandria, Virginia on 23- 25 April 1980

DTIC Science & Technology

1983-01-01

this project, a series of exploratory studies were conducted with 4- year and community college students to develon the Learning Activities...capabilities needed for our national security" (Bement, 1980). Three specific goals for this program in Fiscal Year 1981 are: 1. Provide real growth in the...percent compared to FY 1980; this is about the average increase for all Department of Defense research programs this year ; ( this increase is about

Increasing incidence of Rocky Mountain spotted fever among the American Indian population in the United States.

PubMed

Holman, Robert C; McQuiston, Jennifer H; Haberling, Dana L; Cheek, James E

2009-04-01

To examine trends of Rocky Mountain spotted fever (RMSF) incidence among American Indians compared with other race groups, a retrospective analysis of national RMSF surveillance data reported to the National Electronic Telecommunications System for Surveillance and the Tickborne Rickettsial Disease Case Report Forms system were used. The RMSF incidence for American Indians, which was comparable to those for other race groups during 1990-2000, increased at a disproportionate rate during 2001-2005. The average annual incidence of RMSF reported among American Indians for 2001-2005 was 16.8 per 1,000,000 persons compared with 4.2, 2.6, and 0.5 for white, black, and Asian/Pacific Islander persons, respectively. Most cases in American Indians were reported from Oklahoma (113.1 cases per 1,000,000), North Carolina (60.0), and Arizona (17.2). The incidence of RMSF increased dramatically among American Indians disproportionately to trends for other race groups. Education about tick-borne disease and prevention measures should be addressed for high-risk American Indian populations.

Using National Data to Estimate Average Cost Effectiveness of EFNEP Outcomes by State/Territory

ERIC Educational Resources Information Center

Baral, Ranju; Davis, George C.; Blake, Stephanie; You, Wen; Serrano, Elena

2013-01-01

This report demonstrates how existing national data can be used to first calculate upper limits on the average cost per participant and per outcome per state/territory for the Expanded Food and Nutrition Education Program (EFNEP). These upper limits can then be used by state EFNEP administrators to obtain more precise estimates for their states,…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. School District of Philadelphia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

Pay Inequities for Recently Hired Faculty, 1988-2004

ERIC Educational Resources Information Center

Porter, Stephen R.; Toutkoushian, Robert K.; Moore, John V., III

2008-01-01

The national media and academic journals have reported a sizable wage gap between men and women in academe--a gap that has persisted over time. Data from the National Center for Education Statistics for 2004-2005 show that the average salary for all male faculty ($69,337) exceeded the average salary for female faculty ($56,926) by almost 22%.…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Wonderlic Personnel Test and Elementary Cognitive Tasks as Predictors of Religious Sectarianism, Scriptural Acceptance and Religious Questioning

ERIC Educational Resources Information Center

Bertsch, Sharon; Pesta, Bryan J.

2009-01-01

Lynn, Harvey and Nyborg [Lynn, R., Harvey, J., & Nyborg, H. (in press). Average intelligence predicts atheism rates across 137 nations. "Doi:10.1016/j.intell.2008.03.004".] discovered that average intelligence (IQ) co-varies with national atheism rates. Extending this work, we investigated relationships among individual IQ scores,…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Cleveland Metropolitan School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

Environmentally Responsible Happy Nation Index: Towards an Internationally Acceptable National Success Indicator

ERIC Educational Resources Information Center

Ng, Yew-Kwang

2008-01-01

Amidst increasing attention to happiness studies by economists, the New Economics Foundation launched in July 2006 the Happy Planet Index (Marks et al. 2006). This is the ratio of the average happy life years (HLY) to the per capita ecological footprint of the country concerned. HLY is in turn the product of the average happiness (or life…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

National mortality rates: the impact of inequality?

PubMed

Wilkinson, R G

1992-08-01

Although health is closely associated with income differences within each country there is, at best, only a weak link between national mortality rates and average income among the developed countries. On the other hand, there is evidence of a strong relationship between national mortality rates and the scale of income differences within each society. These three elements are coherent if health is affected less by changes in absolute material standards across affluent populations than it is by relative income or the scale of income differences and the resulting sense of disadvantage within each society. Rather than socioeconomic mortality differentials representing a distribution around given national average mortality rates, it is likely that the degree of income inequality indicates the burden of relative deprivation on national mortality rates.

National data on stroke outcomes in Thailand.

PubMed

Kongbunkiat, Kannikar; Kasemsap, Narongrit; Thepsuthammarat, Kaewjai; Tiamkao, Somsak; Sawanyawisuth, Kittisak

2015-03-01

Stroke is a major public health problem worldwide. There are limited data on national stroke prevalence and outcomes after the beginning of the thrombolytic therapy era in Thailand. This study aimed to investigate the prevalence and factors associated with mortality in stroke patients in Thailand using the national reimbursement databases. Clinical data retrieved included individuals under the universal coverage, social security, and civil servant benefit systems between 1 October 2009 and 30 September 2010. The stroke diagnosis code was based on the International Classification of Diseases 10th revision system including G45 (transient cerebral ischemic attacks and related syndromes), I61 (intracerebral hemorrhage), and I63 (cerebral infarction). The prevalence and stroke outcomes were calculated from these coded data. Factors associated with death were evaluated by multivariable logistic regression analysis. We found that the most frequent stroke subtype was cerebral infarction with a prevalence of 122 patients per 100,000 of population, an average length of hospital stay of 6.8 days, an average hospital charge of 20,740 baht (∼$USD 691), a mortality rate of 7%, and thrombolytic prescriptions of 1%. The significant factors associated with stroke mortality were septicemia, pulmonary embolism, pneumonia, myocardial infarction, status epilepticus, and heart failure. In conclusion, the prevalence and outcomes of stroke in Thailand were comparable with other countries. The era of thrombolytic therapy has just begun in Thailand. Copyright © 2014 Elsevier Ltd. All rights reserved.

The impact of out-of-pocket payments on health care inequity: the case of national health insurance in South Korea.

PubMed

Lee, Weon-Young; Shaw, Ian

2014-07-18

The global financial crisis of 2008 has led to the reinforcement of patient cost sharing in health care policy. This study aimed to explore the impact of direct out-of pocket payments (OOPs) on health care utilization and the resulting financial burden across income groups under the South Korean National Health Insurance (NHI) program with universal population coverage. We used the fourth Korean National Health and Nutrition Examination Survey (KNHNES-IV) and the Korean Household Income and Expenditure Survey (KHIES) of 2007, 2008 and 2009. The Horizontal Inequity Index (HIwv) and the average unit OOPs were used to measure income-related inequity in the quantitative and qualitative aspects of health care utilization, respectively. For financial burden, the incidence rates of catastrophic health expenditure (CHE) were compared across income groups. For outpatient and hospital visits, there was neither pro-poor or pro-rich inequality. The average unit OOPs of the poorest quintile was approximately 75% and 60% of each counterpart in the richest quintile in the outpatient and inpatient services. For the CHE threshold of 40%, the incidence rates were 5.7%, 1.67%, 0.72%, 0.33% and 0.27% in quintiles I (the poorest quintile), II, III, IV and V, respectively. Substantial OOPs under the NHI are disadvantageous, particularly for the lowest income group in terms of health care quality and financial burden.

Comparisons Between TIME-GCM/MERRA Simulations and LEO Satellite Observations

NASA Astrophysics Data System (ADS)

Hagan, M. E.; Haeusler, K.; Forbes, J. M.; Zhang, X.; Doornbos, E.; Bruinsma, S.; Lu, G.

2014-12-01

We report on yearlong National Center for Atmospheric Research (NCAR) thermosphere-ionosphere-mesosphere-electrodynamics general circulation model (TIME-GCM) simulations where we utilize the recently developed lower boundary condition based on 3-hourly MERRA (Modern-Era Retrospective Analysis for Research and Application) reanalysis data to account for tropospheric waves and tides propagating upward into the model domain. The solar and geomagnetic forcing is based on prevailing geophysical conditions. The simulations show a strong day-to-day variability in the upper thermospheric neutral temperature tidal fields, which is smoothed out quickly when averaging is applied over several days, e.g. up to 50% DE3 amplitude reduction for a 10-day average. This is an important result with respect to tidal diagnostics from satellite observations where averaging over multiple days is inevitable. In order to assess TIME-GCM performance we compare the simulations with measurements from the Gravity field and steady-state Ocean Circulation Explorer (GOCE), Challenging Minisatellite Payload (CHAMP) and Gravity Recovery and Climate Experiment (GRACE) satellites.

Source levels and call parameters of harbor seal breeding vocalizations near a terrestrial haulout site in Glacier Bay National Park and Preserve.

PubMed

Matthews, Leanna P; Parks, Susan E; Fournet, Michelle E H; Gabriele, Christine M; Womble, Jamie N; Klinck, Holger

2017-03-01

Source levels of harbor seal breeding vocalizations were estimated using a three-element planar hydrophone array near the Beardslee Islands in Glacier Bay National Park and Preserve, Alaska. The average source level for these calls was 144 dB RMS re 1 μPa at 1 m in the 40-500 Hz frequency band. Source level estimates ranged from 129 to 149 dB RMS re 1 μPa. Four call parameters, including minimum frequency, peak frequency, total duration, and pulse duration, were also measured. These measurements indicated that breeding vocalizations of harbor seals near the Beardslee Islands of Glacier Bay National Park are similar in duration (average total duration: 4.8 s, average pulse duration: 3.0 s) to previously reported values from other populations, but are 170-220 Hz lower in average minimum frequency (78 Hz).

Global effects of income and income inequality on adult height and sexual dimorphism in height.

PubMed

Bogin, Barry; Scheffler, Christiane; Hermanussen, Michael

2017-03-01

Average adult height of a population is considered a biomarker of the quality of the health environment and economic conditions. The causal relationships between height and income inequality are not well understood. We analyze data from 169 countries for national average heights of men and women and national-level economic factors to test two hypotheses: (1) income inequality has a greater association with average adult height than does absolute income; and (2) neither income nor income inequality has an effect on sexual dimorphism in height. Average height data come from the NCD-RisC health risk factor collaboration. Economic indicators are derived from the World Bank data archive and include gross domestic product (GDP), Gross National Income per capita adjusted for personal purchasing power (GNI_PPP), and income equality assessed by the Gini coefficient calculated by the Wagstaff method. Hypothesis 1 is supported. Greater income equality is most predictive of average height for both sexes. GNI_PPP explains a significant, but smaller, amount of the variation. National GDP has no association with height. Hypothesis 2 is rejected. With greater average adult height there is greater sexual dimorphism. Findings support a growing literature on the pernicious effects of inequality on growth in height and, by extension, on health. Gradients in height reflect gradients in social disadvantage. Inequality should be considered a pollutant that disempowers people from the resources needed for their own healthy growth and development and for the health and good growth of their children. © 2017 Wiley Periodicals, Inc.

Screening for inter-hospital differences in cesarean section rates in low-risk deliveries using administrative data: an initiative to improve the quality of care.

PubMed

Aelvoet, Willem; Windey, Francis; Molenberghs, Geert; Verstraelen, Hans; Van Reempts, Patrick; Foidart, Jean-Michel

2008-01-04

Rising national cesarean section rates (CSRs) and unexplained inter-hospital differences in CSRs, led national and international bodies to select CSR as a quality indicator. Using hospital discharge abstracts, we aimed to document in Belgium (1) inter-hospital differences in CSRs among low risk deliveries, (2) a national upward CSR trend, (3) lack of better neonatal outcomes in hospitals with high CSRs, and (4) possible under-use of CS. We defined a population of low risk deliveries (singleton, vertex, full-term, live born, <4500 g, >2499 g). Using multivariable logistic regression techniques, we provided degrees of evidence regarding the observed departure ([relative risk-1]*100) of each hospital (N = 107) from the national CSR and its trend. To determine a benchmark, we defined three CSR groups (high, average and low) and compared them regarding 1 minute Apgar scores and other neonatal endpoints. An anonymous feedback is provided to the hospitals, the College of Physicians (with voluntary disclosure of the outlying hospitals for quality improvement purposes) and to the policy makers. Compared with available information, the completeness and accuracy of the data, regarding the variables selected to determine our study population, showed adequate. Important inter-hospital differences were found. Departures ranged from -65% up to +75%, and 9 "high CSR" and 13 "low CSR" outlying hospitals were identified. We observed a national increasing trend of 1.019 (95%CI [1.015; 1.022]) per semester, adjusted for age groups. In the "high CSR" group 1 minute Apgar scores <4 were over-represented in the subgroup of vaginal deliveries, suggesting CSs not carried out for medical reasons. Under-use of CS was also observed. Given their questionable completeness, except Apgar scores, our neonatal results, showing a significant association of CS with adverse neonatal endpoints, are to be cautiously interpreted. Taking the available evidence into account, the "Average CSR" group seemed to be the best benchmark candidate. Rather than firm statements about quality of care, our results are to be considered a useful screening. The inter-hospital differences in CSR, the national CS upward trend, the indications of over-use and under-use, the geographically different obstetric patterns and the admission day-related concentration of deliveries, whether or not by CS, may trigger initiatives aiming at improving quality of care.

42 CFR 412.212 - National rate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... discharge classified within a DRG, the national rate equals the product of— (1) The national average... under § 412.60(b)) for that DRG. (d) Adjusting for different area wage levels. CMS adjusts the...

The effects of pay-for-performance on tuberculosis treatment in Taiwan.

PubMed

Li, Ya-Hsin; Tsai, Wen-Chen; Khan, Mahmud; Yang, Wen-Ta; Lee, Tsuey-Fong; Wu, Yi-Chun; Kung, Pei-Tseng

2010-07-01

In order to make tuberculosis (TB) treatment more effective and to lower the transmission rate of the disease, the Bureau of National Health Insurance (BNHI) in Taiwan implemented the 'Pay-for-Performance on Tuberculosis' programme (P4P on TB) in 2004. This study investigates the effectiveness of the P4P system in terms of cure rate and length of treatment. This retrospective study obtained information on all TB cases in the national data sets of Taiwan for the years 2002 to 2005. The number of cases in pre-P4P years (2002 and 2003) was 25 754, compared with 33 536 in the post-P4P implementation years (2004 and 2005). The effectiveness of the programme was evaluated by comparing the TB cure rate and length of treatment before and after the implementation of the P4P programme, and between participating and non-participating hospitals. Logistic regression analysis was conducted to explore the factors affecting TB patients' cure rate within a 12-month treatment period. The cure rate and the average length of treatment before the implementation of P4P were 46.9% and 256.24 days, respectively, compared with 63.0% and 249.74 days after implementation of P4P. The cure rate and length of treatment in P4P hospitals were 68.1% and 249.13 days, respectively, compared with 42.4% and 53.71 days in non-P4P hospitals. This study found that both the cure rate and average length of treatment for cured cases improved significantly after the implementation of the P4P on TB programme in Taiwan. Compared with non-P4P hospitals, P4P hospitals had significantly better treatment outcomes. Patients' age, income level, the physician density of a patient's place of residence, and whether the hospital has joined the P4P on TB programme are factors affecting the treatment outcomes of TB patients in Taiwan.

Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital

PubMed Central

Haule, Caspar; Ongom, Peter A; Kimuli, Timothy

2013-01-01

Introduction The treatment of adhesive small bowel obstruction is controversial, with both operative and non-operative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin®) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. Methods An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital’s emergency and general surgical wards were included. Randomisation was to Gastrografin® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. Results All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance (P = 0.67). Average time to relief of obstruction was shorter in the Gastrografin® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference (P = 0.023). The average length of hospital stay was shorter in the Gastrografin® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference (P = 0.04). Conclusion The use of Gastrografin® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and reduces the length of hospital stay compared with standard conservative management. Its role in reducing the rate of laparotomies remains inconclusive. PMID:24729947

Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital.

PubMed

Haule, Caspar; Ongom, Peter A; Kimuli, Timothy

2013-12-01

The treatment of adhesive small bowel obstruction is controversial, with both operative and non-operative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin ® ) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital's emergency and general surgical wards were included. Randomisation was to Gastrografin ® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin ® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance ( P = 0.67 ). Average time to relief of obstruction was shorter in the Gastrografin ® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference ( P = 0.023 ). The average length of hospital stay was shorter in the Gastrografin ® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference ( P = 0.04 ). The use of Gastrografin ® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and reduces the length of hospital stay compared with standard conservative management. Its role in reducing the rate of laparotomies remains inconclusive.

Seasonal patterns of predation for gray wolves in the multi-prey system of Yellowstone National Park.

PubMed

Metz, Matthew C; Smith, Douglas W; Vucetich, John A; Stahler, Daniel R; Peterson, Rolf O

2012-05-01

1. For large predators living in seasonal environments, patterns of predation are likely to vary among seasons because of related changes in prey vulnerability. Variation in prey vulnerability underlies the influence of predators on prey populations and the response of predators to seasonal variation in rates of biomass acquisition. Despite its importance, seasonal variation in predation is poorly understood. 2. We assessed seasonal variation in prey composition and kill rate for wolves Canis lupus living on the Northern Range (NR) of Yellowstone National Park. Our assessment was based on data collected over 14 winters (1995-2009) and five spring-summers between 2004 and 2009. 3. The species composition of wolf-killed prey and the age and sex composition of wolf-killed elk Cervus elaphus (the primary prey for NR wolves) varied among seasons. 4. One's understanding of predation depends critically on the metric used to quantify kill rate. For example, kill rate was greatest in summer when quantified as the number of ungulates acquired per wolf per day, and least during summer when kill rate was quantified as the biomass acquired per wolf per day. This finding contradicts previous research that suggests that rates of biomass acquisition for large terrestrial carnivores tend not to vary among seasons. 5. Kill rates were not well correlated among seasons. For example, knowing that early-winter kill rate is higher than average (compared with other early winters) provides little basis for anticipating whether kill rates a few months later during late winter will be higher or lower than average (compared with other late winters). This observation indicates how observing, for example, higher-than-average kill rates throughout any particular season is an unreliable basis for inferring that the year-round average kill rate would be higher than average. 6. Our work shows how a large carnivore living in a seasonal environment displays marked seasonal variation in predation because of changes in prey vulnerability. Patterns of wolf predation were influenced by the nutritional condition of adult elk and the availability of smaller prey (i.e. elk calves, deer). We discuss how these patterns affect our overall understanding of predator and prey population dynamics. © 2012 The Authors. Journal of Animal Ecology © 2012 British Ecological Society.

Spending on medicines in Israel in an international context.

PubMed

Sax, Philip

2005-05-01

Like most developed countries, in the last decade Israel's healthcare system has been subject to cost-containing measures in the drug sector. To provide comparative information in an international context on the level of outpatient drug expenditures in Israel, both total and those publicly financed, and to analyze how these have changed with time during the last decade. Using definitions of the OECD (Organization of Economic Cooperation and Development), internationally comparable data on total expenditure and public expenditure on medicines in Israel are provided. The Israeli estimates are based on data from the Ministry of Health audited reports of financial activities of the health management organizations and from the family expenditure surveys carried out by the Central Bureau of Statistics. Per capita total and public expenditures in Israel are analyzed over time, as are their share of national expenditure on health and of gross domestic product. Israel expenditures are then compared with those for individual member countries of the OECD, as well as a 21 country average, from 1992 to 2002. Analysis of the Israeli expenditure data shows a considerable reduction in growth of per capita total and public expenditures on medicines since 1997. Growth in the share of total drug expenditure of NEH and of GDP has also been constrained since 1997. In an international context, per capita expenditure on medicines in Israel, particularly what is publicly financed, is one of the lowest. Furthermore, its share of NEH and GDP is also very low compared to other countries. This substantive gap in spending on medicines between Israel and other countries has increased since 1997. Israel, a medium-income country with a lower than average level of expenditure on health compared to OECD countries, has a particularly low level of expenditure on medicines. Whereas the share of health expenditure of GDP in Israel is similar to the international average, the share of drug expenditure of GDP is well below the average. In addition to structural and longer-term factors contributing to Israel's low per capita spending on medicines, such as the young population and the apparently low level of actual prices paid by most institutional purchasers, recent years are witness to the growing impact of National Health Insurance budgetary pressures on HMOs as well as continual increases in prescription cost sharing by patients. The impact is felt both on the demand side (higher copayments, administrative and prescribing restrictions) and perhaps more crucially on the supply side (price competition, mainly from generics). Substantial extra public funding for the addition of new drugs to the NHI basket in recent years has had no overall impact on these longer-term spending patterns.

75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...] Lunch and Centers Breakfast supper \\1\\ Snack Contingous States: Paid 0.26 0.26 0.06 Reduced Price 1.18 2...

Injuries and fatalities among emergency medical technicians and paramedics in the United States.

PubMed

Maguire, Brian J; Smith, Sean

2013-08-01

Emergency medical services personnel treat 22 million patients a year, yet little is known of their risk of injury and fatality. Work-related injury and fatality rates among US paramedics and emergency medical technicians (EMTs) are higher than the national average for all occupations. Data collected by the Department of Labor (DOL) Bureau of Labor Statistics were reviewed to identify injuries and fatalities among EMTs and paramedics from 2003 through 2007. The characteristics of fatal injuries are described and the rates and relative risks of the non-fatal injuries were calculated and compared to the national average. Of the 21,749 reported cases, 21,690 involved non-fatal injuries or illnesses that resulted in lost work days among EMTs and paramedics within the private sector. Of the injuries, 3,710 (17%) resulted in ≥31 days of lost work time. A total of 14,470 cases (67%) involved sprains or strains; back injury was reported in 9,290 of the cases (43%); and the patient was listed as the source of injury in 7,960 (37%) cases. The most common events were overexertion (12,146, 56%), falls (2,169, 10%), and transportation-related (1,940, 9%). A total of 530 assaults were reported during the study period. Forty-five percent of the cases occurred among females (females accounted for 27% of employment in this occupation during 2007). In 2007, EMTs and paramedics suffered 349.9 injuries with days away from work per 10,000 full-time workers, compared to an average of 122.2 for all private industry occupations (Relative risk = 2.9; 95% CI: 2.7-3.0). During the study period, 59 fatalities occurred among EMTs and paramedics in both the private industry and in the public sector. Of those fatalities, 51 (86%) were transportation-related and five (8%) were assaults; 33 (56%) were classified as "multiple traumatic injuries." Data from the DOL show that EMTs and paramedics have a rate of injury that is about three times the national average for all occupations. The vast majority of fatalities are secondary to transportation related-incidents. Assaults are also identified as a significant cause of fatality. The findings also indicate that females in this occupational group may have a disproportionately larger number of injuries. Support is recommended for further research related to causal factors and for the development, evaluation and promulgation of evidence-based interventions to mitigate this problem.

Historical bac-barrier shoreline changes, Padre Island National Seashore, Texas

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

Prouty, J.S.

1989-09-01

Historical progradation rates of the Laguna Madre shoreline at Padre Island National Seashore have varied considerably, largely in response to rainfall fluctuations and perhaps grazing pressure. Analysis of aerial photographs indicates that near the northern margin of the National Seashore the shoreline prograded at an average rate of 26 ft/year between 1941 and 1950. The average rate of progradation increased to 42 ft/year between 1950 and 1964. Average rates then slowed in the late 1960s, and since 1969 the shoreline has prograded at an average rate of only 1 ft/year. Some areas of the shoreline are presently eroding. Early mapsmore » and accounts suggest that a century ago North Padre Island was largely vegetated. Overgrazing and a series of droughts in the late 19th and early 20th centuries denuded the island, and prevailing winds blew sand westward across the island into Laguna Madre. With higher than average rainfall in the past 2 decades and less grazing, the island has significantly revegetated. Winds now carry less sand to Laguna Madre; reduced sand supply is a major cause of present-day shoreline retreat.« less

Comparison of Data Quality of NOAA's ISIS and SURFRAD Networks to NREL's SRRL-BMS

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

Anderberg, M.; Sengupta, M.

2014-11-01

This report provides analyses of broadband solar radiometric data quality for the National Oceanic and Atmospheric Administration's Integrated Surface Irradiance Study and Surface Radiation Budget Network (SURFRAD) solar measurement networks. The data quality of these networks is compared to that of the National Renewable Energy Laboratory's Solar Radiation Research Laboratory Baseline Measurement System (SRRL-BMS) native data resolutions and hourly averages of the data from the years 2002 through 2013. This report describes the solar radiometric data quality testing and flagging procedures and the method used to determine and tabulate data quality statistics. Monthly data quality statistics for each network weremore » plotted by year against the statistics for the SRRL-BMS. Some of the plots are presented in the body of the report, but most are in the appendix. These plots indicate that the overall solar radiometric data quality of the SURFRAD network is superior to that of the Integrated Surface Irradiance Study network and can be comparable to SRRL-BMS.« less

Inter-laboratory Comparison of Three Earplug Fit-test Systems

PubMed Central

Byrne, David C.; Murphy, William J.; Krieg, Edward F.; Ghent, Robert M.; Michael, Kevin L.; Stefanson, Earl W.; Ahroon, William A.

2017-01-01

The National Institute for Occupational Safety and Health (NIOSH) sponsored tests of three earplug fit-test systems (NIOSH HPD Well-Fit™, Michael & Associates FitCheck, and Honeywell Safety Products VeriPRO®). Each system was compared to laboratory-based real-ear attenuation at threshold (REAT) measurements in a sound field according to ANSI/ASA S12.6-2008 at the NIOSH, Honeywell Safety Products, and Michael & Associates testing laboratories. An identical study was conducted independently at the U.S. Army Aeromedical Research Laboratory (USAARL), which provided their data for inclusion in this report. The Howard Leight Airsoft premolded earplug was tested with twenty subjects at each of the four participating laboratories. The occluded fit of the earplug was maintained during testing with a soundfield-based laboratory REAT system as well as all three headphone-based fit-test systems. The Michael & Associates lab had highest average A-weighted attenuations and smallest standard deviations. The NIOSH lab had the lowest average attenuations and the largest standard deviations. Differences in octave-band attenuations between each fit-test system and the American National Standards Institute (ANSI) sound field method were calculated (Attenfit-test - AttenANSI). A-weighted attenuations measured with FitCheck and HPD Well-Fit systems demonstrated approximately ±2 dB agreement with the ANSI sound field method, but A-weighted attenuations measured with the VeriPRO system underestimated the ANSI laboratory attenuations. For each of the fit-test systems, the average A-weighted attenuation across the four laboratories was not significantly greater than the average of the ANSI sound field method. Standard deviations for residual attenuation differences were about ±2 dB for FitCheck and HPD Well-Fit compared to ±4 dB for VeriPRO. Individual labs exhibited a range of agreement from less than a dB to as much as 9.4 dB difference with ANSI and REAT estimates. Factors such as the experience of study participants and test administrators, and the fit-test psychometric tasks are suggested as possible contributors to the observed results. PMID:27786602

Readability of Online Patient Education Materials Related to IR.

PubMed

McEnteggart, Gregory E; Naeem, Muhammad; Skierkowski, Dorothy; Baird, Grayson L; Ahn, Sun H; Soares, Gregory

2015-08-01

To assess the readability of online patient education materials (OPEM) related to common diseases treated by and procedures performed by interventional radiology (IR). The following websites were chosen based on their average Google search return for each IR OPEM content area examined in this study: Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiological Society of Europe (CIRSE), National Library of Medicine, RadiologyInfo, Mayo Clinic, WebMD, and Wikipedia. IR OPEM content area was assessed for the following: peripheral arterial disease, central venous catheter, varicocele, uterine artery embolization, vertebroplasty, transjugular intrahepatic portosystemic shunt, and deep vein thrombosis. The following algorithms were used to estimate and compare readability levels: Flesch-Kincaid Grade Formula, Flesch Reading Ease Score, Gunning Frequency of Gobbledygook, Simple Measure of Gobbledygook, and Coleman-Liau Index. Data were analyzed using general mixed modeling. On average, online sources that required beyond high school grade-level readability were Wikipedia (15.0), SIR (14.2), and RadiologyInfo (12.4); sources that required high school grade-level readability were CIRSE (11.3), Mayo Clinic (11.0), WebMD (10.6), and National Library of Medicine (9.0). On average, OPEM on uterine artery embolization, vertebroplasty, varicocele, and peripheral arterial disease required the highest level of readability (12.5, 12.3, 12.3, and 12.2, respectively). The IR OPEM assessed in this study were written above the recommended sixth-grade reading level and the health literacy level of the average American adult. Many patients in the general public may not have the ability to read and understand health information in IR OPEM. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

The Differential Impact of User-Fee Exemption Compared to Conditional Cash Transfers on Safe Deliveries in Nepal.

PubMed

Pradhan, Elina; Fan, Victoria Y

2017-08-01

To assess the differential impact of a copayment exemption compared to a cash incentive on increasing skilled birth attendance (i.e., birth attended by a skilled health worker) in Nepal. This study used data on 8,785 children born between July 2005 and December 2008, obtained from the nationally representative Demographic and Health Surveys, 2006 and 2011. Twenty-five districts received both the policy interventions, and the remaining 50 control districts received only the cash incentive. We employed a difference-in-differences model to compare children born in districts with both interventions to those in districts with conditional cash transfers only. Average marginal effects of the difference-in-difference coefficient on skilled birth attendance measures are estimated. Skilled birth attendance in districts with both interventions was no higher on average than in districts with only the cash incentive. In areas with adequate road networks, however, significantly higher skilled birth attendance was observed in districts with both interventions compared to those with only the cash incentive. The added incentive of the user-fee exemption did not significantly increase skilled birth attendance relative to the presence of the cash incentive. User-fee exemptions may not be effective in areas with inadequate road infrastructure. © Health Research and Educational Trust.

National mortality rates: the impact of inequality?

PubMed Central

Wilkinson, R G

1992-01-01

Although health is closely associated with income differences within each country there is, at best, only a weak link between national mortality rates and average income among the developed countries. On the other hand, there is evidence of a strong relationship between national mortality rates and the scale of income differences within each society. These three elements are coherent if health is affected less by changes in absolute material standards across affluent populations than it is by relative income or the scale of income differences and the resulting sense of disadvantage within each society. Rather than socioeconomic mortality differentials representing a distribution around given national average mortality rates, it is likely that the degree of income inequality indicates the burden of relative deprivation on national mortality rates. PMID:1636827

Care Received by Elderly US Stroke Survivors may be Underestimated

PubMed Central

Skolarus, Lesli E.; Freedman, Vicki A.; Feng, Chunyang; Wing, Jeffrey J.; Burke, James F.

2016-01-01

Background and Purpose Previous studies exploring stroke-related caregiving focused solely on informal caregiving and a relatively limited set of activities. We sought to determine whether, and at what cost, stroke survivors receive more care than matched controls using an expanded definition of caregiving and inclusion of paid caregivers. Methods Data were drawn from the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries. NHATS personnel conducted in-person interviews with respondents or proxies to determine the weekly hours of care received. We compared hours of assistance received between self-reported stroke survivors (N=892) and demographic- and comorbidity-matched non-stroke controls (N=892). The annual cost of stroke caregiving was estimated using reported paid caregiving data and estimates of unpaid caregiving costs. Results Of community dwelling elderly stroke survivors, 51.4% received help from a caregiver. Stroke survivors received an average of 10 hours of additional care per week compared to demographic- and comorbidity-matched controls (22.3 hours vs. 11.8 hours, p<0.01). We estimate that the average annual cost for caregiving for an elderly stroke survivor is approximately $11,300, or about $40 billion annually, for all elderly stroke survivors, of which $5,000 per person, or $18.2 billion annually, is specific to stroke. Conclusions Although stroke survivors are known to require considerable caregiving resources, our findings suggest that prior assessments may underestimate hours of care received and hence costs. PMID:27387990

Facial Plastic Surgery Patient Resources Exceed National Institute Recommendations.

PubMed

Chu, Michael W; Cook, Julia A; Tholpady, Sunil S; Schmalbach, Cecelia E; Momeni, Arash

2017-05-01

Patient education is essential in enhancing the physician-patient therapeutic alliance, patient satisfaction, and clinical outcomes. The American Medical Association and National Institute of Health recommend that information be written at a 6th-grade reading level, but online resources often exceed patient literacy. The purpose of this study is to assess readability of online material for facial plastics procedures presented on academic plastic surgery and otolaryngology websites.An Internet search was performed of all academic institutions that had both plastic surgery and otolaryngology training programs who offered patient information on facial plastic surgery procedures. National society websites for both plastic surgery and otolaryngology were also analyzed. All procedural information was compiled and readability analyses were performed. A 2-tailed Z-test was used to compare scores, and statistical significance was set at P < 0.05.Sixty-three programs were identified; 42 had educational material. The overall average readability for all information was at a 10th-grade reading level. The national plastic surgery website had a significantly higher word count and number of syllables per word compared to the national otolaryngology website (P < 0.001, P = 0.04).The complexity of written resources represents an obstacle to online patient education and efforts to improve readability could benefit patients seeking medical information online. Current online education materials are a potential hindrance to patient education, satisfaction, and decision making. Healthcare institutions should consider writing new materials with simpler language that would be accessible to patients.

Waterfowl harvest at Tule Lake National Wildlife Refuge, 1936-41

USGS Publications Warehouse

Gilmer, D.S.; Hicks, J.M.; Bartonek, J.C.; McCollum, E.H.

1986-01-01

Waterfowl harvest at Tule Lake National Wildlife Refuge (NWR) for the 6-yr period 1936-41 is described and compared with a recent (1978-83) period. During the early period 46,987 geese and 76,143 ducks were bagged during 48,610 hunter-visits. Hunting seasons were 30 to 60 d in length. Greater White-fronted Geese Anser albifrons, followed by Northern Pintails Anas acuta, and Cackling Canada Geese Branta canadensis minima were the most important birds in the harvest. Average harvest was 1.0 goose and 1.6 ducks per hunter-visit. A short (30-d) and late hunting season drastically curtailed harvest in 1937. Reduced hunting activity in 1941 was attributed to military mobilization. During the 1978-83 period 34,416 geese and 63,458 ducks were bagged during 69,170 hunter-visits. Hunting seasons during this period were mostly 93 d in length. The most important bird in the harvest was the Mallard A. platyrhynchos, followed by White-fronted Goose and Northern Pintail. Average harvest was 0.5 goose and 0.9 duck per hunter-visit. In general dabbling ducks increased in overall importance while diving ducks decreased between the two periods. Harvest decreased 20.5% while hunter-visits increased 42.3%.

Beverage Consumption Habits among the European Population: Association with Total Water and Energy Intakes

PubMed Central

Nissensohn, Mariela; Sánchez-Villegas, Almudena; Galan, Pilar; Turrini, Aida; Arnault, Nathalie; Mistura, Lorenza; Ortiz-Andrellucchi, Adriana; Szabo de Edelenyi, Fabien; D’Addezio, Laura; Serra-Majem, Lluis

2017-01-01

Background: Fluid and water intake have received limited attention in epidemiological studies. The aim of this study was to compare the average daily consumption of foods and beverages in adults of selective samples of the European Union (EU) population in order to understand the contribution of these to the total water intake (TWI), evaluate if the EU adult population consumes adequate amounts of total water (TW) according to the current guidelines, and to illustrate the real water intake in Europe. Methods: Three national European dietary surveys have been selected: Spain used the Anthropometry, Intake, and Energy Balance Study (ANIBES) population database, Italy analyzed data from the Italian National Food Consumption Survey (INRAN-SCAI 2005-06), and French data came from the NutriNet-Santé database. Mean daily consumption was used to compare between individuals. TWI was compared with European Food Safety Authority (EFSA) reference values for adult men and women. Results: On average, in Spain, TWI was 1.7 L (SE 22.9) for men and 1.6 L (SE 19.4) for women; Italy recorded 1.7 L (SE 16.9) for men and 1.7 L (SE 14.1) for women; and France recorded 2.3 L (SE 4.7) for men and 2.1 L (SE 2.4) for women. With the exception of women in France, neither men nor women consumed sufficient amounts of water according to EFSA reference values. Conclusions: This study highlights the need to formulate appropriate health and nutrition policies to increase TWI in the EU population. The future of beverage intake assessment requires the use of new instruments, techniques, and the application of the new available technologies. PMID:28406441

Estimating the cost of informal caregiving for elderly patients with cancer.

PubMed

Hayman, J A; Langa, K M; Kabeto, M U; Katz, S J; DeMonner, S M; Chernew, M E; Slavin, M B; Fendrick, A M

2001-07-01

As the United States population ages, the increasing prevalence of cancer is likely to result in higher direct medical and nonmedical costs. Although estimates of the associated direct medical costs exist, very little information is available regarding the prevalence, time, and cost associated with informal caregiving for elderly cancer patients. To estimate these costs, we used data from the first wave (1993) of the Asset and Health Dynamics (AHEAD) Study, a nationally representative longitudinal survey of people aged 70 or older. Using a multivariable, two-part regression model to control for differences in health and functional status, social support, and sociodemographics, we estimated the probability of receiving informal care, the average weekly number of caregiving hours, and the average annual caregiving cost per case (assuming an average hourly wage of $8.17) for subjects who reported no history of cancer (NC), having a diagnosis of cancer but not receiving treatment for their cancer in the last year (CNT), and having a diagnosis of cancer and receiving treatment in the last year (CT). Of the 7,443 subjects surveyed, 6,422 (86%) reported NC, 718 (10%) reported CNT, and 303 (4%) reported CT. Whereas the adjusted probability of informal caregiving for those respondents reporting NC and CNT was 26%, it was 34% for those reporting CT (P <.05). Those subjects reporting CT received an average of 10.0 hours of informal caregiving per week, as compared with 6.9 and 6.8 hours for those who reported NC and CNT, respectively (P <.05). Accordingly, cancer treatment was associated with an incremental increase of 3.1 hours per week, which translates into an additional average yearly cost of $1,200 per patient and just over $1 billion nationally. Informal caregiving costs are substantial and should be considered when estimating the cost of cancer treatment in the elderly.

Trophic state in Voyageurs National Park lakes before and after implementation of a revised water-level management plan

USGS Publications Warehouse

Christensen, Victoria G.; Maki, Ryan P.

2015-01-01

We compiled Secchi depth, total phosphorus, and chlorophyll a (Chla) data from Voyageurs National Park lakes and compared datasets before and after a new water-level management plan was implemented in January 2000. Average Secchi depth transparency improved (from 1.9 to 2.1 m, p = 0.020) between 1977-1999 and 2000-2011 in Kabetogama Lake for August samples only and remained unchanged in Rainy, Namakan, and Sand Point Lakes, and Black Bay in Rainy Lake. Average open-water season Chla concentration decreased in Black Bay (from an average of 13 to 6.0 μg/l, p = 0.001) and Kabetogama Lake (from 9.9 to 6.2 μg/l, p = 0.006) between 1977-1999 and 2000-2011. Trophic state index decreased significantly in Black Bay from 59 to 51 (p = 0.006) and in Kabetogama Lake from 57 to 50 (p = 0.006) between 1977-1999 and 2000-2011. Trophic state indices based on Chla indicated that after 2000, Sand Point, Namakan, and Rainy Lakes remained oligotrophic, whereas eutrophication has decreased in Kabetogama Lake and Black Bay. Although nutrient inputs from inflows and internal sources are still sufficient to produce annual cyanobacterial blooms and may inhibit designated water uses, trophic state has decreased for Kabetogama Lake and Black Bay and there has been no decline in lake ecosystem health since the implementation of the revised water-level management plan.

Cost of schizophrenia in the Medicare program.

PubMed

Feldman, Rachel; Bailey, Robert A; Muller, James; Le, Jennifer; Dirani, Riad

2014-06-01

Medicare beneficiaries diagnosed with non-schizoaffective schizophrenia (MBS) in a 5% national Medicare fee-for-service sample from 2003-2007 were followed for 1-6 years. Medicare population and cost estimates also were made from 2001-2009. Service utilization and Medicare (and beneficiary share) payments for all services except prescription drugs were analyzed. Although adults with schizophrenia make up approximately 1% of the US adult population, they represent about 1.5% of Medicare beneficiaries. MBSs are disproportionately male and minority compared to national data describing the overall schizophrenia population. They also are younger than the general Medicare population (GMB): males are 9 years younger than females on average, and most enter Medicare long before age 65 through eligibility for social security disability, remaining in the program until death. The cost of care for MBSs in 2009 was, on average, 80% higher than for the average GMB per patient year (2010 dollars), and more than 50% of these costs are attributable to a combination of psychiatric and medical hospitalizations, concentrated in about 30% of MBSs with 1 or more hospitalizations per year. From 2004-2009, total estimated Medicare fee-for-service payments for MBSs increased from $9.4 billion to $11.5 billion, excluding Part D prescription drugs and payments for services to MBSs in Medicare for less than 1 year. Study results characterize utilization and costs for other services and suggest opportunities for further study to inform policy to improve access and continuity of care and decrease costs to the Medicare program associated with this population.

Association between liver transplant center performance evaluations and transplant volume.

PubMed

Buccini, L D; Segev, D L; Fung, J; Miller, C; Kelly, D; Quintini, C; Schold, J D

2014-09-01

There has been increased oversight of transplant centers and stagnation in liver transplantation nationally in recent years. We hypothesized that centers that received low performance (LP) evaluations were more likely to alter protocols, resulting in reduced rates of transplants and patients placed on the waiting list. We evaluated the association of LP evaluations and transplant activity among liver transplant centers in the United States using national Scientific Registry of Transplant Recipients data (January 2007 to July 2012). We compared the average change in recipient and candidate volume and donor and patient characteristics based on whether the centers received LP evaluations. Of 92 eligible centers, 27 (29%) received at least one LP evaluation. Centers without an LP evaluation (n = 65) had an average increase of 9.3 transplants and 14.9 candidates while LP centers had an average decrease of 39.9 transplants (p < 0.01) and 67.3 candidates (p < 0.01). LP centers reduced the use of older donors, donations with longer cold ischemia, and donations after cardiac death (p-values < 0.01). There was no association between the change in transplant volume and measured performance (R(2)  = 0.002, p = 0.91). Findings indicate a strong association between performance evaluations and changes in candidate listings and transplants among liver transplant centers, with no measurable improvement in outcomes associated with reduction in transplant volume. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

Abnormal chemical element concentrations in lichens of Isle Royale National Park

USGS Publications Warehouse

Bennett, J.P.

1995-01-01

Lichens have been used for many years to monitor changes in deposited airborne chemical elements in many areas, but few studies have focused on areas suspected of experiencing slightly elevated pollution. Detection of subtle patterns of slightly elevated pollutants calls for developing several lines of evidence as opposed to single line studies used in heavily polluted areas. This study of two lichen species, Hypogymnia physodes and Evernia mesomorpha, in Isle Royale National Park, Michigan compares the concentrations and ranks of elements with the concentrations and ranks of the elements in the earth's crust, changes in element concentrations over a nine year period, and the geography of element concentrations in the park. S, Zn, Pb, Cd and Se were elevated in both species and higher in rank compared to the concentrations and ranks in the earth's crust. Toxic elements increased 123% in Hypogymnia and 62% in Evernia over 9 years, compared to increases of 45% and 59% for non-toxic elements in each species, respectively. Geographically, the lichens at certain localities with higher exposures experienced higher than average element concentrations. Finally, tissue concentrations of Mn, S and Se at some localities were above levels known to be either toxic or similar to those found in polluted areas. These four lines of evidence suggest that Isle Royale National Park is experiencing the onset of chronic air pollution stress from a number of sources.

Retrieval of Areal-averaged Spectral Surface Albedo from Transmission Data Alone: Computationally Simple and Fast Approach

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

Kassianov, Evgueni I.; Barnard, James C.; Flynn, Connor J.

We introduce and evaluate a simple retrieval of areal-averaged surface albedo using ground-based measurements of atmospheric transmission alone at five wavelengths (415, 500, 615, 673 and 870nm), under fully overcast conditions. Our retrieval is based on a one-line semi-analytical equation and widely accepted assumptions regarding the weak spectral dependence of cloud optical properties, such as cloud optical depth and asymmetry parameter, in the visible and near-infrared spectral range. To illustrate the performance of our retrieval, we use as input measurements of spectral atmospheric transmission from Multi-Filter Rotating Shadowband Radiometer (MFRSR). These MFRSR data are collected at two well-established continental sitesmore » in the United States supported by the U.S. Department of Energy’s (DOE’s) Atmospheric Radiation Measurement (ARM) Program and National Oceanic and Atmospheric Administration (NOAA). The areal-averaged albedos obtained from the MFRSR are compared with collocated and coincident Moderate Resolution Imaging Spectroradiometer (MODIS) white-sky albedo. In particular, these comparisons are made at four MFRSR wavelengths (500, 615, 673 and 870nm) and for four seasons (winter, spring, summer and fall) at the ARM site using multi-year (2008-2013) MFRSR and MODIS data. Good agreement, on average, for these wavelengths results in small values (≤0.01) of the corresponding root mean square errors (RMSEs) for these two sites. The obtained RMSEs are comparable with those obtained previously for the shortwave albedos (MODIS-derived versus tower-measured) for these sites during growing seasons. We also demonstrate good agreement between tower-based daily-averaged surface albedos measured for “nearby” overcast and non-overcast days. Thus, our retrieval originally developed for overcast conditions likely can be extended for non-overcast days by interpolating between overcast retrievals.« less

Quantifying the utilization of medical devices necessary to detect postmarket safety differences: A case study of implantable cardioverter defibrillators.

PubMed

Bates, Jonathan; Parzynski, Craig S; Dhruva, Sanket S; Coppi, Andreas; Kuntz, Richard; Li, Shu-Xia; Marinac-Dabic, Danica; Masoudi, Frederick A; Shaw, Richard E; Warner, Frederick; Krumholz, Harlan M; Ross, Joseph S

2018-06-12

To estimate medical device utilization needed to detect safety differences among implantable cardioverter defibrillators (ICDs) generator models and compare these estimates to utilization in practice. We conducted repeated sample size estimates to calculate the medical device utilization needed, systematically varying device-specific safety event rate ratios and significance levels while maintaining 80% power, testing 3 average adverse event rates (3.9, 6.1, and 12.6 events per 100 person-years) estimated from the American College of Cardiology's 2006 to 2010 National Cardiovascular Data Registry of ICDs. We then compared with actual medical device utilization. At significance level 0.05 and 80% power, 34% or fewer ICD models accrued sufficient utilization in practice to detect safety differences for rate ratios <1.15 and an average event rate of 12.6 events per 100 person-years. For average event rates of 3.9 and 12.6 events per 100 person-years, 30% and 50% of ICD models, respectively, accrued sufficient utilization for a rate ratio of 1.25, whereas 52% and 67% for a rate ratio of 1.50. Because actual ICD utilization was not uniformly distributed across ICD models, the proportion of individuals receiving any ICD that accrued sufficient utilization in practice was 0% to 21%, 32% to 70%, and 67% to 84% for rate ratios of 1.05, 1.15, and 1.25, respectively, for the range of 3 average adverse event rates. Small safety differences among ICD generator models are unlikely to be detected through routine surveillance given current ICD utilization in practice, but large safety differences can be detected for most patients at anticipated average adverse event rates. Copyright © 2018 John Wiley & Sons, Ltd.

Expanding the g-Nexus: Further Evidence Regarding the Relations among National IQ, Religiosity and National Health Outcomes

ERIC Educational Resources Information Center

Reeve, Charlie L.

2009-01-01

The current study seeks to better understand how religiosity and health are positioned within the g-nexus. Specifically, the degree to which differences in average IQ across nations is associated with differences in national religiosity (i.e., belief rate) and national health statistics independent of differences in national wealth is examined.…

Americans hear as well or better today compared with 40 years ago: hearing threshold levels in the unscreened adult population of the United States, 1959-1962 and 1999-2004.

PubMed

Hoffman, Howard J; Dobie, Robert A; Ko, Chia-Wen; Themann, Christa L; Murphy, William J

2010-12-01

(1) To present hearing threshold data from a recent nationally representative survey in the United States (National Health and Nutrition Examination Survey, 1999-2004) in a distributional format that might be appropriate to replace Annex B in international (ISO-1999) and national (ANSI S3.44) standards and (2) to compare these recent data with older survey data (National Health Examination Survey I, 1959-1962) on which the current Annex B is based. Better-ear threshold distributions (selected percentiles and their confidence intervals) were estimated using linear interpolation. The 95% confidence intervals for the medians for the two surveys were compared graphically for each of the four age groups and for both men and women. In addition, we calculated odds ratios comparing the prevalences of better-ear hearing impairment (thresholds > 25 dB HL) between the two surveys, for 500, 1000, 2000, and 4000 Hz, and for their four-frequency average. Across age and sex groups, median thresholds were lower (better) in the 1999-2004 survey at 500, 3000, 4000, and 6000 Hz (8000 Hz was not tested in the 1959-1962 survey). For both men and women, the prevalence of hearing impairment was significantly lower in 1999-2004 at 500, 2000, and 4000 Hz, but not at 1000 Hz. For men and women of a specific age, high-frequency hearing thresholds were lower (better) in 1999-2004 than in 1959-1962. The prevalences of hearing impairment were also lower in the recent survey. Differences seen at 500 Hz may be attributable at least in part to changes in standards for ambient noise in audiometry. The National Health and Nutrition Examination Survey 1999-2004 distributions are offered as a possible replacement for Annex B in ISO-1999 and ANSI S3.44.

Epidemiologic Measures for Quantifying the Incidence of Concussion in National Collegiate Athletic Association Sports.

PubMed

Kerr, Zachary Y; Roos, Karen G; Djoko, Aristarque; Dalton, Sara L; Broglio, Steven P; Marshall, Stephen W; Dompier, Thomas P

2017-03-01

Injury rates compare the relative frequency of sport-related concussions across groups. However, they may not be intuitive to policy makers, parents, or coaches in understanding the likelihood of concussion. To describe 4 measures of incidence (athlete-based rate, athlete-based risk, team-based rate, and team-based risk) during the 2011-2012 through 2014-2015 academic years.  Descriptive epidemiology study. Aggregate injury and exposure data collected from the National Collegiate Athletic Association Injury Surveillance Program in 13 sports (men's baseball, basketball, football, ice hockey, lacrosse, soccer, and wrestling and women's basketball, ice hockey, lacrosse, soccer, softball, and volleyball). Collegiate student-athletes. Sport-related concussion data from the National Collegiate Athletic Association Injury Surveillance Program during the 2011-2012 through 2014-2015 academic years were analyzed. We calculated concussion rates per 1000 athlete-exposures (AEs), concussion risk, average number of concussions per team, and percentage of teams with at least 1 concussion. During the 2011-2012 through 2014-2015 academic years, 1485 concussions were sustained by 1410 student-athletes across 13 sports. Concussion rates ranged from 0.09/1000 AEs in men's baseball to 0.89/1000 AEs in men's wrestling. Concussion risk ranged from 0.74% in men's baseball to 7.92% in men's wrestling. The average ± SD number of concussions per team ranged from 0.25 ± 0.43 in men's baseball to 5.63 ± 5.36 in men's football. The percentage of teams with a concussion ranged from 24.5% in men's baseball to 80.6% in men's football.   Although men's wrestling had a higher concussion rate and risk, men's football had the largest average number of concussions per team and the largest percentage of teams with at least 1 concussion. The risk of concussion, average number of concussions per team, and percentage of teams with concussions may be more intuitive measures of incidence for decision makers. Calculating these additional measures is feasible within existing injury surveillance programs, and this method can be applied to other injury types.

Epidemiologic Measures for Quantifying the Incidence of Concussion in National Collegiate Athletic Association Sports

PubMed Central

Kerr, Zachary Y.; Roos, Karen G.; Djoko, Aristarque; Dalton, Sara L.; Broglio, Steven P.; Marshall, Stephen W.; Dompier, Thomas P.

2017-01-01

Context: Injury rates compare the relative frequency of sport-related concussions across groups. However, they may not be intuitive to policy makers, parents, or coaches in understanding the likelihood of concussion. Objective: To describe 4 measures of incidence (athlete-based rate, athlete-based risk, team-based rate, and team-based risk) during the 2011–2012 through 2014–2015 academic years. Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data collected from the National Collegiate Athletic Association Injury Surveillance Program in 13 sports (men's baseball, basketball, football, ice hockey, lacrosse, soccer, and wrestling and women's basketball, ice hockey, lacrosse, soccer, softball, and volleyball). Patients or Other Participants: Collegiate student-athletes. Main Outcome Measure(s): Sport-related concussion data from the National Collegiate Athletic Association Injury Surveillance Program during the 2011–2012 through 2014–2015 academic years were analyzed. We calculated concussion rates per 1000 athlete-exposures (AEs), concussion risk, average number of concussions per team, and percentage of teams with at least 1 concussion. Results: During the 2011–2012 through 2014–2015 academic years, 1485 concussions were sustained by 1410 student-athletes across 13 sports. Concussion rates ranged from 0.09/1000 AEs in men's baseball to 0.89/1000 AEs in men's wrestling. Concussion risk ranged from 0.74% in men's baseball to 7.92% in men's wrestling. The average ± SD number of concussions per team ranged from 0.25 ± 0.43 in men's baseball to 5.63 ± 5.36 in men's football. The percentage of teams with a concussion ranged from 24.5% in men's baseball to 80.6% in men's football. Conclusions: Although men's wrestling had a higher concussion rate and risk, men's football had the largest average number of concussions per team and the largest percentage of teams with at least 1 concussion. The risk of concussion, average number of concussions per team, and percentage of teams with concussions may be more intuitive measures of incidence for decision makers. Calculating these additional measures is feasible within existing injury surveillance programs, and this method can be applied to other injury types. PMID:27331336

Comparison of cost, dosage and clinical preference for risperidone and olanzapine.

PubMed

Rabinowitz, J; Lichtenberg, P; Kaplan, Z

2000-12-15

Because risperidone and olanzapine have similar efficacy and tolerability in the treatment of schizophrenia, costs, physician experience, and preference become relevant considerations in making treatment decisions. The purpose of this paper is to compare daily treatment costs of risperidone and olanzapine, and to examine psychiatrists' clinical preferences. Dosage information was obtained from a national Ministry of Health registry and a national survey of psychiatrists. In addition, psychiatrists' clinical preference of antipsychotic medication and dosage for patient subtypes were examined by the national survey. Data from the registry and national survey estimated the mean daily dose of risperidone to be one-third that of olanzapine, irrespective of patient subtype. Taking into account drug costs and dosage requirements, the average daily retail price was US $6.85 for risperidone and US $13.60 for olanzapine. Psychiatrists preferred risperidone for first-episode psychosis and elderly psychosis, and olanzapine for patients sensitive to EPS. They rated the drugs equally effective on positive and negative symptoms, for chronic patients, for treatment-refractory patients and relapse prevention. Risperidone has a substantial cost advantage over olanzapine, and was preferred by psychiatrists for more indications.

Reducing energy intake and energy density for a sustainable diet: a study based on self-selected diets in French adults.

PubMed

Masset, Gabriel; Vieux, Florent; Verger, Eric Olivier; Soler, Louis-Georges; Touazi, Djilali; Darmon, Nicole

2014-06-01

Studies on theoretical diets are not sufficient to implement sustainable diets in practice because of unknown cultural acceptability. In contrast, self-selected diets can be considered culturally acceptable. The objective was to identify the most sustainable diets consumed by people in everyday life. The diet-related greenhouse gas emissions (GHGE) for self-selected diets of 1918 adults participating in the cross-sectional French national dietary survey Individual and National Survey on Food Consumption (INCA2) were estimated. "Lower-Carbon," "Higher-Quality," and "More Sustainable" diets were defined as having GHGE lower than the overall median value, a probability of adequate nutrition intake (PANDiet) score (a measure of the overall nutritional adequacy of a diet) higher than the overall median value, and a combination of both criteria, respectively. Diet cost, as a proxy for affordability, and energy density were also assessed. More Sustainable diets were consumed by 23% of men and 20% of women, and their GHGE values were 19% and 17% lower than the population average (mean) value, respectively. In comparison with the average value, Lower-Carbon diets achieved a 20% GHGE reduction and lower cost, but they were not sustainable because they had a lower PANDiet score. Higher-Quality diets were not sustainable because of their above-average GHGE and cost. More Sustainable diets had an above-average PANDiet score and a below-average energy density, cost, GHGE, and energy content; the energy share of plant-based products was increased by 20% and 15% compared with the average for men and women, respectively. A strength of this study was that most of the dimensions for "sustainable diets" were considered, ie, not only nutritional quality and GHGE but also affordability and cultural acceptability. A reduction in diet-related GHGE by 20% while maintaining high nutritional quality seems realistic. This goal could be achieved at no extra cost by reducing energy intake and energy density and increasing the share of plant-based products. © 2014 American Society for Nutrition.

Status and trends in atmospheric deposition and emissions near Atlanta, Georgia, 1986-99

USGS Publications Warehouse

Peters, N.E.; Meyers, T.P.; Aulenbach, Brent T.

2002-01-01

Wet and dry atmospheric deposition were investigated from weekly data, 1986-99 (1986-97 for dry deposition) at the Panola Mountain Research Watershed (PMRW), a forested research site 25 km, southeast of Atlanta, Georgia. Furthermore, the wet deposition was compared to that at three adjacent National Atmospheric Deposition Program's National Trends Network (NTN) sites (GA41, 50 km south of PMRW; AL99, 175 km northwest; NC25, 175 km north-northeast) and dry deposition was compared to that at adjacent Clean Air Status and Trends Network (CASTNET) sites, co-located at the NTN sites. The pH of precipitation is acidic and the dominant acid anion is SO4; the pH (derived from the volume-weighted mean H concentration) averages 4.44 for 1986-99, and varies seasonally with average lowest values in summer (4.19) and highest in winter (4.63). From 1986-99, the annual wet deposition of sulfur (S) and nitrogen (N) averaged 400 and 300 eq ha-1 (6.4 and 4.2 kg ha-1), respectively. Inferential model estimates of annual dry S and N deposition from 1986-97 averaged 130 and 150 eq ha-1 (2.1 and 2.1 kg ha-1), respectively. From 1993-99, net S deposition (dry deposition plus canopy interactions) for coniferous and deciduous throughfall (throughfall minus wet-only deposition) averaged 400 and 150 eq ha-1 (6.4 and 2.1 kg ha-1), respectively. The annual wet deposition of S and N species at PMRW was comparable to that at NTN sites, with the exception of higher N species deposition at AL99 and relatively lower H, SO4 and NO3 deposition at GA41. Dry S deposition at PMRW differed markedly from the CASTNET sites despite similarity in S concentrations for all but NC25; the differences are attributed to differences in model parameters associated with the landscape and vegetation characteristics at the sites. At PMRW, atmospheric deposition trends were not detected for the entire sampling period, but were detected for shorter periods (4-5yr). Annual S and N deposition increased from 1986 to 1991, decreased to 1995 and then increased to 1999. SO2 emissions from seven major point sources within 120 km of PMRW decreased markedly from the late 1980s to 1995 and have remained relatively constant or increased slightly from 1995 to 1998 Annual wet and dry S deposition at PMRW significantly correlates (p < 0.01) with SO2 emissions, and the correlation is dominated by the large SO2 emissions decreases in the early 1990s, consistent with the implementation of Phase I of Title IV of the 1990 Clean Air Act Amendments.

Department of Transportation, National Highway Traffic Safety Administration : light truck average fuel economy standard, model year 1999

DOT National Transportation Integrated Search

1997-04-18

Section 32902(a) of title 49, United States Code, requires the Secretary of Transportation to prescribe by regulation, at least 18 months in advance of each model year, average fuel economy standards (known as "Corporate Average Fuel Economy" or "CAF...

7 CFR 760.209 - Livestock payment calculations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the relevant average income loss sustained by the contract grower, with respect to the dead... the Secretary that represents the average number of pounds of corn per day necessary to feed that...) of this section equals the quotient obtained by dividing: (1) The higher of: (i) The national average...

7 CFR 760.209 - Livestock payment calculations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of the relevant average income loss sustained by the contract grower, with respect to the dead... the Secretary that represents the average number of pounds of corn per day necessary to feed that...) of this section equals the quotient obtained by dividing: (1) The higher of: (i) The national average...

[Fertility in Loja, Bolivar, Esmeraldas, Azuay and El Oro. Series: Provincial reports from the Demographic and Maternal-Child Health Survey, 1994 (ENDEMAIN-94)].

PubMed

Pozo Avalos, A

1997-09-01

During the periods 1965-69 and 1989-94, Ecuador's total fertility rate (TFR) declined from nearly 7 to 3.6, while contraceptive prevalence rose from 33.6% to 56.8%. The 15 provinces of Ecuador were divided into 3 equal groups on the basis of Bongaarts' index of contraception, and their fertility characteristics were compared. The groups discussed here showed moderate differences in the index of contraception from the national average of 0.435. 4 of the 5 provinces in group II had indices higher than the national average: Loja, 0.567; Bolivar, 0.566; Esmeraldas, 0.535; and Azuay, 0.526. El Oro's index of 0.398 was lower. El Oro's TFR of 3.46 was lower than the national average of 3.61, but it still was in the third phase of the fertility transition. Although Loja and Bolivar had nearly identical indices of contraception, the TFR in Loja (4.15) was significantly lower than that in Bolivar (5.12). The TFRs were 4.66 in Esmeraldas and 3.95 in Azuay. The differences in TFRs in provinces with similar indices of contraception are due in part to different age patterns of fertility, distributions of women according to educational and marital status, and other factors. Age-specific fertility rates for women aged 15-19 ranged from a low of 65/1000 in Loja to a high of 120 in Esmeraldas. Maternal education was the single greatest observed influence on the TFR. The TFR at the national level was 6.24 for illiterate women and 2.13 for those with higher education. The TFR in the 5 provinces for women with primary or lower education ranged from 6.1 in Esmeraldas and Bolivar to 4.02 in El Oro. The differential between the most and least educated women ranged from 1.36 in El Oro to 4.27 in Bolivar. The proportion of women single ranged from 29.3% in El Oro to 48.6% in Loja. Calculation of the indices of contraception, marriage, and postpartum infertility showed, as expected, that El Oro had the most favorable indices.

The cost of karst subsidence and sinkhole collapse in the United States compared with other natural hazards

USGS Publications Warehouse

Weary, David J.

2015-01-01

Rocks with potential for karst formation are found in all 50 states. Damage due to karst subsidence and sinkhole collapse is a natural hazard of national scope. Repair of damage to buildings, highways, and other infrastructure represents a significant national cost. Sparse and incomplete data show that the average cost of karst-related damages in the United States over the last 15 years is estimated to be at least $300,000,000 per year and the actual total is probably much higher. This estimate is lower than the estimated annual costs for other natural hazards; flooding, hurricanes and cyclonic storms, tornadoes, landslides, earthquakes, or wildfires, all of which average over $1 billion per year. Very few state organizations track karst subsidence and sinkhole damage mitigation costs; none occurs at the Federal level. Many states discuss the karst hazard in their State hazard mitigation plans, but seldom include detailed reports of subsidence incidents or their mitigation costs. Most State highway departments do not differentiate karst subsidence or sinkhole collapse from other road repair costs. Amassing of these data would raise the estimated annual cost considerably. Information from insurance organizations about sinkhole damage claims and payouts is also not readily available. Currently there is no agency with a mandate for developing such data. If a more realistic estimate could be made, it would illuminate the national scope of this hazard and make comparison with costs of other natural hazards more realistic.

State of infection prevention in US hospitals enrolled in the National Health and Safety Network.

PubMed

Stone, Patricia W; Pogorzelska-Maziarz, Monika; Herzig, Carolyn T A; Weiner, Lindsey M; Furuya, E Yoko; Dick, Andrew; Larson, Elaine

2014-02-01

This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent health care-associated infections (HAIs) in intensive care units (ICUs). All hospitals, except Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation involved completing a survey assessing the presence of evidence-based prevention policies and clinician adherence and joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and nonrespondents. Of the 3,374 eligible hospitals, 975 provided data (29% response rate) on 1,653 ICUs, and there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions, and the average hours per week devoted to data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and nonrespondents. Guidelines for IP staffing in acute care hospitals need to be updated. In future work, we will analyze the associations between HAI rates and infection prevention and control program characteristics, as well as the inplementation of and clinician adherence to evidence-based policies. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Drinking water insecurity: water quality and access in coastal south-western Bangladesh.

PubMed

Benneyworth, Laura; Gilligan, Jonathan; Ayers, John C; Goodbred, Steven; George, Gregory; Carrico, Amanda; Karim, Md Rezaul; Akter, Farjana; Fry, David; Donato, Katherine; Piya, Bhumika

2016-01-01

National drinking water assessments for Bangladesh do not reflect local variability, or temporal differences. This paper reports on the findings of an interdisciplinary investigation of drinking water insecurity in a rural coastal south-western Bangladesh. Drinking water quality is assessed by comparison of locally measured concentrations to national levels and water quality criteria; resident's access to potable water and their perceptions are based on local social surveys. Residents in the study area use groundwater far less than the national average; salinity and local rainwater scarcity necessitates the use of multiple water sources throughout the year. Groundwater concentrations of arsenic and specific conductivity (SpC) were greater than surface water (pond) concentrations; there was no statistically significant seasonal difference in mean concentrations in groundwater, but there was for ponds, with arsenic higher in the dry season. Average arsenic concentrations in local water drinking were 2-4 times times the national average. All of the local groundwater samples exceeded the Bangladesh guidance for SpC, although the majority of residents surveyed did not perceive their water as having a 'bad' or 'salty' taste.

Mifamurtide for high-grade, resectable, nonmetastatic osteosarcoma following surgical resection: a cost-effectiveness analysis.

PubMed

Johal, Sukhvinder; Ralston, Stephen; Knight, Christopher

2013-12-01

Mifamurtide is an immune macrophage stimulant that when added to standard chemotherapy has demonstrated survival benefit for newly diagnosed osteosarcoma. The objectives of this study were to investigate the cost-effectiveness of adding mifamurtide to standard three- or four-agent chemotherapy for high-grade, resectable, nonmetastatic osteosarcoma following surgical resection and the issues of obtaining robust cost-effectiveness estimates for ultra-orphan drugs, given the shortage of data. An economic evaluation was conducted from the perspective of the UK's National Health Service as part of the manufacturer's submission to the National Institute for Health and Care Excellence. The disease process was simplified to a transition through a series of health states, modeled by using a Markov approach. Data to inform the model were derived from patient-level data of Study INT-0133, published literature, and expert opinion. The final efficacy measure was life-years gained (LYG), and utilities were used to obtain quality-adjusted life-years (QALYs). For a 60-year time frame and a discount rate of 3.5% for outcomes, patients receiving mifamurtide benefited from an average additional 1.57 years of life and 1.34 QALYs, compared with patients receiving chemotherapy alone, giving an incremental cost-effectiveness ratio (ICER) of £58,737 per LYG and £68,734 per QALY. Because treatment effects were both substantial in restoring health and sustained over a very long period, the National Institute for Health and Care Excellence changed its guidance to allow a discount of 1.5% for outcomes to be applied in these special circumstances. By using this discount factor, it was found that patients receiving mifamurtide had an average additional 2.58 years of life and 2.20 QALYs compared with patients receiving chemotherapy alone, resulting in an ICER of £35,765 per LYG and £41,933 per QALY. Mifamurtide's ICER is cost-effective compared with that of other orphan and ultra-orphan drugs, for which prices and corresponding cost-effectiveness estimates are high. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A longitudinal epidemiological comparison of suicide and other causes of death in Italian children and adolescents.

PubMed

Pompili, Maurizio; Vichi, Monica; De Leo, Diego; Pfeffer, Cynthia; Girardi, Paolo

2012-02-01

The objective of the study is to evaluate temporal trends, gender effects and methods of completed suicide amongst children and adolescent (aged 10-17) when compared with temporal trends of deaths from other causes. Data were extracted from the Italian Mortality Database, which is collected by the Italian National Census Bureau (ISTAT) and processed by the Statistics Unit of National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS) at the National Institute of Health (Istituto Superiore di Sanità). A total of 1,871 children and adolescents, age 10-17 years, committed suicide in Italy from 1971 to 2003 and 109 died by suicide during the last 3-year period of observation (2006-2008). The average suicide rate over the entire period of observation was 0.91 per 100,000; the rate was 1.21 for males and 0.59 for females. During the study period, the general mortality of children and adolescents, age 10-17 years, decreased dramatically, the average annual percentage change decrease was of -3.3% (95% CI -4.4 to -1.9) for males and -2.9% (95% IC -4.4 to -2.5) for females. The decrease was observed, for both genders, for all causes of deaths except suicide. For males, the most frequent method was hanging (54.5%), followed by shooting/fire arms (19.6%), falls/jumping from high places (12.7%); for females, the most frequent method, jumping from high places/falls, accounted for 35.7% of suicides during the whole study period. In conclusion, this study highlights that over the course of several decades suicide is a far less preventable cause of death as compared to other causes of death amongst children and adolescents. Our study demonstrated that suicide rates in adolescents are not a stable phenomenon over the 40 years period of study. It suggested that rates for males and females differed and varied in different ways during specific time periods of this study. National suicide prevention actions should parallel prevention measures implemented to reduce other causes of death.

[Relationship between crown form of upper central incisors and papilla filling in Chinese Han-nationality youth].

PubMed

Yang, X; Le, D; Zhang, Y L; Liang, L Z; Yang, G; Hu, W J

2016-10-18

To explore a crown form classification method for upper central incisor which is more objective and scientific than traditional classification method based on the standardized photography technique. To analyze the relationship between crown form of upper central incisors and papilla filling in periodontally healthy Chinese Han-nationality youth. In the study, 180 periodontally healthy Chinese youth ( 75 males, and 105 females ) aged 20-30 (24.3±4.5) years were included. With the standardized upper central incisor photography technique, pictures of 360 upper central incisors were obtained. Each tooth was classified as triangular, ovoid or square by 13 experienced specialist majors in prothodontics independently and the final classification result was decided by most evaluators in order to ensure objectivity. The standardized digital photo was also used to evaluate the gingival papilla filling situation. The papilla filling result was recorded as present or absent according to naked eye observation. The papilla filling rates of different crown forms were analyzed. Statistical analyses were performed with SPSS 19.0. The proportions of triangle, ovoid and square forms of upper central incisor in Chinese Han-nationality youth were 31.4% (113/360), 37.2% (134/360) and 31.4% (113/360 ), respectively, and no statistical difference was found between the males and females. Average κ value between each two evaluators was 0.381. Average κ value was raised up to 0.563 when compared with the final classification result. In the study, 24 upper central incisors without contact were excluded, and the papilla filling rates of triangle, ovoid and square crown were 56.4% (62/110), 69.6% (87/125), 76.2% (77/101) separately. The papilla filling rate of square form was higher (P=0.007). The proportion of clinical crown form of upper central incisor in Chinese Han-nationality youth is obtained. Compared with triangle form, square form is found to favor a gingival papilla that fills the interproximal embrasure space. The consistency of the present classification method for upper central incisor is not satisfying, which indicates that a new classification method, more scientific and objective than the present one, is to be found.

Computer usage and national energy consumption: Results from a field-metering study

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

Desroches, Louis-Benoit; Fuchs, Heidi; Greenblatt, Jeffery

The electricity consumption of miscellaneous electronic loads (MELs) in the home has grown in recent years, and is expected to continue rising. Consumer electronics, in particular, are characterized by swift technological innovation, with varying impacts on energy use. Desktop and laptop computers make up a significant share of MELs electricity consumption, but their national energy use is difficult to estimate, given uncertainties around shifting user behavior. This report analyzes usage data from 64 computers (45 desktop, 11 laptop, and 8 unknown) collected in 2012 as part of a larger field monitoring effort of 880 households in the San Francisco Baymore » Area, and compares our results to recent values from the literature. We find that desktop computers are used for an average of 7.3 hours per day (median = 4.2 h/d), while laptops are used for a mean 4.8 hours per day (median = 2.1 h/d). The results for laptops are likely underestimated since they can be charged in other, unmetered outlets. Average unit annual energy consumption (AEC) for desktops is estimated to be 194 kWh/yr (median = 125 kWh/yr), and for laptops 75 kWh/yr (median = 31 kWh/yr). We estimate national annual energy consumption for desktop computers to be 20 TWh. National annual energy use for laptops is estimated to be 11 TWh, markedly higher than previous estimates, likely reflective of laptops drawing more power in On mode in addition to greater market penetration. This result for laptops, however, carries relatively higher uncertainty compared to desktops. Different study methodologies and definitions, changing usage patterns, and uncertainty about how consumers use computers must be considered when interpreting our results with respect to existing analyses. Finally, as energy consumption in On mode is predominant, we outline several energy savings opportunities: improved power management (defaulting to low-power modes after periods of inactivity as well as power scaling), matching the rated power of power supplies to computing needs, and improving the efficiency of individual components.« less

Pediatric retropharyngeal abscesses: a national perspective.

PubMed

Lander, Lina; Lu, Sam; Shah, Rahul K

2008-12-01

To determine the resource utilization and national variation in the management of pediatric retropharyngeal abscesses. The Kids' Inpatient Database (KID) 2003 was analyzed. International Classification of Diseases, Ninth Revision code 478.24 was the inclusion criteria. One thousand three hundred and twenty-one admissions with retropharyngeal abscess were sampled from the KID in 2003; there were no deaths. The mean age of patients was 5.1 years (S.D. 4.4 years); 63% were male. Of all admissions, 563 (43%) patients underwent surgical drainage of their infection; surgical patients had longer length of stays and total charges than patients managed medically. The average state spending per admission varied from $5126 (Utah) to $27,776 (California). There was seasonal variation in admissions with the highest percentage of admissions occurring in March (10.7%) and lowest in August (3.8%). Indicators of increased resource utilization included age (older patients), increased length of stay, non-elective admission, discharge quarter, and number of other diagnoses on record. There is a statistically significant decrease in the length of stay and total charges in patients admitted in the Midwest compared to other regions of the country. This study demonstrates national demographics and normative data on a commonly treated pediatric disease process, retropharyngeal space infections. The average demographic of such a patient is a 5-year-old male from an urban location admitted in a non-elective fashion via the emergency department. The mean total charges were $16,377; 90% of admissions had total charges less than $28,511. Patients who underwent surgical procedures had mean total charges of $22,013. There exists significant national variation in resource utilization for this commonly treated disease process.

Educational attainment of children born to mothers with epilepsy.

PubMed

Lacey, Arron S; Pickrell, William Owen; Thomas, Rhys H; Kerr, Mike P; White, Cathy P; Rees, Mark I

2018-03-27

Small prospective studies have identified that children exposed to valproate in utero have poorer scores on cognitive testing. We wanted to identify whether children exposed to antiepileptic drugs (AEDs) in utero have poorer school performance. We used anonymised, linked, routinely collected healthcare records to identify children born to mothers with epilepsy. We linked these children to their national attainment Key Stage 1 (KS1) tests in mathematics, language and science at the age of 7 and compared them with matched children born to mothers without epilepsy, and with the national KS1 results. We used the core subject indicator (CSI) as an outcome measure (the proportion of children achieving a minimum standard in all subjects) and the results in individual subjects. We identified 440 children born to mothers with epilepsy with available KS1 results. Compared with a matched control group, fewer children with mothers being prescribed sodium valproate during pregnancy achieved the national minimum standard in CSI (-12.7% less than the control group), mathematics (-12.1%), language (-10.4%) and in science (-12.2%). Even fewer children with mothers being prescribed multiple AEDs during pregnancy achieved a national minimum standard: CSI (by -20.7% less than the control group), mathematics (-21.9%), language (-19.3%) and science (-19.4%). We did not observe any significant difference in children whose mothers were prescribed carbamazepine or were not taking an AED when compared with the control group. In utero exposure to AEDs in combination, or sodium valproate alone, is associated with a significant decrease in attainment in national educational tests for 7-year-old children compared with both a matched control group and the all-Wales national average. These results give further support to the cognitive and developmental effects of in utero exposure to sodium valproate as well as multiple AEDs, which should be balanced against the need for effective seizure control for women during pregnancy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

75 FR 41796 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

..., afterschool snacks and breakfasts served to children participating in the National School Lunch and School... Factors and to the maximum Federal reimbursement rates for lunches and afterschool snacks served to... afterschool snacks served under the National School Lunch Program are rounded down to the nearest whole cent...

Estimation of national forest visitor spending averages from National Visitor Use Monitoring: round 2

Treesearch

Eric M. White; Darren B. Goodding; Daniel J. Stynes

2013-01-01

The economic linkages between national forests and surrounding communities have become increasingly important in recent years. One way national forests contribute to the economies of surrounding communities is by attracting recreation visitors who, as part of their trip, spend money in communities on the periphery of the national forest. We use survey data collected...

Lack of a standardised UK care pathway resulting in national variations in management and outcomes of paediatric small area scalds.

PubMed

Trevatt, Alexander E J; Kirkham, Emily N; Allix, Bradley; Greenwood, Rosemary; Coy, Karen; Hollén, Linda I; Young, Amber E R

2016-09-01

There is a paucity of evidence guiding management of small area partial thickness paediatric scalds. This has prevented the development of national management guidelines for these injuries. This research aimed to investigate whether a lack of evidence for national guidelines has resulted in variations in both management and outcomes of paediatric small area scalds across England and Wales (E&W). A national survey of initial management of paediatric scalds ≤5% Total Body Surface Area (%TBSA) was sent to 14 burns services in E&W. Skin graft rates of anonymised burns services over seven years were collected from the international Burns Injury Database (iBID). Average skin grafting rates across services were compared. Length of stay and proportion of patients receiving general anaesthesia for dressing application at each service were also compared. All 14 burns services responded to the survey. Only 50% of services had a protocol in place for the management of small area burns. All protocols varied in how partial thickness paediatrics scalds ≤5% TBSA should be managed. There was no consensus as to which scalds should be treated using biosynthetic dressings. Data from iBID for 11,917 patients showed that the average reported skin grafting rate across all burns services was 2.3% (95% CI 2.1, 2.6) but varied from 0.3% to 7.1% (P<0.001). Service provider remained associated with likelihood of skin grafting when variations in the %TBSA case mix seen by each service were controlled for (χ(2)=87.3, P<0.001). The use of general anaesthetics across services varied between 0.6 and 35.5% (P<0.001). The median length of stay across services varied from 1 to 3 days (P<0.001). A lack of evidence guiding management of small-area paediatric scalds has resulted in variation in management of these injuries across E&W. There is also significant variation in outcomes for these injuries. Further research is indicated to determine if care pathways and outcomes are linked. An evidence-based national policy for the management of small area paediatric scalds would ensure that high quality, standardised care is delivered throughout E&W and variations in outcome are reduced. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Psychoactive Drugs in Plastic Surgery

PubMed Central

Davison, Steven P.; Hayes, Kylie D.

2017-01-01

Background: Psychoactive drug use is on the rise in the United States, with plastic surgery patients a potentially susceptible group. This study aimed to determine the incidence of cosmetic and reconstructive patients in our practice taking psychoactive drugs and to compare those values with the national average. Furthermore, we discuss the patient safety concerns when patients withhold their medical history information over the course of their treatment. Methods: Urban private plastic practice patients who underwent surgery in a closed practice from 2009 to 2016 were divided into cosmetic and reconstructive cohorts. Review for drug use was medical scripts, history, and Surescripts drug reporting. Extracted information includes age, race, procedure, psychoactive medications, and whether or not they stated a mental health diagnosis on their medical history forms. Only patients with complete records were included. Results: A total of 830 patients were included in statistical analysis. Due to minimal cohort number, 70 men were excluded, as there were no comparative national data. Our analysis found that 33.6% cosmetic patients and 46.3% reconstructive patients used at least one psychoactive drug. Conclusion: There is a statistically significant difference between psychoactive drug use at our practice compared with the general population and a significantly larger percentage of reconstructive patients taking drugs compared with the cosmetic cohort. PMID:28458985

Commercial viability of hybrid vehicles : best household use and cross national considerations.

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

Santini, D. J.; Vyas, A. D.

1999-07-16

Japanese automakers have introduced hybrid passenger cars in Japan and will soon do so in the US. In this paper, we report how we used early computer simulation model results to compare the commercial viability of a hypothetical near-term (next decade) hybrid mid-size passenger car configuration under varying fuel price and driving patterns. The fuel prices and driving patterns evaluated are designed to span likely values for major OECD nations. Two types of models are used. One allows the ''design'' of a hybrid to a specified set of performance requirements and the prediction of fuel economy under a number ofmore » possible driving patterns (called driving cycles). Another provides an estimate of the incremental cost of the hybrid in comparison to a comparably performing conventional vehicle. In this paper, the models are applied to predict the NPV cost of conventional gasoline-fueled vehicles vs. parallel hybrid vehicles. The parallel hybrids are assumed to (1) be produced at high volume, (2) use nickel metal hydride battery packs, and (3) have high-strength steel bodies. The conventional vehicle also is assumed to have a high-strength steel body. The simulated vehicles are held constant in many respects, including 0-60 time, engine type, aerodynamic drag coefficient, tire rolling resistance, and frontal area. The hybrids analyzed use the minimum size battery pack and motor to meet specified 0-60 times. A key characteristic affecting commercial viability is noted and quantified: that hybrids achieve the most pronounced fuel economy increase (best use) in slow, average-speed, stop-and-go driving, but when households consistently drive these vehicles under these conditions, they tend to travel fewer miles than average vehicles. We find that hours driven is a more valuable measure than miles. Estimates are developed concerning hours of use of household vehicles versus driving cycle, and the pattern of minimum NPV incremental cost (or benefit) of selecting the hybrid over the conventional vehicle at various fuel prices is illustrated. These results are based on data from various OECD motions on fuel price, annual miles of travel per vehicle, and driving cycles assumed to be applicable in those nations. Scatter in results plotted as a function of average speed, related to details of driving cycles and the vehicles selected for analysis, is discussed.« less

Target CLAB Zero: A national improvement collaborative to reduce central line-associated bacteraemia in New Zealand intensive care units.

PubMed

Gray, Jonathon; Proudfoot, Suzanne; Power, Maxine; Bennett, Brandon; Wells, Sue; Seddon, Mary

2015-09-04

Central line-associated bacteraemia (CLAB) is a preventable cause of patient morbidity and mortality in intensive care units. Target CLAB Zero was a national campaign that ran from October 2011 to March 2013 across all New Zealand ICUs (intensive care units). The campaign aimed to reduce the national CLAB rate to less than one incident per 1,000 line days and to establish a national measurement system for CLAB. We used Institute for Healthcare Improvement (IHI) Breakthrough Series methodology to structure the campaign. IHI bundles of care for catheter insertion and maintenance were implemented across 25 New Zealand ICUs. We collected monthly data on line days, CLAB infections and compliance with the bundles. Data were analysed using run charts. The rate of CLAB per 1,000 line days fell from 3.32 at baseline to an average of 0.28 between April 2012 and March 2013. In the final 3-month period, January to March 2013, average insertion bundle compliance was 80% and average maintenance bundle compliance was 75%. All ICUs participated in the collaborative. Over 90% of those invited attended all three national learning sessions and bi-monthly regional learning sessions. National collaboratives can effect improvement and shared learning in New Zealand. International evidence combined with New Zealand experience, a supportive methodology, partnership, clinical respect and an effective communication plan were keys to successful engagement.

Trends in Average Living Children at the Time of Terminal Contraception: A Time Series Analysis Over 27 Years Using ARIMA (p, d, q) Nonseasonal Model.

PubMed

Mumbare, Sachin S; Gosavi, Shriram; Almale, Balaji; Patil, Aruna; Dhakane, Supriya; Kadu, Aniruddha

2014-10-01

India's National Family Welfare Programme is dominated by sterilization, particularly tubectomy. Sterilization, being a terminal method of contraception, decides the final number of children for that couple. Many studies have shown the declining trend in the average number of living children at the time of sterilization over a short period of time. So this study was planned to do time series analysis of the average children at the time of terminal contraception, to do forecasting till 2020 for the same and to compare the rates of change in various subgroups of the population. Data was preprocessed in MS Access 2007 by creating and running SQL queries. After testing stationarity of every series with augmented Dickey-Fuller test, time series analysis and forecasting was done using best-fit Box-Jenkins ARIMA (p, d, q) nonseasonal model. To compare the rates of change of average children in various subgroups, at sterilization, analysis of covariance (ANCOVA) was applied. Forecasting showed that the replacement level of 2.1 total fertility rate (TFR) will be achieved in 2018 for couples opting for sterilization. The same will be achieved in 2020, 2016, 2018, and 2019 for rural area, urban area, Hindu couples, and Buddhist couples, respectively. It will not be achieved till 2020 in Muslim couples. Every stratum of population showed the declining trend. The decline for male children and in rural area was significantly faster than the decline for female children and in urban area, respectively. The decline was not significantly different in Hindu, Muslim, and Buddhist couples.

Multi-Model Combination techniques for Hydrological Forecasting: Application to Distributed Model Intercomparison Project Results

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

Ajami, N K; Duan, Q; Gao, X

2005-04-11

This paper examines several multi-model combination techniques: the Simple Multi-model Average (SMA), the Multi-Model Super Ensemble (MMSE), Modified Multi-Model Super Ensemble (M3SE) and the Weighted Average Method (WAM). These model combination techniques were evaluated using the results from the Distributed Model Intercomparison Project (DMIP), an international project sponsored by the National Weather Service (NWS) Office of Hydrologic Development (OHD). All of the multi-model combination results were obtained using uncalibrated DMIP model outputs and were compared against the best uncalibrated as well as the best calibrated individual model results. The purpose of this study is to understand how different combination techniquesmore » affect the skill levels of the multi-model predictions. This study revealed that the multi-model predictions obtained from uncalibrated single model predictions are generally better than any single member model predictions, even the best calibrated single model predictions. Furthermore, more sophisticated multi-model combination techniques that incorporated bias correction steps work better than simple multi-model average predictions or multi-model predictions without bias correction.« less

Average household exposure to newspaper coverage about the harmful effects of hormone therapy and population-based declines in hormone therapy use.

PubMed

Haas, Jennifer S; Miglioretti, Diana L; Geller, Berta; Buist, Diana S M; Nelson, David E; Kerlikowske, Karla; Carney, Patricia A; Dash, Sarah; Breslau, Erica S; Ballard-Barbash, Rachel

2007-01-01

The news media facilitated the rapid dissemination of the findings from the estrogen plus progestin therapy arm of the Women's Health Initiative (EPT-WHI). To examine the relationship between the potential exposure to newspaper coverage and subsequent hormone therapy (HT) use. DESIGN/POPULATION: Population-based cohort of women receiving mammography at 7 sites (327,144 postmenopausal women). The outcome was the monthly prevalence of self-reported HT use. Circulation data for local, regional, and national newspapers was used to create zip-code level measures of the estimated average household exposure to newspaper coverage that reported the harmful effects of HT in July 2002. Women had an average potential household exposure of 1.4 articles. There was substantial variation in the level of average household exposure to newspaper coverage; women from rural sites received less than women from urban sites. Use of HT declined for all average potential exposure groups after the publication of the EPT-WHI. HT prevalence among women who lived in areas where there was an average household exposure of at least 3 articles declined significantly more (45 to 27%) compared to women who lived in areas with <1 article (43 to 31%) during each of the subsequent 5 months (relative risks 0.86-0.92; p < .006 for all). Greater average household exposure to newspaper coverage about the harms associated with HT was associated with a large population-based decline in HT use. Further studies should examine whether media coverage directly influences the health behavior of individual women.

23 CFR 650.707 - Rating factor.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Average Daily Truck Traffic in thousands (Pick up trucks and light delivery trucks not included). For load... restricted. The ADTT should be the annual average volume, not peak or seasonal; (4) N is National Highway...

23 CFR 650.707 - Rating factor.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Average Daily Truck Traffic in thousands (Pick up trucks and light delivery trucks not included). For load... restricted. The ADTT should be the annual average volume, not peak or seasonal; (4) N is National Highway...

23 CFR 650.707 - Rating factor.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Average Daily Truck Traffic in thousands (Pick up trucks and light delivery trucks not included). For load... restricted. The ADTT should be the annual average volume, not peak or seasonal; (4) N is National Highway...

23 CFR 650.707 - Rating factor.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Average Daily Truck Traffic in thousands (Pick up trucks and light delivery trucks not included). For load... restricted. The ADTT should be the annual average volume, not peak or seasonal; (4) N is National Highway...

23 CFR 650.707 - Rating factor.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Average Daily Truck Traffic in thousands (Pick up trucks and light delivery trucks not included). For load... restricted. The ADTT should be the annual average volume, not peak or seasonal; (4) N is National Highway...

Demographic and fertility characteristics of 4 squatter settlements.

PubMed

Yusof, K; Zulkifli, S N

1985-01-01

The demographic and fertility profiles of 4 squatter areas, 2 with Sang Kancil, a community development project designed specifically for squatter settlements in Kuala Lumpur, are described. Data were taken from a census conducted in 1982. Figure 1 maps out the location of the study areas in the Federal Territory. The squatter household (5.4 members) varied little from the average Malaysian household. The average age of the male head of household was 40 years, i.e., not within the high fertility group; the mean duration of stay was 10 years. Household income/month averaged M$760, falling between estimates for urban and rural mean. Comparing the data on the 2 squatter areas, the non-Sang Kancil head of household was, on average, slightly older and had stayed about 2 years longer than his Sang Kancil counterpart. These differences were statistically significant. Both areas were comparable with regard to household income and size. Ethnically, the Sang Kancil areas were predominantly Malay, comprising 86% of total households. The control areas had a more mixed ethnic structure. From 1978-81, annual increases in total population had been fairly uniform, at around 2%, in non-Sang Kancil Areas. Yet, the Sang Kancil population experienced a growth spurt in 1980, which subsequently declined and appeared to level off. 1982 figures were disregarded in this analysis as they were based on a 1/2 year enumeration only. The age distribution pattern of all squatter areas combined was fairly similar to the national distribution pyramid but for a higher proportion of people in the 15-44 age group than national figures. The proportion of dependents, 0-14 years, was comparable despite having more people in this fertile age group. The proportion of infants (0-11 months) in the control population was constant, but there was a decline down to control values by the end of the surveyed period in the Sang Kancil group. In the toddler group, decreases were evident for both populations. Additionally, the proportion of the population in the 20-39 age group, considered the most fertile, was consistently higher in the Sang Kancil areas throughout the 4.5 years. Thus, for Sang Kancil areas, fertility appeared to have dropped; it has remained fairly steady in non-Sang Kancil controls. In addition to contraceptive practice, 2 others factors most likely have contributed to fertility declines: a progressive decline in those who were married, which is likely to have had a negative effect on fertility rates; and evidence of induced abortion.

Fukushima after the Great East Japan Earthquake: lessons for developing responsive and resilient health systems.

PubMed

Fukuma, Shingo; Ahmed, Shahira; Goto, Rei; Inui, Thomas S; Atun, Rifat; Fukuhara, Shunichi

2017-06-01

On 11 March 2011, the Great East Japan Earthquake, followed by a tsunami and nuclear-reactor meltdowns, produced one of the most severe disasters in the history of Japan. The adverse impact of this 'triple disaster' on the health of local populations and the health system was substantial. In this study we examine population-level health indicator changes that accompanied the disaster, and discuss options for re-designing Fukushima's health system, and by extension that of Japan, to enhance its responsiveness and resilience to current and future shocks. We used country-level (Japan-average) or prefecture-level data (2005-2014) available from the portal site of Official Statistics of Japan for Fukushima, Miyagi, and Iwate, the prefectures that were most affected by the disaster, to compare trends before (2005-2010) and after (2011-2014) the 'disaster'. We made time-trend line plots to describe changes over time in age-adjusted cause-specific mortality rates in each prefecture. All three prefectures, and in particular Fukushima, had lower socio-economic indicators, an older population, lower productivity and gross domestic product per capita, and less higher-level industry than the Japan average. All three prefectures were 'medically underserved', with fewer physicians, nurses, ambulance calls and clinics per 100 000 residents than the Japan average. Even before the disaster, age-adjusted all-cause mortality in Fukushima was in general higher than the national rates. After the triple disaster we found that the mortality rate due to myocardial infarction increased substantially in Fukushima while it decreased nationwide. Compared to Japan average, spikes in mortality due to lung disease (all three prefectures), stroke (Iwate and Miyagi), and all-cause mortality (Miyagi and Fukushima) were also observed post-disaster. The cause-specific mortality rate from cancer followed similar trends in all three prefectures to those in Japan as a whole. Although we found a sharp rise in ambulance calls in Iwate and Miyagi, we did not see such a rise in Fukushima: a finding which may indicate limited responsiveness to acute demand because of pre-existing restricted capacity in emergency ambulance services. We analyze changes in indicators of health and health systems infrastructure in Fukushima before and five years following the disaster, and explored health systems' strengths and vulnerabilities. Spikes in mortality rates for selected non-infectious conditions common among older individuals were observed compared to the national trends. The results suggest that poorer reserves in the health care delivery system in Fukushima limited its capacity to effectively meet sudden unexpected increases in demand generated by the disaster.

Will the European Union reach the United Nations Millennium declaration target of a 50% reduction of tuberculosis mortality between 1990 and 2015?

PubMed

van der Werf, Marieke J; Bonfigli, Sandro; Hruba, Frantiska

2017-07-06

The Millennium Development Goals (MDG) provide targets for 2015. MDG 6 includes a target to reduce the tuberculosis (TB) death rate by 50% compared with 1990. We aimed to assess whether this target was reached by the European Union (EU) and European Economic Area countries. We used Eurostat causes of death data to assess whether the target was reached in the EU. We calculated the reduction in reported and adjusted death rates and the annual average percentage decline based on the available data. Between 1999 and 2014, the TB death rate decreased by 50%, the adjusted death rate by 56% and the annual average percentage decline was 5.43% (95% confidence interval 4.94-6.74) for the EU. Twenty of 26 countries reporting >5 TB deaths in the first reporting year reached the target of 50% reduction in adjusted death rate. The EU reached the MDG target of a 50% reduction of the TB death rate and also the annual average percentage decline was larger than the 2.73% needed to reach the target. The World Health Organization 'End TB Strategy' requires a further reduction of the number of TB deaths of 35% by 2020 compared to 2015, which will challenge TB prevention and care services in the EU.

The modes of physician remuneration and their effect on direct patient contact.

PubMed

Basu, Kisalaya; Mandelzys, David

2008-01-01

Initiatives such as primary care reform have allocated millions of dollars towards the Canadian health care system. The way physicians are remunerated affects the supply of physician services and as such is essential to these initiatives to facilitate policy goals. However, there exists a gap in understanding how different modes of remuneration affect physician-patient contact. This paper examines if there is a significant difference between the average full-time-equivalent (FTE) of family physicians (FPs) remunerated through fee-for-service (FFS), salary, and blended arrangements. We used Nova Scotia physician billings dataset which tracks every services performed by both FFS and salaried physicians over the fiscal year 2003 to 2004. We estimated two semi-logarithmic models to examine the relationship between (1) modes of remuneration and FTE, and (2) modes of remuneration and total services, using ordinary least squares method. The National Physician Survey shows a significant difference between the current modes of remuneration and the preferred modes of remuneration; thus ruling out the possibility of selectivity bias. The results show that compared to the FFS FPs, the salaried FPs and blended FPs produce on average 40.46% and 23.13% less FTE respectively. It also indicates that compared to the FFS FPs, the salaried FPs and blended FPs deliver 53.54% and 31.49% fewer services on average.

Longitudinal study on patent citations to academic research articles in nanotechnology (1976-2004)

NASA Astrophysics Data System (ADS)

Hu, Daning; Chen, Hsinchun; Huang, Zan; Roco, Mihail C.

2007-08-01

Academic nanoscale science and engineering (NSE) research provides a foundation for nanotechnology innovation reflected in patents. About 60% or about 50,000 of the NSE-related patents identified by "full-text" keyword searching between 1976 and 2004 at the United States Patent and Trademark Office (USPTO) have an average of approximately 18 academic citations. The most cited academic journals, individual researchers, and research articles have been evaluated as sources of technology innovation in the NSE area over the 28-year period. Each of the most influential articles was cited about 90 times on the average, while the most influential author was cited more than 700 times by the NSE-related patents. Thirteen mainstream journals accounted for about 20% of all citations. Science, Nature and Proceedings of the National Academy of Sciences (PNAS) have consistently been the top three most cited journals, with each article being cited three times on average. There is another kind of influential journals, represented by Biosystems and Origin of Life, which have very few articles cited but with exceptionally high frequencies. The number of academic citations per year from ten most cited journals has increased by over 17 times in the interval (1990-1999) as compared to (1976-1989), and again over 3 times in the interval (2000-2004) as compared to (1990-1999). This is an indication of increased used of academic knowledge creation in the NSE-related patents.

Coarse particle speciation at selected locations in the rural continental United States

NASA Astrophysics Data System (ADS)

Malm, William C.; Pitchford, Marc L.; McDade, Charles; Ashbaugh, Lowell L.

A few short-term special studies at National Parks have shown that coarse mass (CM) (2.5- 10μm) may not be just crustal minerals but may consist of a substantial amount ( ≈40-50%) of carbonaceous material and inorganic salts such as calcium nitrate and sodium nitrate. To more fully investigate the composition of coarse particles, a program of coarse particle sampling and speciation analysis at nine of the Interagency Monitoring of Protected Visual Environments (IMPROVE) sites was initiated 19 March 2003 and operated through the year 2004. Only the data for 2004 are reported here. Sites were selected to be representative of the continental United States and were operated according to IMPROVE protocol analytical procedures. Crustal minerals (soil) are the single largest contributor to CM at all but one monitoring location. The average fractional contributions range from a high of 76% at Grand Canyon National Park to a low of 34% at Mount Rainier National Park. The second largest contributor to CM is organic mass, which on an average annual fractional basis is highest at Mount Rainier at 59%. At Great Smoky Mountains National Park, organic mass contributes 40% on average, while at four sites organic mass concentrations contribute between 20% and 30% of the CM. Nitrates are on average the third largest contributor to CM concentrations. The highest fractional contributions of nitrates to CM are at Brigantine National Wildlife Refuge, Great Smoky Mountains, and San Gorgonio wilderness area at 10-12%. Sulfates contribute less than about 5% at all sites.

Spatial Patterns of Soil Organic Carbon in the United States

NASA Astrophysics Data System (ADS)

Bliss, N. B.

2005-12-01

The Department of the Interior (DOI) has jurisdiction influencing approximately 22 percent of the land area of the United States. The poster presents estimates of the current stocks of soil organic carbon (SOC) on all lands and Federal lands. The DOI lands have about 22 percent of the nation's SOC, so the average carbon intensity (8.66 kg C m-2) about matches the average for all lands (8.81 kg C m-2). However the carbon on DOI lands is not evenly distributed. Of the 17.76 Petagrams (1 Pg = 1015 grams) of SOC on DOI lands, 13.07 Pg (74 percent) are in Alaska, and 4.69 Pg (26 percent) are in the Conterminous U.S. The Alaska soils are wetter and colder than the national average, and the DOI lands in the conterminous U.S. are warmer and drier than the average. A set of SOC maps is shown, developed by intersecting the State Soil Geographic (STATSGO) database with data on federal lands from the National Atlas. With 22 percent of the nation's soil carbon, the DOI lands are important in a national accounting of greenhouse gas emission and sequestration. Future behavior of these lands is uncertain, but in scenarios of warming or drying, carbon released by respiration may exceed carbon captured by photosynthesis, resulting in a net release of carbon to the atmosphere. If warming stimulates a net release of greenhouse gases, this represents a positive feedback contributing to future global warming, a very unstable condition for the global climate system.

49 CFR 525.11 - Termination of exemption; amendment of alternative average fuel economy standard.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 6 2010-10-01 2010-10-01 false Termination of exemption; amendment of alternative average fuel economy standard. 525.11 Section 525.11 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EXEMPTIONS FROM AVERAGE FUEL ECONOMY STANDARDS...

7 CFR 1580.203 - Determination of eligibility and certification by the Administrator.

Code of Federal Regulations, 2010 CFR

2010-01-01

... average price for the agricultural commodity for the marketing year under review is less than 80 percent of the average of the national average prices for the 5 marketing years preceding the most recent marketing year, and (2) Increases in imports of articles like or directly competitive with the agricultural...

Average years of life lost due to breast and cervical cancer and the association with the marginalization index in Mexico in 2000 and 2010.

PubMed

Cervantes, Claudio Alberto Dávila; Botero, Marcela Agudelo

2014-05-01

The objective of this study was to calculate average years of life lost due to breast and cervical cancer in Mexico in 2000 and 2010. Data on mortality in women aged between 20 and 84 years was obtained from the National Institute for Statistics and Geography. Age-specific mortality rates and average years of life lost, which is an estimate of the number of years that a person would have lived if he or she had not died prematurely, were estimated for both diseases. Data was disaggregated into five-year age groups and socioeconomic status based on the 2010 marginalization index obtained from the National Population Council. A decrease in average years of life lost due to cervical cancer (37.4%) and an increase in average years of life lost due breast cancer (8.9%) was observed during the period studied. Average years of life lost due to cervical cancer was greater among women living in areas with a high marginalization index, while average years of life lost due to breast cancer was greater in women from areas with a low marginalization index.

Changes in daily activity patterns with age in U.S. men and women: National Health and Nutrition Examination Survey 2003-04 and 2005-06.

PubMed

Martin, Kathryn R; Koster, Annemarie; Murphy, Rachel A; Van Domelen, Dane R; Hung, Ming-yang; Brychta, Robert J; Chen, Kong Y; Harris, Tamara B

2014-07-01

To compare daily and hourly activity patterns according to sex and age. Cross-sectional, observational. Nationally representative community sample: National Health and Nutrition Examination Survey (NHANES) 2003-04 and 2005-06. Individuals (n = 5,788) aged 20 and older with 4 or more valid days of monitor wear-time, no missing data on valid wear-time minutes, and covariates. Activity was examined as average counts per minute (CPM) during wear-time; percentage of time spent in nonsedentary activity; and time (minutes) spent in sedentary (<100 counts), light (100-759), and moderate to vigorous physical activity (MVPA (≥ 760)). Analyses accounted for survey design, adjusted for covariates, and were sex specific. In adjusted models, men spent slightly more time (~1-2%) in nonsedentary activity than women aged 20 to 34, with levels converging at age 35 to 59, although the difference was not significant. Women aged 60 and older spent significantly more time (~3-4%) in nonsedentary activity than men, despite similarly achieved average CPM. With increasing age, all nonsedentary activity decreased in men; light activity remained constant in women (~30%). Older men had fewer CPM at night (~20), more daytime sedentary minutes (~3), fewer daytime light physical activity minutes (~4), and more MVPA minutes (~1) until early evening than older women. Although sex differences in average CPM declined with age, differences in nonsedentary activity time emerged as men increased sedentary behavior and reduced MVPA time. Maintained levels of light-intensity activity suggest that women continue engaging in common daily activities into older age more than men. Findings may help inform the development of behavioral interventions to increase intensity and overall activity levels, particularly in older adults. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Relationship between the trajectory of mid-latitude cyclones in the eastern Pacific Ocean and the isotopic composition of snowfall in the Sierra Nevada, California

NASA Astrophysics Data System (ADS)

Vasquez, K. T.; Sickman, J. O.; Lucero, D. M.; Heard, A. M.

2014-12-01

Climate change has caused a change in the Sierra Nevada snowpack and the timing of its snowmelt, threatening a valuable water resource that provides for 25 million people and 5 million hectares of irrigated land. Understanding past and future variations in the snowpack is crucial in order to plan future water management. Of particular importance would be an archive of the variability of past snowfall, which can be recorded through the isotopic records found in local paleoproxies (e.g., diatoms). We propose to quantify the relationship between sources of atmospheric moisture in the Sierra Nevada and the isotopic composition of its snowpack to uncover whether isotopic variations recorded in paloearchives are a result of the isotopic composition of the precipitation, thereby showing whether these archives could serve as a reliable source of atmospheric moisture. Preliminary analysis conducted from December 2012 to March 2013 at Sequoia National Park resulted in statistically significant correlations between the isotopic composition of the winter snowfall and storm track trajectories. It was observed that storms originating from more northern latitudes had predominantly lighter isotopes (more negative δ 2H and δ18O) and sub-tropical/tropical Pacific storms showed more positive δ 2H and δ18O. This pattern reflects the isotopic gradient of the Pacific Ocean and can prove useful when interpreting the climatic significance of the δ2H and δ18O values in analyzed proxies. While our initial investigation was promising, the winter of 2012 -2013 was abnormally dry compared to long-term averages. Before directing our investigation to known paleoproxies, we aim to determine if the correlation between storm tracks and isotopic composition of precipitation holds in years with average and above average precipitation through analysis of archived samples from calendar years 2007 - 2011 from Giant Forest in Sequoia National Park (southern sierra) and Manzanita Lake in Lassen Volcanic National Park (northern sierra).

Hawai'i Island Health Workforce Assessment 2008.

PubMed

Withy, Kelley; Andaya, January; Vitousek, Sharon; Sakamoto, David

2009-12-01

Anecdotal reports of a doctor shortage on the Big Island have been circulating for years, but a detailed assessment of the health care workforce had not previously been accomplished. The Hawai'i Island Health Workforce Assessment used licensure data, focus groups, telephone follow up to provider offices, national estimates of average provider supply and analysis of insurance claims data to assess the extent of the existing medical and mental health workforce, approximate how many additional providers might be effectively utilized, develop a population-based estimate of future demand and identify causes and potential solutions for the challenges faced. As of February 2008, the researchers were able to locate 310 practicing physicians, 36 nurse practitioners, 6 physician assistants, 51 psychologists, 57 social workers and 42 other mental health providers. Based on national averages, claims analysis and focus groups, the Island could use approximately 45 additional medical professionals to care for the 85% of the population that is medically insured; a larger number to care for the entire population. Ascertaining a complete roster of mental health professionals was not possible using this methodology. The researchers compared the current supply of physicians with the national average of physicians to population and the number of visits to different specialists for the year 2006 and found specific regional shortages of providers. The focus groups concentrated on solutions to the workforce crisis that include the formation of a well-organized, broad collaboration to coordinate recruitment efforts, expand and strengthen retention and renewal activities, and reinvigorate the health profession pipeline and training opportunities. The researchers recommend collaboration between the community, government, business, health center care providers, hospitals and centers to develop a plan before the tenuous state of healthcare on the Big Island worsens. In addition, continued surveillance of the health workforce is vital to tracking the impact of interventions. This could be accomplished through community informants and data collected at the time of professional relicensure to include practice location and practice intensions for future planning estimates.

Perceptions of Global Warming Among the Poorest Counties in the Southeastern United States.

PubMed

Kearney, Gregory D; Bell, Ronny A

2018-03-07

The geographic position and high level of poverty in the southeastern United States are significant risk factors that contribute to the region's high vulnerability to climate change. The goal of this study was to evaluate beliefs and perceptions of global warming among those living in poverty in the poorest counties in the southeastern United States. Results from this project may be used to support public health efforts to increase climate-related messaging to vulnerable and underserved communities. This was an ecological study that analyzed public opinion poll estimates from previously gathered national level survey data (2016). Responses to 5 questions related to beliefs, attitudes, and perceptions of global warming were evaluated. Counties below the national average poverty level (13.5%) were identified among 11 southeastern US states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Michigan, North Carolina, South Carolina, Tennessee, Virginia). Student t tests were used to compare public perceptions of global warming among the poorest urban and rural counties with national-level public opinion estimates. Overall, counties below the national poverty level in the southeastern US were significantly less likely to believe that global warming was happening compared with national-level estimates. The poorest rural counties were less likely to believe that global warming was happening than the poorest urban counties. Health care providers and public health leaders at regional and local levels are in ideal positions to raise awareness and advocate the health implications of climate change to decision makers for the benefit of helping underserved communities mitigate and adequately adapt to climate-related threats.

Summary of the Validation of the Second Version of the Aster Gdem

NASA Astrophysics Data System (ADS)

Meyer, D. J.; Tachikawa, T.; Abrams, M.; Crippen, R.; Krieger, T.; Gesch, D.; Carabajal, C.

2012-07-01

On October 17, 2011, NASA and the Ministry of Economy, Trade and Industry (METI) of Japan released the second version of the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) Global Digital Elevation Model (GDEM) to users worldwide at no charge as a contribution to the Global Earth Observing System of Systems (GEOSS). The first version of the ASTER GDEM, released on June 29, 2009, was compiled from over 1.2 million scene-based DEMs covering land surfaces between 83°N and 83°S latitudes. The second version (GDEM2) incorporates 260,000 additional scenes to improve coverage, a smaller correlation kernel to yield higher spatial resolution, and improved water masking. As with GDEM1, US and Japanese partners collaborated to validate GDEM2. Its absolute accuracy was within -0.20 meters on average when compared against 18,000 geodetic control points over the conterminous US (CONUS), with an accuracy of 17 meters at the 95% confidence level. The Japan study noted the GDEM2 differed from the 10-meter national elevation grid by -0.7 meters over bare areas, and by 7.4 meters over forested areas. The CONUS study noted a similar result, with the GDEM2 determined to be about 8 meters above the 1 arc-second US National Elevation Database (NED) over most forested areas, and more than a meter below NED over bare areas. A global ICESat study found the GDEM2 to be on average within 3 meters of altimeter-derived control. The Japan study noted a horizontal displacement of 0.23 pixels in GDEM2. A study from the US National Geospatial Intelligence Agency also determined horizontal displacement and vertical accuracy as compared to the 1 arc-second Shuttle Radar Topography Mission DEM. US and Japanese studies estimated the horizontal resolution of the GDEM2 to be between 71 and 82 meters. Finally, the number of voids and artifacts noted in GDEM1 were substantially reduced in GDEM2.

Association between Long-Term Exposure to Particulate Matter Air Pollution and Mortality in a South Korean National Cohort: Comparison across Different Exposure Assessment Approaches

PubMed Central

Kim, Sun-Young; Kim, Ho

2017-01-01

Increasing numbers of cohort studies have reported that long-term exposure to ambient particulate matter is associated with mortality. However, there has been little evidence from Asian countries. We aimed to explore the association between long-term exposure to particulate matter with a diameter ≤10 µm (PM10) and mortality in South Korea, using a nationwide population-based cohort and an improved exposure assessment (EA) incorporating time-varying concentrations and residential addresses (EA1). We also compared the association across different EA approaches. We used information from 275,337 people who underwent health screening from 2002 to 2006 and who had follow-up data for 12 years in the National Health Insurance Service-National Sample Cohort. Individual exposures were computed as 5-year averages using predicted residential district-specific annual-average PM10 concentrations for 2002–2006. We estimated hazard ratios (HRs) of non-accidental and five cause-specific mortalities per 10 µg/m3 increase in PM10 using the Cox proportional hazards model. Then, we compared the association of EA1 with three other approaches based on time-varying concentrations and/or addresses: predictions in each year and addresses at baseline (EA2); predictions at baseline and addresses in each year (EA3); and predictions and addresses at baseline (EA4). We found a marginal association between long-term PM10 and non-accidental mortality. The HRs of five cause-specific mortalities were mostly higher than that of non-accidental mortality, but statistically insignificant. In the comparison between EA approaches, the HRs of EA1 were similar to those of EA2 but higher than EA3 and EA4. Our findings confirmed the association between long-term exposure to PM10 and mortality based on a population-representative cohort in South Korea, and suggested the importance of assessing individual exposure incorporating air pollution changes over time. PMID:28946613

Perception of e-cigarette harm and its correlation with use among U.S. adolescents.

PubMed

Amrock, Stephen M; Zakhar, Joseph; Zhou, Sherry; Weitzman, Michael

2015-03-01

U.S. adolescents increasingly use e-cigarettes. The perceived harm of e-cigarettes has not been described, nor has the correlation between harm perception and e-cigarette use been assessed. This study examines correlates of e-cigarette harm perception and use of e-cigarettes in a national survey. We used cross-sectional nationally representative data from the 2012 National Youth Tobacco Survey (n = 24,658). Cross-tabulations and multivariate ordered probit and logistic regression models were employed to assess relative harm perception and e-cigarette use. Half of U.S. adolescents had heard of e-cigarettes. Of these, 13.2% (95% confidence interval [CI] = 11.7-14.9) and 4.0% (95% CI = 3.4-4.7) reported ever or currently using e-cigarettes, respectively. Of those aware of e-cigarettes, 34.2% (95% CI = 32.8-35.6) believed e-cigarettes were less harmful than cigarettes. Among those trying e-cigarettes, 71.8% (95% CI = 69.0-74.5) believed e-cigarettes were comparatively less harmful. Females and those ≥ 17 years old were more likely to perceive e-cigarettes as more harmful relative to cigarettes, while on average Whites, users of other tobacco products, and those with family members who used tobacco were more likely to perceive e-cigarettes as comparatively safer. Among cigarette-naive e-cigarette users, use of other tobacco products and perceived harm reduction by e-cigarettes were, respectively, on average associated with 1.6 and 4.1 percentage-point increases in e-cigarette use. Perception of e-cigarettes as less harmful than conventional cigarettes was associated with increased e-cigarette use, including among cigarette-naive e-cigarette users. These findings should prompt further scientific investigation and merit attention from regulators. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Recent Trends in National Institutes of Health Funding of Surgical Research

PubMed Central

Rangel, Shawn J.; Efron, Bradley; Moss, R. Lawrence

2002-01-01

Objective To compare the amount of National Institutes of Health (NIH) funding provided to departments of surgery with that provided to other major clinical departments, to examine the relationship between peer-review activity and funding success, and to compare trends in participation in the peer-review process between surgeons and representatives from other clinical departments. Summary Background Data Surgical research has made enormous contributions to human health. This work is fundamentally dependent on fair and unbiased distribution of extramural research funds from the NIH. To date, no published report has examined the relative distribution of extramural support between departments of surgery and other major clinical departments. Methods Data regarding funding trends and peer-review activity were obtained from the NIH and compared between departments of surgery and four nonsurgical departments (medicine, psychiatry, pediatrics, neurology). Award data were examined during 1996 to 2001. Participation trends were examined during 1998 to 2000. Results Success rates of surgical proposals were significantly lower than nonsurgical proposals. Differentials in success rates were greatest for proposals assigned to the National Cancer Institute, although relative underfunding for surgical research spanned all major institutes. Awards for surgical grants averaged 5% to 27% less than nonsurgical grants). Surgeons exhibited 35% to 65% less peer-review activity relative to nonsurgeons when normalized to grant submission activity. Overall, surgeons participated on sections where they made up a relatively smaller proportion of total review members compared to nonsurgeons. Conclusions Surgical grant proposals are less likely to be funded and carry significantly smaller awards compared to nonsurgical proposals. Relatively fewer surgeons participate in the review process, and those who do are more likely to be in the minority within study sections. Multiple strategies are needed to address these trends and level the playing field for surgical research. PMID:12192314

Quality assessment of online patient education resources for peripheral neuropathy.

PubMed

Hansberry, David R; Suresh, Ragha; Agarwal, Nitin; Heary, Robert F; Goldstein, Ira M

2013-03-01

Given its practicality, the internet is a primary resource for patients afflicted with diseases like peripheral neuropathy. Therefore, it is important that the readily available online resources on peripheral neuropathy are tailored to the general public, particularly concerning readability. Patient education resources were downloaded from the US National Library of Medicine, Mayo Clinic, National Institute of Neurological Disorders and Stroke, Neuropathy.org, GBS/CIDP Foundation International, Hereditary Neuropathy Foundation, Charcot-Marie-Tooth Association, Foundation for Peripheral Neuropathy, and Neuropathy Action Foundation websites. All patient education material related to peripheral neuropathy was evaluated for its level of readability using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level. The FRE scores averaged 43.4 with only the US National Library of Medicine scoring above 60 (76.5). The Flesch-Kincaid Grade Level scores averaged 11.0. All scores were above a seventh-grade level except the US National Library of Medicine, which had a score of a fifth-grade reading level. Most Americans may not fully benefit from patient education resources concerning peripheral neuropathy education on many of the websites. Only the US National Library of Medicine, which is written at a fifth-grade level, is likely to benefit the average American. © 2013 Peripheral Nerve Society.

An estimation of Canadian population exposure to cosmic rays.

PubMed

Chen, Jing; Timmins, Rachel; Verdecchia, Kyle; Sato, Tatsuhiko

2009-08-01

The worldwide average exposure to cosmic rays contributes to about 16% of the annual effective dose from natural radiation sources. At ground level, doses from cosmic ray exposure depend strongly on altitude, and weakly on geographical location and solar activity. With the analytical model PARMA developed by the Japan Atomic Energy Agency, annual effective doses due to cosmic ray exposure at ground level were calculated for more than 1,500 communities across Canada which cover more than 85% of the Canadian population. The annual effective doses from cosmic ray exposure in the year 2000 during solar maximum ranged from 0.27 to 0.72 mSv with the population-weighted national average of 0.30 mSv. For the year 2006 during solar minimum, the doses varied between 0.30 and 0.84 mSv, and the population-weighted national average was 0.33 mSv. Averaged over solar activity, the Canadian population-weighted average annual effective dose due to cosmic ray exposure at ground level is estimated to be 0.31 mSv.

The Slowdown in Employer Insurance Cost Growth: Why Many Workers Still Feel the Pinch.

PubMed

Collins, Sara R; Radley, David C; Gunja, Munira Z; Beutel, Sophie

2016-10-01

Issue: Although predictions that the Affordable Care Act (ACA) would lead to reductions in employer-sponsored health coverage have not been realized, some of the law’s critics maintain the ACA is nevertheless driving higher premium and deductible costs for businesses and their workers. Goal: To compare cost growth in employer-sponsored health insurance before and after 2010, when the ACA was enacted, and to compare changes in these costs relative to changes in workers’ incomes. Methods: The authors analyzed federal Medical Expenditure Panel Survey data to compare cost trends over the 10-year period from 2006 to 2015. Key findings and conclusions: Compared to the five years leading up to the ACA, premium growth for single health insurance policies offered by employers slowed both in the nation overall and in 33 states and the District of Columbia. There has been a similar slowdown in growth in the amounts employees contribute to health plan costs. Yet many families feel pinched by their health care costs: despite a recent surge, income growth has not kept pace in many areas of the U.S. Employee contributions to premiums and deductibles amounted to 10.1 percent of U.S. median income in 2015, compared to 6.5 percent in 2006. These costs are higher relative to income in many southeastern and southern states, where incomes are below the national average.

Return-to-play rates in National Football League linemen after treatment for lumbar disk herniation.

PubMed

Weistroffer, Joseph K; Hsu, Wellington K

2011-03-01

There is a paucity of evidence demonstrating clinical outcomes of high-end athletes sustaining a treatment for lumbar disk herniation. To evaluate the ability of a National Football League lineman to return to play after lumbar diskectomy. Case series; Level of evidence, 4. National Football League offensive and defensive linemen diagnosed with a lumbar disk herniation were identified by previously published protocols using multiple sources of the public record. Demographic and statistical performance data were compiled for each player both before and after treatment. A total of 66 linemen (36 offensive and 30 defensive) met the inclusion criteria. Fifty-two were treated surgically, and 14 were treated nonsurgically. On average, this group had a body mass index of 35.4 and was 27.6 years old. Of those players treated surgically, 80.8% (42/52) successfully returned to play an average of 33 games over 3.0 years, with 63.5% (33/52) becoming starters after treatment. Conversely, only 28.6% (4/14) of linemen successfully returned to play after nonoperative intervention, which was significantly lower than those treated with a diskectomy (P < .05). Of the linemen in the surgical cohort, 13.5% (7/52) required revision decompression, and 85.7% (6/7) of these players successfully returned to play. National Football League linemen have high return-to-play rates after lumbar diskectomy. Furthermore, because those linemen requiring revision decompression successfully returned to play 85.7% of the time, this cohort should not be denied surgical treatment after recurrent problems. Although the data in our study suggest that National Football League linemen who are treated surgically have superior outcomes to those treated nonoperatively, because of the limitations with the methodology used in this study, further prospective studies are necessary to accurately compare treatment effects and to determine the long-term prognosis for these athletes after retirement.

Gender Differences in Hospital CEO Compensation: A National Investigation of Not-for-Profit Hospitals.

PubMed

Song, Paula H; Lee, Shoou-Yih Daniel; Toth, Matthew; Singh, Simone R; Young, Gary J

2018-01-01

Gender pay equity is a desirable social value and an important strategy to fill every organizational stratum with gender-diverse talent to fulfill an organization's goals and mission. This study used national, large-sample data to examine gender difference in CEO compensation among not-for-profit hospitals. Results showed the average unadjusted annual compensation for female CEOs in 2009 was $425,085 compared with $581,121 for male CEOs. With few exceptions, the difference existed across all types of not-for-profit hospitals. After controlling for hospital- and area-level characteristics, female CEOs of not-for-profit hospitals earned 22.6% less than male CEOs of not-for-profit hospitals. This translates into an earnings differential of $132,652 associated with gender. Explanations and implications of the results are discussed.

The relationship between alcohol price and brand choice among underage drinkers: are the most popular alcoholic brands consumed by youth the cheapest?

PubMed

Albers, Alison B; DeJong, William; Naimi, Timothy S; Siegel, Michael; Jernigan, David H

2014-11-01

We examined the influence of price on alcohol brand choice among underage youth. Using a national sample of 1,032 youth, ages 13-20, recruited from a national Internet panel in 2011-2012, we compared differences in mean prices between popular and unpopular brands, examined the association of price and brand popularity using logistic regression, and rank ordered the average price of top brands. Lower brand-specific prices were significantly associated with higher levels of past 30-day consumption prevalence. However, youth did not preferentially consume the cheapest brands. These findings indicate that youth have preferences for certain brands, even if those brands cost more than competing brands. Our study highlights the need for research on the impact of brand-specific alcohol marketing on underage drinking.

Effects of drug price reduction and prescribing restrictions on expenditures and utilisation of antihypertensive drugs in Korea

PubMed Central

Yoo, Ki-Bong; Lee, Sang Gyu; Park, Sohee; Kim, Tae Hyun; Ahn, Jeonghoon; Cho, Mee-Hyun; Park, Eun-Cheol

2015-01-01

Objectives To evaluate the quantitative effects of the drug price reduction on pharmaceutical expenditures and the new guidelines to restrict prescribing on drug utilisation for antihypertensive drugs. Design We used an interrupted time series design with the National patient sample data of Health Insurance Review and Assessment Service in South Korea. Methods 54 295 participants who were with primary hypertension from the National patient sample data of Health Insurance Review and Assessment Service were included. The study period was from March 2011 to December 2013. The dependent variables were antihypertensive drug costs, antihypertensive drug cost per prescribing day, daily drug utilisation, average number of drugs per month, percentage of original drugs per prescription, drug overutilisation and prohibited combinations. Segmented regression analysis was used. Results The drug price reduction reduced expenditure (US$−1.51, −10.2%), and the new guidelines reduced expenditures even more (US$−2.13; −16.2%). These policies saved US$4.22 (28%) of antihypertensive drug costs per patient in December 2013 compared to March 2012. Drug price reduction policy was introduced in April 2012. We established the policy effect by comparing it before (March 2012) with after(21 months later-December 2012). The effects of the guidelines decreased expenditures, daily drug utilisation and the average number of drugs per month more than did the drug price reduction. Conclusions Both policies saved money. The guidelines were more effective over time and had fewer side effects such as increasing daily drug utilisation and number of drugs than the effects of drug price reduction. PMID:26179644

Aggregate Interview Method of ranking orthopedic applicants predicts future performance.

PubMed

Geissler, Jacqueline; VanHeest, Ann; Tatman, Penny; Gioe, Terence

2013-07-01

This article evaluates and describes a process of ranking orthopedic applicants using what the authors term the Aggregate Interview Method. The authors hypothesized that higher-ranking applicants using this method at their institution would perform better than those ranked lower using multiple measures of resident performance. A retrospective review of 115 orthopedic residents was performed at the authors' institution. Residents were grouped into 3 categories by matching rank numbers: 1-5, 6-14, and 15 or higher. Each rank group was compared with resident performance as measured by faculty evaluations, the Orthopaedic In-Training Examination (OITE), and American Board of Orthopaedic Surgery (ABOS) test results. Residents ranked 1-5 scored significantly better on patient care, behavior, and overall competence by faculty evaluation (P<.05). Residents ranked 1-5 scored higher on the OITE compared with those ranked 6-14 during postgraduate years 2 and 3 (P⩽.5). Graduates who had been ranked 1-5 had a 100% pass rate on the ABOS part 1 examination on the first attempt. The most favorably ranked residents performed at or above the level of other residents in the program; they did not score inferiorly on any measure. These results support the authors' method of ranking residents. The rigorous Aggregate Interview Method for ranking applicants consistently identified orthopedic resident candidates who scored highly on the Accreditation Council for Graduate Medical Education resident core competencies as measured by faculty evaluations, performed above the national average on the OITE, and passed the ABOS part 1 examination at rates exceeding the national average. Copyright 2013, SLACK Incorporated.

School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011.

PubMed

Strøm, Ida Frugård; Schultz, Jon-Håkon; Wentzel-Larsen, Tore; Dyb, Grete

2016-01-01

The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking. This study investigated academic performance, absenteeism, and school support amongst survivors of a terrorist attack in Norway. Data from a longitudinal interview study were linked to officially registered grades of students (N=64) who successfully completed their 3-year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors' registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support. The students' grades were lower the year after the event than they had been the year before, and they were also lower than the national grade point average (p<0.001). However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support. The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved 2 years after the event. The findings underscore the importance of keeping trauma-exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma-sensitive teaching.

[Evaluation of continuing medical training in private sector French cardiologists in 1999].

PubMed

Thébaut, J F; Chabot, J M; Durand, J P; Childs, M; Assouline, S; Breton, C; Fraboulet, J Y; Sebaoun, A; Aviérinos, C

2001-09-01

The authors present the results of a retrospective national enquiry which took place in 1999 and was mailed and faxed to the 3,800 cardiologists practising in the private sector in order to assess the different types of continuous, individual and collective postgraduate training which they had benefited from in the preceding 12 months. The data was analysed by comparison with that obtained from an individualized representative sample in a panel of private sector cardiologists. The results were then compared with the criteria of a yardstick proposed by the National Committee of Continuous Medical Education of 1997, according to the April 25th 1996 decree. The meeting of these criteria would require carrying out 114,000 to 76,000 hour-equivalents of continuous education whereas the present offer is about 100,000 hour-equivalents. The different forms of individual or collective training were compared in the 327 questionnaires which were exploitable following adhesion to the French Society of Cardiology, to the Cardiologists' Union, to local cardiological societies, by age, gender and type of practice. The average number of annual hours of collective education was 52.2 +/- 60.1 hours (25% quartile = 25 hours, 75% = 60 hours). The average value of hours of individual education was 89.7 +/- 89.3 hours (25% quartile = 25 hours; 75% = 120 hours). This evaluation indicates that about 15% of cardiologists practising in the private sector have inadequate continuous medical education and that 68% would satisfy the criteria laid down in 1997. Moreover, the present offer would seem to be adequate providing the criteria of accreditation have been met.

Obsidian hydration dates glacial loading?

USGS Publications Warehouse

Friedman, I.; Pierce, K.L.; Obradovich, J.D.; Long, W.D.

1973-01-01

Three different groups of hydration rinds have been measured on thin sections of obsidian from Obsidian Cliff, Yellowstone National Park, Wyoming . The average thickness of the thickest (oldest) group of hydration rinds is 16.3 micrometers and can be related to the original emplacement of the flow 176,000 years ago (potassium-argon age). In addition to these original surfaces, most thin sections show cracks and surfaces which have average hydration rind thicknesses of 14.5 and 7.9 micrometers. These later two hydration rinds compare closely in thickness with those on obsidian pebbles in the Bull Lake and Pinedale terminal moraines in the West Yellowstone Basin, which are 14 to 15 and 7 to 8 micrometers thick, respectively. The later cracks are thought to have been formed by glacial loading during the Bull Lake and Pinedale glaciations, when an estimated 800 meters of ice covered the Obsidian Cliff flow.

Obsidian hydration dates glacial loading?

PubMed

Friedman, I; Pierce, K L; Obradovich, J D; Long, W D

1973-05-18

Three different groups of hydration rinds have been measured on thin sections of obsidian from Obsidian Cliff, Yellowstone National Park, Wyoming. The average thickness of the thickest (oldest) group of hydration rinds is 16.3 micrometers and can be related to the original emplacement of the flow 176,000 years ago (potassium-argon age). In addition to these original surfaces, most thin sections show cracks and surfaces which have average hydration rind thicknesses of 14.5 and 7.9 micrometers. These later two hydration rinds compare closely in thickness with those on obsidian pebbles in the Bull Lake and Pinedale terminal moraines in the West Yellowstone Basin, which are 14 to 15 and 7 to 8 micrometers thick, respectively. The later cracks are thought to have been formed by glacial loading during the Bull Lake and Pinedale glaciations, when an estimated 800 meters of ice covered the Obsidian Cliff flow.

State trends in the cost of employer health insurance coverage, 2003-2013.

PubMed

Schoen, Cathy; Radley, David; Collins, Sara R

2015-01-01

From 2010 to 2013--the years following the implementation of the Affordable Care Act--there has been a marked slowdown in premium growth in 31 states and the District of Columbia. Yet, the costs employees and their families pay out-of-pocket for deductibles and their share of premiums continued to rise, consuming a greater share of incomes across the country. In all but a handful of states, average deductibles more than doubled over the past decade for employees working in large and small firms. Workers are paying more but getting less protective benefits. Costs are particularly high, compared with median income, in Southern and South Central states, where incomes are below the national average. Based on recent forecasts that predict an uptick in private insurance growth rates starting in 2015, securing slow cost growth for workers, families, and employers will likely require action to address rising costs of medical care services.

NOAA - National Oceanic and Atmospheric Administration - Antarctic Ozone

Science.gov Websites

Hole Returns to Near Average Levels NOAA HOME WEATHER OCEANS FISHERIES CHARTING SATELLITES Returns to Near Average Levels Improvement Noted After Last Year's Record Breaker November 1, 2007 The

Manufacturer's Policies Concerning Average Fuel Economy Standards

DOT National Transportation Integrated Search

1979-01-01

The National Highway Traffic Safety Administration (NHTSA) has been given the responsibility for implementing the average fuel economy standards for passenger automobiles mandated by the Energy Policy and Conservation Act (P.L. 94-163). The standards...

EPA's Summary Report of the Collaborative Green ...

EPA Pesticide Factsheets

The United States Environmental Protection Agency evaluated the performance of a hybrid green-gray infrastructure pilot project installed into the Marlborough Neighborhood by the Kansas City Water Services Department. Kansas City installed 135 vegetated SCMs, 24,290 square feet of porous or permeable pavement, and 292,000 gallons of underground storage space in the residential neighborhood which drained 54% of the total 100 areas studied. Independently, both the Environmental Protection Agency and Kansas City determined that the green-gray combined infrastructure reduced the sewer flow runoff volume by approximately 30% in the combined sewer when the after test conditions were compared to before test conditions. It was also determined that the average drop in concentrations was 52% +/-34% for total suspended solids, 51% +/-33% suspended solid concentration, 37% +/-22% national turbidity units, and 50% average diameter particle size was 21% +/-59% when the outlet from one bioretention measure was compared to the inlet. There was only one storm in which nitrate and phosphate could be compared. The nitrate concentration was reduced by 52% and phosphate reduced by 57%. All analyzed influent samples were non-detect for lead and zinc (< 50 ug/L). Greater than 50% of the total copper concentrations were in the dissolved form. Fecal coliform concentrations were unexpectedly high, with concentrations often above the upper detection limit of 6 million most probable

Experiences of radiological examinations of buildings in Hungary.

PubMed

Homoki, Zsolt; Rell, Péter; Déri, Zsolt; Kocsy, Gábor

2017-05-01

Natural radioisotopes occur everywhere in the environment, being a source of exposure to the general population. Everyone is continuously exposed to terrestrial and cosmic radiations both indoors and outdoors, which are the main contributors to external exposure of individuals. There were made many ambient dose rate and indoor gamma radiation and radon concentration measurements in Hungarian by different laboratories. The main goal of the present work is the summarisation and evaluation of the latest results of the Laboratory of National Public Health Center National Research Directorate for Radiobiology and Radiohygiene. The reviewed examinations were made between 1995 and 2016. The average ambient dose rate was 103 ± 17 nSv/h and the average indoor gamma dose rate was 155 ± 47 nSv/h based on the data of 382 and 581 sampling points, respectively. The average indoor radon concentration was 108 Bq/m 3 with the median value of 75 Bq/m 3 based on the data of 415 sampling points. We performed an additional analysis of the results of 233 personal surveyed buildings where sophisticated gamma radiation and/or indoor radon concentration measurements were made. We were also interested in has got any affect the presence of slag to the radiation levels of the buildings? We found that usually elevated radiation can be detected in houses which contain slag compared to buildings without slag. In addition we conclude that the recommended minimum duration of short-term radon measurement shall be at least three days even if it does by closed conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Automated algorithm for mapping regions of cold-air pooling in complex terrain

NASA Astrophysics Data System (ADS)

Lundquist, Jessica D.; Pepin, Nicholas; Rochford, Caitlin

2008-11-01

In complex terrain, air in contact with the ground becomes cooled from radiative energy loss on a calm clear night and, being denser than the free atmosphere at the same elevation, sinks to valley bottoms. Cold-air pooling (CAP) occurs where this cooled air collects on the landscape. This article focuses on identifying locations on a landscape subject to considerably lower minimum temperatures than the regional average during conditions of clear skies and weak synoptic-scale winds, providing a simple automated method to map locations where cold air is likely to pool. Digital elevation models of regions of complex terrain were used to derive surfaces of local slope, curvature, and percentile elevation relative to surrounding terrain. Each pixel was classified as prone to CAP, not prone to CAP, or exhibiting no signal, based on the criterion that CAP occurs in regions with flat slopes in local depressions or valleys (negative curvature and low percentile). Along-valley changes in the topographic amplification factor (TAF) were then calculated to determine whether the cold air in the valley was likely to drain or pool. Results were checked against distributed temperature measurements in Loch Vale, Rocky Mountain National Park, Colorado; in the Eastern Pyrenees, France; and in Yosemite National Park, Sierra Nevada, California. Using CAP classification to interpolate temperatures across complex terrain resulted in improvements in root-mean-square errors compared to more basic interpolation techniques at most sites within the three areas examined, with average error reductions of up to 3°C at individual sites and about 1°C averaged over all sites in the study areas.

National stereotypes of older people's competence are related to older adults' participation in paid and volunteer work.

PubMed

Bowen, Catherine E; Skirbekk, Vegard

2013-11-01

Why are older people perceived as more competent in some countries relative to others? In the current study, we investigate the extent to which national variation in perceptions of older people's competence is systematically related to national variation in the extent to which older people participate in paid and volunteer work. We used multilevel regression to analyze data from the European Social Survey and test the relationship between perceptions of older people's competence and older people's participation in paid and volunteer work across 28 countries. We controlled for a number of potentially confounding variables, including life expectancy as well as the gender ratio and average education of the older population in each country. We controlled for the average objective cognitive abilities of the older population in a subsample of 11 countries. Older people were perceived as more competent in countries in which more older people participated in paid or volunteer work, independent of life expectancy and the average education, gender makeup, and average cognitive abilities of the older population. The results suggest that older people's participation in paid and volunteer work is related to perceptions of older people's competence independent of older people's actual competence.

Lidar-Based Estimates of Above-Ground Biomass in the Continental US and Mexico Using Ground, Airborne, and Satellite Observations

NASA Technical Reports Server (NTRS)

Nelson, Ross; Margolis, Hank; Montesano, Paul; Sun, Guoqing; Cook, Bruce; Corp, Larry; Andersen, Hans-Erik; DeJong, Ben; Pellat, Fernando Paz; Fickel, Thaddeus;

UK audit of glomerular filtration rate measurement from plasma sampling in 2013.

PubMed

Murray, Anthony W; Lawson, Richard S; Cade, Sarah C; Hall, David O; Kenny, Bob; O'Shaughnessy, Emma; Taylor, Jon; Towey, David; White, Duncan; Carson, Kathryn

2014-11-01

An audit was carried out into UK glomerular filtration rate (GFR) calculation. The results were compared with an identical 2001 audit. Participants used their routine method to calculate GFR for 20 data sets (four plasma samples) in millilitres per minute and also the GFR normalized for body surface area. Some unsound data sets were included to analyse the applied quality control (QC) methods. Variability between centres was assessed for each data set, compared with the national median and a reference value calculated using the method recommended in the British Nuclear Medicine Society guidelines. The influence of the number of samples on variability was studied. Supplementary data were requested on workload and methodology. The 59 returns showed widespread standardization. The applied early exponential clearance correction was the main contributor to the observed variability. These corrections were applied by 97% of centres (50% - 2001) with 80% using the recommended averaged Brochner-Mortenson correction. Approximately 75% applied the recommended Haycock body surface area formula for adults (78% for children). The effect of the number of samples used was not significant. There was wide variability in the applied QC techniques, especially in terms of the use of the volume of distribution. The widespread adoption of the guidelines has harmonized national GFR calculation compared with the previous audit. Further standardization could further reduce variability. This audit has highlighted the need to address the national standardization of QC methods. Radionuclide techniques are confirmed as the preferred method for GFR measurement when an unequivocal result is required.

Parental Influence on Their Adult Children's Sexual Values: A Multi-National Comparison Between the United States, Spain, Costa Rica, and Peru.

PubMed

Negy, Charles; Velezmoro, Rodrigo; Reig-Ferrer, Abilio; Smith-Castro, Vanessa; Livia, Jose

2016-02-01

We examined the influence of perceived parental sexual values, religiosity, and family environment on young adults' sexual values from the United States (n = 218), Spain (n = 240), Costa Rica (n = 172), and Peru (n = 105). On average, and across the four national groups, the messages young adults received from their parents about broad domains of sexual behaviors (masturbation, non-intercourse types of heterosexual sexual activity, premarital sex, same-sex activity, and cohabiting) were unequivocally restrictive. By contrast, across the four groups, young adults on average held rather permissive sexual values and their values differed significantly from those of their parents. Moreover, the nature of perceived parental sexual values (restrictive vs. permissive) was not associated significantly with young adults' sexual values, age of sexual debut, or number of sexual partners. Comparatively, Spanish young adults held the most permissive sexual values, whereas US young adults held the most restrictive sexual values. Religiosity was the strongest predictor of young adults' sexual values, followed by perceived parental sexual values and influence. In conclusion, it appears that despite having perceived restrictive parental messages about sex, these young adults currently hold permissive sexual attitudes, thus calling into question the influence parents actually have on their adult children's sexual values.

Phase Angle of Bioelectrical Impedance Analysis as Prognostic Factor in Palliative Care Patients at the National Cancer Institute in Mexico.

PubMed

Pérez Camargo, Dana A; Allende Pérez, Silvia R; Rivera Franco, Mónica M; Álvarez Licona, Nelson E; Urbalejo Ceniceros, Víctor I; Figueroa Baldenegro, Lilian E

2017-01-01

Patients with advanced cancer often experience symptoms of disease and treatment that contribute to distress such as weight loss, which is present in up to 85% of cancer patients. Palliative care in these patients focuses on care aimed at improving quality of life. Phase angle (PA) is obtained by bioelectric impedance analysis (BIA) and is associated with cellular function. It is considered a reliable marker of malnutrition. A low PA may suggest deterioration of the cell membrane, which in palliative patients may result in a short-term survival. The aim of this study was to associate PA and survival in palliative patients of the National Cancer Institute of Mexico. We included 452 patients (women, 56.4%); the average PA was 4.0°. The most frequent disease was gastric cancer (39.2%). Mean body mass index (BMI) was 22.84. The average survival of patients with PA ≤ 4° was 86 days, while in the group with PA > 4°, it was 163 days (P > 0.0001). PA showed significant positive correlation with survival time and BMI. Our results corroborate the reliability of PA in Mexican population, as an indicator of survival in palliative care patients compared to the reported literature in other countries.

External cause-specific summaries of occupational fatal injuries. Part II: an analysis of years of potential life lost.

PubMed

Bailer, A John; Bena, James F; Stayner, Leslie T; Halperin, William E; Park, Robert M

2003-03-01

Fatal injury surveillance data provide an opportunity to assess the impact of occupational injuries and may indicate which industries or occupations are appreciably more hazardous than others, and thus should be given priority in public health intervention. Fatalities from the National Traumatic Occupational Fatality surveillance system served as the basis for examining external cause (E-code) specific impact summaries. Years of potential life lost (YPLL) were calculated for fatal injuries in the years 1983-1994. Industries and occupations were compared with respect to frequency of fatal injuries. In addition, injuries in categories of external causes are examined across all industries and occupations. Machinery, electric current, homicide, falls, and transportation-related are the external cause groups highlighted by high frequency/rate of occurrence. Electric current event groups are also characterized by high average YPLL. Poisoning, conflagration, and lightning were also identified in several occupations as having high associated average YPLL. The external-cause-specific analysis of average YPLL identified industries and occupations where, on average, younger workers were dying in fatal injuries. Noteworthy in this assessment were homicides and falls. The YPLL measure coupled with more commonly employed indices (e.g., rates) may provide a fuller description of the impact of occupational fatal injuries.

Phylloquinone (vitamin K₁) intake and pulse pressure as a measure of arterial stiffness in older adults.

PubMed

Vaccaro, Joan A; Huffman, Fatma G

2013-01-01

This study examined the relationships among ethnicity/race, lifestyle factors, phylloquinone (vitamin K₁) intake, and arterial pulse pressure in a nationally representative sample of older adults from four ethnic/racial groups: non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, and other Hispanics. This was a cross-sectional study of U.S. representative sample with data from the National Health and Nutrition Examination Surveys, 2007-2008 and 2009-2010 of adults aged 50 years and older (N = 5296). Vitamin K intake was determined by 24-hour recall. Pulse pressure was calculated as the difference between the averages of systolic blood pressure and diastolic blood pressure. Compared to White non-Hispanics, the other ethnic/racial groups were more likely to have inadequate vitamin K₁ intake. Inadequate vitamin K₁ intake was an independent predictor of high arterial pulse pressure. This was the first study that compared vitamin K₁ inadequacy with arterial pulse pressure across ethnicities/races in U.S. older adults. These findings suggest that vitamin K screening may be a beneficial marker for the health of older adults.

A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff.

PubMed

Vanhegan, I S; Malik, A K; Jayakumar, P; Ul Islam, S; Haddad, F S

2012-05-01

Revision arthroplasty of the hip is expensive owing to the increased cost of pre-operative investigations, surgical implants and instrumentation, protracted hospital stay and drugs. We compared the costs of performing this surgery for aseptic loosening, dislocation, deep infection and peri-prosthetic fracture. Clinical, demographic and economic data were obtained for 305 consecutive revision total hip replacements in 286 patients performed at a tertiary referral centre between 1999 and 2008. The mean total costs for revision surgery in aseptic cases (n = 194) were £11 897 (sd 4629), for septic revision (n = 76) £21 937 (sd 10 965), for peri-prosthetic fracture (n = 24) £18 185 (sd 9124), and for dislocation (n = 11) £10 893 (sd 5476). Surgery for deep infection and peri-prosthetic fracture was associated with longer operating times, increased blood loss and an increase in complications compared to revisions for aseptic loosening. Total inpatient stay was also significantly longer on average (p < 0.001). Financial costs vary significantly by indication, which is not reflected in current National Health Service tariffs.

Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

PubMed Central

2011-01-01

Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable to host community members was higher than that for refugees. There was no statistically significant difference between the size of the male and female populations across refugee settlements. Across all settlements reporting to the UNHCR database, the percent of the refugee population that was less than five years of age is 16% on average. Conclusions The availability of a centralized database of health information across UNHCR-supported refugee settlements is a rich resource. The SPHERE standard for emergencies of 1-4 visits per person per year appears to be relevant for Asia in the post-emergency phase, but not for Africa. In Africa, a post-emergency standard of 1-2 visits per person per year should be considered. Although it is often assumed that the size of the female population in refugee settlements is higher than males, we found no statistically significant difference between the size of the male and female populations in refugee settlements overall. Another assumption---that the under-fives make up 20% of the settlement population during the emergency phase---does not appear to hold for the post-emergency phase; under-fives made up about 16% of refugee settlement populations. PMID:21936911

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2011 CFR

2011-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2014 CFR

2014-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2012 CFR

2012-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2013 CFR

2013-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

Floristic summary of 22 National Parks in the Midwestern United States

USGS Publications Warehouse

Bennett, J.P.

1996-01-01

Biological diversity is studied at many geographical scales, but specimen collecting is invariably done at a local level. Collecting of animal and plant specimens leads to the compilation of checklists for multiple small areas, which are sometimes merged to produce larger, regional checklists. Such an approach was employed to study the regional vascular flora of 22 national parks of the midwestern United States. Total number of plant taxa (species level and below) ranged from 86 at Hopewell Culture National Historical Park to 1,399 at Indiana Dunes National Lakeshore and averaged 520 per park. Infraspecific taxa were 12% or less of all taxa at all parks and averaged 7%. Genera per parkranged from 70 to 562, and families ranged from 41 to 145. Non-native species averaged 95 per park, or about 27% on average of the total number of taxa per park. The aggregated regional flora contained just over 2,900 taxa, 828 genera and 160 families. Eleven percent of the taxa were below the species level. Almost 17% of the taxa were non-native, a relatively large percentage, but not out of the range of percentages reported in the literature. The observed and estimated numbers of taxa for this region were in good agreement with other estimates for these latitudes and for a standard regional size. However, the parks do not represent their respective state floras very well when they are aggregated at that scale. Indiana was the best represented state with 65% of the state flora found in the parks, while only 25% of each state's flora were represented by parks in Iowa, Kansas, and Nebraska, and the average representation was only 42%.

Daylight Redirecting Window Films

DTIC Science & Technology

2013-09-01

58) • Energy Independence and Security Act of 2007 (P.L. 110-140) • National Defense Authorization Act for FY 2007 (P.L. 109-364) • National Defense...Authorization Act for FY 2008 (P.L. 110-181) • National Defense Authorization Act for FY 2009 (P.L. 10-417) • Executive Order 13423 • Executive...green-house gas equivalents based on national averages Green-house- gas-equivalent conversion factor for national level usage. Embedded

Compensatory Education: An Analysis of National Versus State and Local Evaluations.

ERIC Educational Resources Information Center

Stickney, Benjamin D.

Discrepancies between the pessimistic national evaluations and the more encouraging state and local evaluations of compensatory education programs are explored in this paper. A conventional explanation for the discrepancies, namely, that the averaging of test scores from a large national sample "cancels out" the results of successful…

The effect of fire on mercury cycling in the soils of forested watersheds: Acadia National Park, Maine, U.S.A

USGS Publications Warehouse

Amirbahman, A.; Ruck, P.L.; Fernandez, I.J.; Haines, T.A.; Kahl, J.S.

2004-01-01

This study compares mercury (Hg) and methylmercury (MeHg) distribution in the soils of two forested stream watersheds at Acadia National Park, Maine, U.S.A. Cadillac Brook watershed, which burned in 1947, has thin soils and predominantly deciduous vegetation. It was compared to the unburned Hadlock Brook watershed, with thicker soil and predominantly coniferous vegetation. Soils in both watersheds were primarily well drained. The fire had a significant impact on the Cadillac watershed, by raising the soil pH, altering the vegetation, and reducing carbon and Hg pools. Total Hg content was significantly higher (P < 0.05) in Hadlock soils (0.18 kg Hg ha-1) compared to Cadillac soils (0. 13 kg Hg ha-1). Hadlock O horizon had an average Hg concentration of 134??48 ng Hg g-1 dry weight, compared to 103??23 ng Hg g-1 dry weight in Cadillac O horizon. Soil pH was significantly higher in all soil horizons at Cadillac compared to Hadlock soils. This difference was especially significant in the O horizon, where Cadillac soils had an average pH of 3.41??0.22 compared to Hadlock soils with an average pH of 2.99??0.13. To study the mobilization potential of Hg in the O horizons of the two watersheds, batch adsorption experiments were conducted, and the results were modeled using surface complexation modeling. The results of Hg adsorption experiments indicated that the dissolved Hg concentration was controlled by the dissolved organic carbon (DOC) concentration. The adsorption isotherms suggest that Hg is more mobile in the O horizon of the unburned Hadlock watershed because of higher solubility of organic carbon resulting in higher DOC concentrations in that watershed. Methylmercury concentrations, however, were consistently higher in the burned Cadillac O horizon (0.20??0.13 ng Hg g-1 dry weight) than in the unburned Hadlock O horizon (0.07??0.07 ng Hg g-1 dry weight). Similarly, Cadillac soils possessed a higher MeHg content (0.30 g MeHg ha-1) than Hadlock soils (0.16 g MeHg ha-1). The higher MeHg concentrations in Cadillac soils may reflect generally faster rates of microbial metabolism due to more rapid nutrient cycling and higher soil pH in the deciduous forest. In this research, we have shown that the amount of MeHg is not a function of the total pool of Hg in the watershed. Indeed, MeHg was inversely proportional to total Hg, suggesting that landscape factors such as soil pH, vegetation type, or land use history (e.g., fire) may be the determining factors for susceptibility to high Hg in biota. ?? 2004 Kluwer Academic Publisher. Printed in the Netherlands.

Epidemiology of Parkinson disease in the city of Kolkata, India

PubMed Central

Das, S.K.; Misra, A.K.; Ray, B.K.; Hazra, A.; Ghosal, M.K.; Chaudhuri, A.; Roy, T.; Banerjee, T.K.; Raut, D.K.

2010-01-01

Objective: No well-designed longitudinal study on Parkinson disease (PD) has been conducted in India. Therefore, we planned to determine the prevalence, incidence, and mortality rates of PD in the city of Kolkata, India, on a stratified random sample through a door-to-door survey. Method: This study was undertaken between 2003 to 2007 with a validated questionnaire by a team consisting of 4 trained field workers in 3 stages. Field workers screened the cases, later confirmed by a specialist doctor. In the third stage, a movement disorders specialist undertook home visits and reviewed all surviving cases after 1 year from last screening. Information on death was collected through verbal autopsy. A nested case-control study (1:3) was also undertaken to determine putative risk factors. The rates were age adjusted to the World Standard Population. Result: A total population of 100,802 was screened. The age-adjusted prevalence rate (PR) and average annual incidence rate were 52.85/100,000 and 5.71/100,000 per year, respectively. The slum population showed significantly decreased PR with age compared with the nonslum population. The adjusted average annual mortality rate was 2.89/100,000 per year. The relative risk of death was 8.98. The case-control study showed that tobacco chewing protected and hypertension increased PD occurrence. Conclusion: This study documented lower prevalence and incidence of PD as compared with Caucasian and a few Oriental populations. The mortality rates were comparable. The decreased age-specific PR among slum populations and higher relative risk of death need further probing. GLOSSARY AAIR = average annual incidence rate; AAMR = average annual mortality rate; CI = confidence interval; FSQ = family screening questionnaire; ICC = intraclass correlation coefficient; IR = incidence rate; MD = movement disorder; NSSO = National Sample Survey Organization; OR = odds ratio; PD = Parkinson disease; PPS = parkinsonism plus syndrome; PR = prevalence rate; PRM = Poisson regression modeling; RR = relative risk; SP = secondary parkinsonism; VA = verbal autopsy. PMID:20938028

Faculty and resident evaluations of medical students on a surgery clerkship correlate poorly with standardized exam scores.

PubMed

Goldstein, Seth D; Lindeman, Brenessa; Colbert-Getz, Jorie; Arbella, Trisha; Dudas, Robert; Lidor, Anne; Sacks, Bethany

2014-02-01

The clinical knowledge of medical students on a surgery clerkship is routinely assessed via subjective evaluations from faculty members and residents. Interpretation of these ratings should ideally be valid and reliable. However, prior literature has questioned the correlation between subjective and objective components when assessing students' clinical knowledge. Retrospective cross-sectional data were collected from medical student records at The Johns Hopkins University School of Medicine from July 2009 through June 2011. Surgical faculty members and residents rated students' clinical knowledge on a 5-point, Likert-type scale. Interrater reliability was assessed using intraclass correlation coefficients for students with ≥4 attending surgeon evaluations (n = 216) and ≥4 resident evaluations (n = 207). Convergent validity was assessed by correlating average evaluation ratings with scores on the National Board of Medical Examiners (NBME) clinical subject examination for surgery. Average resident and attending surgeon ratings were also compared by NBME quartile using analysis of variance. There were high degrees of reliability for resident ratings (intraclass correlation coefficient, .81) and attending surgeon ratings (intraclass correlation coefficient, .76). Resident and attending surgeon ratings shared a moderate degree of variance (19%). However, average resident ratings and average attending surgeon ratings shared a small degree of variance with NBME surgery examination scores (ρ(2) ≤ .09). When ratings were compared among NBME quartile groups, the only significant difference was for residents' ratings of students with the lower 25th percentile of scores compared with the top 25th percentile of scores (P = .007). Although high interrater reliability suggests that attending surgeons and residents rate students with consistency, the lack of convergent validity suggests that these ratings may not be reflective of actual clinical knowledge. Both faculty members and residents may benefit from training in knowledge assessment, which will likely increase opportunities to recognize deficiencies and make student evaluation a more valuable tool. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial

PubMed Central

Smith, Ellen M. Lavoie; Pang, Herbert; Cirrincione, Constance; Fleishman, Stewart; Paskett, Electra D.; Ahles, Tim; Bressler, Linda R.; Fadul, Camilo E.; Knox, Chetaye; Le-Lindqwister, Nguyet; Gilman, Paul B.; Shapiro, Charles L.

2013-01-01

Context There are no known effective treatments for painful chemotherapy-induced peripheral neuropathy (CIPN). Objective The primary objective was to determine the effect of duloxetine 60 mg daily on CIPN “average” pain severity Design Randomized, double-blind, placebo-controlled crossover Setting Eight National Cancer Institute (NCI)-funded cooperative research networks recruited patients from community and academic settings between April 2008 and March 2011. Study follow-up was completed July 2012. Patients 231 patients ≥ 25 years of age were randomized (stratified by chemotherapy drug and CIPN comorbid risk) to receive either duloxetine followed by placebo or placebo followed by duloxetine. Eligible patients reported ≥ Grade 1 sensory CIPN per the NCI Common Toxicity Criteria for Adverse Events and ≥ 4/10 average CIPN-related pain following paclitaxel or oxaliplatin treatment. 81% completed the initial treatment period. Intervention The initial treatment consisted of duloxetine/placebo 30mg/one capsule daily for the first week, then 60mg/two capsules for four additional weeks Outcome Measure The primary hypothesis was that duloxetine would be more effective than placebo in decreasing CIPN pain. Pain severity was assessed using the Brief Pain Inventory-Short Form “average pain” item [0 (no pain) – 10 (as bad as can imagine)]. Results Individuals receiving duloxetine as initial treatment (weeks 1–5) reported a larger mean decrease in average pain (1.06; 95% CI: 0.72, 1.40) compared to placebo-treated patients (0.34; 95% CI: 0.01, 0.66) (p = 0.003) (effect size = 0.513). The observed mean difference in the average pain score between the duloxetine and placebo groups was 0.73 (95% CI: 0.26, 1.20). 59% of duloxetine-treated patients compared to 38% of placebo-treated patients reported decreased pain of any amount. Conclusions Among patients with painful CIPN, the use of duloxetine compared with placebo for 5 weeks resulted in a greater reduction in pain. PMID:23549581

The effects of raking on sugar pine mortality following prescribed fire in Sequoia and Kings Canyon National Parks, California, USA

USGS Publications Warehouse

Nesmith, Jonathan C. B.; O'Hara, Kevin L.; van Mantgem, Phillip J.; de Valpine, Perry

2010-01-01

Prescribed fire is an important tool for fuel reduction, the control of competing vegetation, and forest restoration. The accumulated fuels associated with historical fire exclusion can cause undesirably high tree mortality rates following prescribed fires and wildfires. This is especially true for sugar pine (Pinus lambertiana Douglas), which is already negatively affected by the introduced pathogen white pine blister rust (Cronartium ribicola J.C. Fisch. ex Rabenh). We tested the efficacy of raking away fuels around the base of sugar pine to reduce mortality following prescribed fire in Sequoia and Kings Canyon national parks, California, USA. This study was conducted in three prescribed fires and included 457 trees, half of which had the fuels around their bases raked away to mineral soil to 0.5 m away from the stem. Fire effects were assessed and tree mortality was recorded for three years after prescribed fires. Overall, raking had no detectable effect on mortality: raked trees averaged 30% mortality compared to 36% for unraked trees. There was a significant effect, however, between the interaction of raking and average pre-treatment forest floor fuel depth: the predicted probability of survival of a 50 cm dbh tree was 0.94 vs. 0.96 when average pre-treatment fuel depth was 0 cm for a raked and unraked tree, respectively. When average pre-treatment forest floor fuel depth was 30 cm, the predicted probability of survival for a raked 50 cm dbh tree was 0.60 compared to only 0.07 for an unraked tree. Raking did not affect mortality when fire intensity, measured as percent crown volume scorched, was very low (0% scorch) or very high (>80% scorch), but the raking treatment significantly increased the proportion of trees that survived by 9.6% for trees that burned under moderate fire intensity (1% to 80% scorch). Raking significantly reduced the likelihood of bole charring and bark beetle activity three years post fire. Fuel depth and anticipated fire intensity need to be accounted for to maximize the effectiveness of the treatments. Raking is an important management option to reduce tree mortality from prescribed fire, but is most effective under specific fuel and burning conditions.

Potential for erroneous interpretation of poisoning outcomes due to changes in National Poison Data System reporting.

PubMed

Anderson, Bruce; Ke, Xuehua; Klein-Schwartz, Wendy

2010-08-01

In 2006, the annual report of poison centers in the United States changed the method of reporting profiles for generic substance categories from all exposures to single-substance exposures only. The objective of this study is to describe the potential impact of this reporting change on longitudinal analysis of outcomes. Generic substance categories with data available for all years of the study were manually extracted from Table 22 of the National Poison Data System (NPDS) annual reports for 2002-2007. For each generic substance category, the following data were extracted for each of the 6 years: total number of substance mentions (2002-2005) or single-substance exposures (2006-2007), reason (unintentional or intentional), pediatric exposures (children age <6 years), and outcomes of major effect and death. Data were compared using descriptive analysis (Wilcoxon signed-rank test) and negative binomial regression. There were 65 generic substance categories (30 drug categories and 35 nondrug categories) that had data in all study years. For drug categories the average annual number of reported deaths by substance category decreased by 80.8%, from 2,229 in year 2002-2005 to 428 after the 2006 reporting change (p < 0.0001). The average annual number of reported major outcomes by substance category dropped by 76.0% (p < 0.0001). The impact on nondrug categories was similar: the annual average number of deaths and major effects by substance category decreased by about 50% from 394 and 4,639 per year during 2002-2005 to 198 deaths (p < 0.0001) and 2,357 major effects (p ≤ 0.0001) during 2006-2007. After controlling for potential covariates, multivariate regression showed that there were significant decreases in average rates of reported deaths (61.7 and 35.9%) and major effects (36.3 and 11.2%) for drug categories and nondrug categories, respectively (p < 0.01 for all). Overall rates of major outcomes and deaths reported to poison control centers from 2002 to 2007 have remained constant. The new method of describing demographic data in Table 22 results in outcomes that are different from those reported in previous NPDS annual reports. Comparing NPDS generic substance outcome data before and after the reporting change in 2006 will yield inaccurate results if the change in reporting methodology is not taken into account.

Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates

PubMed Central

Hamidi, Samer

2015-01-01

Introduction A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). Methods The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). Results In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers. PMID:25750545

Epidemiology of burns undergoing hospitalization to the National Burns Unit in the Sultanate of Oman: a 25-year review.

PubMed

Al-Shaqsi, Sultan; Al-Kashmiri, Ammar; Al-Bulushi, Taimoor

2013-12-01

The aim of this study was to describe the epidemiology of burns admitted to the National Burns Unit (NBU) in the Sultanate of Oman between 1987 and 2011. This is a retrospective review of burn patients admitted to Oman's National Burns Unit (NBU) between 1987 and 2011. The data extracted from the national burn registry. The study describes the admission rate by gender and age groups, occupation, causes of burns, time-to-admission, length of stay and in-hospital mortality of burns between 1987 and 2011. During a 25-year from 1987 to 2011, there were 3531 burn patients admitted to the National Burns Unit in Oman. The average admission rate to NBU is 7.02 per 100,000 persons per year. On average, males were more likely to be admitted to the NBU than females during the study period (P value < 0.04). Patients aged 1-10 years old constituted 46.6% of caseload during the study period. Flames and scalds caused 88.4% of burns. About half of all patients admitted to the NBU have burns to more than 11% of total body surface area (TBSA). The average stay in hospital was estimated to be 15.3 days per patient. The average in-hospital mortality rate was estimated to be 8.2% per year (range 1.9-22%). Burns are significant public health issue in the Sultanate of Oman. Children are disproportionately over-represented in this study. Prevention programmes are urgently needed to address this "silent and costly epidemic." Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Extended-hours hemodialysis is associated with lower mortality risk in patients with end-stage renal disease

PubMed Central

Rivara, Matthew B.; Adams, Scott V.; Kuttykrishnan, Sooraj; Kalantar-Zadeh, Kamyar; Arah, Onyebuchi A.; Cheung, Alfred K.; Katz, Ronit; Molnar, Miklos Z.; Ravel, Vanessa; Soohoo, Melissa; Streja, Elani; Himmelfarb, Jonathan; Mehrotra, Rajnish

2016-01-01

Extended-hours hemodialysis offers substantially longer treatment time compared to conventional hemodialysis schedules and is associated with improved fluid and electrolyte control and favorable cardiac remodeling. However, whether extended-hours hemodialysis improves survival remains unclear. Therefore, we determined the association between extended-hours compared to conventional hemodialysis and the risk of all-cause mortality in a nationally representative cohort of patients initiating maintenance dialysis in the United States from 2007 to 2011. Survival analyses using causal inference modeling with marginal structural models were performed to compare mortality risk among 1,206 individuals undergoing thrice weekly extended-hours hemodialysis or 111,707 patients receiving conventional hemodialysis treatments. The average treatment time per session for extended-hours hemodialysis was 399 minutes compared to 211 minutes for conventional therapy. The crude mortality rate with extended-hours hemodialysis was 6.4 deaths per 100 patient-years compared with 14.7 deaths per 100 patient-years for conventional hemodialysis. In the primary analysis, patients treated with extended-hours hemodialysis had a 33% lower adjusted risk of death compared to those who were treated with a conventional regimen (95% confidence interval: 7% to 51%). Additional analyses accounting for analytical assumptions regarding exposure and outcome, facility-level confounders, and prior modality history were similar. Thus, in this large nationally representative cohort, treatment with extended-hours hemodialysis was associated with a lower risk for mortality compared to treatment with conventional in-center therapy. Adequately powered randomized clinical trials comparing extended-hours to conventional hemodialysis are required to confirm these findings. PMID:27555118

Using national hip fracture registries and audit databases to develop an international perspective.

PubMed

Johansen, Antony; Golding, David; Brent, Louise; Close, Jacqueline; Gjertsen, Jan-Erik; Holt, Graeme; Hommel, Ami; Pedersen, Alma B; Röck, Niels Dieter; Thorngren, Karl-Göran

2017-10-01

Hip fracture is the commonest reason for older people to need emergency anaesthesia and surgery, and leads to prolonged dependence for many of those who survive. People with this injury are usually identified very early in their hospital care, so hip fracture is an ideal marker condition with which to audit the care offered to older people by health services around the world. We have reviewed the reports of eight national audit programmes, to examine the approach used in each, and highlight differences in case mix, management and outcomes in different countries. The national audits provide a consistent picture of typical patients - an average age of 80 years, with less than a third being men, and a third of all patients having cognitive impairment - but there was surprising variation in the type of fracture, of operation and of anaesthesia and hospital length of stay in different countries. These national audits provide a unique opportunity to compare how health care systems of different countries are responding to the same clinical challenge. This review will encourage the development and reporting of a standardised dataset to support international collaboration in healthcare audit. Copyright © 2017 Elsevier Ltd. All rights reserved.

Weatherization Works: Final Report of the National Weatherization Evaluation

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

Brown, M.A.

2001-02-01

In 1990, the US Department of Energy (DOE) sponsored a comprehensive evaluation of its Weatherization Assistance Program, the nation's largest residential energy conservation program. Oak Ridge National Laboratory (ORNL) managed the five-part study. This document summarizes the findings of the evaluation. Its conclusions are based mainly on data from the 1989 program year. The evaluation concludes that the Program meets the objectives of its enabling legislation and fulfills its mission statement. Specifically, it saves energy, lowers fuel bills, and improves the health and safety of dwellings occupied by low-income people. In addition, the Program achieves its mission in a cost-effectivemore » manner based on each of three perspectives employed by the evaluators. Finally, the evaluation estimates that the investments made in 1989 will, over a 20-year lifetime, save the equivalent of 12 million barrels of oil, roughly the amount of oil added to the Strategic Petroleum Reserve in each of the past several years. The Program's mission is to reduce the heating and cooling costs for low-income families--particularly the elderly, persons with disabilities, and children by improving the energy efficiency of their homes and ensuring their health and safety. Substantial progress has been made, but the job is far from over. The Department of Health and Human Services (HHS) reports that the average low-income family spends 12 percent of its income on residential energy, compared to only 3% for the average-income family. Homes where low-income families live also have a greater need for energy efficiency improvements, but less money to pay for them.« less

National Economic Development Procedures Manual. Coastal Storm Damage and Erosion

DTIC Science & Technology

1991-09-01

study area is temperate with warm summers and moderate winters. The annual temperature averages approximately 53 degrees Fahrenheit (*F). On average ...January is the coolest month with a mean temperature of 32°F and July is the warmest month. The average annual precipitation is about 45 inches with...0704.0188 Public rooing burden for rhr$ LoIlecton of ,nformaton .s estma eO to average I hour oer resiorse including the time for resrewing inttuctiOn

Our nation's highways 2000

DOT National Transportation Integrated Search

2002-04-29

The information in this publication provides a condensed overview of facts and figures about the Nation's Highways. This publication is designed to be of interest to the average citizen. The Federal Highway Administration (FHWA) is the source of the ...

Corporate Average Fuel Economy Compliance and Effects Modeling System Documentation

DOT National Transportation Integrated Search

2009-04-01

The Volpe National Transportation Systems Center (Volpe Center) of the United States Department of Transportation's Research and Innovative Technology Administration has developed a modeling system to assist the National Highway Traffic Safety Admini...

Peak Running Intensity of International Rugby: Implications for Training Prescription.

PubMed

Delaney, Jace A; Thornton, Heidi R; Pryor, John F; Stewart, Andrew M; Dascombe, Ben J; Duthie, Grant M

2017-09-01

To quantify the duration and position-specific peak running intensities of international rugby union for the prescription and monitoring of specific training methodologies. Global positioning systems (GPS) were used to assess the activity profile of 67 elite-level rugby union players from 2 nations across 33 international matches. A moving-average approach was used to identify the peak relative distance (m/min), average acceleration/deceleration (AveAcc; m/s 2 ), and average metabolic power (P met ) for a range of durations (1-10 min). Differences between positions and durations were described using a magnitude-based network. Peak running intensity increased as the length of the moving average decreased. There were likely small to moderate increases in relative distance and AveAcc for outside backs, halfbacks, and loose forwards compared with the tight 5 group across all moving-average durations (effect size [ES] = 0.27-1.00). P met demands were at least likely greater for outside backs and halfbacks than for the tight 5 (ES = 0.86-0.99). Halfbacks demonstrated the greatest relative distance and P met outputs but were similar to outside backs and loose forwards in AveAcc demands. The current study has presented a framework to describe the peak running intensities achieved during international rugby competition by position, which are considerably higher than previously reported whole-period averages. These data provide further knowledge of the peak activity profiles of international rugby competition, and this information can be used to assist coaches and practitioners in adequately preparing athletes for the most demanding periods of play.

Validation of XCO2 derived from SWIR spectra of GOSAT TANSO-FTS with aircraft measurement data

NASA Astrophysics Data System (ADS)

Inoue, M.; Morino, I.; Uchino, O.; Miyamoto, Y.; Yoshida, Y.; Yokota, T.; Machida, T.; Sawa, Y.; Matsueda, H.; Sweeney, C.; Tans, P. P.; Andrews, A. E.; Biraud, S. C.; Tanaka, T.; Kawakami, S.; Patra, P. K.

2013-10-01

Column-averaged dry air mole fractions of carbon dioxide (XCO2) retrieved from Greenhouse gases Observing SATellite (GOSAT) Short-Wavelength InfraRed (SWIR) observations were validated with aircraft measurements by the Comprehensive Observation Network for TRace gases by AIrLiner (CONTRAIL) project, the National Oceanic and Atmospheric Administration (NOAA), the US Department of Energy (DOE), the National Institute for Environmental Studies (NIES), the HIAPER Pole-to-Pole Observations (HIPPO) program, and the GOSAT validation aircraft observation campaign over Japan. To calculate XCO2 based on aircraft measurements (aircraft-based XCO2), tower measurements and model outputs were used for additional information near the surface and above the tropopause, respectively. Before validation, we investigated the impacts of GOSAT SWIR column averaging kernels (CAKs) and the shape of a priori profiles on the aircraft-based XCO2 calculation. The differences between aircraft-based XCO2 with and without the application of GOSAT CAK were evaluated to be less than ±0.4 ppm at most, and less than ±0.1 ppm on average. Therefore, we concluded that the GOSAT CAK produces only a minor effect on the aircraft-based XCO2 calculation in terms of the overall uncertainty of GOSAT XCO2. We compared GOSAT data retrieved within ±2 or ±5° latitude/longitude boxes centered at each aircraft measurement site to aircraft-based data measured on a GOSAT overpass day. The results indicated that GOSAT XCO2 over land regions agreed with aircraft-based XCO2, except that the former is biased by -0.68 ppm (-0.99 ppm) with a standard deviation of 2.56 ppm (2.51 ppm), whereas the averages of the differences between the GOSAT XCO2 over ocean and the aircraft-based XCO2 were -1.82 ppm (-2.27 ppm) with a standard deviation of 1.04 ppm (1.79 ppm) for ±2° (±5°) boxes.

Validation of XCH4 derived from SWIR spectra of GOSAT TANSO-FTS with aircraft measurement data

NASA Astrophysics Data System (ADS)

Inoue, M.; Morino, I.; Uchino, O.; Miyamoto, Y.; Saeki, T.; Yoshida, Y.; Yokota, T.; Sweeney, C.; Tans, P. P.; Biraud, S. C.; Machida, T.; Pittman, J. V.; Kort, E. A.; Tanaka, T.; Kawakami, S.; Sawa, Y.; Tsuboi, K.; Matsueda, H.

2014-09-01

Column-averaged dry-air mole fractions of methane (XCH4), retrieved from Greenhouse gases Observing SATellite (GOSAT) short-wavelength infrared (SWIR) spectra, were validated by using aircraft measurement data from the National Oceanic and Atmospheric Administration (NOAA), the US Department of Energy (DOE), the National Institute for Environmental Studies (NIES), the HIAPER Pole-to-Pole Observations (HIPPO) program, and the GOSAT validation aircraft observation campaign over Japan. In the calculation of XCH4 from aircraft measurements (aircraft-based XCH4), other satellite data were used for the CH4 profiles above the tropopause. We proposed a data-screening scheme for aircraft-based XCH4 for reliable validation of GOSAT XCH4. Further, we examined the impact of GOSAT SWIR column averaging kernels (CAK) on the aircraft-based XCH4 calculation and found that the difference between aircraft-based XCH4 with and without the application of the GOSAT CAK was less than ±9 ppb at maximum, with an average difference of -0.5 ppb. We compared GOSAT XCH4 Ver. 02.00 data retrieved within ±2° or ±5° latitude-longitude boxes centered at each aircraft measurement site with aircraft-based XCH4 measured on a GOSAT overpass day. In general, GOSAT XCH4 was in good agreement with aircraft-based XCH4. However, over land, the GOSAT data showed a positive bias of 1.5 ppb (2.0 ppb) with a standard deviation of 14.9 ppb (16.0 ppb) within the ±2° (±5°) boxes, and over ocean, the average bias was 4.1 ppb (6.5 ppb) with a standard deviation of 9.4 ppb (8.8 ppb) within the ±2° (±5°) boxes. In addition, we obtained similar results when we used an aircraft-based XCH4 time series obtained by curve fitting with temporal interpolation for comparison with GOSAT data.

The Quality Indicator Survey: background, implementation, and widespread change.

PubMed

Lin, Michael K; Kramer, Andrew M

2013-01-01

The Quality Indicator Survey (QIS) is the most comprehensive regulatory change to the nursing home survey process since the Omnibus Budget Reconciliation Act of 1987 (OBRA-87). In this article we describe the policy evolution that led to the QIS, summarize the QIS method and implementation, and profile the QIS survey results. Following over a decade of development, in 2007 the Centers for Medicare and Medicaid Services (CMS) began the national rollout of QIS. The intent was to improve consistency in the nursing home survey and to render the survey process more resident-centered and aligned with the intent of OBRA-87. We reviewed policy reports and firsthand accounts from the lead developer of the QIS methodology and leader of the national training contract for QIS. Changes in survey findings are profiled based on analysis of the publicly available Nursing Home Compare database from 2004 to 2010. Nineteen states implemented the QIS between 2007 and 2010, with nearly 20% of U.S. nursing homes receiving QIS surveys in 2010. Nursing homes surveyed with the QIS received more survey deficiencies on average than in the traditional survey; however, average numbers of deficiencies across states became more similar over the early implementation of QIS, with lower-than-average geographic areas experiencing increases and higher-than-average geographic areas experiencing decreases in survey deficiencies. The explicit and structured questioning of residents in the QIS is associated with increases in deficiencies related to choice, dignity, dental care, and nurse staffing. We describe ways in which the QIS affected the regulatory agencies, providers, and resident communities, although these effects are difficult to quantify. CMS's implementation of QIS is a significant step toward a more resident-centered, comprehensive, and consistent survey process. Substantial changes, however, are required not only among regulators but also among nursing homes. We argue that these new expectations and norms surrounding quality assessment and quality assurance are an important component of achieving culture change in U.S. nursing homes.

Spatiotemporal exposure modeling of ambient erythemal ultraviolet radiation.

PubMed

VoPham, Trang; Hart, Jaime E; Bertrand, Kimberly A; Sun, Zhibin; Tamimi, Rulla M; Laden, Francine

2016-11-24

Ultraviolet B (UV-B) radiation plays a multifaceted role in human health, inducing DNA damage and representing the primary source of vitamin D for most humans; however, current U.S. UV exposure models are limited in spatial, temporal, and/or spectral resolution. Area-to-point (ATP) residual kriging is a geostatistical method that can be used to create a spatiotemporal exposure model by downscaling from an area- to point-level spatial resolution using fine-scale ancillary data. A stratified ATP residual kriging approach was used to predict average July noon-time erythemal UV (UV Ery ) (mW/m 2 ) biennially from 1998 to 2012 by downscaling National Aeronautics and Space Administration (NASA) Total Ozone Mapping Spectrometer (TOMS) and Ozone Monitoring Instrument (OMI) gridded remote sensing images to a 1 km spatial resolution. Ancillary data were incorporated in random intercept linear mixed-effects regression models. Modeling was performed separately within nine U.S. regions to satisfy stationarity and account for locally varying associations between UV Ery and predictors. Cross-validation was used to compare ATP residual kriging models and NASA grids to UV-B Monitoring and Research Program (UVMRP) measurements (gold standard). Predictors included in the final regional models included surface albedo, aerosol optical depth (AOD), cloud cover, dew point, elevation, latitude, ozone, surface incoming shortwave flux, sulfur dioxide (SO 2 ), year, and interactions between year and surface albedo, AOD, cloud cover, dew point, elevation, latitude, and SO 2 . ATP residual kriging models more accurately estimated UV Ery at UVMRP monitoring stations on average compared to NASA grids across the contiguous U.S. (average mean absolute error [MAE] for ATP, NASA: 15.8, 20.3; average root mean square error [RMSE]: 21.3, 25.5). ATP residual kriging was associated with positive percent relative improvements in MAE (0.6-31.5%) and RMSE (3.6-29.4%) across all regions compared to NASA grids. ATP residual kriging incorporating fine-scale spatial predictors can provide more accurate, high-resolution UV Ery estimates compared to using NASA grids and can be used in epidemiologic studies examining the health effects of ambient UV.

Variations in Patterns of Utilization and Charges for the Care of Low Back Pain in North Carolina, 2000 to 2009: A Statewide Claims' Data Analysis.

PubMed

Hurwitz, Eric L; Li, Dongmei; Guillen, Jenni; Schneider, Michael J; Stevans, Joel M; Phillips, Reed B; Phelan, Shawn P; Lewis, Eugene A; Armstrong, Richard C; Vassilaki, Maria

2016-05-01

The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by patterns of care for the treatment of low back pain in North Carolina. This was an analysis of low-back-pain-related closed claim data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, 9th Revision diagnostic codes for uncomplicated low back pain (ULBP) and complicated low back pain (CLBP). Care patterns with single-provider types and no referrals incurred the least charges on average for both ULBP and CLBP. When care did not include referral providers or services, for ULBP, MD and DC care was on average $465 less than MD and PT care. For CLBP, MD and DC care averaged $965 more than MD and PT care. However, when care involved referral providers or services, MD and DC care was on average $1600 less when compared to MD and PT care for ULBP and $1885 less for CLBP. Risk-adjusted charges (available 2006-2009) for patients in the middle quintile of risk were significantly less for DC care patterns. Chiropractic care alone or DC with MD care incurred appreciably fewer charges for ULBP than MD care with or without PT care. This finding was reversed for CLBP. Adjusted charges for both ULBP and CLBP patients were significantly lower for DC patients. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Is public health between East and West? Analysis of wealth, health and mortality in Austria, Central and Eastern European Countries and Croatia relative to the European Union.

PubMed

Hofmarcher, M M

1998-09-01

To provide a conceptual framework for health planning activities in the "middle income" transition countries. Economic, demographic, and disease-related data in Central and Eastern European (CEE) countries, including Croatia and Austria, were compared to the Europen Union (EU) average. Data were selected from the databases provided by the World Health Organization, Organization for Economic Cooperation and Development, World Bank, United Nations, and the European Bank of Reconstruction and Development. Life expectancy and mortality were extrapolated until the year 2000 by using an exponential growth model for the WHO time series data, starting in 1994. Death rates due to ischemic heart diseases (18%) and cerebrovascular diseases (13%) were selected to show frequent causes of death. Relative to the EU average, the gross domestic product (GDP) share of health expenditures in transition countries was disproportionate to wealth and premature death. The population in CEE-countries was younger and the share of people aged >65 was predicted to remain about 15% below the EU average and Austria. For Croatia, the share of people aged 65 would be on the increase, similar to the share predicted for Austria (slightly above the EU average). Mortality of selected non-communicable, chronic diseases is predicted to increase and remain relatively high. Mortality rates due to infectious diseases have been declining but remained comparatively on a high level. Coexistence of demographic and epidemiological transition along with high mortality rates due to infectious diseases creates a "double burden". Economic transition has the potential to comprise both the increase in wealth, and life and health expectancy.

Beyond an “Either-Or” Approach to Home- and Center-Based Child Care: Comparing Children and Families who Combine Care Types with Those Who Use Just One

PubMed Central

Gordon, Rachel A.; Colaner, Anna; Usdansky, Margaret L.; Melgar, Claudia

2013-01-01

Most research focuses on preschoolers’ primary non-parental child care arrangement despite evidence that multiple arrangements are relatively common. Using the nationally-representative Early Childhood Longitudinal Study, Birth Cohort, we compare characteristics and outcomes of families whose 4-year olds attend both home- and center-based child care with those who attend either home- or center-based care exclusively or receive no non-parental care at all. We find that about one fifth of 4-year olds attend both home- and center-based child care. Mothers’ priorities for care (getting their child ready for school, matching their families’ cultural background) and perceptions of good local care options predict their combining home- and center-based care. Preschoolers score higher on reading and math assessments, on average, when they attend centers, alone or in combination with home-based child care, than when they are cared for only in homes, either by their parents or by others. Preschoolers’ average socioemotional outcomes generally do not differ between families who do and who do not combine care types. Implications for research and policy are discussed. PMID:24187434

Measurement error in time-series analysis: a simulation study comparing modelled and monitored data.

PubMed

Butland, Barbara K; Armstrong, Ben; Atkinson, Richard W; Wilkinson, Paul; Heal, Mathew R; Doherty, Ruth M; Vieno, Massimo

2013-11-13

Assessing health effects from background exposure to air pollution is often hampered by the sparseness of pollution monitoring networks. However, regional atmospheric chemistry-transport models (CTMs) can provide pollution data with national coverage at fine geographical and temporal resolution. We used statistical simulation to compare the impact on epidemiological time-series analysis of additive measurement error in sparse monitor data as opposed to geographically and temporally complete model data. Statistical simulations were based on a theoretical area of 4 regions each consisting of twenty-five 5 km × 5 km grid-squares. In the context of a 3-year Poisson regression time-series analysis of the association between mortality and a single pollutant, we compared the error impact of using daily grid-specific model data as opposed to daily regional average monitor data. We investigated how this comparison was affected if we changed the number of grids per region containing a monitor. To inform simulations, estimates (e.g. of pollutant means) were obtained from observed monitor data for 2003-2006 for national network sites across the UK and corresponding model data that were generated by the EMEP-WRF CTM. Average within-site correlations between observed monitor and model data were 0.73 and 0.76 for rural and urban daily maximum 8-hour ozone respectively, and 0.67 and 0.61 for rural and urban loge(daily 1-hour maximum NO2). When regional averages were based on 5 or 10 monitors per region, health effect estimates exhibited little bias. However, with only 1 monitor per region, the regression coefficient in our time-series analysis was attenuated by an estimated 6% for urban background ozone, 13% for rural ozone, 29% for urban background loge(NO2) and 38% for rural loge(NO2). For grid-specific model data the corresponding figures were 19%, 22%, 54% and 44% respectively, i.e. similar for rural loge(NO2) but more marked for urban loge(NO2). Even if correlations between model and monitor data appear reasonably strong, additive classical measurement error in model data may lead to appreciable bias in health effect estimates. As process-based air pollution models become more widely used in epidemiological time-series analysis, assessments of error impact that include statistical simulation may be useful.

Chlorophyll maxima in mountain ponds and lakes, Mount Rainier National Park, Washington State, USA

USGS Publications Warehouse

Larson, Gary L.

2000-01-01

Hypolimnetic chlorophyll maxima are common in clear lakes and often occur at depths with between 1 and 0.1% of the surface incident light. Little is known, however, about the concentrations of chlorophyll in thermally unstratified mountain ponds and how these concentrations compare to epilimnetic and hypolimnetic concentrations in mountain lakes. The objectives of this study were to document the concentrations of chlorophyll in thermally unstratified ponds and stratified lakes in Mount Rainier National Park (MORA) and to compare the results with concentrations and distributions of chlorophyll in clear-deep lakes in the Oregon Cascade Range and the Sierra Nevada Range. Thirty-two ponds (<2.5 m deep) and 14 lakes(>9.9 m deep) were sampled primarily during the summers of 1992 to 1996 at MORA. Water samples from near the surface (0.1–0.5 m) of ponds and near the surface and near the bottom of lakes were collected over the deepest part of each system. One exception, Mowich Lake, was sampled at seven depths between the surface and 50 m (Z=58.6 m). Chlorophyll concentrations were low in all systems, but higher in ponds (average 1.8 μg·L−1) than in lakes. Chlorophyll concentrations were higher in hypolimnetic lake samples (average 0.7 μg·L−1) than in epilimnetic lake samples (average 0.2 μg·L−1). Elevated concentrations of chlorophyll in mountain ponds, relative to those in hypolimnetic lake samples, may have been influenced by increased nutrient availability from interactions at the mud-water interface and, in this park, defecation by elk that used many of the ponds as wallows. Mowich Lake showed a chlorophyll maximum (~1.5 μg·L−1) near the lake bottom. Based on Secchi disk clarity readings, the depth of 1.0% incident surface solar radiation was greater than the maximum depths of the ponds and lakes. Comparative data from other clear-deep lakes in the Oregon Cascade Range and Sierra Nevada Range suggested that deep-chlorophyll maxima (~1.5 μg·L−1) occurred at <1.0% and > 0.1% of the incident surface solar radiation, and that the typical maximum depths ranged between 75 and 140 m during thermal stratification.

National forest visitor spending averages and the influence of trip-type and recreation activity.

Treesearch

Eric M. White; Daniel I. Stynes

2008-01-01

Estimates of national forest recreation visitor spending serve us inputs to regional economic analyses and help to identify the economic linkages between national forest recreation use and local forest communities. When completing recreation-related analyses, managers, planners, and researchers frequently think of visitors in terms of recreation activity. When...

75 FR 25323 - Light-Duty Vehicle Greenhouse Gas Emission Standards and Corporate Average Fuel Economy Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

...EPA and NHTSA are issuing this joint Final Rule to establish a National Program consisting of new standards for light-duty vehicles that will reduce greenhouse gas emissions and improve fuel economy. This joint Final Rule is consistent with the National Fuel Efficiency Policy announced by President Obama on May 19, 2009, responding to the country's critical need to address global climate change and to reduce oil consumption. EPA is finalizing greenhouse gas emissions standards under the Clean Air Act, and NHTSA is finalizing Corporate Average Fuel Economy standards under the Energy Policy and Conservation Act, as amended. These standards apply to passenger cars, light-duty trucks, and medium-duty passenger vehicles, covering model years 2012 through 2016, and represent a harmonized and consistent National Program. Under the National Program, automobile manufacturers will be able to build a single light-duty national fleet that satisfies all requirements under both programs while ensuring that consumers still have a full range of vehicle choices. NHTSA's final rule also constitutes the agency's Record of Decision for purposes of its National Environmental Policy Act (NEPA) analysis.

Levels and patterns of internal migration in Europe: A cohort perspective.

PubMed

Bernard, Aude

2017-11-01

Europe displays important variations in the level of internal migration, with a clear spatial gradient of high mobility in northern and western Europe but lower mobility in the south and east. However, cross-national variation in levels of internal migration remains poorly understood, because it is analysed almost exclusively using cross-sectional data and period measures. This paper seeks to advance understanding of cross-national variation in migration levels in 14 European countries by drawing on a recently proposed suite of migration cohort measures, coupled with internationally comparable retrospective residential histories. It shows that differences in migration levels are mainly attributable to variation in the extent of repeat movement, which is underpinned by the differences in mean ages at first and last move that together delineate the average length of migration careers. Cohort analysis provides a robust foundation for exploring the demographic mechanisms underpinning variation in migration levels across countries and over time.

Intercomparison of Streamflow Simulations between WRF-Hydro and Hydrology Laboratory-Research Distributed Hydrologic Model Frameworks

NASA Astrophysics Data System (ADS)

KIM, J.; Smith, M. B.; Koren, V.; Salas, F.; Cui, Z.; Johnson, D.

2017-12-01

The National Oceanic and Atmospheric Administration (NOAA)-National Weather Service (NWS) developed the Hydrology Laboratory-Research Distributed Hydrologic Model (HL-RDHM) framework as an initial step towards spatially distributed modeling at River Forecast Centers (RFCs). Recently, the NOAA/NWS worked with the National Center for Atmospheric Research (NCAR) to implement the National Water Model (NWM) for nationally-consistent water resources prediction. The NWM is based on the WRF-Hydro framework and is run at a 1km spatial resolution and 1-hour time step over the contiguous United States (CONUS) and contributing areas in Canada and Mexico. In this study, we compare streamflow simulations from HL-RDHM and WRF-Hydro to observations from 279 USGS stations. For streamflow simulations, HL-RDHM is run on 4km grids with the temporal resolution of 1 hour for a 5-year period (Water Years 2008-2012), using a priori parameters provided by NOAA-NWS. The WRF-Hydro streamflow simulations for the same time period are extracted from NCAR's 23 retrospective run of the NWM (version 1.0) over CONUS based on 1km grids. We choose 279 USGS stations which are relatively less affected by dams or reservoirs, in the domains of six different RFCs. We use the daily average values of simulations and observations for the convenience of comparison. The main purpose of this research is to evaluate how HL-RDHM and WRF-Hydro perform at USGS gauge stations. We compare daily time-series of observations and both simulations, and calculate the error values using a variety of error functions. Using these plots and error values, we evaluate the performances of HL-RDHM and WRF-Hydro models. Our results show a mix of model performance across geographic regions.

A comparative study of satellite estimation for solar insolation in Albania with ground measurements

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

Mitrushi, Driada, E-mail: driadamitrushi@yahoo.com; Berberi, Pëllumb, E-mail: pellumb.berberi@gmail.com; Muda, Valbona, E-mail: vmuda@hotmail.com

The main objective of this study is to compare data provided by Database of NASA with available ground data for regions covered by national meteorological net NASA estimates that their measurements of average daily solar radiation have a root-mean-square deviation RMSD error of 35 W/m{sup 2} (roughly 20% inaccuracy). Unfortunately valid data from meteorological stations for regions of interest are quite rare in Albania. In these cases, use of Solar Radiation Database of NASA would be a satisfactory solution for different case studies. Using a statistical method allows to determine most probable margins between to sources of data. Comparison of meanmore » insulation data provided by NASA with ground data of mean insulation provided by meteorological stations show that ground data for mean insolation results, in all cases, to be underestimated compared with data provided by Database of NASA. Converting factor is 1.149.« less

The use of alternative pollutant metrics in time-series studies of ambient air pollution and respiratory emergency department visits.

PubMed

Darrow, Lyndsey A; Klein, Mitchel; Sarnat, Jeremy A; Mulholland, James A; Strickland, Matthew J; Sarnat, Stefanie E; Russell, Armistead G; Tolbert, Paige E

2011-01-01

Various temporal metrics of daily pollution levels have been used to examine the relationships between air pollutants and acute health outcomes. However, daily metrics of the same pollutant have rarely been systematically compared within a study. In this analysis, we describe the variability of effect estimates attributable to the use of different temporal metrics of daily pollution levels. We obtained hourly measurements of ambient particulate matter (PM₂.₅), carbon monoxide (CO), nitrogen dioxide (NO₂), and ozone (O₃) from air monitoring networks in 20-county Atlanta for the time period 1993-2004. For each pollutant, we created (1) a daily 1-h maximum; (2) a 24-h average; (3) a commute average; (4) a daytime average; (5) a nighttime average; and (6) a daily 8-h maximum (only for O₃). Using Poisson generalized linear models, we examined associations between daily counts of respiratory emergency department visits and the previous day's pollutant metrics. Variability was greatest across O₃ metrics, with the 8-h maximum, 1-h maximum, and daytime metrics yielding strong positive associations and the nighttime O₃ metric yielding a negative association (likely reflecting confounding by air pollutants oxidized by O₃). With the exception of daytime metric, all of the CO and NO₂ metrics were positively associated with respiratory emergency department visits. Differences in observed associations with respiratory emergency room visits among temporal metrics of the same pollutant were influenced by the diurnal patterns of the pollutant, spatial representativeness of the metrics, and correlation between each metric and copollutant concentrations. Overall, the use of metrics based on the US National Ambient Air Quality Standards (for example, the use of a daily 8-h maximum O₃ as opposed to a 24-h average metric) was supported by this analysis. Comparative analysis of temporal metrics also provided insight into underlying relationships between specific air pollutants and respiratory health.

Epidemiology of pancreatic cancer in France: descriptive study from the French national hospital database.

PubMed

Maire, Frédérique; Cibot, Jean-Olivier; Compagne, Catherine; Hentic, Olivia; Hammel, Pascal; Muller, Nelly; Ponsot, Philippe; Levy, Philippe; Ruszniewski, Philippe

2017-08-01

Although indirect evidence suggests that the incidence of pancreatic adenocarcinoma has increased in the last decade, few data are available in European countries. The aim of the present study was to update the epidemiology of pancreatic cancer in France in 2014 from the French national hospital database (Programme de Médicalisation des Systèmes d'Information). All patients hospitalized for pancreatic cancer in France in 2014 in public or private institutions were included. Patient and stays (length, type of support, institutions) characteristics were studied. The results were compared with those observed in 2010. A total of 13 346 (52% men, median age 71 years) new patients were treated for pancreatic cancer in 2014, accounting for a 12.5% increase compared with 2010. Overall, 22% of patients were operated on. Liver metastases were present in 60% of cases. The disease accounted for 146 680 hospital stays (+24.8% compared with 2010), 76% of which were related to chemotherapy (+32%). The average annual number and length of stay were 7 and 2.6 days, respectively. In 2014, 11 052 deaths were reported (+15.8%). Approximately 13 350 new cases of pancreatic cancer were observed in France in 2014. The increase in incidence was associated with a marked increase in hospital stays for chemotherapy.

Determination of appropriate funding for maintenance : final report.

DOT National Transportation Integrated Search

1997-01-01

Recent national studies of Department of Transportation (DOT) maintenance funding indicate that Louisiana funding levels have not kept pace with the national average, and the level of road servicing has declined as a result. The Louisiana Department ...

2012 - 2016 Corporate Average Fuel Economy compliance and effects modeling system documentation

DOT National Transportation Integrated Search

2010-03-01

The Volpe National Transportation Systems Center (Volpe Center) of the United States Department of Transportation's Research and Innovative Technology Administration has developed a modeling system to assist the National Highway Traffic Safety Admini...

2017 - 2025 Corporate Average Fuel Economy Compliance and Effects Modeling System Documentation.

DOT National Transportation Integrated Search

2012-08-31

The Volpe National Transportation Systems Center (Volpe Center) of the United States Department of Transportations Research and Innovative Technology Administration has developed a modeling system to assist the National Highway Traffic Safety Admi...

78 FR 47274 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... following correction: On page 45181, the Table titled ``AFTERSCHOOL SNACKS SERVED IN AFTERSCHOOL CARE PROGRAMS'' is corrected to read as set forth below: Afterschool Snacks Served in Afterschool Care Programs...

Estimation of the diesel exhaust exposures of railroad workers: II. National and historical exposures.

PubMed

Woskie, S R; Smith, T J; Hammond, S K; Schenker, M B; Garshick, E; Speizer, F E

1988-01-01

The diesel exhaust exposures of railroad workers in thirteen job groups from four railroads in the United States were used to estimate U.S. national average exposures with a linear statistical model which accounts for the significant variability in exposure caused by climate, the differences among railroads and the uneven distribution of railroad workers across climatic regions. Personal measurements of respirable particulate matter, adjusted to remove the contribution of cigarette smoke particles, were used as a marker for diesel exhaust. The estimated national means of adjusted respirable particulate matter (ARP) averaged 10 micrograms/m3 lower than the simple means for each job group, reflecting the climatic differences between the northern railroads studied and the distribution of railroad workers nationally. Limited historical records, including some industrial hygiene data, were used to evaluate past diesel exhaust exposures, which were estimated to be approximately constant from the 1950's to 1983.

Comparison of ultrasonic and thermospray systems for high performance sample introduction to inductively coupled plasma atomic emission spectrometry

NASA Astrophysics Data System (ADS)

Conver, Timothy S.; Koropchak, John A.

1995-06-01

This paper describes detailed work done in our lab to compare analytical figures of merit for pneumatic, ultrasonic and thermospray sample introduction (SI) systems with three different inductively coupled plasma-atomic emission spectrometry (ICP-AES) instruments. One instrument from Leeman Labs, Inc. has an air path echelle spectrometer and a 27 MHz ICP. For low dissolved solid samples with this instrument, we observed that the ultrasonic nebulizer (USN) and fused silica aperture thermospray (FSApT) both offered similar LOD improvements as compared to pneumatic nebulization (PN), 14 and 16 times, respectively. Average sensitivities compared to PN were better for the USN, by 58 times, compared to 39 times for the FSApT. For solutions containing high dissolved solids we observed that FSApT optimized at the same conditions as for low dissolved solids, whereas USN required changes in power and gas flows to maintain a stable discharge. These changes degraded the LODs for USN substantially as compared to those utilized for low dissolved solid solutions, limiting improvement compared to PN to an average factor of 4. In general, sensitivities for USN were degraded at these new conditions. When solutions with 3000 μg/g Ca were analyzed, LOD improvements were smaller for FSApT and USN, but FSApT showed an improvement over USN of 6.5 times. Sensitivities compared to solutions without high dissolved solids were degraded by 19% on average for FSApT, while those for USN were degraded by 26%. The SI systems were also tested with a Varian Instruments Liberty 220 having a vacuum path Czerny-Turner monochromator and a 40 MHz generator. The sensitivities with low dissolved solids solutions compared to PN were 20 times better for the USN and 39 times better for FSApT, and LODs for every element were better for FSApT. Better correlation between relative sensitivities and anticipated relative analyte mass fluxes for FSApT and USN was observed with the Varian instrument. LOD improvements averaged 18 times lower than PN with FSApT while with USN values averaged 8 times lower. When solutions with high dissolved solids were studied it was found that FSApT still offered 5.5 times better LODs than PN and USN offered 4.6 times better LODs than PN. Sensitivities for FSApT averaged 20 times better, while those for USN were 13 times better compared to PN. Finally, background RSDs on the Varian system were generally higher for FSApT than for the USN for similar sample types. A third instrument used for a small set of elements was a Perkin-Elmer model 5500 ICP-AES. This system has a 27 MHz generator with a N 2 purged Czerny-Turner monochromator. LOD trends, background RSDs, and sensitivities were similar to those with the Leeman instrument. However, matrix effects more closely resembled those seen with the Varian instrument for both SI systems. To compare performance and recoveries on a real sample, a National Institute of Standards and Technology, Standard Reference Material 1643c trace elements in water, was analyzed using the Varian system and it was found that both SI systems offered similar recoveries.

Bariatric surgeries performed by the Brazilian National Health System in residents of the Metropolitan Region of Porto Alegre, Rio Grande do Sul, Brazil, 2010-2016.

PubMed

Carvalho, Adriane da Silva; Rosa, Roger Dos Santos

2018-06-11

to characterize caracterize by Brazilian National Health System (SUS) hospitalizations for bariatric surgeries in residents of the Metropolitan Region of Porto Alegre, RS, Brazil, from 2010 to 2016. data analysis of the National Hospital Information System (SIH/SUS); calculation of indicators by sex, age groups, use of Intensive Care Unit and hospitalization expenses; the target population were patients aged 15 years and older. there were 1,249 hospitalizations (178.4/year; 5.4/100 thousand inhab./year), and the average age was 41.3±10.3 years old (average±standard deviation); the female sex was more prevalent (85.0%) and the age group 35-39 years accounted for 234 cases (18.7%); 227 patients (18.2%) needed ICU; there were 2 (0.2%) deaths; the mean for hospital stay was 5.1±3.2 days; the average annual expense was BRL1,073.830.29±223,791.48; and the average cost for hospitalization was BRL6,018.26±851,34 (BRL1,171.03/day). bariatric surgeries were characterized as procedures undergone by young female adults, with relatively frequent use of ICU and low fatality.