Does charging different user fees for primary and secondary care affect first-contacts with primary healthcare? A systematic review.

PubMed

Hone, Thomas; Lee, John Tayu; Majeed, Azeem; Conteh, Lesong; Millett, Christopher

2017-06-01

Policy-makers are increasingly considering charging users different fees between primary and secondary care (differential user charges) to encourage utilisation of primary health care in health systems with limited gate keeping. A systematic review was conducted to evaluate the impact of introducing differential user charges on service utilisation. We reviewed studies published in MEDLINE, EMBASE, the Cochrane library, EconLIT, HMIC, and WHO library databases from January 1990 until June 2015. We extracted data from the studies meeting defined eligibility criteria and assessed study quality using an established checklist. We synthesized evidence narratively. Eight studies from six countries met our eligibility criteria. The overall study quality was low, with diversity in populations, interventions, settings, and methods. Five studies examined the introduction of or increase in user charges for secondary care, with four showing decreased secondary care utilisation, and three showing increased primary care utilisation. One study identified an increase in primary care utilisation after primary care user charges were reduced. The introduction of a non-referral charge in secondary care was associated with lower primary care utilisation in one study. One study compared user charges across insurance plans, associating higher charges in secondary care with higher utilisation in both primary and secondary care. Overall, the impact of introducing differential user-charges on primary care utilisation remains uncertain. Further research is required to understand their impact as a demand side intervention, including implications for health system costs and on utilisation among low-income patients. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Coordination of physiological and structural traits in Amazon forest trees

NASA Astrophysics Data System (ADS)

Patiño, S.; Fyllas, N. M.; Baker, T. R.; Paiva, R.; Quesada, C. A.; Santos, A. J. B.; Schwarz, M.; Ter Steege, H.; Phillips, O. L.; Lloyd, J.

2011-05-01

Many plant traits covary in a non-random manner reflecting interdependencies associated with "ecological strategy" dimensions. To understand how plants modulate their structural investments to best maintain and utilise their physiological capabilities, data on leaf and leaflet size and the ratio of leaf area to sapwood area (ΦLS) obtained for 1040 tree species located in 53 tropical forest plots across the Amazon Basin were incorporated into an analysis utilising existing data on species maximum height (Hmax), seed size, leaf mass per unit area (MA), foliar nutrients and δ13C and branch xylem density (ρx). Utilising a common principal components approach allowing eigenvalues to vary between two soil fertility dependent species groups, five genetically controlled trait dimensions were identified. The first involves primarily cations, foliar carbon and MA and is associated with differences in foliar construction costs. The second relates to the classic "leaf economic spectrum", but with increased individual leaf areas and a higher ΦLS newly identified components. The third relates primarily to increasing Hmax and hence variations in light acquisition strategy involving greater MA, reductions in ΦLS and less negative δ13C. Although these first three dimensions were more important for species from high fertility sites the final two dimensions were more important for low fertility species and were associated with variations linked to reproductive and shade tolerance strategies. Environmental conditions also influenced structural traits with ρx decreasing with increased soil fertility and decreasing with increased temperatures. This soil fertility response appears to be synchronised with increases in foliar nutrient concentrations and reductions in foliar [C]. Leaf and leaflet area and ΦLS were less responsive to the environment than ρx. Thus although genetically determined foliar traits such as those associated with leaf construction costs coordinate independently of structural characteristics, others tend to covary with leaf size, ΦLS, S tolerance strategies. Several traits such as MA and [C] are important components of more than one dimension with their ambiguous nature reflecting different underlying causes of variation. Environmental effects on structural and physiological characteristics are also coordinated but in a different way to the gamut of linkages associated with genotypic differences.

Utilisation of antihyperglycaemic drugs in ten European countries: different developments and different levels.

PubMed

Melander, A; Folino-Gallo, P; Walley, T; Schwabe, U; Groop, P-H; Klaukka, T; Vallano, A; Laporte, J-R; Gallego, M R; Schiappa, M; Røder, M; Kampmann, J P; de Swaef, A; Aberg, M; Månsson, N-O; Lindblad, U

2006-09-01

The aim of this study was to compare developments in the utilisation of antihyperglycaemic drugs (AHGDs) in ten European countries. Data on the yearly utilisation of insulin and oral AHGDs were collected from public registers in Denmark, Finland, Norway, Sweden, Belgium, England, Germany, Italy, Portugal and Spain, and were expressed as defined daily doses per 1,000 inhabitants per day. Total AGHD utilisation increased everywhere, but at different rates and levels. Insulin utilisation doubled in England and Germany, but hardly changed in Belgium, Portugal or Italy. Sulfonylurea utilisation doubled in Spain, England and Denmark but was reduced in Germany and Sweden. Metformin utilisation increased greatly everywhere. There were two- to three-fold differences in AHGD utilisation even between neighbouring countries. In Finland, there were more users of both insulin (+120%) and oral AHGDs (+80%) than in Denmark, and the daily oral AHGD doses were higher. In Denmark and Sweden, AHGD utilisation was equal in subjects aged <45 years, but in those >or=45 years of age, both insulin and oral AHGD utilisation were twice as high in Sweden. The ubiquitous increase in AHGD utilisation, particularly metformin, seems logical, considering the increasing prevalence of type 2 diabetes and the results of the UK Prospective Diabetes Study. However, the large differences even between neighbouring countries are more difficult to explain, and suggest different habits and attitudes in terms of screening and management of type 2 diabetes.

Trends, determinants and inequities of 4+ ANC utilisation in Bangladesh.

PubMed

Rahman, Aminur; Nisha, Monjura Khatun; Begum, Tahmina; Ahmed, Sayem; Alam, Nurul; Anwar, Iqbal

2017-01-13

The objectives of this study are to document the trend on utilisation of four or more (4 + ) antenatal care (ANC) over the last 22 years period and to explore the determinants and inequity of 4 + ANC utilisation as reported by the last two Bangladesh Demographic and Health surveys (BDHS) (2011 and 2014). The data related to ANC have been extracted from the BDHS data set which is available online as an open source. STATA 13 software was used for organising and analysing the data. The outcome variable considered for this study was utilisation of 4 + ANC. Trends of 4 + ANC were measured in percentage and predictors for 4 + ANC were measured through bivariate and multivariable analysis. The concentration index was estimated for assessing inequity in 4 + ANC utilisation. Utilisation of 4 + ANC has increased by about 26% between the year 1994 and 2014. Higher level of education, residing in urban region and richest wealth quintile were found to be significant predictors. The utilisation of 4 + ANC has decreased with increasing parity and maternal age. The inequity indices showed consistent inequities in 4 + ANC utilisation, and such inequities were increased between 2011 and 2014. In Bangladesh, the utilisation of any ANC rose steadily between 1994 and 2014, but progress in terms of 4 + ANC utilisation was much slower as the expectation was to achieve the national set target (50%: 4 + ANC utilisation) by 2016. Socio-economic inequities were observed in groups that failed to attend a 4 + ANC visit. Policymakers should pay special attention to increase the 4 + ANC coverage where this study can facilitate to identify the target groups whom need to be intervened on priority basis.

Analyzing Forest Inventory Data from Geo-Located Photographs

NASA Astrophysics Data System (ADS)

Toivanen, Timo; Tergujeff, Renne; Andersson, Kaj; Molinier, Matthieu; Häme, Tuomas

2015-04-01

Forests are widely monitored using a variety of remote sensing data and techniques. Remote sensing offers benefits compared to traditional in-situ forest inventories made by experts. One of the main benefits is that the number of ground reference plots can be significantly reduced. Remote sensing of forests can provide reduced costs and time requirement compared to full forest inventories. The availability of ground reference data has been a bottleneck in remote sensing analysis over wide forested areas, as the acquisition of this data is an expensive and slow process. In this paper we present a tool for estimating forest inventory data from geo-located photographs. The tool can be used to estimate in-situ forest inventory data including estimated biomass, tree species, tree height and diameter. The collected in-situ forest measurements can be utilized as a ground reference material for spaceborne or airborne remote sensing data analysis. The GPS based location information with measured forest data makes it possible to introduce measurements easily as in-situ reference data. The central projection geometry of digital photographs allows the use of the relascope principle [1] to measure the basal area of stems per area unit, a variable very closely associated with tree biomass. Relascope is applied all over the world for forest inventory. Experiments with independent ground reference data have shown that in-situ data analysed from photographs can be utilised as reference data for satellite image analysis. The concept was validated by comparing mobile measurements with 54 independent ground reference plots from the Hyytiälä forest research station in Finland [2]. Citizen scientists could provide the manpower for analysing photographs from forests on a global level and support researchers working on tasks related to forests. This low-cost solution can also increase the coverage of forest management plans, particularly in regions where possibilities to invest on expensive planning work are limited. References [1] Bitterlich, W. (1984) The Relascope Idea: Relative Measurements in Forestry, Commonwealth Agricultural Bureaux, Farnham Royal, 1984. [2] Molinier, M., Hame, T., Toivanen, T., Andersson, K., Mutanen, T., Relasphone -- Mobile phone and interactive applications to collect ground reference biomass data for satellite image analysis, Geoscience and Remote Sensing Symposium (IGARSS), 2014 IEEE International, pp. 836-839, 13-18 July 2014, doi: 10.1109/IGARSS.2014.6946554

Analysis of biophysical and anthropogenic variables and their relation to the regional spatial variation of aboveground biomass illustrated for North and East Kalimantan, Borneo.

PubMed

Van der Laan, Carina; Verweij, Pita A; Quiñones, Marcela J; Faaij, André Pc

2014-12-01

Land use and land cover change occurring in tropical forest landscapes contributes substantially to carbon emissions. Better insights into the spatial variation of aboveground biomass is therefore needed. By means of multiple statistical tests, including geographically weighted regression, we analysed the effects of eight variables on the regional spatial variation of aboveground biomass. North and East Kalimantan were selected as the case study region; the third largest carbon emitting Indonesian provinces. Strong positive relationships were found between aboveground biomass and the tested variables; altitude, slope, land allocation zoning, soil type, and distance to the nearest fire, road, river and city. Furthermore, the results suggest that the regional spatial variation of aboveground biomass can be largely attributed to altitude, distance to nearest fire and land allocation zoning. Our study showed that in this landscape, aboveground biomass could not be explained by one single variable; the variables were interrelated, with altitude as the dominant variable. Spatial analyses should therefore integrate a variety of biophysical and anthropogenic variables to provide a better understanding of spatial variation in aboveground biomass. Efforts to minimise carbon emissions should incorporate the identified factors, by 1) the maintenance of lands with high AGB or carbon stocks, namely in the identified zones at the higher altitudes; and 2) regeneration or sustainable utilisation of lands with low AGB or carbon stocks, dependent on the regeneration capacity of the vegetation. Low aboveground biomass densities can be found in the lowlands in burned areas, and in non-forest zones and production forests.

Development Of Polarimetric Decomposition Techniques For Indian Forest Resource Assessment Using Radar Imaging Satellite (Risat-1) Images

NASA Astrophysics Data System (ADS)

Sridhar, J.

2015-12-01

The focus of this work is to examine polarimetric decomposition techniques primarily focussed on Pauli decomposition and Sphere Di-Plane Helix (SDH) decomposition for forest resource assessment. The data processing methods adopted are Pre-processing (Geometric correction and Radiometric calibration), Speckle Reduction, Image Decomposition and Image Classification. Initially to classify forest regions, unsupervised classification was applied to determine different unknown classes. It was observed K-means clustering method gave better results in comparison with ISO Data method.Using the algorithm developed for Radar Tools, the code for decomposition and classification techniques were applied in Interactive Data Language (IDL) and was applied to RISAT-1 image of Mysore-Mandya region of Karnataka, India. This region is chosen for studying forest vegetation and consists of agricultural lands, water and hilly regions. Polarimetric SAR data possess a high potential for classification of earth surface.After applying the decomposition techniques, classification was done by selecting region of interests andpost-classification the over-all accuracy was observed to be higher in the SDH decomposed image, as it operates on individual pixels on a coherent basis and utilises the complete intrinsic coherent nature of polarimetric SAR data. Thereby, making SDH decomposition particularly suited for analysis of high-resolution SAR data. The Pauli Decomposition represents all the polarimetric information in a single SAR image however interpretation of the resulting image is difficult. The SDH decomposition technique seems to produce better results and interpretation as compared to Pauli Decomposition however more quantification and further analysis are being done in this area of research. The comparison of Polarimetric decomposition techniques and evolutionary classification techniques will be the scope of this work.

An analysis of partial efficiencies of energy utilisation of different macronutrients by barramundi (Lates calcarifer) shows that starch restricts protein utilisation in carnivorous fish.

PubMed

Glencross, Brett D; Blyth, David; Bourne, Nicholas; Cheers, Susan; Irvin, Simon; Wade, Nicholas M

2017-02-01

This study examined the effect of including different dietary proportions of starch, protein and lipid, in diets balanced for digestible energy, on the utilisation efficiencies of dietary energy by barramundi (Lates calcarifer). Each diet was fed at one of three ration levels (satiety, 80 % of initial satiety and 60 % of initial satiety) for a 42-d period. Fish performance measures (weight gain, feed intake and feed conversion ratio) were all affected by dietary energy source. The efficiency of energy utilisation was significantly reduced in fish fed the starch diet relative to the other diets, but there were no significant effects between the other macronutrients. This reduction in efficiency of utilisation was derived from a multifactorial change in both protein and lipid utilisation. The rate of protein utilisation deteriorated as the amount of starch included in the diet increased. Lipid utilisation was most dramatically affected by inclusion levels of lipid in the diet, with diets low in lipid producing component lipid utilisation rates well above 1·3, which indicates substantial lipid synthesis from other energy sources. However, the energetic cost of lipid gain was as low as 0·65 kJ per kJ of lipid deposited, indicating that barramundi very efficiently store energy in the form of lipid, particularly from dietary starch energy. This study defines how the utilisation efficiency of dietary digestible energy by barramundi is influenced by the macronutrient source providing that energy, and that the inclusion of starch causes problems with protein utilisation in this species.

Factors that influence utilisation of HIV/AIDS prevention methods among university students residing at a selected university campus.

PubMed

Ndabarora, Eléazar; Mchunu, Gugu

2014-01-01

Various studies have reported that university students, who are mostly young people, rarely use existing HIV/AIDS preventive methods. Although studies have shown that young university students have a high degree of knowledge about HIV/AIDS and HIV modes of transmission, they are still not utilising the existing HIV prevention methods and still engage in risky sexual practices favourable to HIV. Some variables, such as awareness of existing HIV/AIDS prevention methods, have been associated with utilisation of such methods. The study aimed to explore factors that influence use of existing HIV/AIDS prevention methods among university students residing in a selected campus, using the Health Belief Model (HBM) as a theoretical framework. A quantitative research approach and an exploratory-descriptive design were used to describe perceived factors that influence utilisation by university students of HIV/AIDS prevention methods. A total of 335 students completed online and manual questionnaires. Study findings showed that the factors which influenced utilisation of HIV/AIDS prevention methods were mainly determined by awareness of the existing university-based HIV/AIDS prevention strategies. Most utilised prevention methods were voluntary counselling and testing services and free condoms. Perceived susceptibility and perceived threat of HIV/AIDS score was also found to correlate with HIV risk index score. Perceived susceptibility and perceived threat of HIV/AIDS showed correlation with self-efficacy on condoms and their utilisation. Most HBM variables were not predictors of utilisation of HIV/AIDS prevention methods among students. Intervention aiming to improve the utilisation of HIV/AIDS prevention methods among students at the selected university should focus on removing identified barriers, promoting HIV/AIDS prevention services and providing appropriate resources to implement such programmes.

Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study

PubMed Central

Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-01-01

Objective While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. Design We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. Setting We interviewed participants at Japan Clubs and their offices. Participants 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. Results We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. Conclusions The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. PMID:27006344

Utilisation of cancer screening services by disabled women in Chile

PubMed Central

Rotarou, Elena S.

2017-01-01

Background Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. Methods We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Results Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. Conclusions This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and acknowledge the complexity of the patient population. PMID:28459874

Utilisation of cancer screening services by disabled women in Chile.

PubMed

Sakellariou, Dikaios; Rotarou, Elena S

2017-01-01

Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and acknowledge the complexity of the patient population.

The utilisation of health research in policy-making: concepts, examples and methods of assessment

PubMed Central

Hanney, Stephen R; Gonzalez-Block, Miguel A; Buxton, Martin J; Kogan, Maurice

2003-01-01

The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies. PMID:12646071

Floodwater utilisation values of wetland services - a case study in Northeastern China

NASA Astrophysics Data System (ADS)

Lü, S. B.; Xu, S. G.; Feng, F.

2012-02-01

Water plays a significant role in wetlands. Floodwater utilisation in wetlands brings a wide range of wetland services, from goods production and water regulation to animal protection and aesthetics related to water supply in wetlands. In this study, the floodwater utilisation values of wetland services were estimated within the Momoge wetland and Xianghai wetland in western Jilin province of northeastern China. From 2003 to 2008, the floodwater diverted from the Nenjiang and Tao'er River is 381 million m3, which translates into a monetary value of approximately 1.35 billion RMB in 2008 (RMB: Chinese Currency, RMB 6.80 = US 1), and the ratio of economic value, eco-environmental value, and social value is 1:12:2. Besides the monetary value of the water itself, excessive floodwater utilisation may bring losses to wetlands; the threshold floodwater utilisation volumes in wetlands are discussed. Floodwater utilisation can alleviate water shortages in wetlands, and the evaluation of floodwater utilisation in wetland services in monetary terms is a guide for the effective use of the floodwater resources and for the conservation of wetlands.

Estimation and mapping of above-ground biomass of mangrove forests and their replacement land uses in the Philippines using Sentinel imagery

NASA Astrophysics Data System (ADS)

Castillo, Jose Alan A.; Apan, Armando A.; Maraseni, Tek N.; Salmo, Severino G.

2017-12-01

The recent launch of the Sentinel-1 (SAR) and Sentinel-2 (multispectral) missions offers a new opportunity for land-based biomass mapping and monitoring especially in the tropics where deforestation is highest. Yet, unlike in agriculture and inland land uses, the use of Sentinel imagery has not been evaluated for biomass retrieval in mangrove forest and the non-forest land uses that replaced mangroves. In this study, we evaluated the ability of Sentinel imagery for the retrieval and predictive mapping of above-ground biomass of mangroves and their replacement land uses. We used Sentinel SAR and multispectral imagery to develop biomass prediction models through the conventional linear regression and novel Machine Learning algorithms. We developed models each from SAR raw polarisation backscatter data, multispectral bands, vegetation indices, and canopy biophysical variables. The results show that the model based on biophysical variable Leaf Area Index (LAI) derived from Sentinel-2 was more accurate in predicting the overall above-ground biomass. In contrast, the model which utilised optical bands had the lowest accuracy. However, the SAR-based model was more accurate in predicting the biomass in the usually deficient to low vegetation cover non-forest replacement land uses such as abandoned aquaculture pond, cleared mangrove and abandoned salt pond. These models had 0.82-0.83 correlation/agreement of observed and predicted value, and root mean square error of 27.8-28.5 Mg ha-1. Among the Sentinel-2 multispectral bands, the red and red edge bands (bands 4, 5 and 7), combined with elevation data, were the best variable set combination for biomass prediction. The red edge-based Inverted Red-Edge Chlorophyll Index had the highest prediction accuracy among the vegetation indices. Overall, Sentinel-1 SAR and Sentinel-2 multispectral imagery can provide satisfactory results in the retrieval and predictive mapping of the above-ground biomass of mangroves and the replacement non-forest land uses, especially with the inclusion of elevation data. The study demonstrates encouraging results in biomass mapping of mangroves and other coastal land uses in the tropics using the freely accessible and relatively high-resolution Sentinel imagery.

The experiences of culturally and linguistically diverse family caregivers in utilising dementia services in Australia

PubMed Central

2013-01-01

Background Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. Methods The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Results Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. Conclusions The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia. PMID:24148155

The experiences of culturally and linguistically diverse family caregivers in utilising dementia services in Australia.

PubMed

Xiao, Lily Dongxia; De Bellis, Anita; Habel, Lesley; Kyriazopoulos, Helena

2013-10-22

Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia.

Wetlands or aquatic ape? Availability of food resources.

PubMed

Ellis, D V

1993-01-01

A human evolutionary scenario including an ape inhabiting marine wetlands is rational in a number of contexts. The concept is viable ecologically due to the availability of abundant animal foods in a variety of habitats ranging from mangrove forests to coral reefs. The food resources include mollusks, crustacea and fish abundant in wet zones and pools between high and low tide levels. There is seasonal abundance of swarming marsh insects, turtles, eggs and chicks of colonial birds, and occasional beached and dying marine mammals. Some of these foods would provide an enriched source of polyunsaturated essential fatty acids needed for brain development, and thus allow a spiral of increasing brain development, tool utilisation for better food gathering, and vocal communication for group action. The concept is viable also in terms of availability of the ape-human stock in the African Rift Valley, isolated from montane forests during the late Pliocene, and as an adaptive explanation for many of the species-specific human characters not found in other ground living primates.

Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.

PubMed

Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-03-22

While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. We interviewed participants at Japan Clubs and their offices. 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. 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/

Impacts Of Climate Change On Ecosystems Management In Africa: An Assessment Of Disaster Risk Management And Adaptation

NASA Astrophysics Data System (ADS)

Ndebele-Murisa, M. R.

2015-12-01

This paper is a synthesis of eight studies which demonstrate the interface between disaster risk management (DRM) and adaptation. The studies; conducted from November 2011 to July 2012 included diverse ecosystems from forests, coastlines, rural areas to a lake region and showed that climate change/variability are major factors among other factors such as deforestation and land degradation, unsustainable land use practices, overharvesting of natural products and invasive species encroachment that are causing changes in ecosystems. The most common extreme events reported included shifts in and shorter rainfall seasons, extended droughts, increased temperatures, extreme heat, heavy rainfall, flooding, inundation, strong winds and sea level rises. As a result of these climate phenomena, adverse impacts on ecosystems and communities were reported as biodiversity loss, reduced fish catch, reduced water for forests/agriculture/consumption, increased rough waves, coastal erosion/sediment deposition and lastly land/mud slides in order of commonality. In response to these impacts communities are practicing coping and adaptation strategies but there is a huge gap between proper DRM and adaptation. This is mainly because the adaptation is practiced as an aftermath with very little effort propelled towards proactive DRM or preparedness. In addition, national level policies are archaic and do not address the current environmental changes. This was demonstrated in Togo where wood energy potential is deteriorating at an unprecedented rate but is projected to increase between 6.4% and 101% in the near and far future if the national forest action plans are implemented; preventing an energy crisis in the country. This shows that appropriate legal and policy frameworks and well planned responses to projected extreme events and climate changes are crucial in order to prevent disasters and to achieve sustainable utilisation of resources in the continent.

Quantification of uncertainty in aerosol optical thickness retrieval arising from aerosol microphysical model and other sources, applied to Ozone Monitoring Instrument (OMI) measurements

NASA Astrophysics Data System (ADS)

Määttä, A.; Laine, M.; Tamminen, J.; Veefkind, J. P.

2014-05-01

Satellite instruments are nowadays successfully utilised for measuring atmospheric aerosol in many applications as well as in research. Therefore, there is a growing need for rigorous error characterisation of the measurements. Here, we introduce a methodology for quantifying the uncertainty in the retrieval of aerosol optical thickness (AOT). In particular, we concentrate on two aspects: uncertainty due to aerosol microphysical model selection and uncertainty due to imperfect forward modelling. We apply the introduced methodology for aerosol optical thickness retrieval of the Ozone Monitoring Instrument (OMI) on board NASA's Earth Observing System (EOS) Aura satellite, launched in 2004. We apply statistical methodologies that improve the uncertainty estimates of the aerosol optical thickness retrieval by propagating aerosol microphysical model selection and forward model error more realistically. For the microphysical model selection problem, we utilise Bayesian model selection and model averaging methods. Gaussian processes are utilised to characterise the smooth systematic discrepancies between the measured and modelled reflectances (i.e. residuals). The spectral correlation is composed empirically by exploring a set of residuals. The operational OMI multi-wavelength aerosol retrieval algorithm OMAERO is used for cloud-free, over-land pixels of the OMI instrument with the additional Bayesian model selection and model discrepancy techniques introduced here. The method and improved uncertainty characterisation is demonstrated by several examples with different aerosol properties: weakly absorbing aerosols, forest fires over Greece and Russia, and Sahara desert dust. The statistical methodology presented is general; it is not restricted to this particular satellite retrieval application.

Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

PubMed Central

Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

2016-01-01

Objectives To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. Setting A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Participants Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants. Main outcome measures For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. Results In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). Conclusions ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. PMID:27279477

Conservation strategies for orangutans: reintroduction versus habitat preservation and the benefits of sustainably logged forest.

PubMed

Wilson, Howard B; Meijaard, Erik; Venter, Oscar; Ancrenaz, Marc; Possingham, Hugh P

2014-01-01

The Sumatran orangutan is currently listed by the IUCN as critically endangered and the Bornean species as endangered. Unless effective conservation measures are enacted quickly, most orangutan populations without adequate protection face a dire future. Two main strategies are being pursued to conserve orangutans: (i) rehabilitation and reintroduction of ex-captive or displaced individuals; and (ii) protection of their forest habitat to abate threats like deforestation and hunting. These strategies are often mirrored in similar programs to save other valued and endangered mega-fauna. Through GIS analysis, collating data from across the literature, and combining this information within a modelling and decision analysis framework, we analysed which strategy or combination of strategies is the most cost-effective at maintaining wild orangutan populations, and under what conditions. We discovered that neither strategy was optimal under all circumstances but was dependent on the relative cost per orangutan, the timescale of management concern, and the rate of deforestation. Reintroduction, which costs twelve times as much per animal as compared to protection of forest, was only a cost-effective strategy at very short timescales. For time scales longer than 10-20 years, forest protection is the more cost-efficient strategy for maintaining wild orangutan populations. Our analyses showed that a third, rarely utilised strategy is intermediate: introducing sustainable logging practices and protection from hunting in timber production forest. Maximum long-term cost-efficiency is achieved by working in conservation forest. However, habitat protection involves addressing complex conservation issues and conflicting needs at the landscape level. We find a potential resolution in that well-managed production forests could achieve intermediate conservation outcomes. This has broad implications for sustaining biodiversity more generally within an economically productive landscape. Insights from this analysis should provide a better framework to prioritize financial investments, and facilitate improved integration between the organizations that implement these strategies.

Conservation Strategies for Orangutans: Reintroduction versus Habitat Preservation and the Benefits of Sustainably Logged Forest

PubMed Central

Wilson, Howard B.; Meijaard, Erik; Venter, Oscar; Ancrenaz, Marc; Possingham, Hugh P.

2014-01-01

The Sumatran orangutan is currently listed by the IUCN as critically endangered and the Bornean species as endangered. Unless effective conservation measures are enacted quickly, most orangutan populations without adequate protection face a dire future. Two main strategies are being pursued to conserve orangutans: (i) rehabilitation and reintroduction of ex-captive or displaced individuals; and (ii) protection of their forest habitat to abate threats like deforestation and hunting. These strategies are often mirrored in similar programs to save other valued and endangered mega-fauna. Through GIS analysis, collating data from across the literature, and combining this information within a modelling and decision analysis framework, we analysed which strategy or combination of strategies is the most cost-effective at maintaining wild orangutan populations, and under what conditions. We discovered that neither strategy was optimal under all circumstances but was dependent on the relative cost per orangutan, the timescale of management concern, and the rate of deforestation. Reintroduction, which costs twelve times as much per animal as compared to protection of forest, was only a cost-effective strategy at very short timescales. For time scales longer than 10–20 years, forest protection is the more cost-efficient strategy for maintaining wild orangutan populations. Our analyses showed that a third, rarely utilised strategy is intermediate: introducing sustainable logging practices and protection from hunting in timber production forest. Maximum long-term cost-efficiency is achieved by working in conservation forest. However, habitat protection involves addressing complex conservation issues and conflicting needs at the landscape level. We find a potential resolution in that well-managed production forests could achieve intermediate conservation outcomes. This has broad implications for sustaining biodiversity more generally within an economically productive landscape. Insights from this analysis should provide a better framework to prioritize financial investments, and facilitate improved integration between the organizations that implement these strategies. PMID:25025134

Interactive effects of frequent burning and timber harvesting on above ground carbon biomass in temperate eucalypt forests

NASA Astrophysics Data System (ADS)

Collins, Luke; Penman, Trent; Ximenes, Fabiano; Bradstock, Ross

2015-04-01

The sequestration of carbon has been identified as an important strategy to mitigate the effects of climate change. Fuel reduction burning and timber harvesting are two common co-occurring management practices within forests. Frequent burning and timber harvesting may alter forest carbon pools through the removal and redistribution of biomass and demographic and structural changes to tree communities. Synergistic and antagonistic interactions between frequent burning and harvesting are likely to occur, adding further complexity to the management of forest carbon stocks. Research aimed at understanding the interactive effects of frequent fire and timber harvesting on carbon biomass is lacking. This study utilised data from two long term (25 - 30 years) manipulative burning experiments conducted in southern Australia in temperate eucalypt forests dominated by resprouting canopy species. Specifically we examined the effect of fire frequency and harvesting on (i) total biomass of above ground carbon pools and (ii) demographic and structural characteristics of live trees. We also investigated some of the mechanisms driving these changes. Frequent burning reduced carbon biomass by up to 20% in the live tree carbon pool. Significant interactions occurred between fire and harvesting, whereby the reduction in biomass of trees >20 cm diameter breast height (DBH) was amplified by increased fire frequency. The biomass of trees <20 cm DBH increased with harvesting intensity in frequently burnt areas, but was unaffected by harvesting intensity in areas experiencing low fire frequency. Biomass of standing and fallen coarse woody debris was relatively unaffected by logging and fire frequency. Fire and harvesting significantly altered stand structure over the study period. Comparison of pre-treatment conditions to current conditions revealed that logged sites had a significantly greater increase in the number of small trees (<40 cm DBH) than unlogged sites. Logged sites showed a significant decrease in the number of large trees (>60 cm DBH) over the study period, while unlogged sites showed an increase. Frequently burnt logged sites showed the greatest reduction in large trees, presumably due to increased fire related mortality and collapse. Analysis of tree survival and growth data suggest that mortality rate is increased and growth rate reduced in frequently burnt areas compared to unburnt areas. Our findings suggest that future shifts towards more frequent fire (both prescribed fire and wildfire) could potentially lead to broad scale reductions in carbon sequestration in temperate forests and woodlands dominated by resprouting canopy species. Reductions in carbon sequestration associated with frequent burning will potentially be amplified in intensively harvested landscapes.

Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study.

PubMed

Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

2016-06-08

To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Adult ED visits (aged ≥18 years) during 2009-2013, with or without receiving CT, were enrolled as the study participants. For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). ED CT utilisation rates increased significantly during 2009-2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. 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/

Outpatient echocardiography in the evaluation of innocent murmurs in children: utilisation benchmarking.

PubMed

Frias, Patricio A; Oster, Matthew; Daley, Patricia A; Boris, Jeffrey R

2016-03-01

We sought to benchmark the utilisation of echocardiography in the outpatient evaluation of heart murmurs by evaluating two large paediatric cardiology centres. Although criteria exist for appropriate use of echocardiography, there are no benchmarking data demonstrating its utilisation. We performed a retrospective cohort study of outpatients aged between 0 and 18 years at the Sibley Heart Center Cardiology and the Children's Hospital of Philadelphia Division of Cardiology, given a sole diagnosis of "innocent murmur" from 1 July, 2007 to 31 October, 2010. Using internal claims data, we compared the utilisation of echocardiography according to centre, patient age, and physician years of service. Of 23,114 eligible patients (Sibley Heart Center Cardiology: 12,815, Children's Hospital of Philadelphia Division of Cardiology: 10,299), 43.1% (Sibley Heart Center Cardiology: 45.2%, Children's Hospital of Philadelphia Division of Cardiology: 40.4%; p1-5 years had the lowest utilisation (32.7%). In two large paediatric cardiology practices, the overall utilisation of echocardiography by physicians with a sole diagnosis of innocent murmur was similar. There was significant and similar variability in utilisation by provider at both centres. Although these data serve as initial benchmarking, the variability in utilisation highlights the importance of appropriate use criteria.

Socioeconomic inequalities in health care utilisation in Norway: the population-based HUNT3 survey.

PubMed

Vikum, Eirik; Krokstad, Steinar; Westin, Steinar

2012-08-22

In this study we investigated the distribution of self-reported health care utilisation by education and household income in a county population in Norway, in a universal public health care system based on ideals of equal access for all according to need, and not according to wealth. The study included 24,147 women and 20,608 men aged 20 years and above in the third Nord-Trøndelag Health Survey (HUNT 3) of 2006-2008. Income-related horizontal inequity was estimated through concentration indexes, and inequity by both education and income was estimated as risk ratios through conventional regression. We found no overall pro-rich or pro-educated socioeconomic gradient in needs-adjusted utilisation of general practitioner or inpatient care. However, we found overall pro-rich and pro-educated inequity in utilisation of both private medical specialists and hospital outpatient care. For these services there were large differences in levels of inequity between younger and older men and women. In contrast with recent studies from Norway, we found pro-rich and pro-educated social inequalities in utilisation of hospital outpatient services and not only private medical specialists. Utilisation of general practitioner and inpatient services, which have low access threshold or are free of charge, we found to be equitable.

Factors influencing utilisation of maternal health services by adolescent mothers in Low-and middle-income countries: a systematic review.

PubMed

Banke-Thomas, Oluwasola Eniola; Banke-Thomas, Aduragbemi Oluwabusayo; Ameh, Charles Anawo

2017-02-16

Adolescent mothers aged 15-19 years are known to have greater risks of maternal morbidity and mortality compared with women aged 20-24 years, mostly due to their unique biological, sociological and economic status. Nowhere Is the burden of disease greater than in low-and middle-income countries (LMICs). Understanding factors that influence adolescent utilisation of essential maternal health services (MHS) would be critical in improving their outcomes. We systematically reviewed the literature for articles published until December 2015 to understand how adolescent MHS utilisation has been assessed in LMICs and factors affecting service utilisation by adolescent mothers. Following data extraction, we reported on the geographical distribution and characteristics of the included studies and used thematic summaries to summarise our key findings across three key themes: factors affecting MHS utilisation considered by researcher(s), factors assessed as statistically significant, and other findings on MHS utilisation. Our findings show that there has been minimal research in this study area. 14 studies, adjudged as medium to high quality met our inclusion criteria. Studies have been published in many LMICs, with the first published in 2006. Thirteen studies used secondary data for assessment, data which was more than 5 years old at time of analysis. Ten studies included only married adolescent mothers. While factors such as wealth quintile, media exposure and rural/urban residence were commonly adjudged as significant, education of the adolescent mother and her partner were the commonest significant factors that influenced MHS utilisation. Use of antenatal care also predicted use of skilled birth attendance and use of both predicted use of postnatal care. However, there may be some context-specific factors that need to be considered. Our findings strengthen the need to lay emphasis on improving girl child education and removing financial barriers to their access to MHS. Opportunities that have adolescents engaging with health providers also need to be seized. These will be critical in improving adolescent MHS utilisation. However, policy and programmatic choices need to be based on recent, relevant and robust datasets. Innovative approaches that leverage new media to generate context-specific dis-aggregated data may provide a way forward.

Maternal health services utilisation by Kenyan adolescent mothers: Analysis of the Demographic Health Survey 2014.

PubMed

Banke-Thomas, Aduragbemi; Banke-Thomas, Oluwasola; Kivuvani, Mwikali; Ameh, Charles Anawo

2017-06-01

Kenya has one of the highest adolescent fertility rates in East-Africa, estimated at 106 births per 1000 females aged 15-19years. In addition to promoting safe sexual behaviour, utilisation of maternal health services (MHS) is essential to prevent poor outcomes of pregnancy and childbirth. To ensure optimum planning, particularly in the context of the Sustainable Development Goals, this study assesses the current service utilisation patterns of Kenyan adolescent mothers and the factors that affect this utilisation. Using data from the recently published 2014 Kenya Demographic Health Survey, we collected demographic and utilisation data of all three MHSs (antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC)) of adolescent mothers aged 15-19years. We then conducted bivariate and multivariate analyses to test associations between selected demographic and service utilisation variables. Our findings showed that half of Kenyan adolescent mothers have had their first birth by the age of 16. MHS utilisation rates amongst Kenyan adolescent mothers were 93%, 65%, 92% for ANC, SBA and PNC respectively. Mother's education, religion, ethnicity, place of residence, wealth quintile, mass media exposure, and geographical region were significant predictors for both ANC and SBA utilisation. Education level of partner was significant for ANC utilisation while parity was significant for both SBA and PNC. Adolescent MHS utilisation is not optimum in Kenya. More work that includes affordable care provision, cultural re-orientation, targeted mass-media campaigns and male involvement in care need to be done with emphasis on the most disadvantaged areas. Copyright © 2017 Elsevier B.V. All rights reserved.

Stoichiometric modelling of assimilatory and dissimilatory biomass utilisation in a microbial community

PubMed Central

Hunt, Kristopher A.; Jennings, Ryan deM.; Inskeep, William P.; Carlson, Ross P.

2017-01-01

Summary Assimilatory and dissimilatory utilisation of autotroph biomass by heterotrophs is a fundamental mechanism for the transfer of nutrients and energy across trophic levels. Metagenome data from a tractable, thermoacidophilic microbial community in Yellowstone National Park was used to build an in silico model to study heterotrophic utilisation of autotroph biomass using elementary flux mode analysis and flux balance analysis. Assimilatory and dissimilatory biomass utilisation was investigated using 29 forms of biomass-derived dissolved organic carbon (DOC) including individual monomer pools, individual macromolecular pools and aggregate biomass. The simulations identified ecologically competitive strategies for utilizing DOC under conditions of varying electron donor, electron acceptor or enzyme limitation. The simulated growth environment affected which form of DOC was the most competitive use of nutrients; for instance, oxygen limitation favoured utilisation of less reduced and fermentable DOC while carbon-limited environments favoured more reduced DOC. Additionally, metabolism was studied considering two encompassing metabolic strategies: simultaneous versus sequential use of DOC. Results of this study bound the transfer of nutrients and energy through microbial food webs, providing a quantitative foundation relevant to most microbial ecosystems. PMID:27387069

COPD: Health Care Utilisation Patterns with Different Disease Management Interventions.

PubMed

Luk, Edwin K; Hutchinson, Anastasia F; Tacey, Mark; Irving, Louis; Khan, Fary

2017-08-01

The management of COPD is a significant and costly issue worldwide, with acute healthcare utilisation consisting of admissions and outpatient attendances being a major contributor to the cost. Pulmonary rehabilitation (PR) and integrated disease management (IDM) are often offered. Whilst there is strong evidence of physical and quality of life outcomes following IDM and PR, few studies have looked into healthcare utilisation. The aims of this study were to confirm whether IDM and PR reduce acute healthcare utilisation and to identify factors which contribute to acute health care utilisation or increased mortality. This was a retrospective cohort study of patients with COPD who were referred to IDM over a 10-year period. Patients were also offered an 8-week PR program. Data collected were matched with the hospital dataset to obtain information on inpatient, ED and outpatient attendances. 517 patients were enrolled to IDM. 315 (61%) also commenced PR and 220 (43%) completed PR. Patients who were referred to PR were younger and had less comorbidities (p < 0.001). Both groups (IDM only and IDM + PR referred) had reductions in healthcare utilisation but the IDM-only group had greater reductions. A survival benefit (HR 0.68, 95% CI 0.50-0.92) was seen in those who were PR completers compared to patients who received IDM only. Patients with COPD who successfully complete PR in addition to participating in IDM have improved survival. IDM alone was effective in the reduction of healthcare utilisation; however, the addition of PR did not reduce healthcare usage further.

Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria

PubMed Central

Asuzu, Michael C.

2015-01-01

Background Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities. Aim To assess the utilisation of community-based health facility (CBHF) amongst adults in Ibadan, Nigeria Settings A low-income community in Ibadan North West Local Government Area of Oyo State. Methods A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents' sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05. Results The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90% had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8%) and self-medication (12.1%). Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05). However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF. Conclusion The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation. PMID:26245600

Sample entropy analysis for the estimating depth of anaesthesia through human EEG signal at different levels of unconsciousness during surgeries.

PubMed

Liu, Quan; Ma, Li; Fan, Shou-Zen; Abbod, Maysam F; Shieh, Jiann-Shing

2018-01-01

Estimating the depth of anaesthesia (DoA) in operations has always been a challenging issue due to the underlying complexity of the brain mechanisms. Electroencephalogram (EEG) signals are undoubtedly the most widely used signals for measuring DoA. In this paper, a novel EEG-based index is proposed to evaluate DoA for 24 patients receiving general anaesthesia with different levels of unconsciousness. Sample Entropy (SampEn) algorithm was utilised in order to acquire the chaotic features of the signals. After calculating the SampEn from the EEG signals, Random Forest was utilised for developing learning regression models with Bispectral index (BIS) as the target. Correlation coefficient, mean absolute error, and area under the curve (AUC) were used to verify the perioperative performance of the proposed method. Validation comparisons with typical nonstationary signal analysis methods (i.e., recurrence analysis and permutation entropy) and regression methods (i.e., neural network and support vector machine) were conducted. To further verify the accuracy and validity of the proposed methodology, the data is divided into four unconsciousness-level groups on the basis of BIS levels. Subsequently, analysis of variance (ANOVA) was applied to the corresponding index (i.e., regression output). Results indicate that the correlation coefficient improved to 0.72 ± 0.09 after filtering and to 0.90 ± 0.05 after regression from the initial values of 0.51 ± 0.17. Similarly, the final mean absolute error dramatically declined to 5.22 ± 2.12. In addition, the ultimate AUC increased to 0.98 ± 0.02, and the ANOVA analysis indicates that each of the four groups of different anaesthetic levels demonstrated significant difference from the nearest levels. Furthermore, the Random Forest output was extensively linear in relation to BIS, thus with better DoA prediction accuracy. In conclusion, the proposed method provides a concrete basis for monitoring patients' anaesthetic level during surgeries.

Virtual screening by a new Clustering-based Weighted Similarity Extreme Learning Machine approach

PubMed Central

Kudisthalert, Wasu

2018-01-01

Machine learning techniques are becoming popular in virtual screening tasks. One of the powerful machine learning algorithms is Extreme Learning Machine (ELM) which has been applied to many applications and has recently been applied to virtual screening. We propose the Weighted Similarity ELM (WS-ELM) which is based on a single layer feed-forward neural network in a conjunction of 16 different similarity coefficients as activation function in the hidden layer. It is known that the performance of conventional ELM is not robust due to random weight selection in the hidden layer. Thus, we propose a Clustering-based WS-ELM (CWS-ELM) that deterministically assigns weights by utilising clustering algorithms i.e. k-means clustering and support vector clustering. The experiments were conducted on one of the most challenging datasets–Maximum Unbiased Validation Dataset–which contains 17 activity classes carefully selected from PubChem. The proposed algorithms were then compared with other machine learning techniques such as support vector machine, random forest, and similarity searching. The results show that CWS-ELM in conjunction with support vector clustering yields the best performance when utilised together with Sokal/Sneath(1) coefficient. Furthermore, ECFP_6 fingerprint presents the best results in our framework compared to the other types of fingerprints, namely ECFP_4, FCFP_4, and FCFP_6. PMID:29652912

Drug-related stigma and access to care among people who inject drugs in Vietnam.

PubMed

Lan, Chiao-Wen; Lin, Chunqing; Thanh, Duong Cong; Li, Li

2018-03-01

There are considerable challenges faced by people with a history of injecting drug use (PWID) in Vietnam, including drug-related stigma and lack of access to healthcare. Seeking and utilising healthcare, as well as harm reduction programs for PWID, are often hampered by drug-related stigma. This study aimed to examine the impacts of drug-related stigma on access to care and utilisation of harm reduction programs among PWID in Vietnam. A cross-sectional study was conducted in two provinces in Vietnam, Phú Thọ and Vinh Phúc. The study participants completed the survey by using Audio Computer-Assisted Self-Interview between late 2014 and early 2015. Linear multiple regression models and logistic regression models were used to assess the relationship among drug-related stigma, access to care and utilisation of harm reduction programs, including methadone maintenance treatment (MMT) and needle exchange programs (NEP). A total of 900 PWID participated in this study. Drug-related stigma was significantly associated with lower level of access to care, but not with utilisation of MMT or NEP. Older age was positively associated with higher levels of access to care. Levels of education were positively correlated with access to care, as well as utilisation of MMT and NEP. This study underscores the need for future interventions to reduce drug-related stigma in society and in health-care settings to improve PWID's utilisation of care services. Special attention should be paid to younger PWID and those with lower levels of education. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Socioeconomic inequalities in dental services utilisation in a Norwegian county: the third Nord-Trondelag Health Survey.

PubMed

Vikum, Eirik; Krokstad, Steinar; Holst, Dorthe; Westin, Steinar

2012-11-01

To assess the level of socioeconomic inequity in dental care utilisation in Norway and enable comparison with recent international comparative studies. We studied dental care utilisation among 17,136 men and 21,414 women in the third Nord-Trøndelag Health Survey (2006-08). Respondents aged 20 years and above were included in the study, and analyses were also performed within subgroups of age and gender (20-39, 40-59, and ≥60 years). Income-related horizontal inequity was estimated by means of concentration indices. Education-related inequity was estimated as relative risks. We found consistent pro-rich income inequity among men and women of all ages. The level of income inequity was highest among men and women ≥60 years, and in this group the income gradient was steepest between the poorest and the middle quintiles. Pro-educated inequity was found exclusively among men and women ≥60 years. General attendance was high (77%). The overall level of income-related inequity in dental services utilisation was low compared to other European countries as reported in two recent international studies of socioeconomic inequalities in dental care utilisation. Pro-rich and pro-educated inequity is a public health challenge mainly in the older part of the population.

Antenatal Care Utilisation and Content between Low-Risk and High-Risk Pregnant Women

PubMed Central

Yeoh, Ping Ling; Hornetz, Klaus; Dahlui, Maznah

2016-01-01

Background The purpose of antenatal care is to monitor and improve the wellbeing of the mother and foetus. The World Health Organization recommends risk-oriented strategy that includes: (i) routine care to all women, (ii) additional care for women with moderately severe diseases and complications, (iii) specialised obstetrical and neonatal care for women with severe diseases and complications. Antenatal care is concerned with adequate care in order to be effective. Measurement for adequacy of antenatal care often applies indexes that assess initiation of care and number of visits. In addition, adequacy of care content should also be assessed. Results of studies in developed settings demonstrate that women without risk factors use antenatal services more frequently than recommended. Such over-utilisation is problematic for low-resourced settings. Moreover, studies show that a substantial proportion of high-risk women had utilisation or content of care below the recommended standard. Yet studies in developing countries have seldom included a comparison between low-risk and high-risk women. The purpose of the study was therefore to assess adequacy of care and pregnancy outcomes for the different risk groups. Methods A retrospective study using a multistage sampling technique, at public-funded primary health care clinics was conducted. Antenatal utilisation level was assessed using a modified Adequacy of Prenatal Care Utilisation index that measures the timing for initiation of care and observed-to-expected visits ratio. Adequacy of antenatal care content assessed compliance to routine care based on the local guidelines. Results Intensive or “adequate-plus” antenatal care utilisation as defined by the modified index was noted in over half of the low-risk women. On the other hand, there were 26% of the high-risk women without the expected intensive utilisation. Primary- or non-educated high-risk women were less likely to have a higher antenatal care utilisation level compared with tertiary educated ones (OR = 0.20, P = 0.003). Half of all women had <80% of the recommended antenatal care content. A higher proportion of high-risk than low-risk women scored <80% of the routine care content (p<0.015). The majority of the additional laboratory tests were performed on high-risk women. Provision of antenatal education showed comparatively poor compliance to guidelines, more than half of the antenatal advice topics assessed were rarely provided to the women. High-risk women were associated with a higher prevalence of adverse pregnancy outcome. Conclusions Disproportionate utilisation of antenatal care according to risk level of pregnancy indicates the need for better scheduling of care. The risk-oriented approach often results in a tendency to focus on the risk conditions of the women. Training interventions are recommended to improve communication and to help healthcare professionals understand the priorities of the women. Further studies are required to assess the reason for disproportionate utilisation of antenatal care according to risk level and how delivery of antenatal advice can be improved, reviewing both user and provider perspectives. PMID:27010482

Time utilisation trends of supported employment services by persons with mental disability in South Africa.

PubMed

Van Niekerk, Lana; Coetzee, Zelda; Engelbrecht, Madri; Hajwani, Zerina; Terreblanche, Santie

2015-01-01

This paper reports on the second phase of a two-phased study that was undertaken to determine the feasibility of supported employment (SE) as a strategy with which to facilitate the employment of persons with disability in competitive work contexts. The study population comprised people with mental disabilities receiving SE in the Western Cape Province, South Africa. To describe the components of SE utilised by persons with mental disability (i.e. psychiatric or intellectual disability) in terms of type and time utilisation patterns over 12 months. Criterion sampling, a form of purposive sampling, was used to identify 29 study participants - 19 with intellectual disability and 10 with psychiatric disability. Data collection commenced for each participant when a work placement had been identified and preparation for such ensued. Data was collected prospectively for a period of 12 months. SE service components utilised by participants were captured using a data capture sheet that was developed for this purpose. Time utilisation indicated a steep downwards trend for both cohorts. The decrease in utilisation of SE service components over a period of one year was more pronounced in the psychiatric disability (PD) cohort, who utilized almost half the total SE services in the first month. SE services can be considered as a viable option for return to work in resource-constrained environments. Providers of SE services will need to modify approaches in order to meet contextual realities.

Fire intensity drives post-fire temporal pattern of soil carbon accumulation in Australian fire-prone forests.

PubMed

Sawyer, Robert; Bradstock, Ross; Bedward, Michael; Morrison, R John

2018-01-01

The impact of fire on global C cycles is considerable but complex. Nevertheless, studies on patterns of soil C accumulation following fires of differing intensity over time are lacking. Our study utilised 15 locations last burnt by prescribed fire (inferred low intensity) and 18 locations last burnt by wildfire (inferred high intensity), with time since fire (TSF) up to 43years, in a homogenous forest type in south eastern Australia. Following a stratified approach to mineral soil sampling, the soil % total C (% C Tot ) and % recalcitrant pyrogenic C (% RPC), were estimated. Generalised additive models indicated increases in % C Tot at TSF >30years in sites last burnt by wildfire. Estimates in sites last subjected to prescribed fire however, remained constant across the TSF chronosequence. There was no significant difference in % C Tot between the different fire types for the first 20years after fire. In the first 10years after wildfires, % RPC was elevated, declining to a minimum at ca. TSF 25years. After prescribed fires, % RPC was unaffected by TSF. Differences in response of % C Tot and % RPC to fire type may reflect the strength of stimulation of early successional processes and extent of charring. The divergent response to fire type in % C Tot was apparent at TSF longer than the landscape average fire return interval (i.e., 15 to 20years). Thus, any attempt to increase C sequestration in soils would require long-term exclusion of fire. Conversely, increased fire frequency is likely to have negligible impact on soil C stocks in these forests. Further investigation of the effects of fire frequency, fire intensity combinations and interaction of fire with other disturbances will enhance prediction of the likely impact of imposed or climatically induced changes to fire regimes on soil C. Copyright © 2017 Elsevier B.V. All rights reserved.

Hospital emergency department utilisation rates among the immigrant population in Barcelona, Spain

PubMed Central

Buron, Andrea; Cots, Francesc; Garcia, Oscar; Vall, Oriol; Castells, Xavier

2008-01-01

Background The recent increase in the number of immigrants of Barcelona represents a challenge for the public healthcare system, the emergency department being the most used healthcare service by this group. However, utilisation rates in our environment have not yet been studied. We aimed to compare emergency department utilisation rates between Spanish-born and foreign-born residents in a public hospital of Barcelona. Methods The study population included all adults residing in the area of study and visiting the emergency department of Hospital del Mar in 2004. The emergency care episodes were selected from the Emergency Department register, and the population figures from the Statistics Department of Barcelona. Emergency care episodes were classified into five large clinical categories. Adjusted rate ratios (RR) of utilisation among foreign-born vs. Spanish-born residents were assessed through negative binomial regression. Results The overall utilisation rate was 382 emergency contacts per 1,000 persons-years. The RR for foreign-born versus Spanish-born residents was 0.62 (95% CI: 0.52; 0.74%). The RR was also significantly below one in surgery (0.51, 95% CI: 0.42; 0.63), traumatology (0.47, 95% CI: 0.38; 0.59), medicine (0.48, 95% CI: 0.38; 0.59) and psychiatry (0.42, 95% CI: 0.18; 0.97). No differences were found in utilisation of gynaecology and minor emergency services. Conclusion The overall lower utilisation rates obtained for foreign-born residents is consistent with previous studies and is probably due to the "healthy immigrant effect". Thus, the population increase due to immigration does not translate directly into a corresponding increase in the number of emergency contacts. The lack of differences in minor and gynaecological emergency care supports the hypothesis that immigrants overcome certain barriers by using the emergency department to access to health services. The issue of healthcare barriers should therefore be addressed, especially among immigrants. PMID:18315871

Resource Utilisation and Curriculum Implementation in Community Colleges in Kenya

ERIC Educational Resources Information Center

Kigwilu, Peter Changilwa; Akala, Winston Jumba

2017-01-01

The study investigated how Catholic-sponsored community colleges in Nairobi utilise the existing physical facilities and teaching and learning resources for effective implementation of Artisan and Craft curricula. The study adopted a mixed methods research design. Proportional stratified random sampling was used to sample 172 students and 18…

Correlate of Resource Utilization and Students' Learning Outcome in Colleges of Education in South West Nigeria

ERIC Educational Resources Information Center

Ibukun, W. O.; Akinfolarin, C. A.; Alimi, O. S.

2011-01-01

This study investigated resource utilisation in vocational and technical education as a correlate of student learning outcome in selected colleges of education in south west Nigeria. The study examined the relationship between time, space and physical resource utilisation and perceived student learning outcome. The study used the descriptive…

The Schooling Experience of Adolescent Boys with AD/HD: An Australian Case Study

ERIC Educational Resources Information Center

Gibbs, Kathryn; Mercer, K. Louise; Carrington, Suzanne

2016-01-01

This study explored the experience of schooling of six adolescent boys diagnosed with AD/HD from the perspectives of the boys, their mothers and their teachers. The study utilised social constructionism as the theoretical orientation and the Dynamic Developmental Theory (DDT) of AD/HD as the explanatory framework. Utilising a multiple,…

Is healthcare really equal for all? Assessing the horizontal and vertical equity in healthcare utilisation among older Ghanaians.

PubMed

Dei, Vincent; Sebastian, Miguel San

2018-06-20

There is a lack of focused research on the older population in Ghana and about issues pertaining to their access to healthcare services. Furthermore, information is lacking regarding the fairness in the access to these services. This study aimed to ascertain whether horizontal and vertical equity requirements were being met in the healthcare utilisation among older adults aged 50 years and above. This study was based on a secondary cross-sectional data from the World Health Organization's Study on global AGEing (SAGE) and adult health wave 1 conducted from 2007 to 2008 in Ghana. Data on 4304 older adults aged 50 years-plus were analysed. Bivariate and multivariable analyses were carried out to analyse the association between outpatient/inpatient utilisation and (1) socioeconomic status (SES), controlling for need variables (horizontal equity) and (2) need variables, controlling for SES (vertical equity). Odds ratios with 95% confidence intervals were calculated to analyse the association between relevant variables. Horizontal and vertical inequities were found in the utilisation of outpatient services. Inpatient healthcare utilisation was both horizontally and vertically equitable. Women were found to be more likely to use outpatient services than men but had reduced odds of using inpatient services. Possessing a health insurance was also significantly associated with the use of both inpatient and outpatient services. Whilst equity exists in inpatient care utilisation, more needs to be done to achieve equity in the access to outpatient services. The study reaffirms the need to evaluate both the horizontal and vertical dimensions in the assessment of equity in healthcare access. It provides the basis for further research in bridging the healthcare access inequity gap among older adults in Ghana.

Determinants of utilisation differences for cancer medicines in Belgium, Scotland and Sweden.

PubMed

Ferrario, Alessandra

2017-12-01

Little comparative evidence is available on utilisation of cancer medicines in different countries and its determinants. The aim of this study was to develop a statistical model to test the correlation between utilisation and possible determinants in selected European countries. A sample of 31 medicines for cancer treatment that obtained EU-wide marketing authorisation between 2000 and 2012 was selected. Annual data on medicines' utilisation covering the in- and out-patient public sectors were obtained from national authorities between 2008 and 2013. Possible determinants of utilisation were extracted from HTA reports and complemented by contacts with key informants. A longitudinal mixed effect model was fitted to test possible determinants of medicines utilisation in Belgium, Scotland and Sweden. In the all-country model, the number of indications reimbursed positively correlated with increased consumption of medicines [one indication 2.6, 95% CI (1.8-3.6); two indications 2.4, 95% CI (1.4-4.3); three indications 4.9, 95% CI (2.2-10.9); all P < 0.01], years since EU-wide marketing authorisation [1.2, 95% CI (1.02-1.4); p < 0.05], price per DDD [0.9, 95% CI (0.998-0.999), P < 0.01], and Prescrire rating [0.5, 95% CI (0.3-0.9), P < 0.05] after adjusting for time and other covariates. In this study, the most important correlates of increased utilisation in a sample of cancer medicines introduced in the past 15 years were: medicines coverage and time since marketing authorisation. Prices had a negative effect on consumption in Belgium and Sweden. The positive impact of financial MEAs in Scotland suggests that the latter may remove the regressive effect of list prices on consumption.

Health services utilisation disparities between English speaking and non-English speaking background Australian infants

PubMed Central

2010-01-01

Background To examine the differences in health services utilisation and the associated risk factors between infants from non-English speaking background (NESB) and English speaking background (ESB) within Australia. Methods We analysed data from a national representative longitudinal study, the Longitudinal Study of Australian Children (LSAC) which started in 2004. We used survey logistic regression coupled with survey multiple linear regression to examine the factors associated with health services utilisation. Results Similar health status was observed between the two groups. In comparison to ESB infants, NESB infants were significantly less likely to use the following health services: maternal and child health centres or help lines (odds ratio [OR] 0.56; 95% confidence intervals [CI], 0.40-0.79); maternal and child health nurse visits (OR 0.68; 95% CI, 0.49-0.95); general practitioners (GPs) (OR 0.58; 95% CI, 0.40-0.83); and hospital outpatient clinics (OR 0.54; 95% CI, 0.31-0.93). Multivariate analysis results showed that the disparities could not be fully explained by the socioeconomic status and language barriers. The association between English proficiency and the service utilised was absent once the NESB was taken into account. Maternal characteristics, family size and income, private health insurance and region of residence were the key factors associated with health services utilisation. Conclusions NESB infants accessed significantly less of the four most frequently used health services compared with ESB infants. Maternal characteristics and family socioeconomic status were linked to health services utilisation. The gaps in health services utilisation between NESB and ESB infants with regard to the use of maternal and child health centres or phone help, maternal and child health nurse visits, GPs and paediatricians require appropriate policy attentions and interventions. PMID:20374663

Utilisation of primary total knee joint replacements across socioeconomic status in the Barwon Statistical Division, Australia, 2006-2007: a cross-sectional study.

PubMed

Brennan, Sharon Lee; Stanford, Tyman; Wluka, Anita E; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

2012-01-01

There are few Australian data that examine the association between total knee joint replacement (TKR) utilisation and socioeconomic status (SES). This study examined TKR surgeries with a diagnosis of osteoarthritis (OA) performed for residents of Barwon Statistical Division (BSD) for 2006-2007. Cross-sectional. BSD, South-eastern Victoria, Australia All patients who underwent a TKR for OA, 2006-2007, and whose residential postcode was identified as within the BSD of Australia, and for whom SES data were available, were eligible for inclusion. Primary TKR data ascertained from the Australian Orthopaedic Association National Joint Replacement Registry. Residential addresses were matched with the Australian Bureau of Statistics census data, and the Index of Relative Socioeconomic Disadvantage was used to determine SES, categorised into quintiles whereby quintile 1 indicated the most disadvantaged and quintile 5 the least disadvantaged. Age-specific and sex-specific rates of TKR utilisation per 1000 person-years were reported for 10-year age bands. Females accounted for 62.7% of the 691 primary TKR surgeries performed during 2006-2007. The greatest utilisation rates of TKR in males was 7.6 observed in those aged >79 years, and in 10.2 in females observed in those aged 70-79 years. An increase in TKR was observed for males in SES quintile four compared to quintile 1 in which the lowest utilisation which was observed (p=0.04). No differences were observed in females across SES quintiles. Further investigation is warranted on a larger scale to examine the role that SES may play in TKR utilisation, and to determine whether any social disparities in TKR utilisation reflect health system biases or geographic differences.

Health service utilisation amongst urban Aboriginal and Torres Strait Islander children aged younger than 5 years registered with a primary health-care service in South-East Queensland.

PubMed

Hall, Kerry K; Chang, Anne B; Anderson, Jennie; Arnold, Daniel; Otim, Michael; O'Grady, Kerry-Ann F

2018-06-01

The majority of Australia's Aboriginal and/or Torres Strait Islander children live in urban areas; however, little is known about their health service use. We aimed to describe health service utilisation amongst a cohort of urban Aboriginal and/or Torres Strait Islander children aged <5 years. We analysed health service utilisation data collected in an ongoing prospective cohort study of children aged <5 years registered with an Aboriginal-owned and operated primary health-care service. Enrolled children were followed monthly for 12 months, with data on health service utilisation collected at baseline and at each monthly follow-up. Health service utilisation rates, overall and by service provider and reason for presentation, were calculated and reported as incidence rates per 100 child-months with the corresponding 95% confidence intervals (CIs). Between February 2013 and November 2015, 180 children were enrolled, and 1541 child-months of observation were available for analysis. The overall incidence of health service utilisation was 52.5 per 100 child-months (95% CI 48.7-56.5); 81% of encounters were with general practitioners. Presentation rates were the highest for acute respiratory illnesses (30.7/100 child-months, 95% CI 27.8-33.9). In this community, acute respiratory illnesses are predominant causes of health service utilisation in young children. The health-care utilisation profile of these children presents important opportunities for health promotion and intervention. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Utilization of physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria.

PubMed

Olaleye, Olubukola Adebisi; Lawal, Zainab Iyabo

2017-03-01

To investigate the pattern of referral for and utilisation of physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria. Referral notes and medical records of patients admitted in the University College Hospital, Ibadan with a clinical diagnosis of stroke between January, 2009 and December, 2013 were retrospectively reviewed. Information on age, sex, type of stroke, length of hospital stay, referral for physiotherapy and utilisation of physiotherapy were retrieved. Data were summarised using descriptive statistics and analysed using Chi-square test. A total of 783 patients with stroke were admitted in the hospital during the period under study. The in-patient mortality rate was 37.2%. The mean Length of Hospital Stay (LoHS) was 16.17±12.34 days. Referral rate for physiotherapy was high (75.8%) and the mean time from admission to referral for physiotherapy was three days. Majority of patients referred utilised physiotherapy (63.4%) and mean number of physiotherapy sessions received during in-patient care was 8.69±6.45. There was a significant association between LoHS and utilisation of in-patientphysiotherapy (p=0.02). The referral rate of stroke patients for physiotherapy was relatively high. Utilisation of in-patient physiotherapy reduced length of hospital stay among patients with stroke. Utilisation of out-patient physiotherapy was low. Strategies to enhance out-patient utilisation should be explored.

Utilisation of joint movement range in arboreal primates compared with human subjects: an evolutionary frame for primary osteoarthritis.

PubMed Central

Alexander, C J

1994-01-01

OBJECTIVE--To determine whether an arboreal lifestyle required full use of movement ranges underutilised in nine joint groups in humans, because under-utilisation of available movement range may be associated with susceptibility to primary osteoarthritis. METHODS--Utilisation of the nine joint groups was studied in two species of primate exercising in a simulated arboreal environment, using 'focal animal' observation techniques supplemented by telephoto photography and by review of archival material from other sources. Fifteen apes were observed over a total observation period of 20.2 man-hours and 152 films were analysed for utilisation of movement range. RESULTS--With one exception, all the movement ranges reported to be under-utilised in humans were fully utilised by the apes in climbing activities. The exception, metacarpophalangeal extension, was an essential component of the chimpanzee ground progression mode of knuckle walking. CONCLUSIONS--The underused movement range in several human joints is explicable as residual capacity from a semiarboreal lifestyle. If the correlation with primary osteoarthritis is confirmed, it suggests that the disease may reflect a disparity between inherited capacity and current need. The significance of the result lies in its implication that primary osteoarthritis may be preventable. Images PMID:7826133

Utilisation of joint movement range in arboreal primates compared with human subjects: an evolutionary frame for primary osteoarthritis.

PubMed

Alexander, C J

1994-11-01

To determine whether an arboreal lifestyle required full use of movement ranges underutilised in nine joint groups in humans, because under-utilisation of available movement range may be associated with susceptibility to primary osteoarthritis. Utilisation of the nine joint groups was studied in two species of primate exercising in a simulated arboreal environment, using 'focal animal' observation techniques supplemented by telephoto photography and by review of archival material from other sources. Fifteen apes were observed over a total observation period of 20.2 man-hours and 152 films were analysed for utilisation of movement range. With one exception, all the movement ranges reported to be under-utilised in humans were fully utilised by the apes in climbing activities. The exception, metacarpophalangeal extension, was an essential component of the chimpanzee ground progression mode of knuckle walking. The underused movement range in several human joints is explicable as residual capacity from a semiarboreal lifestyle. If the correlation with primary osteoarthritis is confirmed, it suggests that the disease may reflect a disparity between inherited capacity and current need. The significance of the result lies in its implication that primary osteoarthritis may be preventable.

Utilisation of hepatocellular carcinoma screening in Australians at risk of hepatitis B virus-related carcinoma and prescribed anti-viral therapy.

PubMed

Sheppard-Law, Suzanne; Zablotska-Manos, Iryna; Kermeen, Melissa; Holdaway, Susan; Lee, Alice; George, Jacob; Zekry, Amany; Maher, Lisa

2018-07-01

To investigate hepatocellular carcinoma screening utilisation and factors associated with utilisation among patients prescribed hepatitis B virus anti-viral therapy and at risk of hepatocellular carcinoma. The incidence of hepatocellular carcinoma has increased in Australia over the past three decades with chronic hepatitis B virus infection a major contributor. hepatocellular carcinoma surveillance programs aim to detect cancers early enabling curative treatment options, longer survival and longer times to recurrence. Multi-site cross-sectional survey. An online study questionnaire was administered to eligible participants attending three Sydney tertiary hospitals. Data were grouped into six mutually exclusive hepatocellular carcinoma risk factor categories as per American Association for the Study of Liver Diseases guidelines. All analyses were undertaken in STATA. Logistic regression was used to assess the associations between covariates and screening utilisation. Multivariate models described were assessed using the Hosmer-Lemeshow goodness of fit. Of the 177 participants, 137 (77.4%) self-reported that US had been performed in the last six months. Awareness that screening should be performed and knowing the correct frequency of US screening were independently associated with screening utilisation. Participants who knew that screening should be undertaken were three times more likely to have had pretreatment education or were prescribed hepatitis B virus anti-viral treatment for >4 years. Participants reporting a family history of hepatocellular carcinoma were less likely to know that screening should be undertaken every 6 months. While utilisation of hepatocellular carcinoma surveillance programs was higher in this study than in previous reports, strategies to further improve surveillance remain necessary. Findings from this research form the basis for proposing strategies to improve utilisation of hepatocellular carcinoma screening, inform hepatitis B virus-related clinical practice and for the delivery of care and nursing education to people receiving hepatitis B virus anti-viral therapy and at risk of developing hepatocellular carcinoma. © 2018 John Wiley & Sons Ltd.

Skills Utilisation at Work, the Quality of the Study Programme and Fields of Study

ERIC Educational Resources Information Center

Støren, Liv Anne; Arnesen, Clara Åse

2016-01-01

This paper examines the factors that may have impact on the extent to which the knowledge and skills of master's degree graduates in Norway are utilised at work, three years after graduation. The focus is on the impact of the quality of the study programme as well as the graduates' fields of study, when also taking into account other factors…

The effects of floodplain forest restoration and logjams on flood risk and flood hydrology

NASA Astrophysics Data System (ADS)

Dixon, Simon; Sear, David A.; Sykes, Tim; Odoni, Nicholas

2015-04-01

Flooding is the most common natural catastrophe, accounting for around half of all natural disaster related deaths and causing economic losses in Europe estimated at over € 2bn per year. In addition flooding is expected to increase in magnitude and frequency with climate change, effectively shortening the return period for a given magnitude flood. Increasing the height and extent of hard engineered defences in response to increased risk is both unsustainable and undesirable. Thus alternative approaches to flood mitigation are needed such as harnessing vegetation processes to slow the passage of flood waves and increase local flood storage. However, our understanding of these effects at the catchment scale is limited. In this presentation we demonstrate the effects of two river restoration approaches upon catchment scale flood hydrology. The addition of large wood to river channels during river restoration projects is a popular method of attempting to improve physical and biological conditions in degraded river systems. Projects utilising large wood can involve the installation of engineered logjams (ELJs), the planting and enhancement of riparian forests, or a combination of both. Altering the wood loading of a channel through installation of ELJs and increasing floodplain surface complexity through encouraging mature woodland could be expected to increase the local hydraulic resistance, increasing the timing and duration of overbank events locally and therefore increasing the travel time of a flood wave through a reach. This reach-scale effect has been documented in models and the field; however the impacts of these local changes at a catchment scale remains to be illustrated. Furthermore there is limited knowledge of how changing successional stages of a restored riparian forest through time may affect its influence on hydromorphic processes. We present results of a novel paired numerical modelling study. We model changes in flood hydrology based on a 98km² catchment using OVERFLOW; a simplified hydrological model using a spatially distributed unit hydrograph approach. Restoration scenarios for the hydrological modelling are informed by the development of a new conceptual model of riparian forest succession, including quantitative estimates of deadwood inputs to the system, using a numerical forest growth model. We explore scenarios using ELJs alone as well as managed and unmanaged riparian forest restoration at scales from reach to sub-catchment. We demonstrate that changes to catchment flood hydrology with restoration are highly location dependant and downstream flood peaks can in some cases increase through synchronisation of sub-catchment flood waves. We constrain magnitude estimates for increases and decreases in flood peaks for modelled restoration scenarios and scales. Finally we analyse the potential for using riparian forest restoration as part of an integrated flood risk management strategy, including specific examples of type and extent of restoration which may prove most beneficial.

Use of native species to improve carbon sequestration and contribute towards solving the environmental problems of the timberlands in Biscay, northern Spain.

PubMed

Rodríguez-Loinaz, Gloria; Amezaga, Ibone; Onaindia, Miren

2013-05-15

The rapid transformation of natural forest areas into fast-growing exotic species plantations, where the main objective is timber and pulp production, has led to a neglect of other services forests provide in many parts of the world. One example of such a problem is the county of Biscay, where the management of these plantations has negative impacts on the environment, creating the necessity to evaluate alternative tree species for use in forestry. The actual crisis in the forest sector of the region could be an opportunity to change to native species plantations that could help restore ecosystem structure and function. However, forest managers of the region are using the current interest on carbon sequestration by forest to persist with the "pine and eucalyptus culture", arguing that these species provide a big C sequestration service. Moreover, they are promoting the expansion of eucalyptus plantations to obtain biomass for the pulp and paper industry and for bioenergy. The aim of this paper is to answer the following questions: Is this argument used by the foresters well-founded? or, could the use of native species in plantations improve the C sequestration service in Biscay while avoiding the environmental problems the actual plantations cause? To answer these questions we created three alternative future scenarios: a) the Services scenario, where there is a substitution of fast-growing exotic plantations by native broadleaf species plantations; b) the Biomass scenario, where there is a bet on eucalyptus plantations; and c) the Business as usual scenario. The changes in the C stock in living biomass in these scenarios have been simulated by a hybrid approach utilising inventories and models, and the period considered was 150 years. Our results show that the substitution of existing exotic plantations by plantations of native species has the greatest potential for increasing C sequestration. Although short- and mid-term outcomes may differ, when the long-term (more than 50 years) is considered, the C stock in the living biomass in the Services scenario is the greatest, accumulating 38% more C than the Business as usual scenario and 70% more C than the Biomass scenario at the end of the study period. Thus, changing pine and eucalyptus by native species in plantations, while solving some of the environmental problems of the actual plantations, sequesters more C in the long-term. As C sequestration initiatives only make sense if there is a good chance of long-term persistence of the C stocks created, there is no C sequestration argument for the foresters to continue with the actual policy of the use of fast-growing exotic species. Copyright © 2013 Elsevier Ltd. All rights reserved.

Public Health Knowledge Utilisation by Policy Actors: An Evaluation Study in Midden-Holland, the Netherlands

ERIC Educational Resources Information Center

de Goede, Joyce; Steenkamer, Betty; Treurniet, Henriëtte; Putters, Kim; van Oers, Hans

2011-01-01

A comprehensive report has been prepared on the state of public health and healthcare in the Midden-Holland region of the Netherlands. This study describes the development of the report and the mechanisms behind public health knowledge utilisation by three groups of health policy actors: local authorities, public health professionals and regional…

Patients’ subjective concepts about primary healthcare utilisation: the study protocol of a qualitative comparative study between Norway and Germany

PubMed Central

Herrmann, Wolfram J; Haarmann, Alexander; Flick, Uwe; Bærheim, Anders; Lichte, Thomas; Herrmann, Markus

2013-01-01

Background In Germany, utilisation of ambulatory healthcare services is high compared with other countries: While a study based on the process data of German statutory health insurances showed an average of 17.1 physician-patient-contacts per year, the comparable figure for Norway is about five. The usual models of healthcare utilisation, such as Rosenstock's Health Belief Model and Andersen's Behavioural Model, cannot explain these differences adequately. Organisational factors of the healthcare system, such as gatekeeping, do not explain the magnitude of the differences. Our hypothesis is that patients’ subjective concepts about primary healthcare utilisation play a major role in explaining different healthcare utilisation behaviour in different countries. Hence, the aim of this study is to explore these subjective concepts comparatively, between Germany and Norway. Methods/design With that aim in mind, we chose a comparative qualitative study design. In Norway and Germany, we are going to interview 20 patients each with qualitative episodic interviews. In addition, we are going to conduct participant observation in four German and four Norwegian primary care practices. The data will be analysed by thematic coding. Using selected categories, we are going to conduct comparative case and group analyses. Ethics and dissemination The study adheres to the Declaration of Helsinki. All interviewees will sign informed consent forms and all patients will be observed during consultation. Strict rules for data security will apply. Developed theory and policy implications are going to be disseminated by a workshop, presentations for experts and laypersons and publications. PMID:23794555

Investigating Over Critical Thresholds of Forest Megafires Danger Conditions in Europe Utilising the ECMWF ERA-Interim Reanalysis

NASA Astrophysics Data System (ADS)

Petroliagkis, Thomas I.; Camia, Andrea; Liberta, Giorgio; Durrant, Tracy; Pappenberger, Florian; San-Miguel-Ayanz, Jesus

2014-05-01

The European Forest Fire Information System (EFFIS) has been established by the Joint Research Centre (JRC) and the Directorate General for Environment (DG ENV) of the European Commission (EC) to support the services in charge of the protection of forests against fires in the EU and neighbour countries, and also to provide the EC services and the European Parliament with information on forest fires in Europe. Within its applications, EFFIS provides current and forecast meteorological fire danger maps up to 6 days. Weather plays a key role in affecting wildfire occurrence and behaviour. Meteorological parameters can be used to derive meteorological fire weather indices that provide estimations of fire danger level at a given time over a specified area of interest. In this work, we investigate the suitability of critical thresholds of fire danger to provide an early warning for megafires (fires > 500 ha) over Europe. Past trends of fire danger are analysed computing daily fire danger from weather data taken from re-analysis fields for a period of 31 years (1980 to 2010). Re-analysis global data sets coming from the construction of high-quality climate records, which combine past observations collected from many different observing and measuring platforms, are capable of describing how Fire Danger Indices have evolved over time at a global scale. The latest and most updated ERA-Interim dataset of the European Centre for Medium-Range Weather Forecast (ECMWF) was used to extract meteorological variables needed to compute daily values of the Canadian Fire Weather Index (CFWI) over Europe, with a horizontal resolution of about 75x75 km. Daily time series of CFWI were constructed and analysed over a total of 1,071 European NUTS3 centroids, resulting in a set of percentiles and critical thresholds. Such percentiles could be used as thresholds to help fire services establish a measure of the significance of CFWI outputs as they relate to levels of fire potential, fuel conditions and fire danger. Median percentile values of fire days accumulated over the 31-year period were compared to median values of all days from that period. As expected, the CWFI time series exhibit different values on fire days than on all days. In addition, a percentile analysis was performed in order to determine the behaviour of index values corresponding to fire events falling into the megafire category. This analysis resulted in a set of critical thresholds based on percentiles. By utilising such thresholds, an initial framework of an early warning system has being established. By lowering the value of any of these thresholds, the number of hits could be increased until all extremes were captured (resulting in zero misses). However, in doing so, the number of false alarms tends to increase significantly. Consequently, an optimal trade-off between hits and false alarms has to be established when setting different (critical) CFWI thresholds.

Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data.

PubMed

Browne, Joyce L; Kayode, Gbenga A; Arhinful, Daniel; Fidder, Samuel A J; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin

2016-03-18

This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care. A population-based cross-sectional study. We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status. Utilisation of antenatal, skilled delivery and postnatal care. Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care. After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01). This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service. 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/

Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis

PubMed Central

2018-01-01

Background Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen’s behavioural model. Methods Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Results Predisposing (OR = 0.89; 95% CI 0.81–0.97) and enabling (OR = 0.90; 95% CI 0.85–0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Conclusions Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services. PMID:29420660

Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis.

PubMed

Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro

2018-01-01

Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

PubMed

Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

2011-10-31

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

Can we reliably estimate managed forest carbon dynamics using remotely sensed data?

NASA Astrophysics Data System (ADS)

Smallman, Thomas Luke; Exbrayat, Jean-Francois; Bloom, A. Anthony; Williams, Mathew

2015-04-01

Forests are an important part of the global carbon cycle, serving as both a large store of carbon and currently as a net sink of CO2. Forest biomass varies significantly in time and space, linked to climate, soils, natural disturbance and human impacts. This variation means that the global distribution of forest biomass and their dynamics are poorly quantified. Terrestrial ecosystem models (TEMs) are rarely evaluated for their predictions of forest carbon stocks and dynamics, due to a lack of knowledge on site specific factors such as disturbance dates and / or managed interventions. In this regard, managed forests present a valuable opportunity for model calibration and improvement. Spatially explicit datasets of planting dates, species and yield classification, in combination with remote sensing data and an appropriate data assimilation (DA) framework can reduce prediction uncertainty and error. We use a Baysian approach to calibrate the data assimilation linked ecosystem carbon (DALEC) model using a Metropolis Hastings-Markov Chain Monte Carlo (MH-MCMC) framework. Forest management information is incorporated into the data assimilation framework as part of ecological and dynamic constraints (EDCs). The key advantage here is that DALEC simulates a full carbon balance, not just the living biomass, and that both parameter and prediction uncertainties are estimated as part of the DA analysis. DALEC has been calibrated at two managed forests, in the USA (Pinus taeda; Duke Forest) and UK (Picea sitchensis; Griffin Forest). At each site DALEC is calibrated twice (exp1 & exp2). Both calibrations (exp1 & exp2) assimilated MODIS LAI and HWSD estimates of soil carbon stored in soil organic matter, in addition to common management information and prior knowledge included in parameter priors and the EDCs. Calibration exp1 also utilises multiple site level estimates of carbon storage in multiple pools. By comparing simulations we determine the impact of site-level observations on uncertainty and error on predictions, and which observations are key to constraining ecosystem processes. Preliminary simulations indicate that DALEC calibration exp1 accurately simulated the assimilated observations for forest and soil carbon stock estimates including, critically for forestry, standing wood stocks (R2 = 0.92, bias = -4.46 MgC ha-1, RMSE = 5.80 MgC ha-1). The results from exp1 indicate the model is able to find parameters that are both consistent with EDC and observations. In the absence of site-level stock observations (exp2) DALEC accurately estimates foliage and fine root pools, while the median estimate of above ground litter and wood stocks (R2 = 0.92, bias = -48.30 MgC ha-1, RMSE = 50.30 MgC ha-1) are over- and underestimated respectively, site-level observations are within model uncertainty. These results indicate that we can estimate managed forests dynamics using remotely sensed data, particularly as remotely sensed above ground biomass maps become available to provide constraint to correct biases in woody accumulation.

Demand and utilisation of labour analgesia service by Nigerian women.

PubMed

Imarengiaye, C O; Ande, A B A

2006-02-01

This study sought to determine the clinical correlates of the demand and utilisation of labour analgesia resources by Nigerian women in labour. All consenting women were interviewed on arrival at the Unit and while in labour. Biodata, options for relief of labour pain, request for analgesia, method of analgesia, VAS score and cervical score at time of request for analgesia were obtained. A total of 288 women in labour were studied. Of these, 108 (37.5%) patients were aware that the pain of labour can be relieved but only 26.0% had prenatal information on labour analgesia. However, 85.1% of the patients would want their pain of labour relieved. A total of 112 (38.9%) did receive analgesia during labour. Cervical dilatation of <4 cm at presentation to the Unit and nulliparity were likely factors for pain treatment during labour (p = 0.001, chi2 test). There is poor utilisation of labour analgesia services. Improved antenatal information on labour analgesia may boost the utilisation of these resources by Nigerian women in labour.

The smartphone in the memory clinic: A study of patient and care partner's utilisation habits.

PubMed

Benge, Jared F; Dinh, Kara L; Logue, Erin; Phenis, Richard; Dasse, Michelle N; Scullin, Michael K

2018-04-16

Smartphones have potential as cognitive aids for adults with cognitive impairments. However, little is known about how patients and their care partners utilise smartphones in their day-to-day lives. We collected self-reported smartphone utilisation data from patients referred for neuropsychological evaluations (N = 53), their care partners (N = 44), and an Amazon Mechanical Turk control sample (N = 204). Patient participants were less likely to own a smartphone than controls, with increasing age associated with less utilisation of smartphone features in all groups. Of the patients who owned smartphones, spontaneous use of cognitive aid features (e.g., reminders and calendars) occurred on only a monthly-to-weekly basis; by comparison, patients reported utilising social/general features (e.g., email and internet) on a weekly-to-daily basis. Individuals referred for geriatric cognitive disorder evaluations were less likely to own and use smartphones than individuals referred for other reasons. Care partners reported using their smartphones more frequently than control group adults, with 55% of care partners endorsing utilising their device in caring for the patient. Building upon existing smartphone use habits to increase the use of cognitive aid features may be a feasible intervention for some patients, and including care partners in such interventions is encouraged.

Impact of Nutritional Status and Sleep Quality on Hospital Utilisation in the Oldest Old with Heart Failure.

PubMed

Selan, S; Hellström, A; Fagerström, C

2016-02-01

To describe three-year trends in nutritional status and sleep quality and their impact on hospital utilisation in the oldest old (80 +) with heart failure (HF). Single-centred longitudinal observational study. South-eastern Sweden. 90 elderly (80+) with objectively verified HF. Baseline data from the Mini Nutritional Assessment (MNA) and on sleep quality were collected through structured interviews following the HF diagnosis (n=90) and at a three-year follow-up (n=41). Data on hospital utilisation during the three years following the HF diagnosis were also collected. Nineteen percent of the participants were found to have impaired nutritional status, a condition that increased hospital utilisation by four bed days per year. A majority (85%) had impaired sleep quality, but no impact on hospital utilisation was found. Nutritional status and sleep quality were stable over the three-year period. In the oldest old with HF, impaired nutritional status and impaired sleep quality are already common at HF diagnosis. Impaired nutritional status increases hospital utilisation significantly. Therefore, it is of supreme importance to systematically evaluate nutritional status and sleep quality in the oldest old when they are diagnosed with HF, as well as to take action if impairments are present.

Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study

PubMed Central

Meng, Di; Palen, Ted E; Tsai, Joanne; McLeod, Melanie; Garrido, Terhilda; Qian, Heather

2015-01-01

Objective To assess associations between secure patient–clinician email use and clinical services utilisation over time. Design Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences between propensity score-matched groups of secure patient–clinician email users and non-users for utilisation 1–12 months before and 7–18 months after first email (users) or a randomly assigned index date (non-users). Setting US integrated healthcare delivery system. Participants 9345 adults with first secure email use between July 2011 and July 2012 and continuous enrolment for ≥30 months and 9345 adults without secure email use between July 2010 and July 2012 matched to users on demographics, health status, and baseline utilisation. Primary Outcome Measures Rates of office visits, patient-initiated phone calls, scheduled telephone visits, after-hours clinic visits, emergency department visits, and hospitalisations. Results After controlling for multiple factors, no statistically significant differences in utilisation between secure email users and non-users occurred. Utilisation transiently increased by 88–237% around first email use. Annual rates of patient-initiated phone calls decreased among secure email users, 0.2 fewer calls per person (95% CI −0.3 to −0.1), from a mean of 4.1 calls per person 1–12 months before first use to a mean of 3.8 calls per person 7–18 months after first use. Rates of patient-initiated phone calls also decreased among non-users, 0.1 fewer calls per person (95% CI −0.2 to 0.0), from a mean of 4.2 calls per person 1–12 months before the index date to mean of 4.1 calls per person 7–18 months after the index date. Conclusions Compared with non-users, patient use of secure email with clinicians was not associated with statistically significant differences in clinical services utilisation 7–18 months after first use. PMID:26553841

Association between secure patient-clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study.

PubMed

Meng, Di; Palen, Ted E; Tsai, Joanne; McLeod, Melanie; Garrido, Terhilda; Qian, Heather

2015-11-09

To assess associations between secure patient-clinician email use and clinical services utilisation over time. Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences between propensity score-matched groups of secure patient-clinician email users and non-users for utilisation 1-12 months before and 7-18 months after first email (users) or a randomly assigned index date (non-users). US integrated healthcare delivery system. 9345 adults with first secure email use between July 2011 and July 2012 and continuous enrolment for ≥30 months and 9345 adults without secure email use between July 2010 and July 2012 matched to users on demographics, health status, and baseline utilisation. Rates of office visits, patient-initiated phone calls, scheduled telephone visits, after-hours clinic visits, emergency department visits, and hospitalisations. After controlling for multiple factors, no statistically significant differences in utilisation between secure email users and non-users occurred. Utilisation transiently increased by 88-237% around first email use. Annual rates of patient-initiated phone calls decreased among secure email users, 0.2 fewer calls per person (95% CI -0.3 to -0.1), from a mean of 4.1 calls per person 1-12 months before first use to a mean of 3.8 calls per person 7-18 months after first use. Rates of patient-initiated phone calls also decreased among non-users, 0.1 fewer calls per person (95% CI -0.2 to 0.0), from a mean of 4.2 calls per person 1-12 months before the index date to mean of 4.1 calls per person 7-18 months after the index date. Compared with non-users, patient use of secure email with clinicians was not associated with statistically significant differences in clinical services utilisation 7-18 months after first use. 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/

The Effect of Children's Rights Training on Primary School Students' Utilisation and Knowledge Level about Children's Rights

ERIC Educational Resources Information Center

Ozmen, Suna Kaymak; Ocal, Tugba; Ozmen, Ahmet

2014-01-01

Recently, children's rights issue has taken attention. In this study, main purpose was to investigate the utilisation and knowledge level of 4th and 5th grade primary school students after children's rights training. The participants of this survey study were selected randomly from 10 schools. Results indicated that students had the chance to…

Demystifying the Rubric: A Five-Step Pedagogy to Improve Student Understanding and Utilisation of Marking Criteria

ERIC Educational Resources Information Center

Jones, Lorraine; Allen, Bill; Dunn, Peter; Brooker, Lesley

2017-01-01

Marking-criteria rubrics are commonly used to judge the quality of student work, but few students receive instruction to effectively use and apply rubrics. This study investigates an intervention designed to encourage effective utilisation of rubrics. The study, completed over two years (2011: n = 189 respondents; 2012: n = 464 respondents) in a…

Pilot Study Evaluation of Suicide Prevention Gatekeeper Training Utilising STORM in a British University Setting

ERIC Educational Resources Information Center

Gask, Linda; Coupe, Nia; McElvenny, Damien; Green, Gill

2017-01-01

Recent years have seen increasing awareness of the wide range of mental health problems faced by students. Gatekeeper training has been shown to have a positive impact on knowledge and attitudes about suicide prevention, although the evidence for skills acquisition is limited. We utilised the STORM® training package in an exploratory study to…

Sample entropy analysis for the estimating depth of anaesthesia through human EEG signal at different levels of unconsciousness during surgeries

PubMed Central

Fan, Shou-Zen; Abbod, Maysam F.

2018-01-01

Estimating the depth of anaesthesia (DoA) in operations has always been a challenging issue due to the underlying complexity of the brain mechanisms. Electroencephalogram (EEG) signals are undoubtedly the most widely used signals for measuring DoA. In this paper, a novel EEG-based index is proposed to evaluate DoA for 24 patients receiving general anaesthesia with different levels of unconsciousness. Sample Entropy (SampEn) algorithm was utilised in order to acquire the chaotic features of the signals. After calculating the SampEn from the EEG signals, Random Forest was utilised for developing learning regression models with Bispectral index (BIS) as the target. Correlation coefficient, mean absolute error, and area under the curve (AUC) were used to verify the perioperative performance of the proposed method. Validation comparisons with typical nonstationary signal analysis methods (i.e., recurrence analysis and permutation entropy) and regression methods (i.e., neural network and support vector machine) were conducted. To further verify the accuracy and validity of the proposed methodology, the data is divided into four unconsciousness-level groups on the basis of BIS levels. Subsequently, analysis of variance (ANOVA) was applied to the corresponding index (i.e., regression output). Results indicate that the correlation coefficient improved to 0.72 ± 0.09 after filtering and to 0.90 ± 0.05 after regression from the initial values of 0.51 ± 0.17. Similarly, the final mean absolute error dramatically declined to 5.22 ± 2.12. In addition, the ultimate AUC increased to 0.98 ± 0.02, and the ANOVA analysis indicates that each of the four groups of different anaesthetic levels demonstrated significant difference from the nearest levels. Furthermore, the Random Forest output was extensively linear in relation to BIS, thus with better DoA prediction accuracy. In conclusion, the proposed method provides a concrete basis for monitoring patients’ anaesthetic level during surgeries. PMID:29844970

The use of secure anonymised data linkage to determine changes in healthcare utilisation following severe open tibial fractures.

PubMed

Page, Piers R J; Trickett, Ryan W; Rahman, Shakeel M; Walters, Angharad; Pinder, Leila M; Brooks, Caroline J; Hutchings, Hayley; Pallister, Ian

2015-07-01

Severe open fractures of the lower limbs are complex injuries requiring expert multidisciplinary management in appropriate orthoplastic centres. This study aimed to assess the impact of open fractures on healthcare utilisation and test the null hypotheses that there is no difference in healthcare utilisation between the year before and year after injury, and that there is no difference in healthcare utilisation in the year post-injury between patients admitted directly to an orthoplastic centre in keeping with the joint BOA/BAPRAS standards and those having initial surgery elsewhere. This retrospective cohort study utilising secure anonymised information linkage (SAIL), a novel databank of anonymised nationally pooled health records, recruited patients over 18 years of age sustaining severe open lower limb fractures managed primarily or secondarily at our centre and who had data available in the SAIL databank. 101 patients met inclusion criteria and 90 of these had records in the SAIL databank. The number of days in hospital, number of primary care attendances, number of outpatient attendances and number of emergency department attendances in the years prior and subsequent to injury were recorded. Patients sustaining open fractures had significantly different healthcare utilisation in the year after injury when compared with the year before, in terms of days spent in hospital (23.42 vs. 1.70, p=0.000), outpatient attendances (11.98 vs. 1.05, p=0.000), primary care attendances (29.48 vs. 11.99, p=0.000) and emergency department presentations (0.2 vs. 0.01, p=0.025). Patients admitted directly to orthoplastic centres had significantly fewer operations (1.78 vs. 3.31) and GP attendances (23.6 vs. 33.52) than those transferred in subsequent to initial management in other units. There is a significant increase in healthcare utilisation after open tibial fracture. Adherence to national standards minimises the impact of this on both patients and health services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are healthcare aides underused in long-term care? A cross-sectional study on continuing care facilities in Canada.

PubMed

Arain, Mubashir A; Deutschlander, Siegrid; Charland, Paola

2017-05-17

Over the last 10 years, appropriate workforce utilisation has been an important discussion among healthcare practitioners and policy-makers. The role of healthcare aides (HCAs) has also expanded to improve their utilisation. This evolving role of HCAs in Canada has prompted calls for standardised training, education and scope of practice for HCAs. The purpose of this research was to examine the differences in HCAs training and utilisation in continuing care facilities. From June 2014 to July 2015, we conducted a mixed-method study on HCA utilisation in continuing care. This paper presents findings gathered solely from the prospective cross-sectional survey of continuing care facilities (long-term care (LTC) and supportive living (SL)) on HCA utilisation. We conducted this study in a Western Canadian province. The managers of the continuing care facilities (SL and LTC) were eligible to participate in the survey. The pattern of HCAs involvement in medication assistance and other care activities in SL and LTC facilities. We received 130 completed surveys (LTC=64 and SL=52). Our findings showed that approximately 81% of HCAs were fully certified. We found variations in how HCAs were used in SL and LTC facilities. Overall, HCAs in SL were more likely to be involved in medication management such as assisting with inhaled medication and oral medication delivery. A significantly larger proportion of survey respondents from SL facilities reported that medication assistance training was mandatory for their HCAs (86%) compared with the LTC facilities (50%) (p value <0.01). The utilisation of HCAs varies widely between SL and LTC facilities. HCAs in SL facilities may be considered better used according to their required educational training and competencies. Expanding the role of HCAs in LTC facilities may lead to a cost-effective and more efficient utilisation of workforce in continuing care facilities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

To fractionate municipal solid waste incineration bottom ash: Key for utilisation?

PubMed

Sormunen, Laura Annika; Rantsi, Riina

2015-11-01

For the past decade, the Finnish waste sector has increasingly moved from the landfilling of municipal solid waste towards waste incineration. New challenges are faced with the growing amounts of municipal solid waste incineration bottom ash, which are mainly landfilled at the moment. Since this is not a sustainable or a profitable solution, finding different utilisation applications for the municipal solid waste incineration bottom ash is crucial. This study reports a comprehensive analysis of bottom ash properties from one waste incineration plant in Finland, which was first treated with a Dutch bottom ash recovery technique called advanced dry recovery. This novel process separates non-ferrous and ferrous metals from bottom ash, generating mineral fractions of different grain sizes (0-2 mm, 2-5 mm, 5-12 mm and 12-50 mm). The main aim of the study was to assess, whether the advanced bottom ash treatment technique, producing mineral fractions of different grain sizes and therefore properties, facilitates the utilisation of municipal solid waste incineration bottom ash in Finland. The results were encouraging; the bottom ash mineral fractions have favourable behaviour against the frost action, which is especially useful in the Finnish conditions. In addition, the leaching of most hazardous substances did not restrict the utilisation of bottom ash, especially for the larger fractions (>5 mm). Overall, this study has shown that the advanced bottom ash recovering technique can be one solution to increase the utilisation of bottom ash and furthermore decrease its landfilling in Finland. © The Author(s) 2015.

The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda.

PubMed

Dhillon, Ranu S; Bonds, Matthew H; Fraden, Max; Ndahiro, Donald; Ruxin, Josh

2012-01-01

This study investigates the impact of subsidising community-based health insurance (mutuelle) enrolment, removing point-of-service co-payments, and improving service delivery on health facility utilisation rates in Mayange, a sector of rural Rwanda of approximately 25,000 people divided among five 'imidugudu' or small villages. While comprehensive service upgrades were introduced in the Mayange Health Centre between April 2006 and February 2007, utilisation rates remained similar to comparison sites. Between February 2007 and April 2007, subsidies for mutuelle enrolment established virtually 100% coverage. Immediately after co-payments were eliminated in February 2007, patient visits levelled at a rate triple the previous value. Regression analyses using data from Mayange and two comparison sites indicate that removing financial barriers resulted in about 0.6 additional annual visits for curative care per capita. Although based on a single local pilot, these findings suggest that in order to achieve improved health outcomes, key short-term objectives include improved service delivery and reduced financial barriers. Based on this pilot, higher utilisation rates may be affected if broader swaths of the population are enrolled in mutuelle and co-payments are eliminated. Health leaders in Rwanda should consider further studies to determine if the impact of eliminating co-payments and increasing subsidies for mutuelle enrolment as seen in Mayange holds at greater levels of scale. Broader studies to better elucidate the impact of enrolment subsidies and co-payment subsidies on utilisation, health outcomes, and costs would also provide policy insights.

Factors associated with postnatal care utilisation in Rwanda: A secondary analysis of 2010 Demographic and Health Survey data.

PubMed

Rwabufigiri, Bernard N; Mukamurigo, Judith; Thomson, Dana R; Hedt-Gautier, Bethany L; Semasaka, Jean Paul S

2016-05-31

Postnatal care (PNC) in the first seven days is important for preventing morbidity and mortality in mothers and new-borns. Sub-Saharan African countries, which account for 62 % of maternal deaths globally, have made major efforts to increase PNC utilisation, but utilisation rates remains low even in countries like Rwanda where PNC services are universally available for free. This study identifies key socio-economic and demographic factors associated with PNC utilisation in Rwanda to inform improved PNC policies and programs. This is a secondary analysis of the 2010 Demographic and Health Survey, a national multi-stage, cross-sectional survey. In bivariate analysis, we used chi-square tests to identify demographic and socio-economic factors associated with PNC utilisation at α = 0.1. Pearson's R statistic (r > 0.5) was used to identify collinear covariates, and to choose which covariate was more strongly associated with PNC utilisation. Manual backward stepwise logistic regression was performed on the remaining covariates to identify key factors associated with PNC utilisation at α = 0.05. All analyses were performed in Stata 13 adjusting for sampling weights, clustering, and stratification. Of the 2,748 women with a live birth in the last two years who answered question about PNC utilisation, 353 (12.8 %) returned for PNC services within seven days after birth. Three factors were positively associated with PNC use: delivering at a health facility (OR: 2.97; 95 % CI: 2.28-3.87), being married but not involved with one's own health care decision-making (OR: 1.69; 95 % CI: 1.17, 2.44) compared to being married and involved; and being in the second (OR: 1.46; 95 % CI: 1.01-2.09) or richest wealth quintile (OR: 2.04; 95 % CI: 1.27-3.29) compared to the poorest. Mother's older age at delivery was negatively associated with PNC use (20-29 - OR: 0.51, 95 % CI: 0.29-0.87; 30-39 - OR: 0.47, 95 % CI: 0.27-0.83; 40-49 - OR: 0.32, 95 % CI: 0.16-0.64). Low PNC utilisation in Rwanda appears to be a universal problem though older age and poverty are further barriers to PNC utilisation. A recent change in the provision of BCG vaccination to new-borns might promote widespread PNC utilisation. We further recommend targeted campaigns to older mothers and poorest mothers, focusing on perceptions of health system quality, cultural beliefs, and pregnancy risks.

Dental health-care service utilisation and its determinants in West Iran: a cross-sectional study.

PubMed

Rezaei, Satar; Woldemichael, Abraha; Zandian, Hamed; Homaie Rad, Enayatollah; Veisi, Navid; Karami Matin, Behzad

2018-06-01

Dental health care is not only an effective strategy for the prevention, early diagnosis and treatment of oral diseases but also contributes to the general health of communities. This study aimed to investigate the situation of dental health-care service utilisation and its determinants in Kermanshah city, western Iran, in 2015. A cross-sectional study on a total of 894 household heads was conducted. The participants were selected using a multistage sampling technique. A self-administered questionnaire was used to collect the data. Multiple logistic regression was performed to assess factors associated with utilisation of dental-care services and a negative binomial regression was carried out to identify the main factor associated with the frequency of visiting a dentist for dental health care. A statistically significant association was considered at a value of P < 0.05. All the analyses were performed using STATA version 12. Of the total household heads who participated in the study, 60.3% and 9.9% reported visiting a dentist for dental treatment in the past year and for 6-monthly dental check-ups, respectively. The average ± standard deviation number of visits by a respondent was 2.08 ± 2.97. Of the total number of respondents, 281 (31.4%) reported visiting a dentist once or twice in the last 12 months for dental health-care services, while 28.9% reported visiting a dentist more than twice in the same time period. Ageing, having dental insurance, higher income, being a university graduate, self-rated poor oral health and not regularly brushing own teeth were the main factors associated with utilisation of dental health-care services. Our study indicates that dental health-care utilisation among households in the study area was influenced by a number of factors, including being socio-economically disadvantaged, self-rated poor oral health and not regularly brushing own teeth. Therefore, in this setting, dental-intervention programmes, including dental health insurance, should focus on mechanisms that can strengthen utilisation of preventive dental health-care services among disadvantaged households. © 2017 FDI World Dental Federation.

Landscape-scale factors affecting feral horse habitat use during summer within the rocky mountain foothills.

PubMed

Girard, Tisa L; Bork, Edward W; Nielsen, Scott E; Neilsen, Scott E; Alexander, Mike J

2013-02-01

Public lands occupied by feral horses in North America are frequently managed for multiple uses with land use conflict occurring among feral horses, livestock, wildlife, and native grassland conservation. The factors affecting habitat use by horses is critical to understand where conflict may be greatest. We related horse presence and abundance to landscape attributes in a GIS to examine habitat preferences using 98 field plots sampled within a portion of the Rocky Mountain Forest Reserve of SW Alberta, Canada. Horse abundance was greatest in grassland and cut block habitats, and lowest in conifer and mixedwood forest. Resource selection probability functions and count models of faecal abundance indicated that horses preferred areas closer to water, with reduced topographic ruggedness, situated farther from forests, and located farther away from primary roads and trails frequented by recreationalists, but closer to small linear features (i.e. cut lines) that may be used as beneficial travel corridors. Horse presence and abundance were closely related to cattle presence during summer, suggesting that both herbivores utilise the same habitats. Estimates of forage biomass removal (44 %) by mid-July were near maximum acceptable levels. In contrast to horse-cattle associations, horses were negatively associated with wild ungulate abundance, although the mechanism behind this remains unclear and warrants further investigation. Our results indicate that feral horses in SW Alberta exhibit complex habitat selection patterns during spring and summer, including overlap in use with livestock. This finding highlights the need to assess and manage herbivore populations consistent with rangeland carrying capacity and the maintenance of range health.

Landscape-Scale Factors Affecting Feral Horse Habitat Use During Summer Within The Rocky Mountain Foothills

NASA Astrophysics Data System (ADS)

Girard, Tisa L.; Bork, Edward W.; Neilsen, Scott E.; Alexander, Mike J.

2013-02-01

Public lands occupied by feral horses in North America are frequently managed for multiple uses with land use conflict occurring among feral horses, livestock, wildlife, and native grassland conservation. The factors affecting habitat use by horses is critical to understand where conflict may be greatest. We related horse presence and abundance to landscape attributes in a GIS to examine habitat preferences using 98 field plots sampled within a portion of the Rocky Mountain Forest Reserve of SW Alberta, Canada. Horse abundance was greatest in grassland and cut block habitats, and lowest in conifer and mixedwood forest. Resource selection probability functions and count models of faecal abundance indicated that horses preferred areas closer to water, with reduced topographic ruggedness, situated farther from forests, and located farther away from primary roads and trails frequented by recreationalists, but closer to small linear features (i.e. cut lines) that may be used as beneficial travel corridors. Horse presence and abundance were closely related to cattle presence during summer, suggesting that both herbivores utilise the same habitats. Estimates of forage biomass removal (44 %) by mid-July were near maximum acceptable levels. In contrast to horse-cattle associations, horses were negatively associated with wild ungulate abundance, although the mechanism behind this remains unclear and warrants further investigation. Our results indicate that feral horses in SW Alberta exhibit complex habitat selection patterns during spring and summer, including overlap in use with livestock. This finding highlights the need to assess and manage herbivore populations consistent with rangeland carrying capacity and the maintenance of range health.

Modular operation of membrane bioreactors for higher hydraulic capacity utilisation.

PubMed

Veltmann, K; Palmowski, L M; Pinnekamp, J

2011-01-01

Using data from 6 full-scale municipal membrane bioreactors (MBR) in Germany the hydraulic capacity utilisation and specific energy consumption were studied and their connexion shown. The average hydraulic capacity utilisation lies between 14% and 45%. These low values are justified by the necessity to deal with intense rain events and cater for future flow increases. However, this low hydraulic capacity utilisation leads to high specific energy consumption. The optimisation of MBR operation requires a better utilisation of MBR hydraulic capacity, particularly under consideration of the energy-intensive membrane aeration. A first approach to respond to large influent flow fluctuations consists in adjusting the number of operating modules. This is practised by most MBR operators but so far mostly with variable flux and constant membrane aeration. A second approach is the real-time adjustment of membrane aeration in line with flux variations. This adjustment is not permitted under current manufacturers' warranty conditions. A further opportunity is a discontinuous operation, in which filtration takes place over short periods at high flux and energy for membrane aeration is saved during filtration pauses. The integration of a buffer volume is thereby indispensable. Overall a modular design with small units, which can be activated/ inactivated according to the influent flow and always operate under optimum conditions, enables a better utilisation of MBR hydraulic capacity and forms a solid base to reduce MBR energy demand.

Barriers to utilisation of antenatal care services in South Sudan: a qualitative study in Rumbek North County.

PubMed

Wilunda, Calistus; Scanagatta, Chiara; Putoto, Giovanni; Montalbetti, Francesca; Segafredo, Giulia; Takahashi, Risa; Mizerero, Serge André; Betrán, Ana Pilar

2017-05-22

Access to adequate antenatal care (ANC) is critical in ensuring a good maternal health and in preventing maternal and neonatal morbidity and mortality. South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic, and political factors. This study was conducted to identify barriers to utilisation of ANC services in Rumbek North County. Using a qualitative design, data were collected through 14 focus group discussions with 169 women and 45 men and 12 key informant interviews with community leaders, staff working in health facilities, and the staff of the County Health Department. Data were analysed using inductive content analysis. The perceived barriers to ANC utilisation were categorised as follows: 1) Issues related to access to health facilities and lack of resources. These included long distance to health facilities, lack of means of transportation to the health facilities, floods and poor roads, and demand for payment for health care at some health facilities; 2) The influence of the socio-cultural context and conflict including heavy burden of domestic chores, the negative influence of husbands who were reluctant to allow their wives to attend ANC, and insecurity; 3) Perceptions about pregnancy including misperceptions about the benefits of ANC and low perceived risk of pregnancy-related complications; and 4) Perceptions about the quality of care and the efficacy of medical treatment. This study identified a myriad of factors deeply entrenched in the society, which prevent women from utilising ANC services. It also elicits broad aspects of interconnectedness among the barriers. To ensure effectiveness, strategies to improve utilisation of ANC in the study area and in similar contexts need to take into account the barriers identified by this study.

Gender and the utilisation of health services in the Ashanti Region, Ghana.

PubMed

Buor, Daniel

2004-09-01

The survey seeks to structure a model for gender-based health services utilisation for the Ashanti Region of Ghana, and in addition, recommend intervention measures to ensure gender equity in the utilisation of health services. A sample size of 650 covered over 3108 houses, and the main research instruments were the questionnaire and formal interview. A multiple regression model is used for the analysis of the relationship between the complex independent variables and utilisation by gender. Results show that although females have a greater need for health services than males, they do not utilise health services as much. Secondly, whereas quality of service, health status, service cost and education have greater effect on male utilisation than females, distance and income have higher impact on female utilisation. It is recommended that, to ensure equity in health care utilisation, females be empowered through increased access to formal education and sustainable income opportunities. The introduction of a national health insurance scheme is also recommended to ensure adequate access by both sexes.

Cost and utilisation of healthcare resources during rehabilitation after ankle fracture are not linked to health insurance, income, gender, or pain: an observational study.

PubMed

Lin, Chung-Wei Christine; Haas, Marion; Moseley, Anne M; Herbert, Robert D; Refshauge, Kathryn M

2008-01-01

What are the costs and utilisation of healthcare resources, their determinants, and quality of life for people attending outpatient physiotherapy after ankle fracture? Longitudinal observational study. Ninety-four adults (2 dropouts) following cast removal after isolated ankle fracture attending outpatient physiotherapy at three hospitals in Sydney, Australia. Costs incurred (direct healthcare costs and out-of-pocket costs) and utilisation of healthcare system resources were measured at 4, 8, 12, 16, 20, and 24 weeks. Quality of life was measured shortly after cast removal and at 4, 12, and 24 weeks. Factors known to influence costs and utilisation in other conditions (private health insurance, income level, gender, and pain) were also measured. The total cost per person was AUD 735 (SD 876) over 24 weeks. Outpatient physiotherapy accounted for the highest costs in both direct healthcare (39%) and out-of-pocket (42%) costs. Less than 20% of participants sought private non-medical care in addition to receiving outpatient physiotherapy. None of the factors investigated had a significant influence on costs and utilisation. Quality of life score improved over the 24 weeks by a mean of 6.1 points out of 45 (95% CI 5.2 to 6.9), with most of the improvement occurring in the domain of independent living. Information on costs and utilisation of healthcare resources can be used to plan health services, eg, the number of physiotherapy sessions required after ankle fracture. Private health insurance, income level, gender, or pain did not influence the costs or the decision behind seeking care over and above publicly-provided physiotherapy.

Withstanding austerity: Equity in health services utilisation in the first stage of the economic recession in Southern Spain.

PubMed

Córdoba-Doña, Juan Antonio; Escolar-Pujolar, Antonio; San Sebastián, Miguel; Gustafsson, Per E

2018-01-01

Scant research is available on the impact of the current economic crisis and austerity policies on inequality in health services utilisation in Europe. This study aimed to describe the trends in horizontal inequity in the use of health services in Andalusia, Spain, during the early years of the Great Recession, and the contribution of demographic, economic and social factors. Consultation with a general practitioner (GP) and specialist, hospitalisation and emergency care were studied through the Andalusian Health Survey 2007 (pre-crisis) and 2011-2012 (crisis), using a composite income index as socioeconomic status (SES) indicator. Horizontal inequity indices (HII) were calculated to take differential healthcare needs into account, and a decomposition analysis of change in inequality between periods was performed. Results showed that before the crisis, the HII was positive (greater access for people with higher SES) for specialist visits but negative (greater access for people with lower SES) in the other three utilisation models. During the crisis no change was observed in inequalities in GP visits, but a pro-poor development was seen for the other types of utilisation, with hospital and emergency care showing significant inequality in favour of low income groups. Overall, the main contributors to pro-poor changes in utilisation were socio-economic variables and poor mental health, due to changes in their elasticities. Our findings show that inequalities in healthcare utilisation largely remained in favour of the less well-off, despite the cuts in welfare benefits and health services provision during the early years of the recession in Andalusia. Further research is needed to monitor the potential impact of such measures in subsequent years.

Withstanding austerity: Equity in health services utilisation in the first stage of the economic recession in Southern Spain

PubMed Central

2018-01-01

Scant research is available on the impact of the current economic crisis and austerity policies on inequality in health services utilisation in Europe. This study aimed to describe the trends in horizontal inequity in the use of health services in Andalusia, Spain, during the early years of the Great Recession, and the contribution of demographic, economic and social factors. Consultation with a general practitioner (GP) and specialist, hospitalisation and emergency care were studied through the Andalusian Health Survey 2007 (pre-crisis) and 2011–2012 (crisis), using a composite income index as socioeconomic status (SES) indicator. Horizontal inequity indices (HII) were calculated to take differential healthcare needs into account, and a decomposition analysis of change in inequality between periods was performed. Results showed that before the crisis, the HII was positive (greater access for people with higher SES) for specialist visits but negative (greater access for people with lower SES) in the other three utilisation models. During the crisis no change was observed in inequalities in GP visits, but a pro-poor development was seen for the other types of utilisation, with hospital and emergency care showing significant inequality in favour of low income groups. Overall, the main contributors to pro-poor changes in utilisation were socio-economic variables and poor mental health, due to changes in their elasticities. Our findings show that inequalities in healthcare utilisation largely remained in favour of the less well-off, despite the cuts in welfare benefits and health services provision during the early years of the recession in Andalusia. Further research is needed to monitor the potential impact of such measures in subsequent years. PMID:29601609

Extent of ESL Teachers' Access To, Utilisation and Production of Research

ERIC Educational Resources Information Center

Sibanda, Jabulani; Begede, Martin P.

2015-01-01

This study employed the survey design on a purposive sample of 100 English Second Language (ESL) teachers from Swaziland and South Africa's Eastern Cape Province, to investigate the extent to which they accessed, utilised and conducted research to better their practice. A survey questionnaire and follow-up structured interviews generated…

The Nature and Significance of Listening Skills in Accounting Practice

ERIC Educational Resources Information Center

Stone, Gerard; Lightbody, Margaret

2012-01-01

While surveys of the employers of accountancy graduates highlight the significance of listening skills, relatively little is known about how such skills are utilised in accounting practice. The present study attempts to address the above lacuna by utilising the findings of in-depth interviews with Australian public accountants about the nature of…

Utilisation and Satisfaction with Rehabilitation Services in Children with Primary Language Impairment Transitioning to School: Parents' Perspective

ERIC Educational Resources Information Center

Mazer, Barbara; Dion, Karyne; Moryoussef, Aguy

2017-01-01

Children with disabilities require coordinated services to optimise transition into school. This study compared type, frequency and approach to service utilisation for children with primary language impairment transitioning from rehabilitation to the educational system, and examined parent satisfaction. Parents responded to a telephone…

Ethnic Variation in Service Utilisation among Children with Intellectual Disability

ERIC Educational Resources Information Center

Dura-Vila, G.; Hodes, M.

2009-01-01

Background: This study examined whether service utilisation among children with intellectual disability (ID) varied by ethnic cultural group. Method: Survey carried out in four special schools in London. Information was provided by school teachers using case files, and 242 children aged 7 to 17 years with mild and moderate ID were identified.…

Estimation of an optimal chemotherapy utilisation rate for cancer: setting an evidence-based benchmark for quality cancer care.

PubMed

Jacob, S A; Ng, W L; Do, V

2015-02-01

There is wide variation in the proportion of newly diagnosed cancer patients who receive chemotherapy, indicating the need for a benchmark rate of chemotherapy utilisation. This study describes an evidence-based model that estimates the proportion of new cancer patients in whom chemotherapy is indicated at least once (defined as the optimal chemotherapy utilisation rate). The optimal chemotherapy utilisation rate can act as a benchmark for measuring and improving the quality of care. Models of optimal chemotherapy utilisation were constructed for each cancer site based on indications for chemotherapy identified from evidence-based treatment guidelines. Data on the proportion of patient- and tumour-related attributes for which chemotherapy was indicated were obtained, using population-based data where possible. Treatment indications and epidemiological data were merged to calculate the optimal chemotherapy utilisation rate. Monte Carlo simulations and sensitivity analyses were used to assess the effect of controversial chemotherapy indications and variations in epidemiological data on our model. Chemotherapy is indicated at least once in 49.1% (95% confidence interval 48.8-49.6%) of all new cancer patients in Australia. The optimal chemotherapy utilisation rates for individual tumour sites ranged from a low of 13% in thyroid cancers to a high of 94% in myeloma. The optimal chemotherapy utilisation rate can serve as a benchmark for planning chemotherapy services on a population basis. The model can be used to evaluate service delivery by comparing the benchmark rate with patterns of care data. The overall estimate for other countries can be obtained by substituting the relevant distribution of cancer types. It can also be used to predict future chemotherapy workload and can be easily modified to take into account future changes in cancer incidence, presentation stage or chemotherapy indications. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

[TANDEM (TAsk force oN long Duration unemployment of Elderly People and Mental health) implementation of a cross-institutional pilot project for elderly long-term unemployed persons - presentation of the project procedure and the utilisation].

PubMed

Steil, C; Meiler, B; Wiesten, I; Wiltfang, J; Kis, B

2013-08-01

The aim of this study is to implement and examine the feasibility of a cross-institutional mental health intervention to comprehend and advance mental health of elderly long-term unemployed persons. Report on the procedure and on the observational study utilisation in a 14-month period. The structure and processes chosen could be implemented into practice successfully. Utilisation was high but 30% dropped out during the procedure. Of the unemployed persons surveyed, 96% received a psychiatric diagnosis. 85% were not having psychiatric treatment. The method chosen is feasible and was accepted by the target group. Project structure and processes proved to be applicable for the implementation of the project aims. The method chosen reaches an up to now "psychiatry-inexperienced" target group characterised by frequent incidence of mental disorders and low utilisation of psychiatric care. Thus, vocational reintegration programmes should be supported by psychiatric services. © Georg Thieme Verlag KG Stuttgart · New York.

The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.

PubMed

Wacker, Margarethe; Holle, Rolf; Heinrich, Joachim; Ladwig, Karl-Heinz; Peters, Annette; Leidl, Reiner; Menn, Petra

2013-07-17

Smoking is seen as the most important single risk to health today, and is responsible for a high financial burden on healthcare systems and society. This population-based cross-sectional study compares healthcare utilisation, direct medical costs, and costs of productivity losses for different smoking groups: current smokers, former smokers, and never smokers. Using a bottom-up approach, data were taken from the German KORA F4 study (2006/2008) on self-reported healthcare utilisation and work absence due to illness for 3,071 adults aged 32-81 years. Unit costs from a societal perspective were applied to utilisation. Utilisation and resulting costs were compared across different smoking groups using generalised linear models to adjust for age, sex, education, alcohol consumption and physical activity. Average annual total costs per survey participant were estimated as €3,844 [95% confidence interval: 3,447-4,233], and differed considerably between smoking groups with never smokers showing €3,237 [2,802-3,735] and former smokers causing €4,398 [3,796-5,058]. There was a positive effect of current and former smoking on the utilisation of healthcare services and on direct and indirect costs. Total annual costs were more than 20% higher (p<0.05) for current smokers and 35% higher (p<0.01) for former smokers compared with never smokers, which corresponds to annual excess costs of €743 and €1,108 per current and former smoker, respectively. Results indicate that excess costs for current and former smokers impose a large burden on society, and that previous top-down cost approaches produced lower estimates for the costs of care for smoking-related diseases. Efforts must be focused on prevention of smoking to achieve sustainable containment on behalf of the public interest.

ICT and OTs: a model of information and communication technology acceptance and utilisation by occupational therapists.

PubMed

Schaper, Louise K; Pervan, Graham P

2007-06-01

There is evidence to suggest that health professionals are reluctant to accept and utilise information and communication technologies (ICT) and concern is growing within health informatics research that this is contributing to the lag in adoption and utilisation of ICT across the health sector. Technology acceptance research within the field of information systems has been limited in its application to health and there is a concurrent need to develop and gain empirical support for models of technology acceptance within health and to examine acceptance and utilisation issues amongst health professionals to improve the success of information system implementation in this arena. This paper outlines a project that examines ICT acceptance and utilisation by Australian occupational therapists. It describes the theoretical basis behind the development of a research model and the methodology being employed to empirically validate the model using substantial quantitative, qualitative and longitudinal data. Preliminary results from Phase II of the study are presented. The theoretical significance of this work is that it uses a thoroughly constructed research model, with potentially the largest sample size ever tested, to extend technology acceptance research into the health sector.

[Day hospitals--predictors for utilisation and quality expectations from the perspective of family caregivers of dementia patients].

PubMed

Donath, Carolin; Bleich, Stefan; Grässel, Elmar

2009-05-01

To relieve the burden on family caregivers of dementia patients, the utilisation of day hospitals should be increased. Therefore, the predictive variables for utilisation as well as family caregivers' views regarding the quality of day hospitals must be investigated. The cross-sectional study was carried out as an anonymous, written survey of family caregivers of dementia patients in four regions of Germany. Quantitative and qualitative data from 404 family caregivers was analysed using binary logistic regression analysis and qualitative content analysis, respectively. In addition, 11 day hospital managers were interviewed concerning their quality concepts. The only significant predictor for the utilisation of day hospitals is the estimate of how helpful this support is for the family caregiver's situation. Those who have already had experiences with a day hospital expressed a wish for medical and psychiatric care by "well-trained" staff and a reasonable form of occupation for the dementia patient. In order to increase utilisation, family caregivers must be convinced of the advantages of using day hospitals. A day hospital that combines both activating occupational therapy and medical care by well-trained staff is what family caregivers wish most for their care-receivers.

Determinants of utilisation of intrapartum obstetric care services in Cambodia, and gaps in coverage.

PubMed

Chomat, Anne Marie; Grundy, John; Oum, Sophal; Bermudez, Odilia I

2011-01-01

Facility delivery and skilled birth attendance are two of the most effective strategies for decreasing maternal mortality. The objectives of this study were to further define utilisation of these services in Cambodia and to uncover socio-economic or location-specific coverage gaps that may exist. We performed a cross-sectional analysis of the 2005 Cambodia Demographic Health Survey (CDHS) to determine prevalence, and determinants, of service utilisation. Out of 6069 women aged 15-49 years, 77% delivered at home, three-fourths without a skilled birth attendant. Poverty, lower education and rural residence were associated with the highest likelihood of poor utilisation of services. Discussion. While there has been an overall increase in facility deliveries and skilled birth attendance since 2000, improvements have been spread unevenly across the population, benefiting mostly urban, wealthier and better educated women. While recent financing initiatives and health system developments appear to have further increased service utilisation since 2005, the extent of their reach to the most vulnerable populations, and their ultimate impact on maternal mortality reduction, remain to be elucidated. Further expanding successful initiatives, particularly among vulnerable populations, is essential. Longitudinal evaluation of ongoing strategies and their impact remains critical.

The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda

PubMed Central

Dhillon, Ranu S.; Bonds, Matthew H.; Fraden, Max; Ndahiro, Donald; Ruxin, Josh

2011-01-01

This study investigates the impact of subsidising community-based health insurance (mutuelle) enrolment, removing point-of-service co-payments, and improving service delivery on health facility utilisation rates in Mayange, a sector of rural Rwanda of approximately 25,000 people divided among five ‘imidugudu’ or small villages. While comprehensive service upgrades were introduced in the Mayange Health Centre between April 2006 and February 2007, utilisation rates remained similar to comparison sites. Between February 2007 and April 2007, subsidies for mutuelle enrolment established virtually 100% coverage. Immediately after co-payments were eliminated in February 2007, patient visits levelled at a rate triple the previous value. Regression analyses using data from Mayange and two comparison sites indicate that removing financial barriers resulted in about 0.6 additional annual visits for curative care per capita. Although based on a single local pilot, these findings suggest that in order to achieve improved health outcomes, key short-term objectives include improved service delivery and reduced financial barriers. Based on this pilot, higher utilisation rates may be affected if broader swaths of the population are enrolled in mutuelle and co-payments are eliminated. Health leaders in Rwanda should consider further studies to determine if the impact of eliminating co-payments and increasing subsidies for mutuelle enrolment as seen in Mayange holds at greater levels of scale. Broader studies to better elucidate the impact of enrolment subsidies and co-payment subsidies on utilisation, health outcomes, and costs would also provide policy insights. PMID:21732708

The effect of overbooking on idle dental chair capacity in the Pretoria region of the Gauteng Oral Health Services.

PubMed

Holtshousen, W S J; Coetzee, E

2012-09-01

An analysis of annual reports revealed that on average 20% of patient appointments with oral hygienists in the Department of Health in the Pretoria region were not utilised due to patient noncompliance (i.e. broken appointments). Many solutions have been considered to address the high rate of noncompliance and the resulting idle chair capacity. One solution selected to overcome some of the negative consequences of broken appointments was deliberate overbooking. The aim of our study was to determine the effect of overbooking on idle dental chair capacity by measuring the utilisation rate over a three month period (July to September) after 25% overbooking was introduced in the Pretoria region. A statistical analysis was conducted on our results to determine an overbooking rate that would ensure full utilisation of the available dental chair capacity. The available time units over the three month study period amounted to 1365, allocated to 1427 patients resulting in an overal overbooking rate of 4.54%. The overall utilisation rate was found to be 79.2%. The calculated regression line estimated that there would be full utilisation of dental chair capacity at an overbooking rate of 26.7%. Overbooking at the levels applied in this study had a minimal overall effect on idle dental chair capacity. Our results confirm the need for careful planning and management in addressing noncompliance. In a manner similar to the clinical situation, organisational development requires a correct diagnosis in order that an appropriate and effective intervention may be designed.

Impact of mass media on the utilization of antenatal care services among women of rural community in Nepal.

PubMed

Acharya, Dilaram; Khanal, Vishnu; Singh, Jitendra Kumar; Adhikari, Mandira; Gautam, Salila

2015-08-12

Antenatal care has several benefits for expecting mothers and birth outcomes; yet many mothers do not utilise this service in Nepal. Mass media may play an important role in increasing the use of antenatal care and other maternal health services. However, the effect of mass media on increasing health service utilisation has remained an under studied area in Nepal. The aim of this study was to investigate the impact of mass media on the utilisation of antenatal care services in rural Nepal. A community-based cross-sectional study was conducted in Sinurjoda Village Development Committee of Dhanusha District, Nepal. A total of 205 mothers of children aged under 1 year were selected using systematic random sampling. Logistic regression was employed to examine the association between selected antenatal care services and mass media exposure after adjusting for other independent variables. A majority of mothers were exposed to mass media. Radio was accessible to most (60.0%) of the participants followed by television (43.41%). Mothers exposed to mass media were more likely to attending antenatal visits [Odds ratio (OR) 6.28; 95% CI (1.01-38.99)], taking rest and sleep during pregnancy [OR 2.65; 95% CI (1.13-6.26)], and receiving TT immunization [OR 5.12; 95% CI (1.23-21.24)] than their non-exposed counterparts. The study reported a positive influence of mass media on the utilisation of antenatal care services in Nepal. Therefore, further emphasis should be given to increase awareness of women of rural Nepal through mass media to improve utilisation of antenatal care services in Nepal.

Understanding Teachers' Perspectives of Factors That Influence Parental Involvement Practices in Special Education in Barbados

ERIC Educational Resources Information Center

Blackman, Stacey; Mahon, Erin

2016-01-01

Parental involvement has been defined in various ways by researchers and is reported to have many advantages for children's education. The research utilises a case study strategy to investigate teachers' perspectives of parental involvement at four case sites in Barbados. In-depth interviews were done with teachers and analysis utilised content…

Exploring the Extent to Which ELT Students Utilise Smartphones for Language Learning Purposes

ERIC Educational Resources Information Center

Yaman, Ismail; Senel, Müfit; Yesilel, Deren Basak Akman

2015-01-01

The advent of smartphones has had dramatic influences on our daily lives and has rendered human beings "walking computers." This holds important reflections in the realm of language learning, as well as in many other areas. This study aimed to explore the extent to which English Language Teaching (ELT) students utilise smartphones for…

Impediments to Effective Utilisation of Information and Communication Technology Tools in Selected Universities in the North-Eastern Nigeria

ERIC Educational Resources Information Center

Momoh, Mustapha

2010-01-01

This study examined the impediments to effective use of Information and Communication Technology (ICT) tools in Nigerian universities. Series of research conducted on the factors militating against computerisation indicated that, there were impediments to effective utilisation of ICT tools in most developing countries. In the light of this, the…

Science Teachers' Utilisation of Innovative Strategies for Teaching Senior School Science in Ilorin, Nigeria

ERIC Educational Resources Information Center

Oyelekan, Oloyede Solomon; Igbokwe, Emoyoke Faith; Olorundare, Adekunle Solomon

2017-01-01

Efforts have been made to improve science teaching in secondary schools in Nigeria, yet, students continue to perform poorly in science subjects. Many innovative teaching strategies have been developed by educators and found to impact significantly on students' academic performance when utilised. Hence, this study was aimed at examining science…

Applications of Mobile GIS in Forestry South Australia

NASA Astrophysics Data System (ADS)

Battad, D. T.; Mackenzie, P.

2012-07-01

South Australian Forestry Corporation (ForestrySA) had been actively investigating the applications of mobile GIS in forestry for the past few years. The main objective is to develop an integrated mobile GIS capability that allows staff to collect new spatial information, verify existing data, and remotely access and post data from the field. Two (2) prototype mobile GIS applications have been developed already using the Environmental Systems Research Institute (ESRI) ARCGISR technology as the main spatial component. These prototype systems are the Forest Health Surveillance System and the Mobile GIS for Wetlands System. The Forest Health Surveillance System prototype is used primarily for aerial forest health surveillance. It was developed using a tablet PC with ArcMapR GIS. A customised toolbar was developed using ArcObjectsR in the Visual Basic 6 Integrated Development Environment (IDE). The resulting dynamic linked library provides a suite of custom tools which enables the following: - quickly create spatial features and attribute the data - full utilisation of global positioning system (GPS) technology - excellent screen display navigation tools, i.e. pan, rotate map, capture of flight path - seamless integration of data into GIS as geodatabase (GDB) feature classes - screen entry of text and conversion to annotation feature classes The Mobile GIS for Wetlands System prototype was developed for verifying existing wetland areas within ForestrySA's plantation estate, collect new wetland data, and record wetland conditions. Mapping of actual wetlands within ForestrySA's plantation estate is very critical because of the need to establish protection buffers around these features during the implementation of plantation operations. System development has been focussed on a mobile phone platform (HTC HD2R ) with WindowsR Mobile 6, ESRI's ArcGISR Mobile software development kit (SDK) employing ArcObjectsR written on C#.NET IDE, and ArcGIS ServerR technology. The system is also implemented in the VILIVR X70. The system has undergone testing by ForestrySA staff and the refinements had been incorporated in the latest version of the system. The system has the following functionalities: - display and query strategic data layers - collect and edit spatial and attribute data - full utilisation of global positioning GPS technology - distance and area measurements - display of high resolution imagery - seamless integration of data into GIS as feature classes - screen display and navigation tools, i.e. pan, zoom in/out, rotate map - capture of flight path The next stages in the development of mobile GIS technologies at ForestrySA are to enhance the systems' capabilities as one of the organization main data capture systems. These include incorporating other applications, e.g. roads/tracks mapping, mapping of significant sites, etc., and migration of the system to Windows Phone7.

Development of a framework to improve the utilisation of malaria research for policy development in Malawi.

PubMed

Mwendera, Chikondi; de Jager, Christiaan; Longwe, Herbert; Hongoro, Charles; Phiri, Kamija; Mutero, Clifford M

2017-11-21

The existing gap between research evidence and public health practice has attributed to the unmet Millennium Development Goals in Africa and consequently, has stimulated the development of frameworks to enhance knowledge translation. These efforts aim at maximising health research utilisation in policy and practice to address the world's disease burdens, including malaria. This study aimed at developing a contextual framework to improve the utilisation of malaria research for policy development in Malawi. The study used two approaches including: two case studies of policy analysis exploring the policy-making process in Malawi, utilisation of local malaria research, and the role of key stakeholders in policy formulation process; and the assessment of facilitating factors and barriers to malaria research utilisation for policy-making in Malawi. From the case studies' lessons and elements identified during the assessment of facilitating factors and barriers, a framework is developed to promote an integrated approach to knowledge translation. In this framework the Ministry of Health is considered as the main user of knowledge from research through the demand created by the research directorate and the National Malaria Control Programme. Key documents identified as being particularly relevant to the Ministry of Health for purposes of knowledge translation include the National Health Research Agenda, Guidelines for Policy Development and Analysis, and Guidelines for Evidence Use in Policy-making. Institutions conducting academic and policy-relevant malaria research in Malawi are identified and a consolidation of their linkages with the users of research is established through the Knowledge Translation Unit, the Evidence Informed decision-making Centre, and the African Institute for Development Policy. Equally, key players in this framework are the funding partners for both research and programmes that need to see accountability and impact of their support. Independent advisors, partners, and consultants also have their vital role in the process. The framework offers a practical basis for the factors identified and their linkages to promote a co-ordinated approach to malaria research utilisation in policy-making. Its applicability and success hinges on its wider dissemination and ownership by the government through the National Malaria Control Programme.

Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon.

PubMed

Fokam, Eric B; Kindzeka, Germaine F; Ngimuh, Leonard; Dzi, Kevin T J; Wanji, Samuel

2017-03-16

Malaria is a serious health concern in Africa. In Cameroon, an endemic country where malaria remains a major public health problem, several control measures have been put in place among which the use of insecticide-treated bednets (LLINs/ITNs) is considered one of the core vector control strategies. However, the greatest challenges include ownership and utilisation by individuals and households. Factors such as age, marital status, gender, education and occupation of the household head, household size, knowledge of bednets, socioeconomic status, and environmental factors have been suggested to have an impact on bednet ownership and utilisation in different settings. The present study sought to determine bednet ownership and utilisation rates and to assess the impact of predictive factors on bednet ownership and use in the Bamenda Health District (BHD) of Cameroon. A cross-sectional study involving 384 households was conducted in six health areas in the BHD. A structured and semi-structured questionnaire was used to collect data on demographic and household characteristics as well as information on their bednet ownership and utilisation. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed. Frequency of bednet ownership was relatively high (63.5%) with LLINs being most abundant (91.9%); the majority of households (87.7%) obtained their bednets during the 2011 free distribution campaign. Utilisation was relatively high (69.3%), with negligence (29.3%) and heat discomfort (26.7%) accounting most for non-usage of bednets. Children less than 5 years (63%) and pregnant women (60%) most often used these nets. Households headed by a married couple, those with older household heads, household with smaller size (5-12 persons), and knowledge of bednets (good knowledge) had positive impacts on bednet ownership (p < 0.05). The gender of the household head (males), their educational level, environmental conditions (presence of suitable mosquito breeding sites), bednet number in households (greater number of bednets) and the prioritised groups (children < 5 and pregnant women) had positive impacts on bednet utilisation in households (p < 0.05). There was a negative association between bednet ownership and utilisation by households as bednet ownership was high and utilisation of these nets was low. Marital status and age of household head, household size, and knowledge of bednets had impacts on bednet ownership while gender and educational level of the household head, environmental suitability, the number of bednets and the two prioritised groups had an impact on bednet usage. These factors may be relevant for policy makers and in decision making for the intensification of campaign strategies to ensure more effective subsequent distribution campaigns in the BHD and beyond.

Improved sugar co-utilisation by encapsulation of a recombinant Saccharomyces cerevisiae strain in alginate-chitosan capsules

PubMed Central

2014-01-01

Background Two major hurdles for successful production of second-generation bioethanol are the presence of inhibitory compounds in lignocellulosic media, and the fact that Saccharomyces cerevisiae cannot naturally utilise pentoses. There are recombinant yeast strains that address both of these issues, but co-utilisation of glucose and xylose is still an issue that needs to be resolved. A non-recombinant way to increase yeast tolerance to hydrolysates is by encapsulation of the yeast. This can be explained by concentration gradients occuring in the cell pellet inside the capsule. In the current study, we hypothesised that encapsulation might also lead to improved simultaneous utilisation of hexoses and pentoses because of such sugar concentration gradients. Results In silico simulations of encapsulated yeast showed that the presence of concentration gradients of inhibitors can explain the improved inhibitor tolerance of encapsulated yeast. Simulations also showed pronounced concentration gradients of sugars, which resulted in simultaneous xylose and glucose consumption and a steady state xylose consumption rate up to 220-fold higher than that found in suspension culture. To validate the results experimentally, a xylose-utilising S. cerevisiae strain, CEN.PK XXX, was constructed and encapsulated in semi-permeable alginate-chitosan liquid core gel capsules. In defined media, encapsulation not only increased the tolerance of the yeast to inhibitors, but also promoted simultaneous utilisation of glucose and xylose. Encapsulation of the yeast resulted in consumption of at least 50% more xylose compared with suspended cells over 96-hour fermentations in medium containing both sugars. The higher consumption of xylose led to final ethanol titres that were approximately 15% higher. In an inhibitory dilute acid spruce hydrolysate, freely suspended yeast cells consumed the sugars in a sequential manner after a long lag phase, whereas no lag phase was observed for the encapsulated yeast, and glucose, mannose, galactose and xylose were utilised in parallel from the beginning of the cultivation. Conclusions Encapsulation of xylose-fermenting S. cerevisiae leads to improved simultaneous and efficient utilisation of several sugars, which are utilised sequentially by suspended cells. The greatest improvement is obtained in inhibitory media. These findings show that encapsulation is a promising option for production of second-generation bioethanol. PMID:25050138

Teachers' Perceptions of the Utilisation of Emotional Intelligence by Their School Principals to Manage Mandated Curriculum Change Processes

ERIC Educational Resources Information Center

Grobler, Bennie; Moloi, Connie; Thakhordas, Sunita

2017-01-01

This quantitative study investigates teachers' perceptions of how Emotional Intelligence (EI) was utilised by their school principals to manage mandated curriculum change processes in schools in the Johannesburg North district of Gauteng in South Africa. Research shows that EI consists of a range of fundamental skills that could enable school…

Motivational Strategies and Utilisation of Internet Resources as Determinants of Research Productivity of Lecturers in Universities of Agriculture in Nigeria

ERIC Educational Resources Information Center

Ajegbomogun, Fredrick Olatunji; Popoola, Sunday Olarenwaju

2013-01-01

This study examined motivational strategies and utilisation of Internet resources as determinants of research productivity of lecturers in universities of agriculture in Nigeria. One thousand, one hundred and thirty two (1,132) copies of the questionnaire were administered on the lecturers in universities of agriculture in Nigeria. Eight hundred…

Utilisation and Impact of the Essential Electronic Agricultural Database (TEEAL) on Library Services in a Nigerian University of Agriculture

ERIC Educational Resources Information Center

Oduwole, A. A.; Sowole, A. O.

2006-01-01

Purpose: This study examined the utilisation of the Essential Electronic Agricultural Library database (TEEAL) at the University of Agriculture Library, Abeokuta, Nigeria. Design/methodology/approach: Data collection was by questionnaire following a purposive sampling technique. A total of 104 out 150 (69.3 per cent) responses were received and…

Skill Formation and Utilisation in the Post-Soviet Transition: Higher Education Planning in Post-Soviet Georgia

ERIC Educational Resources Information Center

Gvaramadze, Irakli

2010-01-01

Changes in the former Soviet system had a dramatic influence on higher education in Georgia. The main objective of the current article is to analyse implications of the post-Soviet transition for the skill formation and skill utilisation system in Georgia. In particular, the study analyses recent trends in Georgian higher education including…

Integrated nuclear data utilisation system for innovative reactors.

PubMed

Yamano, N; Hasegawa, A; Kato, K; Igashira, M

2005-01-01

A five-year research and development project on an integrated nuclear data utilisation system was initiated in 2002, for developing innovative nuclear energy systems such as accelerator-driven systems. The integrated nuclear data utilisation system will be constructed as a modular code system, which consists of two sub-systems: the nuclear data search and plotting sub-system, and the nuclear data processing and utilisation sub-system. The system will be operated with a graphical user interface in order to enable easy utilisation through the Internet by both nuclear design engineers and nuclear data evaluators. This paper presents an overview of the integrated nuclear data utilisation system, describes the development of a prototype system to examine the operability of the user interface and discusses specifications of the two sub-systems.

Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study

PubMed Central

Gerritsen, Annette AM; Bramsen, Inge; Devillé, Walter; van Willigen, Loes HM; Hovens, Johannes E; van der Ploeg, Henk M

2004-01-01

Background This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. Methods/Design The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees. PMID:15070416

Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study.

PubMed

Gerritsen, Annette A M; Bramsen, Inge; Devillé, Walter; van Willigen, Loes H M; Hovens, Johannes E; van der Ploeg, Henk M

2004-03-10

This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees.

Who benefits from public health financing in Zimbabwe? Towards universal health coverage.

PubMed

Shamu, Shepherd; January, James; Rusakaniko, Simbarashe

2017-09-01

Zimbabwe's public health financing model is mostly hospital-based. Financing generally follows the bigger and higher-level hospitals at the expense of smaller, lower-level ones. While this has tended to perpetuate inequalities, the pattern of healthcare services utilisation and benefits on different levels of care and across different socioeconomic groups remains unclear. The purpose of this study was therefore to assess the utilisation of healthcare services and benefits at different levels of care by different socioeconomic groups. We conducted secondary data analysis of the 2010 National Health Accounts survey, which had 7084 households made up of 26,392 individual observations. Results showed significant utilisation of health services by poorer households at the district level (concentration index of -0.13 [CI:-0.2 to -0.06; p < .05]), but with mission hospitals showing equitable utilisation by both groups. Provincial and higher levels showed greater utilisation by richer households (0.19; CI: 0.1-0.29; p < .05). The overall results showed that richer households benefited significantly more from public health funds than poorer households (0.26; CI: 0.2-0.4; p < .05). Richer households disproportionately benefited from public health subsidies overall, particularly at secondary and tertiary levels, which receive more funding and provide a higher level of care.

Low use of contraceptives among rural women in Maitha, Uttar Pradesh, India.

PubMed

Saroha, Ekta; Altarac, Maja; Sibley, Lynn M

2013-05-01

Low contraceptive utilisation and high fertility in rural Uttar Pradesh (UP), India, is a major concern for the world's second most populous country. The association between reasons for low contraceptive utilisation and maternal factors has been inadequately researched. Data from the 'morbidity and performance assessment' study were analysed to explore reasons for low contraceptive utilisation and their association with maternal factors among 308 women in Maitha, rural UP, India. Chi-square, t-test, ANOVA, and logistic regression analyses were conducted. Majority (84.2%) of the rural women in Maitha, UP, India were not using any contraceptives. Upper caste, literate wives, and wives whose husbands were literate were more likely to use contraceptives. About one-third of the women did not want to use a contraceptive because they wanted another child. Large numbers (65.3%) of women wanted to use contraceptives but were unable to do so due to lack of knowledge (38.9%), fear of side-effects (15.5%), husband/family disapproval (15.5%), inconvenience (10.7%), and other reasons (19.1%). Maternal parity, wives' and husband's literacy were significantly associated with the reasons for low contraceptive utilisation (p < 0.05). Contraceptive utilisation can be Improved by taking into consideration such maternal characteristics. All state subsidised contraceptives should be more widely known, understood and made available.

Impact of measles supplementary immunisation activities on utilisation of maternal and child health services in low-income and middle-income countries.

PubMed

Postolovska, Iryna; Helleringer, Stéphane; Kruk, Margaret E; Verguet, Stéphane

2018-01-01

Measles supplementary immunisation activities (SIAs) are an integral component of measles elimination in low-income and middle-income countries (LMICs). Despite their success in increasing vaccination coverage, there are concerns about their negative consequences on routine services. Few studies have conducted quantitative assessments of SIA impact on utilisation of health services. We analysed the impact of SIAs on utilisation of selected maternal and child health services using Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 28 LMICs, where at least one SIA occurred over 2000-2014. Logistic regressions were conducted to investigate the association between SIAs and utilisation of the following services: facility delivery, postnatal care and outpatient sick child care (for fever, diarrhoea, cough). SIAs do not appear to significantly impact utilisation of maternal and child services. We find a reduction in care-seeking for treatment of child cough (OR 0.67; 95% CI 0.48 to 0.95); and a few significant effects at the country level, suggesting the need for further investigation of the idiosyncratic effects of SIAs in each country. The paper contributes to the debate on vertical versus horizontal programmes to ensure universal access to vaccination. Measles SIAs do not seem to affect care-seeking for critical conditions.

Low utilisation of diabetes medicines in Iran, despite their affordability (2000–2012): a time-series and benchmarking study

PubMed Central

Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah

2014-01-01

Objectives Diabetes is a major public health concern worldwide, particularly in low-income and middle-income countries (LMICs). Limited data exist on the status of access to diabetes medicines in LMICs. We assessed the utilisation and affordability of diabetes medicines in Iran as a middle-income country. Design We used a retrospective time-series design (2000–2012) and assessed national diabetes medicines’ utilisation using pharmaceuticals wholesale data. Methods We calculated defined daily dose consumptions per population days (DDDs/1000 inhabitants/day; DIDs) indicator. Findings were benchmarked with data from Organization for Economic Co-operation and Development (OECD) countries. We also employed Drug Utilization-90% (DU-90) method to compare DU-90s with the Essential Medicines List published by the WHO. We measured affordability using number of minimum daily wage required to purchase a treatment course for 1 month. Results Diabetes medicines’ consumption increased from 4.47 to 33.54 DIDs. The benchmarking showed that medicines’ utilisation in Iran in 2011 was only 54% of the median DIDs of 22 OECD countries. Oral hypoglycaemic agents consisted over 80% of use throughout the study period. Regular and isophane insulin (NPH), glibenclamide, metformin and gliclazide were the DU-90 drugs in 2012. Metformin, glibenclamide and regular/NPH insulin combination therapy were affordable throughout the study period (∼0.4, ∼0.1, ∼0.3 of minimum daily wage, respectively). While the affordability of novel insulin preparations improved over time, they were still unaffordable in 2012. Conclusions The utilisation of diabetes medicines was relatively low, perhaps due to underdiagnosis and inadequate management of patients with diabetes. This had occurred despite affordability of essential diabetes medicines in Iran. Appropriate policies are required to address the underutilisation of diabetes medicines in Iran. PMID:25324322

Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria

PubMed Central

Emelumadu, Obiageli F.; Onyeonoro, Ugochukwu Uchenna; Ukegbu, Andrew Ugwunna; Ezeama, Nkiru N.; Ifeadike, Chigozie Ozoemena; Okezie, Obasi Kanu

2014-01-01

Background: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees’ perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. Materials and Methods: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. Results: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4–98.4%) and natal services (92.7%; 95% CI 89.2–95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X2 = 4.61, P = 0.032), married (X2 = 9.70, P = 0.008) and multiparous (X2 = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X2 = 26.94, P = 0.000) and natal (X2 = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. Conclusions: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services. PMID:24791050

A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises.

PubMed

Singh, Neha S; Aryasinghe, Sarindi; Smith, James; Khosla, Rajat; Say, Lale; Blanchet, Karl

2018-01-01

Women and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries. We searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach. Of the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers. Despite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations.

A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises

PubMed Central

Aryasinghe, Sarindi; Smith, James; Khosla, Rajat; Say, Lale; Blanchet, Karl

2018-01-01

Introduction Women and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries. Methods We searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach. Results Of the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers. Conclusions Despite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations. PMID:29736272

Changes in health care utilisation following a reform involving choice and privatisation in Swedish primary care: a five-year follow-up of GP-visits

PubMed Central

2013-01-01

Background The organisation of Swedish primary health care has changed following introduction of free choice of provider for the population in combination with freedom of establishment for private primary care providers. Our aim was to investigate changes in individual health care utilisation following choice and privatisation in Swedish primary care from an equity perspective, in subgroups defined by age, gender and family income. Methods The study is based on register data years 2007 – 2011 from the Skåne Regional Council (population 1.2 million) regarding individual health care utilisation in the form of visits to general practitioner (GP). Health utilisation data was matched with data about individual’s age, gender and family income provided by Statistics Sweden. Multilevel, logistic regression models were constructed to analyse changes in health utilisation in different subgroups and the probability of a GP-visit before and after reform. Results Health care utilisation in terms of both number of individuals that had visited a GP and number of GP-visits per capita increased in all defined subgroups, but to a varying degree. Multilevel logistic regression showed that individuals of both genders aged above 64 and belonging to a family with an income above median had more advantage of the reform, OR 1.25-1.29. Conclusions Reforms involving choice and privatisation in Swedish primary health care improved access to GP-visits generally, but more so for individuals belonging to a family with income above the median. PMID:24171894

Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales

NASA Astrophysics Data System (ADS)

Jegasothy, Edward; McGuire, Rhydwyn; Nairn, John; Fawcett, Robert; Scalley, Benjamin

2017-08-01

Periods of successive extreme heat and cold temperature have major effects on human health and increase rates of health service utilisation. The severity of these events varies between geographic locations and populations. This study aimed to estimate the effects of heat waves and cold waves on health service utilisation across urban, regional and remote areas in New South Wales (NSW), Australia, during the 10-year study period 2005-2015. We divided the state into three regions and used 24 over-dispersed or zero-inflated Poisson time-series regression models to estimate the effect of heat waves and cold waves, of three levels of severity, on the rates of ambulance call-outs, emergency department (ED) presentations and mortality. We defined heat waves and cold waves using excess heat factor (EHF) and excess cold factor (ECF) metrics, respectively. Heat waves generally resulted in increased rates of ambulance call-outs, ED presentations and mortality across the three regions and the entire state. For all of NSW, very intense heat waves resulted in an increase of 10.8% (95% confidence interval (CI) 4.5, 17.4%) in mortality, 3.4% (95% CI 0.8, 7.8%) in ED presentations and 10.9% (95% CI 7.7, 14.2%) in ambulance call-outs. Cold waves were shown to have significant effects on ED presentations (9.3% increase for intense events, 95% CI 8.0-10.6%) and mortality (8.8% increase for intense events, 95% CI 2.1-15.9%) in outer regional and remote areas. There was little evidence for an effect from cold waves on health service utilisation in major cities and inner regional areas. Heat waves have a large impact on health service utilisation in NSW in both urban and rural settings. Cold waves also have significant effects in outer regional and remote areas. EHF is a good predictor of health service utilisation for heat waves, although service needs may differ between urban and rural areas.

Can authorities appreciably enhance the prescribing of oral generic risperidone to conserve resources? Findings from across Europe and their implications.

PubMed

Godman, Brian; Petzold, Max; Bennett, Kathleen; Bennie, Marion; Bucsics, Anna; Finlayson, Alexander E; Martin, Andrew; Persson, Marie; Piessnegger, Jutta; Raschi, Emanuel; Simoens, Steven; Zara, Corinne; Barbui, Corrado

2014-06-13

Generic atypical antipsychotic drugs offer health authorities opportunities for considerable savings. However, schizophrenia and bipolar disorders are complex diseases that require tailored treatments. Consequently, generally there have been limited demand-side measures by health authorities to encourage the preferential prescribing of generics. This is unlike the situation with hypertension, hypercholaesterolaemia or acid-related stomach disorders.The objectives of this study were to compare the effect of the limited demand-side measures in Western European countries and regions on the subsequent prescribing of risperidone following generics; to utilise the findings to provide future guidance to health authorities; and where possible, to investigate the utilisation of generic versus originator risperidone and the prices for generic risperidone. Principally, this was a segmented regression analysis of retrospective time-series data of the effect of the various initiatives in Belgium, Ireland, Scotland and Sweden following the introduction of generic risperidone. The study included patients prescribed at least one atypical antipsychotic drug up to 20 months before and up to 20 months after generic risperidone. In addition, retrospective observational studies were carried out in Austria and Spain (Catalonia) from 2005 to 2011 as well as one English primary care organisation (Bury Primary Care Trust (PCT)). There was a consistent steady reduction in risperidone as a percentage of total selected atypical antipsychotic utilisation following generics. A similar pattern was seen in Austria and Spain, with stable utilisation in one English PCT. However, there was considerable variation in the utilisation of generic risperidone, ranging from 98% of total risperidone in Scotland to only 14% in Ireland. Similarly, the price of generic risperidone varied considerably. In Scotland, generic risperidone was only 16% of pre-patent loss prices versus 72% in Ireland. Consistent findings of no increased prescribing of risperidone post generics with limited specific demand-side measures suggests no 'spillover' effect from one class to another encouraging the preferential prescribing of generic atypical antipsychotic drugs. This is exacerbated by the complexity of the disease area and differences in the side-effects between treatments. There appeared to be no clinical issues with generic risperidone, and prices inversely reflected measures to enhance their utilisation.

Mental Health Status, Health Care Utilisation, and Service Satisfaction among Immigrants in Montreal: An Epidemiological Comparison.

PubMed

Whitley, Rob; Wang, JiaWei; Fleury, Marie-Josee; Liu, Aihua; Caron, Jean

2017-08-01

To examine variations between immigrants and nonimmigrants in 1) prevalence of common mental disorders and other mental health variables; 2) health service utilisation for emotional problems, mental disorders, and addictions, and 3) health service satisfaction. This article is based on a longitudinal cohort study conducted from May 2007 to the present: the Epidemiological Catchment Area Study of Montreal South-West (ZEPSOM). Participants were followed up at 4 time points (T1, n = 2433; T4, n = 1095). Core exposure variables include immigrant status (immigrant vs. nonimmigrant), duration of residence, and region of origin. Key outcome variables included mental health status, health service utilisation, and health service satisfaction. Data were analysed both cross-sectionally and longitudinally. Immigrants had been in Canada for 20 years on average. Immigrants had significantly lower rates of high psychological distress (32.6% vs. 39.1%, P = 0.016), alcohol dependence (1.4% vs. 3.9%, P =0.010), depression (5.2% vs. 9.2%, P = 0.008), and various other mental disorders. They had significantly higher scores of mental well-being (48.9 vs. 47.1 score, P = 0.014) and satisfaction with social (34.0 vs. 33.4 score, P = 0.021) and personal relationships (16.7 vs. 15.6 score, P < 0.001). Immigrants had significantly lower rates of health service utilisation for emotional problems, mental disorders, and addictions and significantly higher rates of health service satisfaction at all time points. Asian and African immigrants had particularly low rates of utilisation and high rates of satisfaction. Immigrants had better overall mental health than nonimmigrants.

Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivery in the Philippines.

PubMed

Hodge, Andrew; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez-Soto, Eliana

2016-07-06

Despite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. The aim of this study is to decompose the principal factors driving the wealth-based utilisation gap. Using national representative data from the 2013 Philippines Demographic and Health Survey, we examine the extent overall differences in the utilisation of maternal health services can be explained by observable factors. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect of differences in measurable characteristics on the wealth-based coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was respectively 41.1 % and 74.6 % for poor and non-poor households. Between 67 and 69 % of the wealth-based coverage gap was explained by differences in observed characteristics. After controlling for factors characterising the socioeconomic status of the household (i.e. the mothers' and her partners' education and occupation), the birth order of the child was the major factor contributing to the disparity. Mothers' religion and the subjective distance to the health facility were also noteworthy. This study has found moderate wealth-based disparities in the utilisation of institutional delivery in the Philippines. The results confirm the importance of recent efforts made by the Philippine government to implement equitable, pro-poor focused health programs in the most deprived geographic areas of the country. The importance of addressing the social determinants of health, particularly education, as well as developing and implementing effective strategies to encourage institutional delivery for higher order births, should be prioritised.

The Effect of Urban Basic Medical Insurance on Health Service Utilisation in Shaanxi Province, China: A Comparison of Two Schemes

PubMed Central

Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

2014-01-01

Background Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Methods Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Results Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Conclusion Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services. PMID:24740282

The effects of new pricing and copayment schemes for pharmaceuticals in South Korea.

PubMed

Lee, Iyn-Hyang; Bloor, Karen; Hewitt, Catherine; Maynard, Alan

2012-01-01

This study examined the effect of new Korean pricing and copayment schemes for pharmaceuticals (1) on per patient drug expenditure, utilisation and unit prices of overall pharmaceuticals; (2) on the utilisation of essential medications and (3) on the utilisation of less costly alternatives to the study medication. Interrupted time series analysis using retrospective observational data. The increasing trend of per patient drug expenditure fell gradually after the introduction of a new copayment scheme. The segmented regression model suggested that per patient drug expenditure might decrease by about 12% 1 year after the copayment increase, compared with the absence of such a policy, with few changes in overall utilisation and unit prices. The level of savings was much smaller when the new price scheme was included, while the effects of a price cut were inconclusive due to the short time period before an additional policy change. Based on the segmented regression models, we estimate that the number of patients filling their antihyperlipidemics prescriptions decreased by 18% in the corresponding period. Those prescribed generic and brand-named antihyperlipidemics declined by around 16 and 19%, respectively, indicating little evidence of generic substitution resulting from the copayment increase. Few changes were found in the use of antihypertensives. The policies under consideration appear to contain costs not by the intended mechanisms, such as substituting generics for brand name products, but by reducing patients' access to costly therapies regardless of clinical necessity. Thus, concerns were raised about potentially compromising overall health and loss of equity in pharmaceutical utilisation. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The effect of urban basic medical insurance on health service utilisation in Shaanxi Province, China: a comparison of two schemes.

PubMed

Zhou, Zhongliang; Zhou, Zhiying; Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

2014-01-01

Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.

Household training vs. mass campaigns: a better method of health communication for preventing malaria.

PubMed

Chourasia, Mehul Kumar; Abraham, Vinod J; John, Jacob

2014-10-01

Malaria is endemic in several states of India with high tribal population. Effective use of long-lasting insecticide treated bed nets (LLITNs) can reduce the burden of malaria in these settings. This study assessed the knowledge and behaviour regarding malaria in a tribal population and compared two health education strategies for enhancing effective utilisation of bed nets. A community-based intervention study was carried out among 218 households in two villages. One community received household level training on effective utilisation of LLITNs while the others received training in a mass campaign and outcomes were measured after 2 months. The study showed that the proportion utilising LLITNs was significantly higher among those receiving household level training as compared to those who received the mass campaign. Household level training appears to be a more effective form of health education for improving knowledge and promoting use of LLITNs in these isolated community groups. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Environmentally friendly use of non-coal ashes in Sweden.

PubMed

Ribbing, C

2007-01-01

The Swedish Thermal Engineering Research Institute (Värmeforsk) initiated an applied research program "Environmentally friendly use of non-coal ashes", in 2002. The program aims at increasing knowledge on the by-products of energy production and their application. The goal of formulating technical and environmental guidelines and assessments is a major point of the program, which is supported by about forty authorities and private organisations. The programme has been divided into four areas: recycling of ashes to forests, geotechnical applications, use in landfilling, and environmental aspects and chemistry. Among all results obtained, the following progress is shown: *Evidence for the positive effects of spreading ashes on forest growth. *A proposal for environmental guidelines on the utilisation of ashes in construction. *A handbook for using non-coal fly ashes in unpaved roads. *Technical and environmental assessments of MSWI bottom ashes in road construction. *Development of the use of ashes with municipal wastewater sludge as a cover for landfills and mine tailings. *Use of ashes from bio-fuels in concrete and replacement of cement in stoop mining. *A method to classify those by-products from combustion that have mirror entries in the EWC as a hazardous or non-hazardous compound. The Ash Programme has also made it possible to increase knowledge on ashes as valuable materials, on quality assurance and on markets for recovered materials.

Bush encroachment monitoring using multi-temporal Landsat data and random forests

NASA Astrophysics Data System (ADS)

Symeonakis, E.; Higginbottom, T.

2014-11-01

It is widely accepted that land degradation and desertification (LDD) are serious global threats to humans and the environment. Around a third of savannahs in Africa are affected by LDD processes that may lead to substantial declines in ecosystem functioning and services. Indirectly, LDD can be monitored using relevant indicators. The encroachment of woody plants into grasslands, and the subsequent conversion of savannahs and open woodlands into shrublands, has attracted a lot of attention over the last decades and has been identified as a potential indicator of LDD. Mapping bush encroachment over large areas can only effectively be done using Earth Observation (EO) data and techniques. However, the accurate assessment of large-scale savannah degradation through bush encroachment with satellite imagery remains a formidable task due to the fact that on the satellite data vegetation variability in response to highly variable rainfall patterns might obscure the underlying degradation processes. Here, we present a methodological framework for the monitoring of bush encroachment-related land degradation in a savannah environment in the Northwest Province of South Africa. We utilise multi-temporal Landsat TM and ETM+ (SLC-on) data from 1989 until 2009, mostly from the dry-season, and ancillary data in a GIS environment. We then use the machine learning classification approach of random forests to identify the extent of encroachment over the 20-year period. The results show that in the area of study, bush encroachment is as alarming as permanent vegetation loss. The classification of the year 2009 is validated yielding low commission and omission errors and high k-statistic values for the grasses and woody vegetation classes. Our approach is a step towards a rigorous and effective savannah degradation assessment.

Advanced fire observation by the Intelligent Infrared Sensor prototype FOCUS on the International Space Station

NASA Astrophysics Data System (ADS)

Oertel, D.; Haschberger, P.; Tank, V.; Lanzl, F.; Zhukov, B.; Jahn, H.; Briess, K.; Lorenz, E.; Roeser, H.-P.; Ginati, A.; Tobehn, C.; Schulte in den Bäumen, J.; Christmann, U.

1999-01-01

Current and planned operational space-borne Earth observation systems provide spatially, radiometrically or temporally crude data for the detection and monitoring of high temperature phenomena on the surface of our planet. High Temperature Events (HTE) very often cause environmental disasters. Such HTE are forest and savannah fires, fires of open coal mines, volcanic activities and others (e.g. fires of oil wells, pipelines etc.). A simultaneous co-registration of a combination of infrared (IR) and visible (VIS) channels is the key for a reliable autonomous on-board detection of High Temperature Events (HTE) on Earth surface, such as vegetation fires and volcano eruptions. This is the main feature of the FOCUS experiment. Furthermore there are ecology-oriented objectives of the FOCUS experiment mainly related to spectrometric/imaging remote inspection and parameter extraction of selected HTEs, and to the assessment of some ecological consequences of HTEs, such as aerosol and gas emission. Based on own experimental work and supported by Co-Investigators from Italy, Greece, France, Spain, Russia and Germany, DLR proposed in 1997 to use the International Space Station (ISS) in its early utilization phase as a platform and test-bed for an Intelligent Infrared Sensor prototype FOCUS of a future Environmental Disaster Recognition Satellite System. FOCUS is considered by ESA as an important mission combining a number of proven technologies and observation techniques to provide the scientific and operational user community with key data for the classification and monitoring of forest fires. FOCUS was selected as one of five European ``Groupings'' to be flown as an externally mounted payload during the early utilisation phase of the ISS. The FOCUS Phase A Study will be performed by OHB-System, DLR and Zeiss from September 1998 until May 1999.

Modelling the Factors that Affect Individuals' Utilisation of Online Learning Systems: An Empirical Study Combining the Task Technology Fit Model with the Theory of Planned Behaviour

ERIC Educational Resources Information Center

Yu, Tai-Kuei; Yu, Tai-Yi

2010-01-01

Understanding learners' behaviour, perceptions and influence in terms of learner performance is crucial to predict the use of electronic learning systems. By integrating the task-technology fit (TTF) model and the theory of planned behaviour (TPB), this paper investigates the online learning utilisation of Taiwanese students. This paper provides a…

Day care for dementia patients from a family caregiver's point of view: a questionnaire study on expected quality and predictors of utilisation - Part II.

PubMed

Donath, Carolin; Winkler, Angelika; Graessel, Elmar; Luttenberger, Katharina

2011-04-13

The investigation of the predictive variables for utilisation of day care and the views of family caregivers of dementia patients about quality of day care are the goals of this work. The cross-sectional study was carried out as an anonymous written survey of family caregivers of dementia patients in Germany. Participants were 404 family caregivers of dementia patients, of these 128 were users of day care, 269 were non-users and 7 gave no details about utilisation. Qualitative and quantitative data were analysed using qualitative content analysis and binary logistic regression analysis. The assessment of how helpful day care is for the individual care situation and the age of the family caregiver are significant predictors for utilisation of day care. Caregivers most frequently cited a programme of activities suited to the abilities of the dementia patients as quality criterion. In order to reduce the number of those caregivers who think they don't need day care compared with the number who really don't need it, caregivers should be transparently informed of the relevant advantages and quality principles of using day care. According to caregivers' wishes, the organisation of day care centres must include activities suited for dementia patients.

Substance use and self-harm: a cross-sectional study of the prevalence, correlates and patterns of medical service utilisation among patients admitted to a South African hospital.

PubMed

Breet, Elsie; Bantjes, Jason; Lewis, Ian

2018-03-06

Substance use is a potentially modifiable risk factor for suicidal behaviour. Little is known about the epidemiology of substance use among self-harm patients in South Africa. This study set out to collect epidemiological data about the prevalence, correlates, and patterns of medical service utilisation among self-harm patients who used substances at the time of self-injury. Data from 238 consecutive self-harm patients treated at an urban hospital in South Africa were analysed using bivariate and multivariate statistics. Approximately 20% of patients reported substance use at the time of self-harm. When compared to other self-harm patients, higher rates of patients who had used substances: had depressed levels of consciousness on admission; utilised more medical resources and required longer hospital admissions; cited relationship difficulties and financial concerns as reasons for their self-harm; reported a previous episode of self-harm; and intended to die as a result of their injuries. Although the observed differences were not statistically significant (p > 0.05), the proportional differences were congruent with international literature. Acute use of substances among self-harm patients warrants more focused research and clinical attention particularly in the context of reducing utilisation of scarce medical resources.

Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China.

PubMed

Tan, Si Ying; Wu, Xun; Yang, Wei

2018-05-08

While moving towards unified social health insurance (SHI) is often a politically popular policy reform in countries where rapid expansion in health insurance coverage has given rise to the segmentation of SHI systems as different SHI schemes were rolled out to serve different populations, the potential impacts of reform on service utilisation and health costs have not been systematically studied. Using data from the Chinese Health and Retirement Longitudinal Study (CHARLS), we compared the mean costs incurred for both inpatient and outpatient care under different health insurance schemes, and the impact of different SHI schemes on treatment utilisation and health care costs using a two-part model. Our results show that Urban Employee Medical Insurance, which offers the most generous benefits, incurs the highest total costs prior to reimbursement when compared to other SHI schemes. Our analysis also shows that utilisation of SHI did not show significant reduction in out-of-pocket payments for outpatients. We argue that, unless effective measures are introduced to deal with perverse provider payment incentives, the move towards a unified system with more generous benefits may usher in a new wave of cost escalation for health care systems in China.

Mesophilic and thermophilic anaerobic digestion of sulphate-containing wastewaters.

PubMed

Colleran, E; Pender, S

2002-01-01

The effect of sulphate at an influent chemical oxygen demand (COD):sulphate ratio of 4 on the operational performance of anaerobic hybrid reactors treating molasses wastewater was investigated under mesophilic and thermophilic conditions in a long-term laboratory-scale study over a 1,081 day period. The presence of sulphate reduced the COD removal efficiency under both mesophilic and thermophilic conditions. At 55 degrees C, effluent acetate levels were consistently greater than 4000 mg l(-1) indicating that thermophilic acetate-utilising methane-producing bacteria (MPB) or sulphate-reducing bacteria (SRB) had not developed in the reactor under the conditions applied. At 37 degrees C, acetate was exclusively utilised by acetoclastic methanogens, whereas H2-utilising SRB predominated over H2-utilising MPB in the competition for hydrogen. By contrast, hydrogenotrophic MPB were shown to outcompete H2-utilising SRB during long-term thermophilic operation. 16SrDNA analysis of the seed sludge and reactor biomass on conclusion of the 37 degrees C and 55 degrees C trials illustrated that the dominant methanogen present on conclusion of the thermophilic trial in the absence of influent sulphate was related to Methanocorpusculum parvuum, and was capable of growth on both acetate and hydrogen. By contrast, an organism closely related to Methanobacterium thermoautotrophicum was the dominant methanogen present in the sulphate-fed reactor on completion of the thermophilic trial.

Impact of measles supplementary immunisation activities on utilisation of maternal and child health services in low-income and middle-income countries

PubMed Central

Postolovska, Iryna; Helleringer, Stéphane; Kruk, Margaret E; Verguet, Stéphane

2018-01-01

Background Measles supplementary immunisation activities (SIAs) are an integral component of measles elimination in low-income and middle-income countries (LMICs). Despite their success in increasing vaccination coverage, there are concerns about their negative consequences on routine services. Few studies have conducted quantitative assessments of SIA impact on utilisation of health services. Methods We analysed the impact of SIAs on utilisation of selected maternal and child health services using Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 28 LMICs, where at least one SIA occurred over 2000–2014. Logistic regressions were conducted to investigate the association between SIAs and utilisation of the following services: facility delivery, postnatal care and outpatient sick child care (for fever, diarrhoea, cough). Results SIAs do not appear to significantly impact utilisation of maternal and child services. We find a reduction in care-seeking for treatment of child cough (OR 0.67; 95% CI 0.48 to 0.95); and a few significant effects at the country level, suggesting the need for further investigation of the idiosyncratic effects of SIAs in each country. Conclusion The paper contributes to the debate on vertical versus horizontal programmes to ensure universal access to vaccination. Measles SIAs do not seem to affect care-seeking for critical conditions. PMID:29755760

Migrant female head porters' enrolment in and utilisation and renewal of the National Health Insurance Scheme in Kumasi, Ghana.

PubMed

Boateng, Simon; Amoako, Prince; Poku, Adjoa Afriyie; Baabereyir, Anthony; Gyasi, Razak Mohammed

2017-01-01

As a social protection policy, Ghana's National Health Insurance Scheme (NHIS) aims to improve access to healthcare, especially for the vulnerable. Migrant female head porters ( kayayoo ), who are part of the informal economic workforce, are underscored as an ethnic minority and vulnerable group in Ghana. This study aimed to analyse the factors associated with enrolment in and renewal and utilisation of the NHIS among migrant female head porters in the Kumasi Metropolis. We purposively sampled 392 migrant female head porters in the Kejetia, Asafo and Bantama markets. We used a binary logit regression model to estimate associations among baseline characteristics, convenience and benefit factors and enrolment in and renewal and utilisation of the NHIS. Age and income significantly increased the probability of NHIS enrolment, renewal and utilisation. Long waiting times at NHIS offices significantly reduced the likelihood of renewal, while provision of drugs highly significantly increased the tendency for migrant female head porters to enrol in, renew and use the NHIS. Consulting and surgery also significantly increased renewal and utilisation of the NHIS. Political commitment is imperative for effective implementation of the decentralisation policy of the NHIS through the National Health Insurance Authority in Kumasi. We argue that retail offices should be well equipped with logistic facilities to ensure convenience in NHIS initial enrolment and renewal processes by citizenry, and by vulnerable groups in particular.

Measuring change in health care equity using small-area administrative data - evidence from the English NHS 2001-2008.

PubMed

Cookson, Richard; Laudicella, Mauro; Donni, Paolo Li

2012-10-01

This study developed a method for measuring change in socio-economic equity in health care utilisation using small-area level administrative data. Our method provides more detailed information on utilisation than survey data but only examines socio-economic differences between neighbourhoods rather than individuals. The context was the English NHS from 2001 to 2008, a period of accelerated expenditure growth and pro-competition reform. Hospital records for all adults receiving non-emergency hospital care in the English NHS from 2001 to 2008 were aggregated to 32,482 English small areas with mean population about 1500 and combined with other small-area administrative data. Regression models of utilisation were used to examine year-on-year change in the small-area association between deprivation and utilisation, allowing for population size, age-sex composition and disease prevalence including (from 2003 to 2008) cancer, chronic kidney disease, coronary heart disease, diabetes, epilepsy, hypertension, hypothyroidism, stroke, transient ischaemic attack and (from 2006 to 2008) atrial fibrillation, chronic obstructive pulmonary disease, obesity and heart failure. There was no substantial change in small-area associations between deprivation and utilisation for outpatient visits, hip replacement, senile cataract, gastroscopy or coronary revascularisation, though overall non-emergency inpatient admissions rose slightly faster in more deprived areas than elsewhere. Associations between deprivation and disease prevalence changed little during the period, indicating that observed need did not grow faster in more deprived areas than elsewhere. We conclude that there was no substantial deterioration in socio-economic equity in health care utilisation in the English NHS from 2001 to 2008, and if anything, there may have been a slight improvement. Copyright © 2012 Elsevier Ltd. All rights reserved.

“Even if I were to consent, my family will never agree”: exploring autopsy services for posthumous occupational lung disease compensation among mineworkers in South Africa

PubMed Central

Banyini, Audrey V.; Rees, David; Gilbert, Leah

2013-01-01

Context In the South African mining sector, cardiorespiratory-specific autopsies are conducted under the Occupational Diseases in Mines and Works Act (ODMWA) on deceased mineworkers to determine eligibility for compensation. However, low levels of autopsy utilisation undermine the value of the service. Objective To explore enablers and barriers to consent that impact on ODMWA autopsy utilisation for posthumous monetary compensation. Methods In-depth interviews were conducted with mineworkers, widows and relatives of deceased mineworkers as well as traditional healers and mine occupational health practitioners. Results A range of socio-cultural barriers to consent for an autopsy was identified. These barriers were largely related to gendered power relations, traditional and religious beliefs, and communication and trust. Understanding these barriers presents opportunities to intervene so as to increase autopsy utilisation. Conclusions Effective interventions could include engagement with healthy mine-workers and their families and re-evaluating the permanent removal of organs. The study adds to our understanding of utilisation of the autopsy services. PMID:23364088

Price and utilisation differences for statins between four countries.

PubMed

Thai, Loc Phuoc; Vitry, Agnes Isabelle; Moss, John Robert

2018-02-01

Australia, England, France and New Zealand use different policies to regulate their medicines market, which can impact on utilisation and price. To compare the prices and utilisation of statins in Australia, England, France and New Zealand from 2011 to 2013. Utilisation of statins in the four countries was compared using Defined Daily Doses (DDD) per 1000 inhabitants per year. Pairwise Laspeyres and Paasche index comparisons were conducted comparing the price and utilisation of statins. The results showed that the price of statins in New Zealand was the cheapest. The price of statins in Australia was most expensive in 2011 and 2012 but France was more expensive in 2013. There were large differences between the Laspeyres index and Paasche index when comparing the price and utilisation of England with Australia and France. The policies that regulate the New Zealand and England medicines markets were more effective in reducing the price of expensive statins. The relative utilisation of cheaper statins was greatest in England and had a large effect on the differences between the two index results. The pricing policies in Australia have been only partly effective in reducing the price of statins compared to other countries.

Quantification of model uncertainty in aerosol optical thickness retrieval from Ozone Monitoring Instrument (OMI) measurements

NASA Astrophysics Data System (ADS)

Määttä, A.; Laine, M.; Tamminen, J.; Veefkind, J. P.

2013-09-01

We study uncertainty quantification in remote sensing of aerosols in the atmosphere with top of the atmosphere reflectance measurements from the nadir-viewing Ozone Monitoring Instrument (OMI). Focus is on the uncertainty in aerosol model selection of pre-calculated aerosol models and on the statistical modelling of the model inadequacies. The aim is to apply statistical methodologies that improve the uncertainty estimates of the aerosol optical thickness (AOT) retrieval by propagating model selection and model error related uncertainties more realistically. We utilise Bayesian model selection and model averaging methods for the model selection problem and use Gaussian processes to model the smooth systematic discrepancies from the modelled to observed reflectance. The systematic model error is learned from an ensemble of operational retrievals. The operational OMI multi-wavelength aerosol retrieval algorithm OMAERO is used for cloud free, over land pixels of the OMI instrument with the additional Bayesian model selection and model discrepancy techniques. The method is demonstrated with four examples with different aerosol properties: weakly absorbing aerosols, forest fires over Greece and Russia, and Sahara dessert dust. The presented statistical methodology is general; it is not restricted to this particular satellite retrieval application.

Ethnic disparities in utilisation of maternal health care services in Ghana: evidence from the 2007 Ghana Maternal Health Survey.

PubMed

Ganle, John Kuumuori

2016-01-01

Disparities in utilisation of maternal health care remain a challenge to attainment of the maternal health-related Millennium Development Goals. The objective of this descriptive study was to examine disparities in utilisation of maternal health care among ethnic groups in Ghana. Data from the 2007 Ghana Maternal Health Survey were analysed for disparities in antenatal care (ANC) visit, utilisation of tetanus toxoid immunisation and iron tablets/syrup intake during pregnancy, place of delivery, skilled birth attendance, caesarean section (CS) and post-natal care (PNC) among different ethnic groups. Findings show that the proportion of women who received any form of skilled antenatal, delivery and PNC in the five years (2003-2007) preceding the survey was 96%, 55% and 55%, respectively. Despite the incremental progress Ghana made in improving access to skilled maternal health care services, large gradients of disparities exist. The ethnic difference in utilisation of institutional prenatal care was small; however, fewer births to women from majority ethnic groups such as the Akan (21%) took place at home compared with births to women from minority ethnic groups such as the Ewe (58.8%), Guan (42.7%), Grusi (53.4%), Mole-Dagbani (74.7%) and Gruma (58.8%). The rate of consultation of a skilled health care provider for delivery among the different ethnic groups also ranged from a low of 27% for births to Mole-Dagbani women to a high of 68.8% among births to Akan women. Minority ethnic groups reported lower utilisation levels for most of the components of skilled maternity care in Ghana. However, ethnic disparities in utilisation of all the components of ANC in Ghana were less compared to delivery in health facilities, skilled attendance at birth, use of CS and PNC. Therefore, efforts to promote universal access to skilled maternity care not only should target those sub-populations with significantly low utilisation levels but also must focus on those components of maternal health care such as skilled attendance at delivery that demonstrate the greatest disparities. There is also the need to further explore who continues to remain excluded from receiving needed care, and how to encourage such women, especially minority women, to seek skilled care.

Juvenile obesity and its association with utilisation and costs of pharmaceuticals - results from the KiGGS study

PubMed Central

2011-01-01

Background According to a national reference, 15% of German children and adolescents are overweight (including obese) and 6.3% are obese. An earlier study analysed the impact of childhood overweight and obesity on different components of direct medical costs (physician, hospital and therapists). To complement the existing literature for Germany, this study aims to explore the association of body mass index (BMI) with utilisation of pharmaceuticals and related costs in German children and adolescents. Methods Based on data from 14, 836 respondents aged 3-17 years in the German Interview and Examination Survey for Children and Adolescents (KiGGS), drug intake and associated costs were estimated using a bottom-up approach. To investigate the association of BMI with utilisation and costs, univariate analyses and multivariate generalised mixed models were conducted. Results There was no significant difference between BMI groups regarding the probability of drug utilisation. However, the number of pharmaceuticals used was significantly higher (14%) for obese children than for normal weight children. Furthermore, there was a trend for more physician-prescribed medication in obese children and adolescents. Among children with pharmaceutical intake, estimated costs were 24% higher for obese children compared with the normal weight group. Conclusions This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem. PMID:22176689

Forest or the trees: At what scale do elephants make foraging decisions?

NASA Astrophysics Data System (ADS)

Shrader, Adrian M.; Bell, Caroline; Bertolli, Liandra; Ward, David

2012-07-01

For herbivores, food is distributed spatially in a hierarchical manner ranging from plant parts to regions. Ultimately, utilisation of food is dependent on the scale at which herbivores make foraging decisions. A key factor that influences these decisions is body size, because selection inversely relates to body size. As a result, large animals can be less selective than small herbivores. Savanna elephants (Loxodonta africana) are the largest terrestrial herbivore. Thus, they represent a potential extreme with respect to unselective feeding. However, several studies have indicated that elephants prefer specific habitats and certain woody plant species. Thus, it is unclear at which scale elephants focus their foraging decisions. To determine this, we recorded the seasonal selection of habitats and woody plant species by elephants in the Ithala Game Reserve, South Africa. We expected that during the wet season, when both food quality and availability were high, that elephants would select primarily for habitats. This, however, does not mean that they would utilise plant species within these habitats in proportion to availability, but rather would show a stronger selection for habitats compared to plants. In contrast, during the dry season when food quality and availability declined, we expected that elephants would shift and select for the remaining high quality woody species across all habitats. Consistent with our predictions, elephants selected for the larger spatial scale (i.e. habitats) during the wet season. However, elephants did not increase their selection of woody species during the dry season, but rather increased their selection of habitats relative to woody plant selection. Unlike a number of earlier studies, we found that that neither palatability (i.e. crude protein, digestibility, and energy) alone nor tannin concentrations had a significant effect for determining the elephants' selection of woody species. However, the palatability:tannin ratio was important for selection of woody species during the dry season. Ultimately, our results indicate that elephants make top-down foraging decisions by first selecting landscapes, then habitats within those landscapes and finally species within habitats. As a result, the impacts they can have across environments are likely the result of the selection of plant species within preferred habitats.

[Results of the marketing research study "Acceptance of physician's office computer systems"].

PubMed

Steinhausen, D; Brinkmann, F; Engelhard, A

1998-01-01

We report on a market research study on the acceptance of computer systems in surgeries. 11,000 returned questionnaires of surgeons--user and nonuser--were analysed. We found out that most of the surgeons used their computers in a limited way, i.e. as a device for accounting. Concerning the level of utilisation there are differentials of Men-Women, West-East and Young-Old. In this study we also analysed the computer using behaviour of gynaecologic surgeons. As a result two third of all nonusers are not intending to utilise a computer in the future.

Mental Health Status, Health Care Utilisation, and Service Satisfaction among Immigrants in Montreal: An Epidemiological Comparison

PubMed Central

Wang, JiaWei; Fleury, Marie-Josee; Liu, Aihua; Caron, Jean

2016-01-01

Objective: To examine variations between immigrants and nonimmigrants in 1) prevalence of common mental disorders and other mental health variables; 2) health service utilisation for emotional problems, mental disorders, and addictions, and 3) health service satisfaction. Methods: This article is based on a longitudinal cohort study conducted from May 2007 to the present: the Epidemiological Catchment Area Study of Montreal South-West (ZEPSOM). Participants were followed up at 4 time points (T1, n = 2433; T4, n = 1095). Core exposure variables include immigrant status (immigrant vs. nonimmigrant), duration of residence, and region of origin. Key outcome variables included mental health status, health service utilisation, and health service satisfaction. Data were analysed both cross-sectionally and longitudinally. Results: Immigrants had been in Canada for 20 years on average. Immigrants had significantly lower rates of high psychological distress (32.6% vs. 39.1%, P = 0.016), alcohol dependence (1.4% vs. 3.9%, P =0.010), depression (5.2% vs. 9.2%, P = 0.008), and various other mental disorders. They had significantly higher scores of mental well-being (48.9 vs. 47.1 score, P = 0.014) and satisfaction with social (34.0 vs. 33.4 score, P = 0.021) and personal relationships (16.7 vs. 15.6 score, P < 0.001). Immigrants had significantly lower rates of health service utilisation for emotional problems, mental disorders, and addictions and significantly higher rates of health service satisfaction at all time points. Asian and African immigrants had particularly low rates of utilisation and high rates of satisfaction. Conclusions: Immigrants had better overall mental health than nonimmigrants. PMID:27836931

Utilisation of the Magnetic Sensor in a Smartphone for Facile Magnetostatics Experiment: Magnetic Field Due to Electrical Current in Straight and Loop Wires

ERIC Educational Resources Information Center

Septianto, R. D.; Suhendra, D.; Iskandar, F.

2017-01-01

This paper reports on the result of a research into the utilisation of a smartphone for the study of magnetostatics on the basis of experiments. The use of such a device gives great measurement result and thus it can replace magnetic sensor tools that are relatively expensive. For the best experimental result, firstly the position of the magnetic…

Effects of immigrant status on Emergency Room (ER) utilisation by children under age one: a population-based study in the province of Reggio Emilia (Italy)

PubMed Central

2013-01-01

Background The primary aim of this study was to assess the effect of immigrant status on Emergency Room (ER) utilisation by children under age one, considering all, non-urgent, very urgent, and followed by hospitalisation visits. The second aim was to investigate the role played by mother’s educational level in the relationship between citizenship and ER utilisation. Methods The cohort study included all healthy singleton live births in the years 2008–2009 and residing in the province of Reggio Emilia, followed for the first year of life in order to study their ER visits. The outcomes were the ER utilisation rate for all, non-urgent, very urgent, and followed by hospitalisation visits. The main explanatory variable was mother’s citizenship. Other covariates were mother’s educational level, maternal age, parity, and child gender. Multivariate analyses (negative binomial regression and zero inflated when appropriate) were performed. Adjusted utilisation Rate Ratios (RR) and their 95% Confidence Intervals (95% CI) were calculated. Trend for age in months by citizenship is depicted. Results There were 3,191 children (36.4%) with at least one ER visit in the first year of life. Adjusted RR show a significantly greater risk of ER visit for immigrants than for Italians: (RR 1.51; 95% CI 1.39-1.63). Immigrants also had a higher risk of non-urgent visits (RR 1.72; 95% CI 1.48-2.00) and for visits followed by hospitalizations (RR 1.58; 95% CI 1.33-1.89). For very urgent visits, the immigrants had a slightly higher risk compared to Italians (RR 1.25; 95% CI 0.98-1.59). The risk of ER visits is higher in the first two months of life (RR1stvs 3rd-12th 2.08; 95% CI 1.93-2.24 and RR 2ndvs 3rd-12th 1.45; 95% CI 1.33-1.58, respectively). Considering all visits, the ER utilisation rate was inversely related with maternal education only for Italians (low educational level 44.0 and high educational level 73.9 for 100 children; p value for trend test < 0.001). Conclusions Our study observed a higher use of ER services by immigrant children and, to a lesser extent, by children of less educated Italian mothers. In immigrants, the excess is mostly due to non-urgent visits and only slightly to high acute conditions. PMID:24176109

Effects of immigrant status on Emergency Room (ER) utilisation by children under age one: a population-based study in the province of Reggio Emilia (Italy).

PubMed

Ballotari, Paola; D'Angelo, Stefania; Bonvicini, Laura; Broccoli, Serena; Caranci, Nicola; Candela, Silvia; Giorgi Rossi, Paolo

2013-11-01

The primary aim of this study was to assess the effect of immigrant status on Emergency Room (ER) utilisation by children under age one, considering all, non-urgent, very urgent, and followed by hospitalisation visits. The second aim was to investigate the role played by mother's educational level in the relationship between citizenship and ER utilisation. The cohort study included all healthy singleton live births in the years 2008-2009 and residing in the province of Reggio Emilia, followed for the first year of life in order to study their ER visits. The outcomes were the ER utilisation rate for all, non-urgent, very urgent, and followed by hospitalisation visits. The main explanatory variable was mother's citizenship. Other covariates were mother's educational level, maternal age, parity, and child gender. Multivariate analyses (negative binomial regression and zero inflated when appropriate) were performed. Adjusted utilisation Rate Ratios (RR) and their 95% Confidence Intervals (95% CI) were calculated. Trend for age in months by citizenship is depicted. There were 3,191 children (36.4%) with at least one ER visit in the first year of life. Adjusted RR show a significantly greater risk of ER visit for immigrants than for Italians: (RR 1.51; 95% CI 1.39-1.63). Immigrants also had a higher risk of non-urgent visits (RR 1.72; 95% CI 1.48-2.00) and for visits followed by hospitalizations (RR 1.58; 95% CI 1.33-1.89). For very urgent visits, the immigrants had a slightly higher risk compared to Italians (RR 1.25; 95% CI 0.98-1.59).The risk of ER visits is higher in the first two months of life (RR(1st vs 3rd-12th) 2.08; 95% CI 1.93-2.24 and RR(2nd vs 3rd-12th) 1.45; 95% CI 1.33-1.58, respectively). Considering all visits, the ER utilisation rate was inversely related with maternal education only for Italians (low educational level 44.0 and high educational level 73.9 for 100 children; p value for trend test < 0.001). Our study observed a higher use of ER services by immigrant children and, to a lesser extent, by children of less educated Italian mothers. In immigrants, the excess is mostly due to non-urgent visits and only slightly to high acute conditions.

Low utilisation of diabetes medicines in Iran, despite their affordability (2000-2012): a time-series and benchmarking study.

PubMed

Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah

2014-10-16

Diabetes is a major public health concern worldwide, particularly in low-income and middle-income countries (LMICs). Limited data exist on the status of access to diabetes medicines in LMICs. We assessed the utilisation and affordability of diabetes medicines in Iran as a middle-income country. We used a retrospective time-series design (2000-2012) and assessed national diabetes medicines' utilisation using pharmaceuticals wholesale data. We calculated defined daily dose consumptions per population days (DDDs/1000 inhabitants/day; DIDs) indicator. Findings were benchmarked with data from Organization for Economic Co-operation and Development (OECD) countries. We also employed Drug Utilization-90% (DU-90) method to compare DU-90s with the Essential Medicines List published by the WHO. We measured affordability using number of minimum daily wage required to purchase a treatment course for 1 month. Diabetes medicines' consumption increased from 4.47 to 33.54 DIDs. The benchmarking showed that medicines' utilisation in Iran in 2011 was only 54% of the median DIDs of 22 OECD countries. Oral hypoglycaemic agents consisted over 80% of use throughout the study period. Regular and isophane insulin (NPH), glibenclamide, metformin and gliclazide were the DU-90 drugs in 2012. Metformin, glibenclamide and regular/NPH insulin combination therapy were affordable throughout the study period (∼0.4, ∼0.1, ∼0.3 of minimum daily wage, respectively). While the affordability of novel insulin preparations improved over time, they were still unaffordable in 2012. The utilisation of diabetes medicines was relatively low, perhaps due to underdiagnosis and inadequate management of patients with diabetes. This had occurred despite affordability of essential diabetes medicines in Iran. Appropriate policies are required to address the underutilisation of diabetes medicines in Iran. 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.

Determinants of skilled birth attendants for delivery in Nepal.

PubMed

Baral, Y R; Lyons, K; Skinner, J; van Teijlingen, E R

2010-01-01

This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women's role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women's involvement in decision making; and women's autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women's role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery. Qualitative research will help further exploration of the issues and contribute to improvement of maternal health services.

The Utilisation of Music by Casino Managers: An Interview Study.

PubMed

Bramley, Stephanie; Dibben, Nicola; Rowe, Richard

2016-12-01

Music is ubiquitous in retail and commercial environments, with some managers believing that music can enhance the customer experience, increase footfall and sales and improve consumer satisfaction. Casino gambling is popular in the United Kingdom and anecdotal evidence suggests that music is often present. However, little is known about the rationale for music use from the perspective of casino managers. In this study semi-structured interviews were conducted with five casino managers to establish their motivations for utilising music, the factors informing their choice of music and the extent to which music is used with the intention of influencing gambling behaviour. Results showed that casino managers utilised two types of music-recorded background music, often sourced via external music supply companies and live music. Live music was often situated away from the gaming floor and used primarily to accompany participation in non-gambling activities. Recorded background music was not used with the direct aim of influencing customers' gambling behaviour, but to create the right atmosphere for gambling and to promote certain moods within the casinos. To achieve these aims casino managers manipulated the tempo, volume and genre of the recorded background music. Casino managers also reported that some gamblers listen to music via portable music players, possibly with the intention of customising their gambling experience. This study is unique as it has provided a first-hand account of casino managers' implicit theories with regards to why they utilise music and the roles which music is considered to fulfil in casinos.

HIV counselling and testing utilisation and attitudes of male inmates in a South African prison.

PubMed

Motshabi, Lelaka C; Pengpid, Supa; Peltzer, Karl

2011-01-01

The Department of Correctional Services Policy on the management of HIV and AIDS for offenders include voluntary counselling and testing (VCT) for HIV as one of the priorities in the rehabilitation of inmates. The aim of this study was to determine factors associated with the utilisation of VCT services in the correctional centres in terms of level of satisfaction, their experiences and expectations, and motivating factors and barriers for VCT utilisation at Losperfontein Correctional Centre, South Africa. This was a case control study (cases being those who underwent testing and controls those who did not) examining predictors of HIV VCT utilisation among 200 male adult sentenced inmates serving medium and maximum sentences. Results indicate that a poor health system (OR=0.34, 95%CI: 0.23 - 0.50) was inversely associated with HIV testing acceptance in prison, while age, educational level, population group, marital status, length of incarceration and access to HIV testing in prison were not associated with HIV testing acceptance in prison. Half of the participants (50%) agreed that VCT services are accessible and are promoted at their correctional centre. Most were satisfied with different components of VCT services, ranging from 79% (fair to very good) for 'the way he/she received you' to 62% 'clarified all your concerns'. This study demonstrated some challenges and benefits to the field of health promotion and HIV prevention in the correctional centres especially with regard to VCT services.

Inequalities in health and health service utilisation among reproductive age women in St. Petersburg, Russia: a cross-sectional study.

PubMed

Dubikaytis, Tatiana; Larivaara, Meri; Kuznetsova, Olga; Hemminki, Elina

2010-11-11

Russian society has faced dramatic changes in terms of social stratification since the collapse of the Soviet Union. During this time, extensive reforms have taken place in the organisation of health services, including the development of the private sector. Previous studies in Russia have shown a wide gap in mortality between socioeconomic groups. There are just a few studies on health service utilisation in post-Soviet Russia and data on inequality of health service use are limited. The aim of the present study was to analyse health (self-rated health and self-reported chronic diseases) and health care utilisation patterns by socioeconomic status (SES) among reproductive age women in St. Petersburg. The questionnaire survey was conducted in 2004 (n = 1147), with a response rate of 67%. Education and income were used as dimensions of SES. The association between SES and health and use of health services was assessed by logistic regression, adjusting for age. As expected low SES was associated with poor self-rated health (education: OR = 1.48; personal income: OR = 1.42: family income: OR = 2.31). University education was associated with use of a wider range of outpatient medical services and increased use of the following examinations: Pap smear (age-adjusted OR = 2.06), gynaecological examinations (age-adjusted OR = 1.62) and mammography among older (more than 40 years) women (age-adjusted OR = 1.98). Personal income had similar correlations, but family income was related only to the use of mammography among older women. Our study suggests a considerable inequality in health and utilisation of preventive health service among reproductive age women. Therefore, further studies are needed to identify barriers to health promotion resources.

Association between health service utilisation of internal migrant children and parents’ acculturation in Guangdong, China: a cross-sectional study

PubMed Central

Peng, Bo-li; Zou, Guan-yang; Chen, Wen; Lin, Yan-wei; Ling, Li

2018-01-01

Objectives To assess the health service utilisation of internal migrant children in Guangdong, China, and to explore the association between children’s health service utilisation and their parents’ acculturation. Design Cross-sectional survey between April and May 2016. Setting Six society-run schools of Tianhe and Baiyun districts in Guangzhou City of China. Participants We recruited all students at grade 7 or 8 and one of their parents who resided in Guangzhou over 6 months without permanent registered residence (hukou) in Guangzhou (1161 pairs completed this survey). 258 children were ill within the past 2 weeks or during the last year. Main outcome measures The main outcome was self-reported health service utilisation. Logistic regression analysis was conducted to explore the association between children’s unmet needs for outpatient or inpatient service and their parents’ acculturation (categorised into high, middle and low groups). Results In total, 216 children, or 18.6% of the total subjects, were ill within the past 2 weeks and were in need of outpatient service; 94 children, or 8.1% of the total subjects, were in need of inpatient service. Among them, 17.6% and 46.8% of the migrant children had unmet needs for outpatient and inpatient services, respectively. After controlling for enabling resources and predisposing characteristics, migrant children with parents in the middle-acculturation group (adjusted OR=3.17, 95% CIs 1.2 to 8.3, P<0.05) were more likely to have an unmet outpatient need than high-acculturation or low-acculturation groups, although only statistically significant when comparing with the high-acculturation group. Stratified analysis suggested that this association could be moderated by their family economic status. Conclusions Our study suggested that the association between migrant children’s health service utilisation and their parents’ acculturation was complex and could be moderated by family economic status. Increasing the service utilisation among migrant children requires improving the acculturation and economic status of the parents of internal migrants. PMID:29331968

Effects of the distribution density of a biomass combined heat and power plant network on heat utilisation efficiency in village-town systems.

PubMed

Zhang, Yifei; Kang, Jian

2017-11-01

The building of biomass combined heat and power (CHP) plants is an effective means of developing biomass energy because they can satisfy demands for winter heating and electricity consumption. The purpose of this study was to analyse the effect of the distribution density of a biomass CHP plant network on heat utilisation efficiency in a village-town system. The distribution density is determined based on the heat transmission threshold, and the heat utilisation efficiency is determined based on the heat demand distribution, heat output efficiency, and heat transmission loss. The objective of this study was to ascertain the optimal value for the heat transmission threshold using a multi-scheme comparison based on an analysis of these factors. To this end, a model of a biomass CHP plant network was built using geographic information system tools to simulate and generate three planning schemes with different heat transmission thresholds (6, 8, and 10 km) according to the heat demand distribution. The heat utilisation efficiencies of these planning schemes were then compared by calculating the gross power, heat output efficiency, and heat transmission loss of the biomass CHP plant for each scenario. This multi-scheme comparison yielded the following results: when the heat transmission threshold was low, the distribution density of the biomass CHP plant network was high and the biomass CHP plants tended to be relatively small. In contrast, when the heat transmission threshold was high, the distribution density of the network was low and the biomass CHP plants tended to be relatively large. When the heat transmission threshold was 8 km, the distribution density of the biomass CHP plant network was optimised for efficient heat utilisation. To promote the development of renewable energy sources, a planning scheme for a biomass CHP plant network that maximises heat utilisation efficiency can be obtained using the optimal heat transmission threshold and the nonlinearity coefficient for local roads. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of a community driven mass media campaign on the utilisation of maternal health care services in rural Malawi.

PubMed

Zamawe, Collins O F; Banda, Masford; Dube, Albert N

2016-01-27

Mass media is critical in disseminating public health information, improving health knowledge and changing health behaviours. However, most of the mass media public health interventions do not sufficiently engage the local people; they are externally determined. Due to this, very little is known about the effects of locally instigated mass media promotion. Therefore, the aim of this study was to examine the impact of a community driven mass media campaign called Phukusi la Moyo (tips of life) on the utilisation of maternal health care services. A community-based cross-sectional study involving 3825 women of reproductive age (15-49 years) was conducted in rural Malawi to evaluate the Phukusi la Moyo (PLM) campaign. To do this, we compared the utilisation of maternal health care services between women who were exposed to the PLM campaign and those who were not. Respondents were identified using a multistage cluster sampling method. This involved systematically selecting communities (clusters), households and respondents. Associations were examined using Pearson chi square test and a multivariable logistic regression model. The likelihood of using contraceptives (AOR = 1.61; 95% CI = 1.32-1.96), sleeping under mosquito bed-nets (AOR = 1.65; 95% CI = 1.39-1.97), utilising antenatal care services (AOR = 2.62; 95% CI = 1.45-4.73) and utilising postnatal care services (AOR = 1.59; CI = 1.29-1.95) were significantly higher among women who had exposure to the PLM campaign than those who did not. No significant association was found between health facility delivery and exposure to the PLM campaign. Women exposed to a community driven mass media campaign in rural Malawi were more likely to utilise maternal health care services than their unexposed counterparts. Since, the use of maternal health care services reduces the risk of maternal morbidity and mortality, community-led mass media could play a significant role towards improving maternal health outcomes in low-and-middle-income countries. Therefore, we recommend the use of locally driven mass media in disseminating public health information in limited resource settings.

Association between health service utilisation of internal migrant children and parents' acculturation in Guangdong, China: a cross-sectional study.

PubMed

Peng, Bo-Li; Zou, Guan-Yang; Chen, Wen; Lin, Yan-Wei; Ling, Li

2018-01-13

To assess the health service utilisation of internal migrant children in Guangdong, China, and to explore the association between children's health service utilisation and their parents' acculturation. Cross-sectional survey between April and May 2016. Six society-run schools of Tianhe and Baiyun districts in Guangzhou City of China. We recruited all students at grade 7 or 8 and one of their parents who resided in Guangzhou over 6 months without permanent registered residence ( hukou ) in Guangzhou (1161 pairs completed this survey). 258 children were ill within the past 2 weeks or during the last year. The main outcome was self-reported health service utilisation. Logistic regression analysis was conducted to explore the association between children's unmet needs for outpatient or inpatient service and their parents' acculturation (categorised into high, middle and low groups). In total, 216 children, or 18.6% of the total subjects, were ill within the past 2 weeks and were in need of outpatient service; 94 children, or 8.1% of the total subjects, were in need of inpatient service. Among them, 17.6% and 46.8% of the migrant children had unmet needs for outpatient and inpatient services, respectively. After controlling for enabling resources and predisposing characteristics, migrant children with parents in the middle-acculturation group (adjusted OR=3.17, 95% CIs 1.2 to 8.3, P<0.05) were more likely to have an unmet outpatient need than high-acculturation or low-acculturation groups, although only statistically significant when comparing with the high-acculturation group. Stratified analysis suggested that this association could be moderated by their family economic status. Our study suggested that the association between migrant children's health service utilisation and their parents' acculturation was complex and could be moderated by family economic status. Increasing the service utilisation among migrant children requires improving the acculturation and economic status of the parents of internal migrants. © 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.

Determinants of antenatal and delivery care utilization in Tigray region, Ethiopia: a cross-sectional study.

PubMed

Tsegay, Yalem; Gebrehiwot, Tesfay; Goicolea, Isabel; Edin, Kerstin; Lemma, Hailemariam; Sebastian, Miguel San

2013-05-14

Despite the international emphasis in the last few years on the need to address the unmet health needs of pregnant women and children, progress in reducing maternal mortality has been slow. This is particularly worrying in sub-Saharan Africa where over 162,000 women still die each year during pregnancy and childbirth, most of them because of the lack of access to skilled delivery attendance and emergency care. With a maternal mortality ratio of 673 per 100,000 live births and 19,000 maternal deaths annually, Ethiopia is a major contributor to the worldwide death toll of mothers. While some studies have looked at different risk factors for antenatal care (ANC) and delivery service utilisation in the country, information coming from community-based studies related to the Health Extension Programme (HEP) in rural areas is limited. This study aims to determine the prevalence of maternal health care utilisation and explore its determinants among rural women aged 15-49 years in Tigray, Ethiopia. The study was a community-based cross-sectional survey using a structured questionnaire. A cluster sampling technique was used to select women who had given birth at least once in the five years prior to the survey period. Univariable and multivariable logistic regression analyses were carried out to elicit the impact of each factor on ANC and institutional delivery service utilisation. The response rate was 99% (n=1113). The mean age of the participants was 30.4 years. The proportion of women who received ANC for their recent births was 54%; only 46 (4.1%) of women gave birth at a health facility. Factors associated with ANC utilisation were marital status, education, proximity of health facility to the village, and husband's occupation, while use of institutional delivery was mainly associated with parity, education, having received ANC advice, a history of difficult/prolonged labour, and husbands' occupation. A relatively acceptable utilisation of ANC services but extremely low institutional delivery was observed. Classical socio-demographic factors were associated with both ANC and institutional delivery attendance. ANC advice can contribute to increase institutional delivery use. Different aspects of HEP need to be strengthened to improve maternal health in Tigray.

Does place of service matter? A utilisation and cost analysis of sexually transmissible infection testing from 2012 claims data.

PubMed

Owusu-Edusei, Kwame; Patel, Chirag G; Gift, Thomas L

2016-04-01

Background In this study, a previous study on the utilisation and cost of sexually transmissible infection (STI) tests was augmented by focusing on outpatient place of service for the most utilised tests. Claims for eight STI tests [chlamydia, gonorrhoea, hepatitis B virus (HBV), HIV, human papillomavirus (HPV), herpes simplex virus type 2 (HSV2), syphilis and trichomoniasis] using the most utilised current procedural terminology (CPT) code for each STI from the 2012 MarketScan outpatient table were extracted. The volume and costs by gender and place of service were then summarised. Finally, semi-log regression analyses were used to further examine and compare costs. Females had a higher number of test claims than males in all places of service for each STI. Together, claims from 'Independent Laboratories', 'Office' and 'Outpatient hospital' accounted for over 93% of all the test claims. The cost of tests were slightly (<5%) different between males and females for most places of service. Except for the estimated average cost for 'Outpatient hospital', the estimated average costs for the other categories were significantly lower (15-80%, P<0.01) than the estimated average cost for 'Emergency Room - Hospital' for all the STIs. Among the predominant service venues, test costs from 'Independent Laboratory' and 'Office' were 30% to 69% lower (P<0.01) than those from 'Outpatient Hospital'. Even though the results from this study are not generalisable, our study shows that almost all STI tests from outpatient claims data were performed in three service venues with considerable cost variations.

Band registration of tuneable frame format hyperspectral UAV imagers in complex scenes

NASA Astrophysics Data System (ADS)

Honkavaara, Eija; Rosnell, Tomi; Oliveira, Raquel; Tommaselli, Antonio

2017-12-01

A recent revolution in miniaturised sensor technology has provided markets with novel hyperspectral imagers operating in the frame format principle. In the case of unmanned aerial vehicle (UAV) based remote sensing, the frame format technology is highly attractive in comparison to the commonly utilised pushbroom scanning technology, because it offers better stability and the possibility to capture stereoscopic data sets, bringing an opportunity for 3D hyperspectral object reconstruction. Tuneable filters are one of the approaches for capturing multi- or hyperspectral frame images. The individual bands are not aligned when operating a sensor based on tuneable filters from a mobile platform, such as UAV, because the full spectrum recording is carried out in the time-sequential principle. The objective of this investigation was to study the aspects of band registration of an imager based on tuneable filters and to develop a rigorous and efficient approach for band registration in complex 3D scenes, such as forests. The method first determines the orientations of selected reference bands and reconstructs the 3D scene using structure-from-motion and dense image matching technologies. The bands, without orientation, are then matched to the oriented bands accounting the 3D scene to provide exterior orientations, and afterwards, hyperspectral orthomosaics, or hyperspectral point clouds, are calculated. The uncertainty aspects of the novel approach were studied. An empirical assessment was carried out in a forested environment using hyperspectral images captured with a hyperspectral 2D frame format camera, based on a tuneable Fabry-Pérot interferometer (FPI) on board a multicopter and supported by a high spatial resolution consumer colour camera. A theoretical assessment showed that the method was capable of providing band registration accuracy better than 0.5-pixel size. The empirical assessment proved the performance and showed that, with the novel method, most parts of the band misalignments were less than the pixel size. Furthermore, it was shown that the performance of the band alignment was dependent on the spatial distance from the reference band.

Runoff response to climate change and human activities in a typical karst watershed, SW China.

PubMed

Xu, Yan; Wang, Shijie; Bai, Xiaoyong; Shu, Dongcai; Tian, Yichao

2018-01-01

This study aims to reveal the runoff variation characteristics of long time series in a karst region, analyse comprehensively its different driving factors, and estimate quantitatively the contribution rates of climate change and human activities to net runoff variation. Liudong river basin, a typical karst watershed in southwest China, is the study site. Statistical methods, such as linear fitting, the Morlet wavelet analysis, normalized curve and double mass curve, are applied to analyse the runoff of the watershed. Results show that the runoff in the karst watershed during the research period exhibits a three-stage change and the abrupt change points are the years 1981 and 2007: (1) 1968-1980, the runoff initially exhibited a trend of sustained decreasing and then an abrupt fluctuation. The runoff was obviously destroyed through precipitation-producing processes. Improper land utilisation and serious forest and grass destruction intensified the fluctuation variation amplitude of the runoff. (2) 1981-2006, the changing processes of runoff and precipitation exhibited good synchronism. Precipitation significantly affected runoff variation and human activities had a slight interference degree. (3) 2007-2013, the fluctuation range of runoff was considerably smaller than that of precipitation. The significant growth of forest and grassland areas and the increase in water consumption mitigated runoff fluctuation and greatly diminished runoff variation amplitude. According to calculation, the relative contribution rates of precipitation and human activities to net runoff variation with 1981-2007 as the reference period were -81% and 181% in average, respectively, during 1968-1980, and -117% and 217% in average, respectively, during 2007-2013. In general, the analysis of runoff variation trend and of the contribution rate of its main influencing factors in the typical karst watershed for nearly half a century may be significant to solve the drought problem in the karst region and for the sustainable development of the drainage basin.

Runoff response to climate change and human activities in a typical karst watershed, SW China

PubMed Central

Xu, Yan; Wang, Shijie; Shu, Dongcai; Tian, Yichao

2018-01-01

This study aims to reveal the runoff variation characteristics of long time series in a karst region, analyse comprehensively its different driving factors, and estimate quantitatively the contribution rates of climate change and human activities to net runoff variation. Liudong river basin, a typical karst watershed in southwest China, is the study site. Statistical methods, such as linear fitting, the Morlet wavelet analysis, normalized curve and double mass curve, are applied to analyse the runoff of the watershed. Results show that the runoff in the karst watershed during the research period exhibits a three-stage change and the abrupt change points are the years 1981 and 2007: (1) 1968–1980, the runoff initially exhibited a trend of sustained decreasing and then an abrupt fluctuation. The runoff was obviously destroyed through precipitation-producing processes. Improper land utilisation and serious forest and grass destruction intensified the fluctuation variation amplitude of the runoff. (2) 1981–2006, the changing processes of runoff and precipitation exhibited good synchronism. Precipitation significantly affected runoff variation and human activities had a slight interference degree. (3) 2007–2013, the fluctuation range of runoff was considerably smaller than that of precipitation. The significant growth of forest and grassland areas and the increase in water consumption mitigated runoff fluctuation and greatly diminished runoff variation amplitude. According to calculation, the relative contribution rates of precipitation and human activities to net runoff variation with 1981–2007 as the reference period were −81% and 181% in average, respectively, during 1968–1980, and −117% and 217% in average, respectively, during 2007–2013. In general, the analysis of runoff variation trend and of the contribution rate of its main influencing factors in the typical karst watershed for nearly half a century may be significant to solve the drought problem in the karst region and for the sustainable development of the drainage basin. PMID:29494602

Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data.

PubMed

Atun, Rifat; Gurol-Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

2016-12-01

Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Using routinely collected health billing records for 2005-2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co-morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply-side variables, and PHC use. Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow-up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

A comparative evaluation of end-emic and non-endemic region of visceral leishmaniasis (Kala-azar) in India with ground survey and space technology.

PubMed

Kesari, Shreekant; Bhunia, Gouri Sankar; Kumar, Vijay; Jeyaram, Algarswamy; Ranjan, Alok; Das, Pradeep

2011-08-01

In visceral leishmaniasis, phlebotomine vectors are targets for control measures. Understanding the ecosystem of the vectors is a prerequisite for creating these control measures. This study endeavours to delineate the suitable locations of Phlebotomus argentipes with relation to environmental characteristics between endemic and non-endemic districts in India. A cross-sectional survey was conducted on 25 villages in each district. Environmental data were obtained through remote sensing images and vector density was measured using a CDC light trap. Simple linear regression analysis was used to measure the association between climatic parameters and vector density. Using factor analysis, the relationship between land cover classes and P. argentipes density among the villages in both districts was investigated. The results of the regression analysis indicated that indoor temperature and relative humidity are the best predictors for P. argentipes distribution. Factor analysis confirmed breeding preferences for P. argentipes by landscape element. Minimum Normalised Difference Vegetation Index, marshy land and orchard/settlement produced high loading in an endemic region, whereas water bodies and dense forest were preferred in non-endemic sites. Soil properties between the two districts were studied and indicated that soil pH and moisture content is higher in endemic sites compared to non-endemic sites. The present study should be utilised to make critical decisions for vector surveillance and controlling Kala-azar disease vectors.

Equity in access to health care among asylum seekers in Germany: evidence from an exploratory population-based cross-sectional study.

PubMed

Bozorgmehr, Kayvan; Schneider, Christine; Joos, Stefanie

2015-11-09

Research on inequities in access to health care among asylum-seekers has focused on disparities between asylum-seekers and resident populations, but little attention has been paid to potential inequities in access to care within the group of asylum-seekers. We aimed to analyse the principles of horizontal equity (i.e., equal access for equal need irrespective of socioeconomic status, SES) and vertical equity (higher allocation of resources to those with higher need) among asylum-seekers in Germany. We performed a secondary exploratory analysis on cross-sectional data obtained from a population-based questionnaire survey among all asylum-seekers (aged 18 or above) registered in three administrative districts in Germany during the three-month study period (N = 1017). Data were collected on health care access (health care utilisation of four types of services and unmet medical need), health care need (approximated by sex, age and self-rated health status), and SES (highest educational attainment and subjective social status, SSS). We calculated odds ratios and 95% confidence intervals (CI) in multiple logistic regression models to analyse associations between SES indicators and access to health care under control of need. We contacted 60.4% (614) of the total asylum-seekers population, of which 25.4% (N = 156) participated in the study. Educational attainment showed no significant effect on health care access in crude models, but was positively associated with utilisation of psychotherapists and hospital admissions in adjusted models. Higher SSS was positively associated with health care utilisation of all types of services. The odds of hospitals admissions for asylum-seekers in the medium and highest SSS category were 3.18 times [1.06, 9.59] and 1.6 times [0.49, 5.23] the odds of those in the lowest SSS category. After controlling for need variables none of the SES indicators were significantly associated with measures of access to care, but a positive association remained, indicating higher utilisation of health care among asylum-seekers with higher SES. Age, sex or general health status were the only significant predictors of health care utilisation in fully adjusted models. The adjusted odds of reporting unmet medical needs among asylum-seekers with "fair/bad/very bad" health status were 2.16 times [0.84, 5.59] the odds of those with "good/very good" health status. Our findings revealed that utilisation of health services among asylum-seekers is associated with higher need (vertical equity met). Horizontal equity was met with respect to educational attainment for most outcomes, but a social gradient in health care utilisation was observed across SSS. Further confirmatory research is needed, especially on potential inequities in unmet medical need and on measurements of SES among asylum-seekers.

Group-based education for patients with type 2 diabetes: a survey of Australian dietitians.

PubMed

Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

2017-09-01

Group-based education has the potential to substantially improve the outcomes of individuals with type 2 diabetes mellitus (T2DM) and reduce the enormous burden that chronic diseases place on healthcare systems worldwide. Despite this proven effectiveness, the utilisation of group services for the management of T2DM by Australian dietitians is surprisingly low. This study surveyed a sample of 263 Australian dietitians to explore the utilisation of group-based education for T2DM, as well as dietitians' preferences for practice and training. The results of this study indicate that Australian dietitians are currently under-utilising group-based education programs for the management of T2DM, with the primary reasons identified as a lack of training provided to dietitians in the area, limited access to facilities suitable for conducting group education, the perceived poor cost-effectiveness of these programs, and the lack of evidence-based practice guidelines for the group-based management of persons with T2DM. Additionally, the majority of preferences for further training were for either face-to-face or web-based formal training conducted over 3-6h. Clear, evidence-based practice guidelines and training resources for group education for the management of T2DM are needed in order to encourage better utilisation of group-based education by Australian dietitians.

Living with a partner and health care use – results from the MONICA survey Augsburg in Southern Germany

PubMed Central

Huber, Carola A.; Baumeister, Sebastian E.; Ladwig, Karl-Heinz; Mielck, Andreas

2007-01-01

Objective: Several studies have shown that social relationships are associated with health care use. This study aims to test if and to which extent a proximal element of social relationships, particularly living together with a partner, influences the health care utilisation in the same way as a distal element such as group membership. Methods: On the basis of a representative random sample of a southern German population (4856 participants), the associations were assessed between the following groups of variables: number of consultations with the general practitioner or internists, type of social relationships (living with a partner, friends, relatives, group memberships), need (evaluated and perceived health status), socio-demographic variables. Results: All analyses showed associations between living with a partner and health care utilisation. Individuals living with a partner had lower levels of utilisation than individuals not living with a partner (mean: 4.3 vs. 5.2). These associations persisted after controlling for socio-demographic and need variables. For the other indicators of social relationships, though, there were no significant associations with outpatient visits. Conclusions: Distinguishing between different types of social relationships is important for disentangling the overall effects of social relationships on health care utilisation. Also, the empirical findings confirm that health care research should not be restricted to medical variables, but should also include psycho-social factors. PMID:19742289

[The influence of the type of insurance access on health and of education on health services utilization patterns].

PubMed

Rodríguez, Marisol; Stoyanova, Alexandrina

2004-05-01

This study analyses the utilisation of health services by gender, type of insurance access and the level of education. Descriptive and logistic regression analysis of the National Health Interview Survey, 1997, confirms that women go more often to the doctor than men. Differences are greater in the case of general practitioners (versus specialists) and public doctors (versus private). However, there are hardly any differences in hospitalisations and emergency visits. Having private access has no impact on hospitalisations, emergency visits or the probability of a visit (except for women), but it increases the probability of visits to specialists (mainly among women) and to private doctors (especially among men), confirming the existence of gender differences in the impact of this variable. In fact, the utilisation patterns by men and women with only public access resemble each other more than those of men and women with only private or dual coverage. Education is to a certain extent inversely related to the probability of a medical visit, visits to a GP and hospitalisations, but directly related to the utilisation of specialists and private doctors. Here, there are also gender disparities: differences in utilisation by educational level are more prominent among men.

Caregiver perceptions of mental health problems and treatment utilisation in siblings of children with mental health problems.

PubMed

Ma, Nylanda; Furber, Gareth; Roberts, Rachel; Winefield, Helen

2016-01-01

Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g., are they assessed for mental health problems? Do they receive appropriate psychological treatment?). The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e., treatment utilisation). Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined.

Life cycle assessment and residue leaching: the importance of parameter, scenario and leaching data selection.

PubMed

Allegrini, E; Butera, S; Kosson, D S; Van Zomeren, A; Van der Sloot, H A; Astrup, T F

2015-04-01

Residues from industrial processes and waste management systems (WMSs) have been increasingly reutilised, leading to landfilling rate reductions and the optimisation of mineral resource utilisation in society. Life cycle assessment (LCA) is a holistic methodology allowing for the analysis of systems and products and can be applied to waste management systems to identify environmental benefits and critical aspects thereof. From an LCA perspective, residue utilisation provides benefits such as avoiding the production and depletion of primary materials, but it can lead to environmental burdens, due to the potential leaching of toxic substances. In waste LCA studies where residue utilisation is included, leaching has generally been neglected. In this study, municipal solid waste incineration bottom ash (MSWI BA) was used as a case study into three LCA scenarios having different system boundaries. The importance of data quality and parameter selection in the overall LCA results was evaluated, and an innovative method to assess metal transport into the environment was applied, in order to determine emissions to the soil and water compartments for use in an LCA. It was found that toxic impacts as a result of leaching were dominant in systems including only MSWI BA utilisation, while leaching appeared negligible in larger scenarios including the entire waste system. However, leaching could not be disregarded a priori, due to large uncertainties characterising other activities in the scenario (e.g. electricity production). Based on the analysis of relevant parameters relative to leaching, and on general results of the study, recommendations are provided regarding the use of leaching data in LCA studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.

PubMed

Villani, Melanie; Nanayakkara, Natalie; Ranasinha, Sanjeeva; Earnest, Arul; Smith, Karen; Soldatos, Georgia; Teede, Helena; Zoungas, Sophia

2017-01-01

This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted. Pre-specified variables related to patient demographics, comorbidities, examination findings, paramedic treatment and transport outcomes were obtained. Logistic regression was used to assess factors associated with transport to hospital. There were 11,417 cases of hyperglycaemia attended by paramedics during the study period, accounting for 0.3-0.4% of the total annual EMS caseload, and equating to 0.54 attendances per 100 people with diabetes in the state of Victoria, Australia, per year. There was a significant increase in annual utilisation, with a rate ratio of 1.62 between 2009 (2.42 cases per 10,000 population) and 2015 (3.91 cases per 10,000 population). Fifty-one percent of cases had type 2 diabetes, 37% had type 1 diabetes, 4% had diabetes with the type unspecified and 8% had no recorded history of diabetes. Ninety percent of cases were transported to hospital. Factors associated with increased odds of transport to hospital included no known history of diabetes, regional/rural locations, case time between 0600 and <1800 hours, increasing number of comorbidities and increasingly unstable vital sign observations. There is substantial utilisation of prehospital EMS for hyperglycaemia. With increased population prevalence of diabetes predicted, further research on opportunities for prevention, as well as optimal management in the prehospital environment is warranted.

Parental decision-making on utilisation of out-of-home respite in children's palliative care: findings of qualitative case study research - a proposed new model.

PubMed

Ling, J; Payne, S; Connaire, K; McCarron, M

2016-01-01

Respite in children's palliative care aims to provide a break for family's from the routine of caring. Parental decision-making regarding the utilisation of out-of-home respite is dependent on many interlinking factors including the child's age, diagnosis, geographical location and the family's capacity to meet their child's care needs. A proposed model for out-of-home respite has been developed based on the findings of qualitative case study research. Utilising multiple, longitudinal, qualitative case study design, the respite needs and experiences of parents caring for a child with a life-limiting condition were explored. Multiple, in-depth interviews were undertaken with the parents identified by a hospital-based children's palliative care team. Data were analysed using thematic analysis. Each individual case consists of a whole study. Cross-case comparison was also conducted. Nine families were recruited and followed for two years. A total of 19 in-depth interviews were conducted with mothers and fathers (one or both) caring for a child with a life-limiting condition in Ireland. Each family reported vastly different needs and experiences of respite from their own unique perspective. Cross-case comparison showed that for all parents utilising respite care, regardless of their child's age and condition, home was the location of choice. Many interlinking factors influencing these decisions included: past experience of in-patient care, and trust and confidence in care providers. Issues were raised regarding the impact of care provision in the home on family life, siblings and the concept of home. Respite is an essential element of children's palliative care. Utilisation of out-of-home respite is heavily dependent on a number of interlinked and intertwined factors. The proposed model of care offers an opportunity to identify how these decisions are made and may ultimately assist in identifying the elements of responsive and family-focused respite that are important to families of children with life-limiting conditions. © 2015 John Wiley & Sons Ltd.

Nutrient utilisation and particulate organic matter changes during summer in the upper mixed layer (Ross Sea, Antarctica)

NASA Astrophysics Data System (ADS)

Catalano, G.; Povero, P.; Fabiano, M.; Benedetti, F.; Goffart, A.

1997-01-01

The relationships among vertical stability, estimated nutrient utilisation and particulate organic matter in the Ross Sea are analysed from data collected during two cruises in the summers of 1987-1988 and 1989-1990. In the upper mixed layer (UML), identified through the vertical stability E( Z(UML)), nutrient consumption is calculated as the difference between the "diluted" nutrient value and the mean calculated from the integrated value in the UML. The nutrient utilisation ratio and E( Z(UML)) are linearly related for E( Z(UML))≤25, whereas for values > 25, the distribution pattern is more scattered and independent of E( Z(UML)). For E( Z(UML))≥25, utilisation values were ≥4, 0.4 and 10 mmol m -3 for nitrate, phosphate and silicate, respectively. Significant relationships between nutrient depletion and both particulate organic carbon (POC) and particulate protein/particulate carbohydrate ratios (PPRT/PCHO) are found. The analysis of particulate matter distribution vs nutrient utilisation shows that the stations could be divided into two groups having different characteristics. The first group includes coastal stations, where high nutrient utilisation, POC and PPRT/PCHO are typical of areas with high production. In the second group (pelagic stations), nutrient utilisation, POC and PPRT/PCHO are lower. The vertical stability can be used to discriminate among the factors that influence primary production.

Social determinants of dental health services utilisation of Greek adults.

PubMed

Pavi, E; Karampli, E; Zavras, D; Dardavesis, T; Kyriopoulos, J

2010-09-01

To identify the determinants of dental care utilisation among Greek adults, with a particular emphasis on socio-economic determinants. Data were collected through a national survey on health and health care services utilisation of a sample of 4,003 Greek adults stratified by geographic region, age and gender. A purpose made questionnaire was used during face-to-face interviews. A 2-stage model was developed to assess the impact of independent variables on dental utilisation likelihood and frequency. 39.6% (1,562) of Greek adults reported having visited a dentist within the last year. Among dental attenders, 32.6% reported prevention as the reason for visit. Statistically significant differences in dental care utilisation were observed in relation to demographic, socioeconomic and lifestyle factors. Logistic regression analysis showed that gender, age, income, education, place of residence, private insurance coverage and self-rated oral health are important determinants of dental services utilisation. Mean number of dental visits within previous year was 1.6. Results from Poisson regression analysis indicated that lower income level correlates to lower number of dental visits, while having visited for treatment (rather than for prevention) correlated to higher number of dental visits. Greek adults do not exhibit satisfactory dental visiting behaviour. Extent of care sought is associated with need for treatment rather than preventive reasons. The findings confirm the existence of socioeconomic inequalities in dental services utilisation among Greek adults.

[Frequency of use of school cafeterias in middle and high schools in 3 French districts].

PubMed

Michaud, C; Feur, E; Gerbouin-Rérolle, P; Leynaud-Rouaud, C; Chateil, S; Gourdon, M

2000-09-01

Reports from the French Ministry of Education warn of a decrease in the use of school food services, especially in sensitive urban areas. They also suggest that this decline has led to cases of malnutrition. This article describes the characteristics of the current supply of school meals and measures the evolution of demand observed between 1992 and 1996 in relation to the economic situation of students' families. The study was carried out in 3 departments in France: Doubs, Herault, and Val de Marne. The administrators of all public and private middle and high schools in the 3 departments received a questionnaire asking them to describe the services offered in their cafeterias and to provide the corresponding statistical and accounting data. External food services near the schools were also taken into account. Seventy-nine percent of schools responded to the survey. Concerning the services offered, 91% of schools have their own cafeterias, of which 81% are managed by the schools. Concerning the evolution of utilisation, a significant decrease in the number of meals served in seen in middle schools. On the other hand, high schools have observed stable utilisation. The positive changes in utilisation are linked, in middle schools, to characteristics of the schools' internal food services (self-service, choice of main courses, modulation of seats). In high schools, positive changes in the utilisation of school services are linked to the lack of external food services near the schools. As middle schools and high schools control the logistics and management of food services offered to students, they are potentially in a position to influence a policy on this issue. The evolution in utilisation is very different among departments and between middle and high schools. While economic precariousness has a negative structural effect on utilisation, it doesn't seem to be a major factor in the evolution of the decrease observed over the past few years.

Cost implications of self-management education intervention programmes in arthritis.

PubMed

Brady, Teresa J

2012-10-01

The purpose of this review is to examine cost implications, including cost-effectiveness analyses, cost-savings calculated from health-care utilisation and intervention delivery costs of arthritis-related self-management education (SME) interventions. Literature searches, covering 1980-March 2012, using arthritis, self-management and cost-related terms, identified 487 articles; abstracts were reviewed to identify those with cost information. Three formal cost-effectiveness analyses emerged; results were equivocal but analyses done from the societal perspective, including out-of-pocket and other indirect costs, were more promising. Eight studies of individual, group and telephone-delivered SME calculated cost-savings based on health-care utilisation changes. These studies had variable results but the costs-savings extrapolation methods are questionable. Meta-analyses of health-care utilisation changes in two specific SME interventions demonstrated only one significant result at 6 months, which did not persist at 12 months. Eleven studies reported intervention delivery costs ranging from $35 to $740 per participant; the variability is likely due to costing methods and differences in delivery mode. Economic analysis in arthritis-related SME is in its infancy; more robust economic evaluations are required to reach sound conclusions. The most common form of analysis used changes in health-care utilisation as a proxy for cost-savings; the results are less than compelling. However, other value metrics, including the value of SME as part of health systems' self-management support efforts, to population health (from improved self-efficacy, psychological well-being and physical activity), and to igniting patient activation, are all important to consider. Published by Elsevier Ltd.

Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review

PubMed Central

2014-01-01

Background Demand-side financing, where funds for specific services are channelled through, or to, prospective users, is now employed in health and education sectors in many low- and middle-income countries. This systematic review aimed to critically examine the evidence on application of this approach to promote maternal health in these settings. Five modes were considered: unconditional cash transfers, conditional cash transfers, short-term payments to offset costs of accessing maternity services, vouchers for maternity services, and vouchers for merit goods. We sought to assess the effects of these interventions on utilisation of maternity services and on maternal health outcomes and infant health, the situation of underprivileged women and the healthcare system. Methods The protocol aimed for collection and synthesis of a broad range of evidence from quantitative, qualitative and economic studies. Nineteen health and social policy databases, seven unpublished research databases and 27 websites were searched; with additional searches of Indian journals and websites. Studies were included if they examined demand-side financing interventions to increase consumption of services or goods intended to impact on maternal health, and met relevant quality criteria. Quality assessment, data extraction and analysis used Joanna Briggs Institute standardised tools and software. Outcomes of interest included maternal and infant mortality and morbidity, service utilisation, factors required for successful implementation, recipient and provider experiences, ethical issues, and cost-effectiveness. Findings on Effectiveness, Feasibility, Appropriateness and Meaningfulness were presented by narrative synthesis. Results Thirty-three quantitative studies, 46 qualitative studies, and four economic studies from 17 countries met the inclusion criteria. Evidence on unconditional cash transfers was scanty. Other demand-side financing modes were found to increase utilisation of maternal healthcare in the index pregnancy or uptake of related merit goods. Evidence of effects on maternal and infant mortality and morbidity outcomes was insufficient. Important implementation aspects include targeting and eligibility criteria, monitoring, respectful treatment of beneficiaries, suitable incentives for providers, quality of care and affordable referral systems. Conclusions Demand-side financing schemes can increase utilisation of maternity services, but attention must be paid to supply-side conditions, the fine-grain of implementation and sustainability. Comparative studies and research on health impact and cost-effectiveness are required. PMID:24438560

Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review.

PubMed

Murray, Susan F; Hunter, Benjamin M; Bisht, Ramila; Ensor, Tim; Bick, Debra

2014-01-17

Demand-side financing, where funds for specific services are channelled through, or to, prospective users, is now employed in health and education sectors in many low- and middle-income countries. This systematic review aimed to critically examine the evidence on application of this approach to promote maternal health in these settings. Five modes were considered: unconditional cash transfers, conditional cash transfers, short-term payments to offset costs of accessing maternity services, vouchers for maternity services, and vouchers for merit goods. We sought to assess the effects of these interventions on utilisation of maternity services and on maternal health outcomes and infant health, the situation of underprivileged women and the healthcare system. The protocol aimed for collection and synthesis of a broad range of evidence from quantitative, qualitative and economic studies. Nineteen health and social policy databases, seven unpublished research databases and 27 websites were searched; with additional searches of Indian journals and websites. Studies were included if they examined demand-side financing interventions to increase consumption of services or goods intended to impact on maternal health, and met relevant quality criteria. Quality assessment, data extraction and analysis used Joanna Briggs Institute standardised tools and software. Outcomes of interest included maternal and infant mortality and morbidity, service utilisation, factors required for successful implementation, recipient and provider experiences, ethical issues, and cost-effectiveness. Findings on Effectiveness, Feasibility, Appropriateness and Meaningfulness were presented by narrative synthesis. Thirty-three quantitative studies, 46 qualitative studies, and four economic studies from 17 countries met the inclusion criteria. Evidence on unconditional cash transfers was scanty. Other demand-side financing modes were found to increase utilisation of maternal healthcare in the index pregnancy or uptake of related merit goods. Evidence of effects on maternal and infant mortality and morbidity outcomes was insufficient. Important implementation aspects include targeting and eligibility criteria, monitoring, respectful treatment of beneficiaries, suitable incentives for providers, quality of care and affordable referral systems. Demand-side financing schemes can increase utilisation of maternity services, but attention must be paid to supply-side conditions, the fine-grain of implementation and sustainability. Comparative studies and research on health impact and cost-effectiveness are required.

Distinct fermentation and antibiotic sensitivity profiles exist in salmonellae of canine and human origin.

PubMed

Wallis, Corrin V; Lowden, Preena; Marshall-Jones, Zoe V; Hilton, Anthony C

2018-02-26

Salmonella enterica is a recognised cause of diarrhoea in dogs and humans, yet the potential for transfer of salmonellosis between dogs and their owners is unclear, with reported evidence both for and against Salmonella as a zoonotic pathogen. A collection of 174 S. enterica isolates from clinical infections in humans and dogs were analysed for serotype distribution, carbon source utilisation, chemical and antimicrobial sensitivity profiles. The aim of the study was to understand the degree of conservation in phenotypic characteristics of isolates across host species. Serovar distribution across human and canine isolates demonstrated nine serovars common to both host species, 24 serovars present in only the canine collection and 39 solely represented within the human collection. Significant differences in carbon source utilisation profiles and ampicillin, amoxicillin and chloramphenicol sensitivity profiles were detected in isolates of human and canine origin. Differences between the human and canine Salmonella collections were suggestive of evolutionary separation, with canine isolates better able to utilise several simple sugars than their human counterparts. Generally higher minimum inhibitory concentrations of three broad-spectrum antimicrobials, commonly used in veterinary medicine, were also observed in canine S. enterica isolates. Differential carbon source utilisation and antimicrobial sensitivity profiles in pathogenic Salmonella isolated from humans and dogs are suggestive of distinct reservoirs of infection for these hosts. Although these findings do not preclude zoonotic or anthroponotic potential in salmonellae, the separation of carbon utilisation and antibiotic profiles with isolate source is indicative that infectious isolates are not part of a common reservoir shared frequently between these host species.

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

Sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea: Korea Health and Nutrition Examination Survey 2008–2012

PubMed Central

Rim, Tyler Hyungtaek; Choi, Moonjung; Yoon, Jin Sook; Kim, Sung Soo

2015-01-01

Objective To determine the sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea. Design Nationwide cross-sectional study Methods 25 752 Koreans over the age of 30 were assessed from a national representative survey. We analysed independent variables of self-reporting eye clinic visits through multivariable analyses of sociodemographic factors. The time since the last visit to an eye clinic was used to assess access to and utilisation of eye care. Results Of the 25 752 respondents, 8237 (32.0%) visited an eye clinic in the past year, 11 028 (42.8%) were seen more than 1 year ago, while 6487 (25.2%) had never seen an ophthalmologist. Eye clinic utilisation was statistically associated with older age, female sex, higher household income, higher education levels, living in an urban area, and having comorbidities including diabetes and hypertension. Middle-aged men between 30 and 49 years were found to be less likely to receive eye care compared to the rest of the population, and the proportion that did plummeted after the financial crisis of 2007. Conclusions There is a substantial sociodemographic disparity in eye care utilisation in Korea, and men with low financial income and education level are especially at risk. Use of eye care among middle-aged men has decreased since the global financial crisis that began in 2007, and therefore healthcare policies and public interventions should be targeted at vulnerable groups to promote access to medical care. PMID:26185177

Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

PubMed Central

Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

2016-01-01

Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27648258

Residential respite care is associated with family carers experiencing financial strain.

PubMed

Aggar, Christina; Ronaldson, Susan; Cameron, Ian D

2014-06-01

Care services for older people are provided with the expectation of supporting carers in their caregiving role. The aim of the study is to investigate the association between the utilisation of care services by older people and the caregiving experience. Cross-sectional design, involving a cohort of family carers (n = 119) of frail older people (≥70 years) enrolled in a clinical trial of frailty treatment in metropolitan Sydney from 2008 to 2011. The caregiving experience was measured in five domains: health, daily schedule, finance, family support and self-esteem (Caregiver Reaction Assessment tool). Multivariate regression analysis demonstrated an association between the utilisation of residential respite care and financial strain (β = -0.613, P = 0.049), after controlling for functional ability, co-residence and age. There is a need to consider carers' financial barriers and concerns in regards to the utilisation of respite care services. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.

Defined daily doses (DDD) do not accurately reflect opioid doses used in contemporary chronic pain treatment.

PubMed

Nielsen, Suzanne; Gisev, Natasa; Bruno, Raimondo; Hall, Wayne; Cohen, Milton; Larance, Briony; Campbell, Gabrielle; Shanahan, Marian; Blyth, Fiona; Lintzeris, Nicholas; Pearson, Sallie; Mattick, Richard; Degenhardt, Louisa

2017-05-01

To assess how well the defined daily dose (DDD) metric reflects opioid utilisation among chronic non-cancer pain patients. Descriptive, cross-sectional study, utilising a 7-day medication diary. Community-based treatment settings, Australia. A sample of 1101 people prescribed opioids for chronic non-cancer pain. Opioid dose data was collected via a self-completed 7-day medication diary capturing names, strengths and doses of each medication taken in the past week. Median daily dose was calculated for each opioid. Comparisons were made to the World Health Organization's (WHO) DDD metric. WHO DDDs ranged from 0.6 to 7.1 times the median opioid doses used by the sample. For transdermal fentanyl and oral hydromorphone, the median dose was comparable with the DDD. The DDD for methadone was 0.6 times lower than the median doses used by this sample of chronic pain patients. In contrast, the DDD for oxycodone and transdermal buprenorphine, the most commonly used strong opioids for chronic pain in Australia, was two to seven times higher than actual doses used. For many opioids, there are key differences between the actual doses used in clinical practice and the WHO's DDDs. The interpretation of opioid utilisation studies using population-level DDDs may be limited, and a recalibration of the DDD for many opioids or the reporting of opioid utilisation in oral morphine equivalent doses is recommended. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Utilisation of formal and informal care and services at home among persons with dementia: a cross-sectional study.

PubMed

Bökberg, Christina; Ahlström, Gerd; Karlsson, Staffan

2017-09-04

The progression of dementia disease implies increasing needs for both informal and formal care and services but also risk of institutionalisation. To better adjust care and services in the phase preceding institutionalisation it is important to find out whether utilisation of formal and informal care and services is determined by increased needs and by who meets the needs. The aim was to compare persons with dementia (65+) with different levels of cognitive impairment, regarding utilisation of formal and informal care and service at home. The participants consisted of 177 persons with dementia ≥65 years old and at risk of nursing home admission, divided into groups according to their cognitive function. Structured interviews were conducted based on questionnaires about type and amount of formal and informal care utilised, as well as questions regarding cognitive impairment, dependency in activities of daily living (ADLs) and neuropsychiatric symptoms. To analyse the data, descriptive and comparative statistics were used. The findings revealed that the group with severe dementia used significantly more help with ADLs and supervision in terms of time (number of hours and days) provided by the informal caregiver, compared with the group with moderate dementia. Utilisation of formal care and services was highest in the group with the most severe cognitive impairments (Standardized Mini-Mental State Examination score of <9). The group with severe dementia were more dependent in ADLs and had more neuropsychiatric symptoms (hallucinations and motor disturbances). They were younger and more often cohabitated with the informal caregiver, compared with the group with moderate dementia. This study shows that in the phase preceding institutionalisation the ADL and supervision needs due to progression of dementia appear to tend to be met first and foremost by the informal caregivers. © 2017 Nordic College of Caring Science.

Pharmacotherapy Evaluation and Utilization in Coronary Artery Bypass Grafting Patients in Kosovo during the Period 2016-2017

PubMed Central

Daci, Armond; Bozalija, Adnan; Cavolli, Raif; Alaj, Rame; Beretta, Giangiacomo; Krasniqi, Shaip

2018-01-01

BACKGROUND: Coronary Artery Bypass Grafting (CABG) is realised in patients with critical or advanced disease of coronary arteries. There are different pharmacotherapeutic approaches which are used as management, treatment and preventive therapy in cardiovascular disease or related comorbidities. Performing a successful surgery, pharmacotherapy, and increase of bypass patency rate remains a serious challenge. AIM: This study aims to analyse the patient characteristics undergoing CABG and evaluation of their drug utilisation rate and daily dosages in the perioperative period. MATERIAL AND METHODS: Data were collected from 102 patients in the period 2016-2017 and detailed therapeutic prescription and dosages, patient characteristics were analysed before the operation, after the operation and visit after operation in the Clinic of Cardiac surgery-University Clinical Center of Kosovo. RESULTS: Our findings had shown that patients provided to have normal biochemical parameters in the clinic before the operation, and were related to cardiovascular diseases and comorbidities and risk factors with mainly elective intervention. The, however, higher utilisation of cardiovascular drugs such as beta blockers, diuretics, anticoagulants, statins and lower calcium blockers, ACEi, ARBs, hydrochlorothiazide, amiodarone were founded. ARBs, beta blockers, statins, nitrates and nadroparin utilisation decreased after operation and visit after the operation, whereas amiodarone only in the visit after the operation. Diuretics are increased after the operation which decreases in the visit after the operation. Regarding the daily dosage, only metoprolol was increased in the visit after operation (P < 0.001) and visit after operation (P < 0.05) whereas losartan and furosemide were increased (P < 0.01) and (P < 0.05) respectively. CONCLUSION: The study showed that beta blockers, statins, aspirin, nitrates (before the operation), furosemide and spironolactone are the most utilised drugs. However, we found low utilisation rate for ACEi, ARBs, clopidogrel, nadroparin, warfarin, xanthines, amiodarone, calcium blockers. Daily dosages were different compared to before CABG only in metoprolol, losartan, and furosemide. PMID:29610608

Quantification of the heterogeneity of prognostic cellular biomarkers in ewing sarcoma using automated image and random survival forest analysis.

PubMed

Bühnemann, Claudia; Li, Simon; Yu, Haiyue; Branford White, Harriet; Schäfer, Karl L; Llombart-Bosch, Antonio; Machado, Isidro; Picci, Piero; Hogendoorn, Pancras C W; Athanasou, Nicholas A; Noble, J Alison; Hassan, A Bassim

2014-01-01

Driven by genomic somatic variation, tumour tissues are typically heterogeneous, yet unbiased quantitative methods are rarely used to analyse heterogeneity at the protein level. Motivated by this problem, we developed automated image segmentation of images of multiple biomarkers in Ewing sarcoma to generate distributions of biomarkers between and within tumour cells. We further integrate high dimensional data with patient clinical outcomes utilising random survival forest (RSF) machine learning. Using material from cohorts of genetically diagnosed Ewing sarcoma with EWSR1 chromosomal translocations, confocal images of tissue microarrays were segmented with level sets and watershed algorithms. Each cell nucleus and cytoplasm were identified in relation to DAPI and CD99, respectively, and protein biomarkers (e.g. Ki67, pS6, Foxo3a, EGR1, MAPK) localised relative to nuclear and cytoplasmic regions of each cell in order to generate image feature distributions. The image distribution features were analysed with RSF in relation to known overall patient survival from three separate cohorts (185 informative cases). Variation in pre-analytical processing resulted in elimination of a high number of non-informative images that had poor DAPI localisation or biomarker preservation (67 cases, 36%). The distribution of image features for biomarkers in the remaining high quality material (118 cases, 104 features per case) were analysed by RSF with feature selection, and performance assessed using internal cross-validation, rather than a separate validation cohort. A prognostic classifier for Ewing sarcoma with low cross-validation error rates (0.36) was comprised of multiple features, including the Ki67 proliferative marker and a sub-population of cells with low cytoplasmic/nuclear ratio of CD99. Through elimination of bias, the evaluation of high-dimensionality biomarker distribution within cell populations of a tumour using random forest analysis in quality controlled tumour material could be achieved. Such an automated and integrated methodology has potential application in the identification of prognostic classifiers based on tumour cell heterogeneity.

[Mental health care for migrants].

PubMed

Lindert, Jutta; Priebe, Stefan; Penka, Simone; Napo, Fatima; Schouler-Ocak, Meryam; Heinz, Andreas

2008-01-01

Global migration and the increasing number of migrants to Europe and Germany diversify the needs in the psychosocial and health care system. Migrants are a heterogeneous group as regards their country of emigration, reasons for migration and legal status. We aim to give an overview on 1) mental health of migrants in Germany, 2) cultural associated explanatory of addictive behaviour, 3) utilisation and help-seeking behaviour migrants with particular regard to addicted migrants, and on 4) barriers within the psychosocial care system. Studies on migration, mental health and utilisation of psychosocial institutions especially of institutions for addicted persons show inconsistent results. The results may be conflicting because of the methods used (e. g. small sample size, variety of methods, studies on clinical populations, studies without control-groups, mono-ethnic studies) or because of differences between populations. Therefore, the comparability of results is limited. Migrants use health and psychosocial care institutions differently from non-migrants. Barriers within the psychosocial care system may be caused by uncertainty of learned behaviour of members of staff how to treat migrants or by institutional barriers. Our findings show that empirical studies on mental health of migrants are still rare. Further specific investigations are needed to get an in-depth understanding of migrants' mental health and their pattern of psychosocial and health care utilisation to modify responsiveness of services.

Gender differences in substrate utilisation during exercise.

PubMed

Ruby, B C; Robergs, R A

1994-06-01

The selection and utilisation of metabolic substrates during endurance exercise are regulated by a complex array of effectors. These factors include, but are not limited to, endurance training and cardiorespiratory fitness, exercise intensity and duration, muscle morphology and histology, hormonal factors and diet. Although the effects of these factors on substrate utilisation patterns are well understood, the variation in substrate utilisation during endurance exercise between males and females is not. Because of the extreme heterogeneity in exercise protocols and individuals studied, the differences in substrate utilisation between males and females remain somewhat inconclusive. Regardless of heterogeneity, if the results from studies are interpreted collectively, an apparent gender difference in the selection and metabolism of substrates can be seen in sedentary individuals. However, this difference between genders diminishes as the level of cardiorespiratory fitness is increased to that of highly trained individuals. During rest and lower intensity exercise, the preferential metabolism of lipid occurs with a concomitant sparing of muscle glycogen. However, as the intensity of exercise is increased, the relative contribution of carbohydrate also increases. The exercise intensity at which the shift from lipid to carbohydrate is determined and regulated by the previously mentioned factors. Because the intensity and duration of exercise play a predominant role, the variation in exercise protocols poses a methodological concern when interpreting previous research. When attempting to compare the metabolism of substrates during endurance exercise, appropriate selection and interpretation of measurement techniques are necessary. Measurement techniques include the nonprotein respiratory exchange ratio, muscle and fat biopsies and the measurement of various blood metabolites, such as free fatty acids and glycerol. Similarly, in vitro analysis of lipolytic activity has also been demonstrated in males and females in response to varying levels of female gonadotrophic hormones. When comparing the substrate utilisation patterns between males and females, the area of hormonal regulation has received less attention. Often the catecholamine response to endurance exercise is measured; however, the gonadotrophic hormones, particularly those of the female, have received less attention when comparing genders. Indeed, the regulatory nature of the female gonadotrophic hormones has been demonstrated. Collectively, the effects of elevated estrogen, as in the luteal phase of menstruation, appear to promote lipolytic activity. Estrogen-mediated lipolytic activation occurs by apparently altering the sensitivity to lipoprotein lipase and by increasing the levels of human growth hormone (somatotropin), an activator of lipolysis.(ABSTRACT TRUNCATED AT 400 WORDS)

Better health outcomes at lower costs: the benefits of primary care utilisation for chronic disease management in remote Indigenous communities in Australia's Northern Territory.

PubMed

Zhao, Yuejen; Thomas, Susan L; Guthridge, Steven L; Wakerman, John

2014-10-04

Indigenous residents living in remote communities in Australia's Northern Territory experience higher rates of preventable chronic disease and have poorer access to appropriate health services compared to other Australians. This study compared health outcomes and costs at different levels of primary care utilisation to determine if primary care represents an efficient use of resources for Indigenous patients with common chronic diseases namely hypertension, diabetes, ischaemic heart disease, chronic obstructive pulmonary disease and renal disease. This was an historical cohort study involving a total of 14,184 Indigenous residents, aged 15 years and over, who lived in remote communities and used a remote clinic or public hospital from 2002 to 2011. Individual level demographic and clinical data were drawn from primary care and hospital care information systems using a unique patient identifier. A propensity score was used to improve comparability between high, medium and low primary care utilisation groups. Incremental cost-effectiveness ratios and acceptability curves were used to analyse four health outcome measures: total and, avoidable hospital admissions, deaths and years of life lost. Compared to the low utilisation group, medium and high levels of primary care utilisation were associated with decreases in total and avoidable hospitalisations, deaths and years of life lost. Higher levels of primary care utilisation for renal disease reduced avoidable hospitalisations by 82-85%, deaths 72-75%, and years of life lost 78-81%. For patients with ischaemic heart disease, the reduction in avoidable hospitalisations was 63-78%, deaths 63-66% and years of life lost 69-73%. In terms of cost-effectiveness, primary care for renal disease and diabetes ranked as more cost-effective, followed by hypertension and ischaemic heart disease. Primary care for chronic obstructive pulmonary disease was the least cost-effective of the five conditions. Primary care in remote Indigenous communities was shown to be associated with cost-savings to public hospitals and health benefits to individual patients. Investing $1 in primary care in remote Indigenous communities could save $3.95-$11.75 in hospital costs, in addition to health benefits for individual patients. These findings may have wider applicability in strengthening primary care in the face of high chronic disease prevalence globally.

Landscape Utilisation, Animal Behaviour and Hendra Virus Risk.

PubMed

Field, H E; Smith, C S; de Jong, C E; Melville, D; Broos, A; Kung, N; Thompson, J; Dechmann, D K N

2016-03-01

Hendra virus causes sporadic fatal disease in horses and humans in eastern Australia. Pteropid bats (flying-foxes) are the natural host of the virus. The mode of flying-fox to horse transmission remains unclear, but oro-nasal contact with flying-fox urine, faeces or saliva is the most plausible. We used GPS data logger technology to explore the landscape utilisation of black flying-foxes and horses to gain new insight into equine exposure risk. Flying-fox foraging was repetitious, with individuals returning night after night to the same location. There was a preference for fragmented arboreal landscape and non-native plant species, resulting in increased flying-fox activity around rural infrastructure. Our preliminary equine data logger study identified significant variation between diurnal and nocturnal grazing behaviour that, combined with the observed flying-fox foraging behaviour, could contribute to Hendra virus exposure risk. While we found no significant risk-exposing difference in individual horse movement behaviour in this study, the prospect warrants further investigation, as does the broader role of animal behaviour and landscape utilisation on the transmission dynamics of Hendra virus.

Evaluation of swine fertilisation medium (SFM) efficiency in preserving spermatozoa quality during long-term storage in comparison to four commercial swine extenders.

PubMed

Fantinati, P; Zannoni, A; Bernardini, C; Forni, M; Tattini, A; Seren, E; Bacci, M L

2009-02-01

In pig production, artificial insemination is widely carried out and the use of fresh diluted semen is predominant. For this reason, there are increasing interests in developing new extenders and in establishing the optimal storage conditions for diluted spermatozoa. In the last few decades, we utilised a homemade diluent (swine fertilisation medium (SFM)) for spermatozoa manipulation and biotechnological application as the production of transgenic pigs utilising the sperm-mediated gene transfer technique. The purpose of the present study is therefore to analyse the ability of SFM, in comparison to four commercial extenders, in preserving the quality of diluted boar semen stored at 16.5°C till 15 days. We utilised some of the main predictive tests as objectively measured motility, acrosome and sperm membrane integrity, high mitochondrial membrane potential and pH. Based on our in vitro study, SFM could be declared as a good long-term extender, able to preserve spermatozoa quality as well as Androhep Enduraguard for up to 6 to 9 days and more.

Differences in social support of caregivers living with partners suffering from COPD or dementia.

PubMed

Nordtug, Bente; Krokstad, Steinar; Sletvold, Olav; Holen, Are

2013-05-01

Future patients with chronic diseases will probably remain longer in their homes. To enable family caregivers to meet these challenges, public services and informal support are essential. This study compared social support between home-dwelling caregivers of partners with chronic obstructive pulmonary disease or dementia. A cross-sectional study of 206 caregivers. Professional aid was quantified by the services utilised. Informal support from family and friends was rated by the number of helping persons and the degree of social withdrawal. The Medical Outcomes Study Social Support Survey Form captured perceived social support. For both diseases, increased severity correlated with more utilisation of professional aid. The chronic obstructive pulmonary disease group perceived more social support, reported less social withdrawal and higher numbers of helping persons. Ill partners' aggressive behaviour reduced perceived support. The use of professional aid was negatively associated with the ill partner's level of self-care, and positively correlated with social withdrawal. Professional aid was more utilised by the dementia group and by men. Differences in caregivers' needs for social support were related to their partner's disease. Counteracting social withdrawal, considering type of illness and gender differences may increase the quality of informal care. © 2011 Blackwell Publishing Ltd.

Stakeholders' perspectives on facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea: a qualitative study.

PubMed

Chol, Chol; Hunter, Cynthia; Debru, Berhane; Haile, Berhana; Negin, Joel; Cumming, Robert G

2018-01-19

Wars affect maternal health services by destroying health systems. Eritrea experienced two wars with neighbouring Ethiopia. Despite this, the maternal mortality ratio (MMR) in Eritrea fell by 69% from 1590 per 100,000 live births in 1990 to 501 in 2015. This study aimed to examine facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea. Using in-depth interviews and field observations for data collection, this qualitative study was conducted in five healthcare facilities in Asmara, the capital of Eritrea, in February and March 2016. The participants were: women (n = 40), husbands (n = 5), healthcare providers (n = 10), and decision makers (n = 5). There were two perceived facilitators of utilisation of and access to maternal health services: health education (related to the WHO health service delivery building blocks) and improvement in gender equality driven by the role played by Eritrean women as combatants during the War of Independence (1961-1991). The only perceived barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and shortage of healthcare workers (related to the WHO health workforce building block). This study assessed women and their husbands/partners' perceptions and the possible effects of contemporary Eritrean culture and the history of war on the utilisation of and access to maternal health services in the country. As well, we examined healthcare providers' and decision makers' perspectives. The two key facilitators of women's utilisation of and access to maternal health services were health education and women's empowerment driven by their role as combatants during the War of Independence. One main barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and a shortage of healthcare workers. As only a limited number of qualitative studies have been published about maternal health services in war-affected sub-Saharan African countries, our findings regarding health education and women's empowerment could be considered in other war-affected countries similar to Eritrea. Nevertheless, further research is needed to investigate our findings - particularly regarding female empowerment driven by women's role in combat in relation to their maternal health.

Coordination of physiological and structural traits in Amazon forest trees

NASA Astrophysics Data System (ADS)

Patiño, S.; Fyllas, N. M.; Baker, T. R.; Paiva, R.; Quesada, C. A.; Santos, A. J. B.; Schwarz, M.; Ter Steege, H.; Phillips, O. L.; Lloyd, J.

2012-02-01

Many plant traits covary in a non-random manner reflecting interdependencies associated with "ecological strategy" dimensions. To understand how plants integrate their structural and physiological investments, data on leaf and leaflet size and the ratio of leaf area to sapwood area (ΦLS) obtained for 1020 individual trees (encompassing 661 species) located in 52 tropical forest plots across the Amazon Basin were incorporated into an analysis utilising existing data on species maximum height (Hmax), seed size, leaf mass per unit area (MA), foliar nutrients and δ13C, and branch xylem density (ρx). Utilising a common principal components approach allowing eigenvalues to vary between two soil fertility dependent species groups, five taxonomically controlled trait dimensions were identified. The first involves primarily cations, foliar carbon and MA and is associated with differences in foliar construction costs. The second relates to some components of the classic "leaf economic spectrum", but with increased individual leaf areas and a higher ΦLS newly identified components for tropical tree species. The third relates primarily to increasing Hmax and hence variations in light acquisition strategy involving greater MA, reductions in ΦLS and less negative δ13C. Although these first three dimensions were more important for species from high fertility sites the final two dimensions were more important for low fertility species and were associated with variations linked to reproductive and shade tolerance strategies. Environmental conditions influenced structural traits with ρx of individual species decreasing with increased soil fertility and higher temperatures. This soil fertility response appears to be synchronised with increases in foliar nutrient concentrations and reductions in foliar [C]. Leaf and leaflet area and ΦLS were less responsive to the environment than ρx. Thus, although genetically determined foliar traits such as those associated with leaf construction costs coordinate independently of structural characteristics such as maximum height, others such as the classical "leaf economic spectrum" covary with structural traits such as leaf size and ΦLS. Coordinated structural and physiological adaptions are also associated with light acquisition/shade tolerance strategies with several traits such as MA and [C] being significant components of more than one ecological strategy dimension. This is argued to be a consequence of a range of different potential underlying causes for any observed variation in such "ambiguous" traits. Environmental effects on structural and physiological characteristics are also coordinated but in a different way to the gamut of linkages associated with genotypic differences.

Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda.

PubMed

Musoke, David; Boynton, Petra; Butler, Ceri; Musoke, Miph Boses

2014-12-01

The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs. To assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. The study was a cross sectional survey that used a structured questionnaire to collect quantitative data among 234 participants. The sample size was obtained using the formula by Leslie Kish. While 89% of the participants were aware that mobile clinics existed in their community, only 28% had received such services in the past month. The majority of participants (84%) did not know whether community health workers existed in their community. The participants' health seeking behaviour the last time they were sick was associated with age (p = 0.028) and occupation (p = 0.009). The most significant challenges in utilising health services were regular stock-out of drugs, high cost of services and long distance to health facilities. There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy.

Optimal management of stationary lithium-ion battery system in electricity distribution grids

NASA Astrophysics Data System (ADS)

Purvins, Arturs; Sumner, Mark

2013-11-01

The present article proposes an optimal battery system management model in distribution grids for stationary applications. The main purpose of the management model is to maximise the utilisation of distributed renewable energy resources in distribution grids, preventing situations of reverse power flow in the distribution transformer. Secondly, battery management ensures efficient battery utilisation: charging at off-peak prices and discharging at peak prices when possible. This gives the battery system a shorter payback time. Management of the system requires predictions of residual distribution grid demand (i.e. demand minus renewable energy generation) and electricity price curves (e.g. for 24 h in advance). Results of a hypothetical study in Great Britain in 2020 show that the battery can contribute significantly to storing renewable energy surplus in distribution grids while being highly utilised. In a distribution grid with 25 households and an installed 8.9 kW wind turbine, a battery system with rated power of 8.9 kW and battery capacity of 100 kWh can store 7 MWh of 8 MWh wind energy surplus annually. Annual battery utilisation reaches 235 cycles in per unit values, where one unit is a full charge-depleting cycle depth of a new battery (80% of 100 kWh).

A prospective randomised study to compare the utility and outcomes of subdural and subperiosteal drains for the treatment of chronic subdural haematoma.

PubMed

Kaliaperumal, Chandrasekaran; Khalil, Ayman; Fenton, Eoin; Okafo, Uchenna; Kaar, George; O'Sullivan, Michael; Marks, Charles

2012-11-01

The usage of a drain following evacuation of a chronic subdural haematoma (CSDH) is known to reduce recurrence. In this study we aim to compare the clinical outcomes and recurrence rate of utilising two different types of drains (subperiosteal and subdural drain) following drainage of a CSDH. Prospective randomised single-centre study analysing 50 patients who underwent CSDH treatment. Two types of drains, subperiosteal (SPD) and subdural (SDD), were utilised on consecutive alternate patients following burr-hole craniostomy, with a total of 25 patients in each group. The drains were left in for 48-h duration and then removed. The modified Rankin Scale (mRS) was used for outcome measurement at 3 and 6 months. Data analysis was performed by unpaired t test with Welch's correction. It was observed that none of the patients in either group had haematoma recurrence during a 6-month follow-up, and a significant difference in outcome was noted at 6 months (p = 0.0118) more than at 3 months (p = 0.0493) according to the statistical analysis. Postoperative seizure and inadvertent placement of the subdural drain into the brain parenchyma were the two complications noted in this study. Anticoagulant use prior to the surgery did not affect the outcome in either group. We conclude there was no recurrence of CSDH utilising the SDD and SPD following burr-hole craniostomy. The mRS measurement at the 6-month follow-up was found to be statistically significant, with better outcomes with utilisation of the SPD. The SPD may thus prove to be more beneficial than the SDD in the treatment of CSDH. A multi-centre study with a larger group of patients is recommended to reinforce the results from our study.

Modelling Pasture-based Automatic Milking System Herds: The Impact of Large Herd on Milk Yield and Economics.

PubMed

Islam, M R; Clark, C E F; Garcia, S C; Kerrisk, K L

2015-07-01

The aim of this modelling study was to investigate the effect of large herd size (and land areas) on walking distances and milking interval (MI), and their impact on milk yield and economic penalties when 50% of the total diets were provided from home grown feed either as pasture or grazeable complementary forage rotation (CFR) in an automatic milking system (AMS). Twelve scenarios consisting of 3 AMS herds (400, 600, 800 cows), 2 levels of pasture utilisation (current AMS utilisation of 15.0 t dry matter [DM]/ha, termed as 'moderate'; optimum pasture utilisation of 19.7 t DM/ha, termed as 'high') and 2 rates of incorporation of grazeable complementary forage system (CFS: 0, 30%; CFS = 65% farm is CFR and 35% of farm is pasture) were investigated. Walking distances, energy loss due to walking, MI, reduction in milk yield and income loss were calculated for each treatment based on information available in the literature. With moderate pasture utilisation and 0% CFR, increasing the herd size from 400 to 800 cows resulted in an increase in total walking distances between the parlour and the paddock from 3.5 to 6.3 km. Consequently, MI increased from 15.2 to 16.4 h with increased herd size from 400 to 800 cows. High pasture utilisation (allowing for an increased stocking density) reduced the total walking distances up to 1 km, thus reduced the MI by up to 0.5 h compared to the moderate pasture, 800 cow herd combination. The high pasture utilisation combined with 30% of the farm in CFR in the farm reduced the total walking distances by up to 1.7 km and MI by up to 0.8 h compared to the moderate pasture and 800 cow herd combination. For moderate pasture utilisation, increasing the herd size from 400 to 800 cows resulted in more dramatic milk yield penalty as yield increasing from c.f. 2.6 and 5.1 kg/cow/d respectively, which incurred a loss of up to $AU 1.9/cow/d. Milk yield losses of 0.61 kg and 0.25 kg for every km increase in total walking distance (voluntary return trip from parlour to paddock) and every one hour increase in MI, respectively. The high pasture utilisation combined with 30% of the farm in CFR in the farm increased milk yield by up to 1.5 kg/cow/d, thereby reducing loss by up to $0.5/cow/d (c.f. the moderate pasture and 800 cow herd scenario). Thus, it was concluded that the successful integration of grazeable CFS with pasture has the potential to improve financial performance compared to the pasture only, large herd, AMS.

An analysis of the costs of treating schizophrenia in Spain: a hierarchical Bayesian approach.

PubMed

Vázquez-Polo, Francisco-Jose; Negrín, Miguel; Cabasés, Juan M; Sánchez, Eduardo; Haro, Joseph M; Salvador-Carulla, Luis

2005-09-01

Health care decisions should incorporate cost of illness and treatment data, particularly for disorders such as schizophrenia with a high morbidity rate and a disproportionately low allocation of resources. Previous cost of illness analyses may have disregarded geographical aspects relevant for resource consumption and unit cost calculation. To compare the utilisation of resources and the care costs of schizophrenic patients in four mental-health districts in Spain (in Madrid, Catalonia, Navarra and Andalusia), and to analyse factors that determine the costs and the differences between areas. A treated prevalence bottom-up three year follow-up design was used for obtaining data concerning socio-demography, clinical evolution and the utilisation of services. 1997 reference prices were updated for years 1998-2000 in euros. We propose two different scenarios, varying in the prices applied. In the first (Scenario 0) the reference prices are those obtained for a single geographic area, and so the cost variations are only due to differences in the use of resources. In the second situation (Scenario 1), we analyse the variations in resource utilisation at different levels, using the prices applicable to each healthcare area. Bayesian hierarchical models are used to discuss the factors that determine such costs and the differences between geographic areas. In scenario 0, the estimated mean cost was 4918.948 euros for the first year. In scenario 1 the highest cost was in Gava (Catalonia) and the lowest in Loja (Andalusia). Mean costs were respectively 4547.24 and 2473.98 euros. With respect to the evolution of costs over time, we observed an increase during the second year and a reduction during the third year. Geographical differences appeared in follow-up costs. The variables related to lower treatment costs were: residence in the family household, higher patient age and being in work. On the contrary, the number of relapses is directly related to higher treatment costs. No differences were observed between health areas concerning resource utilisation. Calculating the costs of a given disease involves two principal factors: the resource utilisation and the prices. In most studies, emphasis is placed on the analysis of resource utilisation. Other evaluations, however, have recognized the implications of incorporating different prices into the final results. In this study we show both scenarios. The factors that determine the cost of schizophrenia for the Spanish case are similar to the factors encountered in studies carried out in other countries. Treatment costs may be reduced by the prevention of psychotic symptoms and relapse. The use of the same price data in multicentre studies may not be realistic. More effort should be made to obtain price data from all the centres or countries participating in a study. In the present study, only direct healthcare and social costs have been included. Future research should consider informal and indirect costs.

Health-care utilisation amongst pregnant women who experience sleeping problems and/or tiredness or fatigue: secondary analysis of a cross-sectional survey of 1835 pregnant women.

PubMed

Lauche, Romy; Hall, Helen; Adams, Jon; Steel, Amie; Broom, Alex; Sibbritt, David

2016-03-01

Sleeping problems and fatigue in pregnancy are often accepted as a normal part of pregnancy; however, these conditions can be linked to serious consequences for both the mother and child. Despite established links between sleeping disturbance and a wide range of pregnancy complications, little is known about the health-care utilisation of women experiencing sleeping problems and fatigue. This study addresses the existing gap in the literature by examining cross-sectional data to identify health service utilisation patterns of pregnant women experiencing sleeping problems and/or tiredness or fatigue. In 2010, a sub-study of the Australian Longitudinal Study on Women's Health was conducted as a cross-sectional survey of 2445 women who had recently given birth. Associations between reported symptoms of sleeplessness and/or tiredness or fatigue and health service utilisation were determined using logistic regression analysis. During their pregnancy, 15.2 % of women experienced sleeping problems while 35.4 % experienced tiredness or fatigue. Women most commonly consulted with an obstetrician (n = 96) or a general practitioner (GP) (n = 74) for their tiredness or fatigue rather than a midwife (n = 56). A substantial number of women sought help from a complementary and alternative medicine (CAM) practitioner for sleeping problems (33 %) or tiredness/fatigue (28 %). Sleeping problems and/or tiredness or fatigue is reported by a reasonable percentage of pregnant women, and women obtain assistance from conventional and CAM practitioners for their symptoms, but not all seek help. Given the serious implications of untreated sleep- and fatigue-related symptoms for mother and baby, this area of research deserves and requires more attention.

GP utilisation by education level among adults with COPD or asthma: a cross-sectional register-based study.

PubMed

Hetlevik, Øystein; Melbye, Hasse; Gjesdal, Sturla

2016-06-09

There is a marked socioeconomic gradient in the prevalence of chronic obstructive pulmonary disease (COPD) and asthma, but a large proportion of patients remain undiagnosed. It is a challenge for general practitioners (GPs) to both identify patients and contribute to equity and high quality in services delivered. The aim of this study was to identify patients with COPD and asthma diagnoses recorded by GPs and explore their utilisation of GP services by education level. This was a cross-sectional, national, register-based study from Norwegian general practice in the period 2009-2011. Based on claims from GPs, the number of patients aged ⩾40 years with a diagnosis of COPD or asthma and their GP services utilisation were estimated and linked to the national education database. Multivariate Poisson and logistic regression models were used to explore the variations in GP utilisation. In the population aged ⩾40 years, 2.8% had COPD and 3.8% had asthma according to GPs' diagnoses. COPD was four times more prevalent in patients with basic education than higher education; this increase was ⩽80% for asthma. Consultation rates were 12% higher (P<0.001) for COPD and 25% higher (P<0.001) for asthma in patients with low versus high education in the age group of 40-59 years after adjusting for comorbidity, and patient and GP characteristics. Approximately 25% of COPD patients and 20% of asthma patients had ⩾1 spirometry test in general practice in 2011, with no significant education differences in adjusted models. The higher consultation rate in lower-education groups indicates that GPs contribute to fair distribution of healthcare.

Utilisation patterns and cost of hospital care for people living with HIV in Ireland in 2012: a single-centre study.

PubMed

Brennan, Aline; Horgan, Mary; Jackson, Arthur; Browne, John P; Bergin, Colm J

2017-03-01

Data on the pattern and cost of health service use by HIV patients are required for evaluations of the cost-effectiveness of new drugs and technologies as well as being essential for service planning. The aim of this study was to identify the utilisation patterns and cost of hospital care for HIV patients in a single centre in Ireland in 2012. Data on the frequency and non-drug costs of all hospital resources used by HIV patients were extracted from a hospital activity-based costing system. Cost data were analysed using a generalised linear model. A total of 328 patients, 3672 patient months, were included in this study. Patients had a mean of 4.4 scheduled infectious disease outpatient appointments per patient year; 37% of patients also used another outpatient service, 15% in-patient services, 4% day-case service and 18% emergency department services in 2012. Patients with very advanced HIV disease continue to incur a disproportionate amount of the total cost of providing care. This study provides baseline utilisation and cost data for use of both infectious-disease and non-infectious disease hospital services and will be useful for service planning in light of the likely increases in resource demands.

A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model.

PubMed

Baines, Tineke; Wittkowski, Anja

2013-09-01

Psychologists have utilised a range of social cognition models to understand variation in physical health and illness-related behaviours. The most widely studied model of illness perceptions has been the Self-Regulation Model (SRM, Leventhal, Nerenz, & Steele, 1984). The illness perceptions questionnaire (IPQ) and its revised version (IPQ-R) have been utilised to explore illness beliefs in physical health. This review examined 13 quantitative studies, which used the IPQ and IPQ-R in mental health in their exploration of illness perceptions in psychosis, bipolar disorder, eating disorders, depression and adolescents experiencing mood disorders. Across these studies the SRM illness dimensions were largely supported. Mental illnesses were commonly viewed as cyclical and chronic, with serious negative consequences. Perceptions regarding chronicity, controllability and negative consequences were associated with coping and help seeking, while engagement with services and help seeking were also related to illness coherence beliefs. Treatment adherence was linked to beliefs that treatment could control one's illness. Whilst a major limitation of the reviewed studies was the use of cross-sectional designs, overall the applicability of the SRM to mental health was supported. The IPQ and IPQ-R were shown to be valuable measures of illness perceptions in mental health, offering implications for clinical practice.

Evaluation de l'intergiciel de communication DDS pour son utilisation dans le domaine avionique

NASA Astrophysics Data System (ADS)

Levesque-Landry, Kevin

Les aeronefs modernes doivent combler de plus en plus de fonctionnalites afin de satisfaire les besoins de la clientele. De ce fait, les besoins en communications des systemes avioniques sont grandissants. De plus, la portabilite et la reutilisabilite des applications sont des defis d'actualite dans le domaine avionique. De ce fait, ce projet de recherche vise a faire une evaluation de la technologie d'intergiciel de service de distribution de donnees (DDS) pour son utilisation dans le domaine avionique. Cette technologie permettrait de reduire la complexite des communications et faciliter la portabilite et reutilisabilite des applications grâce a son interface standardisee. Dans ce projet de recherche, la norme DDS est tout d'abord etudiee pour cibler les fonctionnalites qui sont utiles au domaine avionique. Les differentes polices de qualite de services sont ainsi etudiees et denotent la flexibilite de la technologie DDS. Un intergiciel DDS est egalement evalue dans un environnement de laboratoire afin de mesurer l'impact de l'utilisation de cette technologie sur les performances de latence ainsi que sur l'utilisation de la bande passante. Les resultats montrent une faible augmentation de la latence moyenne lorsque l'intergiciel DDS est utilise. L'intergiciel DDS est egalement utilise dans une etude de cas avec un AFCS (automatic flight control system) afin de quantifier les effets de son utilisation sur une application avionique. Les resultats montrent que l'utilisation de l'intergiciel DDS n'empeche pas l'AFCS d'atteindre la stabilite, mais qu'elle ralentit l'atteinte de cette derniere. Finalement, une etude de cas est effectuee afin de valider que la technologie DDS peut etre utilisee pour construire des systemes redondants. Les resultats montrent que l'intergiciel DDS permet de faire de la redondance de reserve sans avoir un impact visible sur les performances du systeme redondant.

Utilisation of Carbon Sources by Pythium, Phytophthora and Fusarium Species as Determined by Biolog® Microplate Assay

PubMed Central

Khalil, Sammar; Alsanius, Beatrix W

2009-01-01

This study examined the metabolic activity of pure cultures of five root pathogens commonly found in closed hydroponic cultivation systems (Phytophthora cryptogea (PC), Phytophthora capsici (PCP), Pythium aphanidermatum (PA), Fusarium oxysporum f.sp. radicis-lycopersici (FORL) and Fusarium solani (FS)) using sole carbon source utilisation in order to develop effective biocontrol strategies against these pathogens. Aliquots of 150 µL of the mycelial suspension were inoculated in each well of GN2 microtitre plates. On the basis of average well colour development and number of positive wells, the pathogens were divided into two groups, (i) PA and FORL and (ii) PC, PCP and FS. Group (i) was characterised by a short lag-phase, a rapid exponential phase involving almost all carbon sources offered and a long stationary phase, while group (ii) had a more extended lag-phase and a slower utilisation rate of the carbon sources offered. The three isolates in group (ii) differed significantly during their exponential phase. The lowest utilisation rate of carbon sources and number of sources utilised was found for PCP. Of the major group of carbon sources, six carbohydrates, three carboxylic acids and four amino acids were rapidly used by all isolates tested at an early stage. The carbon sources gentibiose, α-D-glucose, maltose, sucrose, D-trehalose, L-aspartic acid, L-glutamic acid, L-proline persisted to the end of the exponential phase.Moreover, similarities between the metabolic profiles of the tested pathogen and the those of the resident microflora could also be found. These findings are of great importance as regards the role of the resident microflora in the biocontrol. PMID:19294012

A rapid appraisal of access to and utilisation of psychotropic medicines in Bihar, India

PubMed Central

2014-01-01

Background A major aspect of providing mental healthcare is access to and use of psychotropic medications. Bihar is a state in northeast India with limited mental healthcare provision; consequently access to and utilisation of psychotropic medications are likely to be limited. However, to date there has been no research assessing the situation. This study therefore aims to analyse the psychotropic medications management cycle (selection, procurement, distribution and use), and identify the barriers to access and utilisation, and their underlying causes. Method A rapid appraisal method was used in which primary and secondary data sources were collected and analysed. Semi-structured interviews were conducted with twenty-two stakeholders and twenty-one service users from the government, non-governmental organisation (NGO) and private sectors. The qualitative data collected was analysed using a comparative thematic approach. The research was supported by the NGOs BasicNeeds and Nav Bharat Jagriti Kendra. Results Availability, distance and cost were the main barriers to access and utilisation. At the medical college hospital level a lack of supply appears to be due to a discrepancy between orders made by the hospital and medications supplied by the manufacturers. At the primary health centre and district hospital level the main barrier is a cycle between lack of demand for treatments for mental illness by doctors and patients. Conclusion Further investigation and monitoring is necessary to ensure the availability of psychotropic medications at the medical college hospital level. In addition, implementation of the District Mental Health Programme is likely to address the access and utilisation barriers due to its potential to break the current cycle of lack of demand. PMID:25053976

Healthcare Utilisation and Empowerment Among Women in Liberia

PubMed Central

Sipsma, Heather; Callands, Tamora A; Bradley, Elizabeth; Harris, Benjamin; Johnson, Billy; Hansen, Nathan B

2014-01-01

Background Many efforts have been undertaken to improve access to healthcare services in low-income settings; nevertheless, underutilisation persists. Women’s lack of empowerment may be a central reason for underutilisation, but empirical literature establishing this relationship is sparse. Methods We conducted a cross-sectional study using data from the 2007 Liberia Demographic and Health Survey. Our sample included all non-pregnant women who were currently married or living with a partner (N=3925 unweighted). We used multivariate logistic regression to assess the associations between constructs derived from the Theory of Gender and Power (TGP) and healthcare utilisation. Results Two-thirds of women (65.6%) had been to a healthcare facility for herself or her children in the past 12 months. Constructs from the three major theoretical structures were associated with healthcare utilisation. Women with no education, compared with women with some education, were less likely to have been to a healthcare facility (OR=0.76; 95% CI 0.62 to 0.93) as were women who had experienced sexual abuse (OR=0.65; 95% CI 0.45 to 0.95) and women who were married (OR=0.69, 95% CI 0.54 to 0.88). Women in higher wealth quintiles, compared with women in the next lower wealth quintile, and women with more decision-making power had greater odds of having been to a healthcare facility (OR=1.22; 95% CI 1.10 to 1.36 and OR=1.10; 95% CI 1.01 to 1.20; respectively). Conclusions Strong associations exist between healthcare utilisation and empowerment among women in Liberia, and gender imbalances are prevalent. This fundamental issue likely needs to be addressed before large-scale improvement in health service utilisation can be expected. PMID:23929617

Sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea: Korea Health and Nutrition Examination Survey 2008-2012.

PubMed

Rim, Tyler Hyungtaek; Choi, Moonjung; Yoon, Jin Sook; Kim, Sung Soo

2015-07-16

To determine the sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea. Nationwide cross-sectional study 25,752 Koreans over the age of 30 were assessed from a national representative survey. We analysed independent variables of self-reporting eye clinic visits through multivariable analyses of sociodemographic factors. The time since the last visit to an eye clinic was used to assess access to and utilisation of eye care. Of the 25,752 respondents, 8237 (32.0%) visited an eye clinic in the past year, 11 028 (42.8%) were seen more than 1 year ago, while 6487 (25.2%) had never seen an ophthalmologist. Eye clinic utilisation was statistically associated with older age, female sex, higher household income, higher education levels, living in an urban area, and having comorbidities including diabetes and hypertension. Middle-aged men between 30 and 49 years were found to be less likely to receive eye care compared to the rest of the population, and the proportion that did plummeted after the financial crisis of 2007. There is a substantial sociodemographic disparity in eye care utilisation in Korea, and men with low financial income and education level are especially at risk. Use of eye care among middle-aged men has decreased since the global financial crisis that began in 2007, and therefore healthcare policies and public interventions should be targeted at vulnerable groups to promote access to medical care. 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.

Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study.

PubMed

McAuley, Kimberley; McAullay, Daniel; Strobel, Natalie A; Marriott, Rhonda; Atkinson, David N; Marley, Julia V; Stanley, Fiona J; Edmond, Karen M

2016-01-01

Indigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants. Our primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation. There were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77-2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98-2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88-2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96-1.13, p = 0.356). WA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.

The effect of forest roads on the reproductive success of forest-dwelling passerine birds

Treesearch

David I. King; Richard M. DeGraaf

2002-01-01

Recent studies indicate that forest roads may affect the distribution of forest-dwelling birds. However, previous studies have not demonstrated any significant effects of forest roads on avian productivity. We studied the effect of maintained and unmaintained forest roads on (1) forest bird nest survival, (2) reproductive parameters of ovenbirds (Seiurus...

A qualitative study exploring the determinants of maternal health service uptake in post-conflict Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-02-05

Armed conflict has been described as an important contributor to the social determinants of health and a driver of health inequity, including maternal health. These conflicts may severely reduce access to maternal health services and, as a consequence, lead to poor maternal health outcomes for a period extending beyond the conflict itself. As such, understanding how maternal health-seeking behaviour and utilisation of maternal health services can be improved in post-conflict societies is of crucial importance. This study aims to explore the determinants (barriers and facilitators) of women's uptake of maternal, sexual and reproductive health services (MSRHS) in two post-conflict settings in sub-Saharan Africa; Burundi and Northern Uganda, and how uptake is affected by exposure to armed conflict. This is a qualitative study that utilised in-depth interviews and focus group discussions (FGDs) for data collection. One hundred and fifteen participants took part in the interviews and FGDs across the two study settings. Participants were women of reproductive age, local health providers and staff of non-governmental organizations. Issues explored included the factors affecting women's utilisation of a range of MSRHS vis-à-vis conflict exposure. The framework method, making use of both inductive and deductive approaches, was used for analyzing the data. A complex and inter-related set of factors affect women's utilisation of MSRHS in post-conflict settings. Exposure to armed conflict affects women's utilisation of these services mainly through impeding women's health seeking behaviour and community perception of health services. The factors identified cut across the individual, socio-cultural, and political and health system spheres, and the main determinants include women's fear of developing pregnancy-related complications, status of women empowerment and support at the household and community levels, removal of user-fees, proximity to the health facility, and attitude of health providers. Improving women's uptake of MSRHS in post-conflict settings requires health system strengthening initiatives that address the barriers across the individual, socio-cultural, and political and health system spheres. While addressing financial barriers to access is crucial, attention should be paid to non-financial barriers as well. The goal should be to develop an equitable and sustainable health system.

Investigating Surface and Near-Surface Bushfire Fuel Attributes: A Comparison between Visual Assessments and Image-Based Point Clouds.

PubMed

Spits, Christine; Wallace, Luke; Reinke, Karin

2017-04-20

Visual assessment, following guides such as the Overall Fuel Hazard Assessment Guide (OFHAG), is a common approach for assessing the structure and hazard of varying bushfire fuel layers. Visual assessments can be vulnerable to imprecision due to subjectivity between assessors, while emerging techniques such as image-based point clouds can offer land managers potentially more repeatable descriptions of fuel structure. This study compared the variability of estimates of surface and near-surface fuel attributes generated by eight assessment teams using the OFHAG and Fuels3D, a smartphone method utilising image-based point clouds, within three assessment plots in an Australian lowland forest. Surface fuel hazard scores derived from underpinning attributes were also assessed. Overall, this study found considerable variability between teams on most visually assessed variables, resulting in inconsistent hazard scores. Variability was observed within point cloud estimates but was, however, on average two to eight times less than that seen in visual estimates, indicating greater consistency and repeatability of this method. It is proposed that while variability within the Fuels3D method may be overcome through improved methods and equipment, inconsistencies in the OFHAG are likely due to the inherent subjectivity between assessors, which may be more difficult to overcome. This study demonstrates the capability of the Fuels3D method to efficiently and consistently collect data on fuel hazard and structure, and, as such, this method shows potential for use in fire management practices where accurate and reliable data is essential.

Life cycle assessment and residue leaching: The importance of parameter, scenario and leaching data selection

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

Allegrini, E., E-mail: elia@env.dtu.dk; Butera, S.; Kosson, D.S.

Highlights: • Relevance of metal leaching in waste management system LCAs was assessed. • Toxic impacts from leaching could not be disregarded. • Uncertainty of toxicity, due to background activities, determines LCA outcomes. • Parameters such as pH and L/S affect LCA results. • Data modelling consistency and coverage within an LCA are crucial. - Abstract: Residues from industrial processes and waste management systems (WMSs) have been increasingly reutilised, leading to landfilling rate reductions and the optimisation of mineral resource utilisation in society. Life cycle assessment (LCA) is a holistic methodology allowing for the analysis of systems and products andmore » can be applied to waste management systems to identify environmental benefits and critical aspects thereof. From an LCA perspective, residue utilisation provides benefits such as avoiding the production and depletion of primary materials, but it can lead to environmental burdens, due to the potential leaching of toxic substances. In waste LCA studies where residue utilisation is included, leaching has generally been neglected. In this study, municipal solid waste incineration bottom ash (MSWI BA) was used as a case study into three LCA scenarios having different system boundaries. The importance of data quality and parameter selection in the overall LCA results was evaluated, and an innovative method to assess metal transport into the environment was applied, in order to determine emissions to the soil and water compartments for use in an LCA. It was found that toxic impacts as a result of leaching were dominant in systems including only MSWI BA utilisation, while leaching appeared negligible in larger scenarios including the entire waste system. However, leaching could not be disregarded a priori, due to large uncertainties characterising other activities in the scenario (e.g. electricity production). Based on the analysis of relevant parameters relative to leaching, and on general results of the study, recommendations are provided regarding the use of leaching data in LCA studies.« less

The Aspergillus nidulans Pyruvate Dehydrogenase Kinases Are Essential To Integrate Carbon Source Metabolism.

PubMed

Ries, Laure Nicolas Annick; de Assis, Leandro José; Rodrigues, Fernando José Santos; Caldana, Camila; Rocha, Marina Campos; Malavazi, Iran; Bayram, Özgür; Goldman, Gustavo H

2018-05-24

The pyruvate dehydrogenase complex (PDH), that converts pyruvate to acetyl-coA, is regulated by pyruvate dehydrogenase kinases (PDHK) and phosphatases (PDHP) that have been shown to be important for morphology, pathogenicity and carbon source utilisation in different fungal species. The aim of this study was to investigate the role played by the three PDHKs PkpA, PkpB and PkpC in carbon source utilisation in the reference filamentous fungus Aspergillus nidulans , in order to unravel regulatory mechanisms which could prove useful for fungal biotechnological and biomedical applications. PkpA and PkpB were shown to be mitochondrial whereas PkpC localised to the mitochondria in a carbon source-dependent manner. Only PkpA was shown to regulate PDH activity. In the presence of glucose, deletion of pkpA and pkpC resulted in reduced glucose utilisation, which affected carbon catabolite repression (CCR) and hydrolytic enzyme secretion, due to de-regulated glycolysis and TCA cycle enzyme activities. Furthermore, PkpC was shown to be required for the correct metabolic utilisation of cellulose and acetate. PkpC negatively regulated the activity of the glyoxylate cycle enzyme isocitrate lyase (ICL), required for acetate metabolism. In summary, this study identified PDHKs important for the regulation of central carbon metabolism in the presence of different carbon sources, with effects on the secretion of biotechnologically important enzymes and carbon source-related growth. This work demonstrates how central carbon metabolism can affect a variety of fungal traits and lays a basis for further investigation into these characteristics with potential interest for different applications. Copyright © 2018, G3: Genes, Genomes, Genetics.

Associations between multimorbidity and additional burden for working-age adults with specific forms of musculoskeletal conditions: a cross-sectional study.

PubMed

Lowe, Dianne B; Taylor, Michael J; Hill, Sophie J

2017-04-04

Multiple health conditions are increasingly a problem for adults with musculoskeletal conditions. However, multimorbidity research has focused primarily on the elderly and those with a limited subset of musculoskeletal disorders. We sought to determine whether associations between multimorbidity and additional burden differ with specific forms of musculoskeletal conditions among working-age adults. Data were sourced from a nationally representative Australian survey. Specific musculoskeletal conditions examined were osteoarthritis; inflammatory arthritis; other forms of arthritis or arthropathies; musculoskeletal conditions not elsewhere specified; gout; back pain; soft tissue disorders; or osteoporosis. Multimorbidity was defined as the additional presence of one or more of the Australian National Health Priority Area conditions. Burden was assessed by self-reported measures of: (i) self-rated health (ii) musculoskeletal-related healthcare and medicines utilisation and, (iii) general healthcare utilisation. Associations between multimorbidity and additional health or healthcare utilisation burden among working-age adults (aged 18 - 64 years of age) with specific musculoskeletal conditions were estimated using logistic regression, adjusting for confounders. Interaction terms were fitted to identify whether there were specific musculoskeletal conditions where multimorbidity was more strongly associated with poorer health or greater healthcare utilisation than in the remaining musculoskeletal group. Among working-age adults, for each of the specified musculoskeletal conditions, multimorbidity was associated with similar, increased likelihood of additional self-rated health burden and certain types of healthcare utilisation. While there were differences in the relationships between multimorbidity and burden for each of the specific musculoskeletal conditions, no one specific musculoskeletal condition appeared to be consistently associated with greater additional health burden in the presence of multimorbidity across the majority of self-rated health burden and healthcare use measures. For working-age people with any musculoskeletal conditions examined here, multimorbidity increases self-reported health and healthcare utilisation burden. As no one musculoskeletal condition appears consistently worse off in the presence of multimorbidity, there is a need to better understand and identify strategies that acknowledge and address the additional burden of concomitant conditions for working-age adults with a range of musculoskeletal conditions.

Riparian landscapes: Linking geodiversity with habitat and biodiversity

NASA Astrophysics Data System (ADS)

Chmieleski, Jana; Danzeisen, Laura

2017-04-01

Keywords: Oder valley, biodiversity, geodiversity River landscapes of all scales originally showed a high diversity of structures and habitats at a small spatial entity, such as the stream beds, terrasses, sand and gravel banks. This variety, with a lot of different elements, patches and patterns, represents not only a variety of geoelements or geomorhological features but also a large biodiversity, both of habitats and species. Riparian landscapes are both, a natural as well as a geoheritage, often even a cultural heritage (sustainabe land use practices). Embankments, utilization for agriculture, constructions for navigation, management measures lead to a strong loss of these structures. This impacts the value of the landscape as well ecosystem functions, not only the biodiversity and the geodiversity but also the recreation function or the aesthetic values. A case study from the National Park Lower Oder Valley in the Northeastern part of Germany, wich is also part of a Geopark („Eiszeitland am Oderrand") presents the connections of the diversity of geomorphological features with biodiversity and shows the loss of features (loss of values) due to intensive utilisation by using GIS-analysis and landscape-metrics. The Northern part of the Oder valley (National Park, transnational protection area of Germany and Poland) have been modified by man since centuries but even so remained in near-natural state that allows semi-(natural) stream dynamics. While the Oder's reparian zone is marked by the stream itself, by its bayous, reed beds, periodically flooded wet meadows and by its natural riparian forest the mineral morainic plateaus are marked by semi-natural forests and dry grasslands. Two areas of different degradation states, a) near-natural and wilderness area and b) grassland area will be compared in order to identify: quantity and extent of features, relation of measure and coverage, connectivity with other features, quantity and types of habitats (with evaluation according to Natura2000 habitat types). First results of that survey will be presented.

Life cycle assessment of biohydrogen and biomethane production and utilisation as a vehicle fuel.

PubMed

Patterson, Tim; Esteves, Sandra; Dinsdale, Richard; Guwy, Alan; Maddy, Jon

2013-03-01

Environmental burdens for the production and utilisation of biomethane vehicle fuel or a biohydrogen/biomethane blend produced from food waste or wheat feed, based on data from two different laboratory experiments, have been compared. For food waste treated by batch processes the two stage system gave high hydrogen yields (84.2l H2kg(-1) VS added) but a lower overall energy output than the single stage system. Reduction in environmental burdens compared with diesel was achieved, supported by the diversion of waste from landfill. For wheat feed, the semi continuously fed two stage process gave low hydrogen yields (7.5l H2kg(-1) VS added) but higher overall energy output. The process delivers reduction in fossil fuel burdens, and improvements in process efficiencies will lead to reduction in CO2 burdens compared with diesel. The study highlights the importance of understanding and optimising biofuel production parameters according to the feedstock utilised. Copyright © 2013 Elsevier Ltd. All rights reserved.

Good Practice Chaplaincy: An Exploratory Study Identifying the Appropriate Skills, Attitudes and Practices for the Selection, Training and Utilisation of Chaplains.

PubMed

Carey, Lindsay B; Rumbold, Bruce

2015-08-01

This article presents an overview of exploratory research regarding the skills, knowledge, attitudes and practices considered necessary for chaplains to be highly competent in providing holistic care to clients and staff. Utilising a qualitative methodology, two focus groups comprising Salvation Army chaplains and their managers provided data about their expectations of chaplaincy personnel and about the pastoral care interventions undertaken by chaplains. The results indicated that while there were some differences in opinion, nevertheless, in overall terms, there was general agreement between chaplains and their managers about particular personal and professional qualities necessary for chaplains to be considered appropriate and proficient. Evidence was also obtained indicating a need for change with regard to the organisational attitude and culture of The Salvation Army towards chaplaincy. Recommendations are presented concerning (1) the selection criteria for chaplaincy, (2) training and utilisation of chaplains plus (3) issues relating to organizational cultural change necessary to develop a future-ready chaplaincy more suitable for the twenty-first century.

Sustainability indicator system and policy processes in Malaysia: a framework for utilisation and learning.

PubMed

Hezri, A A

2004-12-01

Formulation of effective sustainability indicators for national assessment demands a comprehensive understanding of the utilisation, diffusion and dissemination of information in policy processes. To illustrate the dynamic of sustainability assessment within the context of policy processes, this paper uses a case study of national sustainability indicators development in Malaysia. Subsequently, this paper ascribes the limited achievement of national sustainability assessment in Malaysia to four types of constraints: meta-policy issues; technical capacities; communication concerns; and the inherent knowledge gaps within the indicator developer community vis-a-vis their theoretical limitations. It is proposed that such constraints will be encountered in many countries. Drawing from the literature on public policy, this paper outlines a framework for investigating indicator behaviour within policy processes based on well-established concepts such as knowledge utilisation and policy learning. I conclude this paper by elaborating on the corresponding future challenges that must be addressed before effective integration of sustainability indicators within policy systems can occur.

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

PubMed

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

2016-03-01

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

Bacteria contributing to behaviour of radiocarbon in sodium acetate.

PubMed

Ishii, Nobuyoshi; Uchida, Shigeo

2011-07-01

An acetate-utilising bacterium was isolated and identified from deionised water that was used for flooding of paddy soils in this study's batch culture experiments. Bacteria in the deionised water samples formed colonies on agar plates containing [1,2-(14)C] sodium acetate, and the autoradiograms showed that all the colonies were positive for (14)C utilisation. Then one of the acetate-utilising bacteria was isolated. The isolate was characterised by phylogenetic analysis, cell morphology, Gram staining and growth at 30 °C. Phylogenetic analysis based on 16S rRNA sequencing showed that the isolate belonged to the genus Burkholderia. The bacterium was gram-negative rods and grew at 30 °C under aerobic conditions. Based on these characteristics, the isolate was identified as Burkholderia gladioli. Because B. gladioli is often found in soil, water and the rhizosphere, attention must be paid to the relationships between bacteria and the behaviour of (14)C to for the safety assessment of geological disposal of transuranic waste.

Predictors of podiatry utilisation in Australia: the North West Adelaide Health Study.

PubMed

Menz, Hylton B; Gill, Tiffany K; Taylor, Anne W; Hill, Catherine L

2008-08-19

Foot problems are highly prevalent in the community; however no large population-based studies have examined the characteristics of those who do and do not access podiatry services in Australia. The aim of this study was to explore patterns of podiatry utilisation in a population-based sample of people aged 18 years and over living in the northwest region of Adelaide, South Australia. The North West Adelaide Health Study is a representative longitudinal cohort study of 4,060 people randomly selected and recruited by telephone interview. The interview included questions regarding healthcare service utilisation in the past year. Data were also collected on education, income and major medical conditions. Overall, 9.5% of the total sample and 17.7% of those who reported foot pain had attended a podiatrist in the past year. Participants who had accessed podiatry treatment were more likely to be female, be aged over 45 years, be obese, and have major chronic medical conditions (osteoporosis, osteoarthritis, diabetes, cardiovascular disease and high blood pressure). Those who reported foot pain but had not accessed a podiatrist were more likely to be male and be aged 20 to 34 years. Only a small proportion of people who report foot pain have accessed podiatry services in the past year. There is a need to further promote podiatry services to the general community, particularly to men and younger people.

The impact of user fees on access to health services in low- and middle-income countries.

PubMed

Lagarde, Mylene; Palmer, Natasha

2011-04-13

Following an international push for financing reforms, many low- and middle-income countries introduced user fees to raise additional revenue for health systems. User fees are charges levied at the point of use and are supposed to help reduce 'frivolous' consumption of health services, increase quality of services available and, as a result, increase utilisation of services. To assess the effectiveness of introducing, removing or changing user fees to improve access to care in low-and middle-income countries We searched 25 international databases, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group's Trials Register, CENTRAL, MEDLINE and EMBASE. We also searched the websites and online resources of international agencies, organisations and universities to find relevant grey literature. We conducted the original searches between November 2005 and April 2006 and the updated search in CENTRAL (DVD-ROM 2011, Issue 1); MEDLINE In-Process & Other Non-Indexed Citations, Ovid (January 25, 2011); MEDLINE, Ovid (1948 to January Week 2 2011); EMBASE, Ovid (1980 to 2011 Week 03) and EconLit, CSA Illumina (1969 - present) on the 26th of January 2011. We included randomised controlled trials, interrupted time-series studies and controlled before-and-after studies that reported an objective measure of at least one of the following outcomes: healthcare utilisation, health expenditures, or health outcomes. We re-analysed studies with longitudinal data. We computed price elasticities of demand for health services in controlled before-and-after studies as a standardised measure. Due to the diversity of contexts and outcome measures, we did not perform meta-analysis. Instead, we undertook a narrative summary of evidence. We included 16 studies out of the 243 identified. Most of the included studies showed methodological weaknesses that hamper the strength and reliability of their findings. When fees were introduced or increased, we found the use of health services decreased significantly in most studies. Two studies found increases in health service use when quality improvements were introduced at the same time as user fees. However, these studies have a high risk of bias. We found no evidence of effects on health outcomes or health expenditure. The review suggests that reducing or removing user fees increases the utilisation of certain healthcare services. However, emerging evidence suggests that such a change may have unintended consequences on utilisation of preventive services and service quality. The review also found that introducing or increasing fees can have a negative impact on health services utilisation, although some evidence suggests that when implemented with quality improvements these interventions could be beneficial. Most of the included studies suffered from important methodological weaknesses. More rigorous research is needed to inform debates on the desirability and effects of user fees.

African American women's preventative care usage: the role of social support and racial experiences and attitudes.

PubMed

Pullen, Erin; Perry, Brea; Oser, Carrie

2014-09-01

Research suggests that African Americans are less likely to utilise preventative care services than Americans of European descent, and that these patterns may contribute to racial health disparities in the United States. Despite the persistence of inequalities in preventative care utilisation, culturally relevant factors influencing the use of these gateway health services have been understudied among marginalised groups. Using a stratified sample of 205 low-income African American women, this research examines the predictors of receiving a physical exam, with a particular emphasis on how differing levels of social support from friend and family networks and experiences of racial discrimination and cultural mistrust shape utilisation. The findings underscore the importance of traditional predictors of utilisation, including insurance status and having a usual physician. However, they also indicate that supportive ties to friendship networks are associated with higher predicted rates of having an annual physical exam, while social support from family and sentiments of cultural mistrust are associated with lower rates of utilisation. Broadly, the findings indicate that even as traditional predictors of help-seeking become less relevant, it will be critical to explore how variations in discrimination experiences and social relationships across marginalised groups drive patterns of preventative care utilisation. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Metabolic specialisation on preferred prey and constraints in the utilisation of alternative prey in an ant-eating spider.

PubMed

Líznarová, Eva; Pekár, Stano

2016-10-01

Trophic specialists are expected to possess adaptations that increase the efficiency of handling preferred prey. Such adaptations may constrain the ability to utilise alternative prey. Here we tested whether the ant-eating spider Euryopis episinoides possesses metabolic specialisations with increased efficiency in utilising preferred prey and decreased efficiency in utilising alternative prey. In addition, we investigated the contribution of genetic variation via maternal effects. We reared E. episinoides spiders from the first instar on two different diets, either ants (preferred prey) or fruit flies (alternative prey). Spider survival rate and increases in body mass were significantly higher on the ant diet. The total development time did not differ between diet groups, nor did the number of egg sacs per female or the incubation period. However, the number of eggs per egg sac and hatching success were higher on the ant diet. There was a genetic variation in several offspring traits. Our data support the hypothesis that stenophagous ant-eating E. episinoides have a metabolic specialisation on ant utilisation indicated by higher efficiency in utilising ants than fruit flies. While most individuals of E. episinoides were able to capture fruit flies, only very few spiders were able to develop and reproduce on a pure fruit fly diet, suggesting the existence of within-species genetic variation regarding the tolerance to alternative prey. Copyright © 2016 Elsevier GmbH. All rights reserved.

Prebiotic potential of pectin and pectic oligosaccharides to promote anti-inflammatory commensal bacteria in the human colon.

PubMed

Chung, Wing Sun Faith; Meijerink, Marjolein; Zeuner, Birgitte; Holck, Jesper; Louis, Petra; Meyer, Anne S; Wells, Jerry M; Flint, Harry J; Duncan, Sylvia H

2017-11-01

Dietary plant cell wall carbohydrates are important in modulating the composition and metabolism of the complex gut microbiota, which can impact on health. Pectin is a major component of plant cell walls. Based on studies in model systems and available bacterial isolates and genomes, the capacity to utilise pectins for growth is widespread among colonic Bacteroidetes but relatively uncommon among Firmicutes. One Firmicutes species promoted by pectin is Eubacterium eligens. Eubacterium eligens DSM3376 utilises apple pectin and encodes a broad repertoire of pectinolytic enzymes, including a highly abundant pectate lyase of around 200 kDa that is expressed constitutively. We confirmed that certain Faecalibacterium prausnitzii strains possess some ability to utilise apple pectin and report here that F. prausnitzii strains in common with E. eligens can utilise the galacturonide oligosaccharides DP4 and DP5 derived from sugar beet pectin. Faecalibacterium prausnitzii strains have been shown previously to exert anti-inflammatory effects on host cells, but we show here for the first time that E. eligens strongly promotes the production of the anti-inflammatory cytokine IL-10 in in vitro cell-based assays. These findings suggest the potential to explore further the prebiotic potential of pectin and its derivatives to re-balance the microbiota towards an anti-inflammatory profile. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Contributions to the herpetofauna of the Albertine Rift: Two new species of chameleon (Sauria: Chamaeleonidae) from an isolated montane forest, south eastern Democratic Republic of Congo.

PubMed

Tilbury, Colin R; Tolley, Krystal A

2015-01-13

Two new species of chameleons from the genera Rhampholeon and Kinyongia are described from an isolated montane forest remnant situated toward the southern end of the Albertine Rift bordering Lake Tanganyika. The closest known localities of species from these genera are 200km and 400km to the north respectively, separated by large intervening tracts of lowland savannah and Brachystegia (Miombo) woodland - habitats not normally inhabited by species of these genera. Rhampholeon hattinghi sp. nov. and Kinyongia mulyai sp. nov. bear superficial resemblances to previously described species (Rh. boulengeri Steindachner and K. adolfifriderici  (Sternfeld)). Rhampholeon hattinghi sp. nov. has a relatively smooth supra-orbital ridge, deep axillary but absent inguinal mite pockets, prominent white spots on the base of the tail and a uniquely derived hemipenal morphology with billowing parasulcal evaginations. Like K. adolfifriderici, Kinyongia mulyai sp. nov. is devoid of a rostral appendage but differs in having a longer and narrower head, a higher upper labial scale count and by the absence of a dorsal crest in the male. To place these new chameleons within the context of their respective genera, Bayesian and maximum likelihood phylogenetic analyses were carried out utilising two mitochondrial (ND2 and 16S) and one nuclear marker (RAG1).  Both chameleons were found to have morphological features that distinguish them from other congeners. Based on phylogenetic analysis they are clearly separate evolutionary lineages and are described as new species. 

The effect of wheelchair propulsion style on changes in time spent in extreme wrist orientations after a bout of fatiguing propulsion.

PubMed

Zukowski, Lisa A; Hass, Chris J; Shechtman, Orit; Christou, Evangelos A; Tillman, Mark D

2017-10-01

This study compared how wheelchair propulsion styles affect changes in percentage of time spent in extreme wrist orientations, which have been associated with median nerve injury, after a fatiguing bout of propulsion. Twenty novice, non-disabled adult males learned arcing (ARC) and semicircular (SEMI) propulsion styles and utilised each to perform a wheelchair fatigue protocol. ARC and SEMI did not significantly differ in terms of changes after the fatigue protocol in percentage of time spent in extreme flexion/extension or radial/ulnar deviation at the push phase beginning or end. A pattern was observed, although not significant, of greater increases in percentage of time spent in extreme wrist extension and ulnar deviation during the push phase beginning and ulnar deviation during the push phase end while utilising SEMI relative to ARC. This study evinces that individual differences are greater than observed changes in extreme wrist orientations for both propulsion styles. Practitioner Summary: How wheelchair propulsion styles change with fatigue in terms of extreme wrist orientations was examined. This study evinces that individual differences are greater than observed changes in extreme wrist orientations for both propulsion styles and point towards the need for future research on individual differences utilising propulsion styles.

First examination of varying health outcomes of the chronically homeless according to Housing First configuration.

PubMed

Whittaker, Elizabeth; Dobbins, Timothy; Swift, Wendy; Flatau, Paul; Burns, Lucinda

2017-06-01

To determine whether two Housing First configurations (scattered site [SS] versus congregated site [CS]) are associated with different health-related outcomes. This ecological study employed a longitudinal, quantitative design to compare the outcomes from 63 individuals (SS: n=37; CS: n=26) in Sydney, Australia, over 12 months. Both configurations showed similar improvements in quality of life and psychological distress. While recent use of substances remained stable across the two configurations over time, a marginally greater increase in the proportion of CS individuals injecting more than weekly was found. For health service utilisation, CS participants had notably higher service utilisation rates for mental health specialists and the emergency department for mental health reasons at follow-up than SS participants. Preliminary evidence of differential injecting and health service utilisation outcomes between configurations emerged within this small-scale study over the 12-month period. Implications for public health: Given the rapid expansion of both SS and CS Housing First configurations across Western countries and the indications from this initial study that outcomes may differ according to configuration, there remains a need for robust evaluative evidence on the efficacy of various supported housing models on long-term individual outcomes. © 2017 Public Health Association of Australia.

Safety and Efficacy of Warfarin Therapy in Remote Communities of the Top End of Northern Australia.

PubMed

Dennis, Jahde; Majoni, William; Tinsley, Jeffrey; Kangaharan, Nadarajah

2017-12-01

Warfarin remains a widely used anticoagulant but application in the remote context is not well documented. This study aimed to assess in more detail whether warfarin is being utilised effectively in Australia's most isolated and remote areas. Retrospective cohort analysis of 2013 captured international normalised ratio (INR) results from people engaged in long term warfarin usage within a number of remote Northern Australian communities. Assessment of monitoring, effectiveness of dosing and complication rates was undertaken. A cohort of 167 patients was established. On average, warfarin was utilised within therapeutic range 52% of the time. Monitoring frequency averaged 16 days. Major bleeding and thrombo-embolism occurred at rates of 5.8 and 4.1 per 100 patient years respectively. Therapeutic utilisation of warfarin in this setting is close to accepted rates but has room for improvement. Monitoring was acceptable and complication rates were not disproportionately high. This study indicates that warfarin is being used with reasonable safety and efficacy in remote regions, but further research is needed. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Improving Quality and Reducing Waste in Allied Health Workplace Education Programs: A Pragmatic Operational Education Framework Approach.

PubMed

Golder, Janet; Farlie, Melanie K; Sevenhuysen, Samantha

2016-01-01

Efficient utilisation of education resources is required for the delivery of effective learning opportunities for allied health professionals. This study aimed to develop an education framework to support delivery of high-quality education within existing education resources. This study was conducted in a large metropolitan health service. Homogenous and purposive sampling methods were utilised in Phase 1 (n=43) and 2 (n=14) consultation stages. Participants included 25 allied health professionals, 22 managers, 1 educator, and 3 executives. Field notes taken during 43 semi-structured interviews and 4 focus groups were member-checked, and semantic thematic analysis methods were utilised. Framework design was informed by existing published framework development guides. The framework model contains governance, planning, delivery, and evaluation and research elements and identifies performance indicators, practice examples, and support tools for a range of stakeholders. Themes integrated into framework content include improving quality of education and training provided and delivery efficiency, greater understanding of education role requirements, and workforce support for education-specific knowledge and skill development. This framework supports efficient delivery of allied health workforce education and training to the highest standard, whilst pragmatically considering current allied health education workforce demands.

Feasibility study for an innovative industrial red mud utilisation method.

PubMed

Kounalakis, Petros; Aravossis, Konstantinos; Karayianni, ChS

2016-02-01

Red mud is a high volume industrial waste, and its management poses a unique challenge. For the utilisation of red mud, an economical, energy saving, environmental friendly and widely applicable method has been found. The proposed novel method is purely chemical, and achieves the recovery of all the oxides contained in red mud totally and transforms them into high value added products. The present work shows that an investment in an industrial plant, treating red mud and turning a toxic industrial waste in commercial products, is safe and viable. © The Author(s) 2015.

Carbohydrate catabolic flexibility in the mammalian intestinal commensal Lactobacillus ruminis revealed by fermentation studies aligned to genome annotations

PubMed Central

2011-01-01

Background Lactobacillus ruminis is a poorly characterized member of the Lactobacillus salivarius clade that is part of the intestinal microbiota of pigs, humans and other mammals. Its variable abundance in human and animals may be linked to historical changes over time and geographical differences in dietary intake of complex carbohydrates. Results In this study, we investigated the ability of nine L. ruminis strains of human and bovine origin to utilize fifty carbohydrates including simple sugars, oligosaccharides, and prebiotic polysaccharides. The growth patterns were compared with metabolic pathways predicted by annotation of a high quality draft genome sequence of ATCC 25644 (human isolate) and the complete genome of ATCC 27782 (bovine isolate). All of the strains tested utilized prebiotics including fructooligosaccharides (FOS), soybean-oligosaccharides (SOS) and 1,3:1,4-β-D-gluco-oligosaccharides to varying degrees. Six strains isolated from humans utilized FOS-enriched inulin, as well as FOS. In contrast, three strains isolated from cows grew poorly in FOS-supplemented medium. In general, carbohydrate utilisation patterns were strain-dependent and also varied depending on the degree of polymerisation or complexity of structure. Six putative operons were identified in the genome of the human isolate ATCC 25644 for the transport and utilisation of the prebiotics FOS, galacto-oligosaccharides (GOS), SOS, and 1,3:1,4-β-D-Gluco-oligosaccharides. One of these comprised a novel FOS utilisation operon with predicted capacity to degrade chicory-derived FOS. However, only three of these operons were identified in the ATCC 27782 genome that might account for the utilisation of only SOS and 1,3:1,4-β-D-Gluco-oligosaccharides. Conclusions This study has provided definitive genome-based evidence to support the fermentation patterns of nine strains of Lactobacillus ruminis, and has linked it to gene distribution patterns in strains from different sources. Furthermore, the study has identified prebiotic carbohydrates with the potential to promote L. ruminis growth in vivo. PMID:21995520

Inequalities in public health care delivery in Zambia

PubMed Central

2014-01-01

Background Access to adequate health services that is of acceptable quality is important in the move towards universal health coverage. However, previous studies have revealed inequities in health care utilisation in the favour of the rich. Further, those with the greatest need for health services are not getting a fair share. In Zambia, though equity in access is extolled in government documents, there is evidence suggesting that those needing health services are not receiving their fair share. This study seeks therefore, to assess if socioeconomic related inequalities/inequities in public health service utilisation in Zambia still persist. Methods The 2010 nationally representative Zambia Living Conditions and Monitoring Survey data are used. Inequality is assessed using concentration curves and concentrations indices while inequity is assessed using a horizontal equity index: an index of inequity across socioeconomic status groups, based on standardizing health service utilisation for health care need. Public health services considered include public health post visits, public clinic visits, public hospital visits and total public facility visits. Results There is evidence of pro-poor inequality in public primary health care utilisation but a pro-rich inequality in hospital visits. The concentration indices for public health post visits and public clinic visits are −0.28 and −0.09 respectively while that of public hospitals is 0.06. After controlling for need, the pro-poor distribution is maintained at primary facilities and with a pro-rich distribution at hospitals. The horizontal equity indices for health post and clinic are estimated at −0.23 and −0.04 respectively while that of public hospitals is estimated at 0.11. A pro-rich inequity is observed when all the public facilities are combined (horizontal equity index = 0.01) though statistically insignificant. Conclusion The results of the paper point to areas of focus in ensuring equitable access to health services especially for the poor and needy. This includes strengthening primary facilities that serve the poor and reducing access barriers to ensure that health care utilisation at higher-level facilities is distributed in accordance with need for it. These initiatives may well reduce the observed inequities and accelerate the move towards universal health coverage in Zambia. PMID:24645826

Differences in home-based palliative care service utilisation of people with cancer and non-cancer conditions.

PubMed

Kralik, Debbie; Anderson, Barbara

2008-11-01

To identify home-based palliative care service utilisation by people with cancer and non-cancer conditions. Palliative care knowledge and skill have been derived from working with people with cancer. People with chronic conditions are now referred for home-based palliative care; however, there has been few studies published that have explored the impact of service utilisation by people with end-stage chronic conditions. The Australia-modified Karnofsky Performance Status (AKPS) scale was calculated for each person upon referral for home-based palliative care services to determine the functional capacity of the individual at the point of referral. Clients were divided into those with cancer diagnosis and those with non-cancer diagnosis. Service utilisation of the individual client was determined until separation from the palliative care service. The study was undertaken in 2007. The majority of people with cancer (63%) and non-cancer (71%) were assessed as having an AKPS score between 50-60. Thirty-one cancer clients (18·7%) and three non-cancer clients (7·1%) had an AKPS score between 70-90. This suggests that people with cancer are referred to palliative care services earlier than people with non-cancer conditions. People with non-cancer conditions were substantially higher users of home-based palliative care services over a longer period of time. Home-based palliative care service utilisation was higher for people with non-cancer conditions. Cost analysis research is recommended to delineate the actual costs of home-based palliative care service provision between people with cancer and non-cancer conditions. There is growing awareness of the need for palliative care services for people with non-cancer conditions. However, these services are provided for longer periods of time for this client group. Implications for practice are that the palliative care needs of people with non-cancer conditions may not be met within current palliative care service provision. There may be funding implications for home-based palliative care services that intend to meet the needs of people at end of life with non-cancer conditions. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

SU-E-T-215: Interactive Dose Shaping: Proof of Concept Study for Six Prostate Patients

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

Kamerling, CP; German Cancer Research Center; Ziegenhein, P

Purpose: To provide a proof of concept study for IMRT treatment planning through interactive dose shaping (IDS) by utilising the respective tools to create IMRT treatment plans for six prostate patients. Methods: The IDS planning paradigm aims to perform interactive local dose adaptations of an IMRT plan without compromising already established valuable dose features in real-time. Various IDS tools are available in our in-house treatment planning software Dynaplan and were utilised to create IMRT treatment plans for six patients with an adeno-carcinoma of the prostate. The sequenced IDS treatment plans were compared to conventionally optimised clinically approved plans (9 beams,more » co-planar). The starting point consisted of open fields. The IDS tools were utilised to sculpt dose out of the rectum and bladder. For each patient, several IDS plans were created, with different trade-offs between organ sparing and target coverage. The reference dose distributions were imported into Dynaplan. For each patient, the IDS treatment plan with a similar or better trade-off between target coverage and OAR sparing was selected for plan evaluation, guided by a physician. Pencil beam dose calculation was performed on a grid with a voxel size of 1.95×1.95×2.0 mm{sup 3}. D98%, D2%, mean dose and dose-volume indicators as specified by Quantec were calculated for plan evaluation. Results: It was possible to utilise the software prototype to generate treatment plans for prostate patient geometries in 15–45 minutes. Individual local dose adaptations could be performed in less than one second. The average differences compared to the reference plans were for the mean dose: 0.0 Gy (boost) and 1.2 Gy (CTV), for D98%: −1.1 Gy and for D2%: 1.1 Gy (both target volumes). The dose-volume quality indicators were well below the Quantec constraints. Conclusion: Real-time treatment planning utilising IDS is feasible and has the potential to be implemented clinically. Research at The Institute of Cancer Research is supported by Cancer Research UK under Programme C46/A10588.« less

Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal Demographic and Health Survey 2011

PubMed Central

2014-01-01

Background Postnatal care is essential to save the life of the mother and newborn. Knowledge on the determinants of postnatal care assists the policy makers to design, justify and implement appropriate interventions. The current study aimed to analyse the factors associated with utilisation of postnatal care services by mothers in Nepal based on the data from Nepal Demographic and Health Survey (NDHS) 2011. Methods This study utilised the data from NDHS 2011. The association between utilisation of at least one postnatal care visit (within 6 weeks of delivery) and immediate postnatal care (within 24 hours of delivery) with selected factors was examined by using Chi-square test (χ2), followed by multiple logistic regression. Result Of the 4079 mothers, 43.2% reported attending postnatal care within the first six weeks of birth, while 40.9% reported attending immediate postnatal care. Mothers who were from urban areas, from rich families, who were educated, whose partners were educated, who delivered in a health facility, who had attended a four or more antenatal visits, and whose delivery was attended by a skilled attendant were more likely to report attending at least one postnatal care visit. On the other hand, mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to have attended at least one postnatal care visit. Similarly, mothers who were from the urban areas, from rich families, who were educated, whose partners were educated, who had attended four or more antenatal visits, who delivered in a health facility and had delivered in the presence of a skilled birth attendant were more likely to report attending immediate postnatal care. Mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to attend immediate postnatal care. Conclusion The majority of postnatal mothers in Nepal did not seek postnatal care. Increasing utilisation of the recommended four or more antenatal visits, delivery at health facility and increasing awareness and access to services through community-based programs especially for the rural, poor, and less educated mothers may increase postnatal care attendance in Nepal. PMID:24484933

Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study

PubMed Central

Arnold-Reed, Diane; Preen, David; Bulsara, Max; Lennox, Nick; Kinner, Stuart A

2015-01-01

Objective To describe the association between ex-prisoner primary care physician contact within 1 month of prison release and health service utilisation in the 6 months following release. Design A cohort from the Passports study with a mean follow-up of 219 (±44) days postrelease. Associations were assessed using a multivariate Andersen-Gill model, controlling for a range of other factors. Setting Face-to-face, baseline interviews were conducted in a sample of prisoners within 6 weeks of expected release from seven prisons in Queensland, Australia, from 2008 to 2010, with telephone follow-up interviews 1, 3 and 6 months postrelease. Participants From an original population-based sample of 1325 sentenced adult (≥18 years) prisoners, 478 participants were excluded due to not being released from prison during follow-up (n=7, 0.5%), loss to follow-up (n=257, 19.4%), or lacking exposure data (n=214, 16.2%). A total of 847 (63.9%) participants were included in the analyses. Exposure Primary care physician contact within 1 month of follow-up as a dichotomous measure. Main outcome measures Adjusted time-to-event hazard rates for hospital, mental health, alcohol and other drug and subsequent primary care physician service utilisations assessed as multiple failure time-interval data. Results Primary care physician contact prevalence within 1 month of follow-up was 46.5%. One-month primary care physician contact was positively associated with hospital (adjusted HR (AHR)=2.07; 95% CI 1.39 to 3.09), mental health (AHR=1.65; 95% CI 1.24 to 2.19), alcohol and other drug (AHR=1.48; 95% CI 1.15 to 1.90) and subsequent primary care physician service utilisation (AHR=1.47; 95% CI 1.26 to 1.72) over 6 months of follow-up. Conclusions Engagement with primary care physician services soon after prison release increases health service utilisation during the critical community transition period for ex-prisoners. Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN12608000232336). PMID:26068513

A marketing strategy for a nursing college.

PubMed

Pryde, M; Muller, M

1995-08-01

The objective of this study is to explore and describe a marketing strategy for a nursing college. An explorative and descriptive research design, within the context of a nursing college and affiliated hospitals, was followed. A literature study of marketing models was undertaken and the Delphi-method was utilised to determine the contribution of marketing staff and the possible content of a marketing strategy for a nursing college. The results were utilised to describe guidelines for such a strategy, consisting of marketers/marketing agents, target market, product, price, promotional activities, place and market research. Recommendations include the planning, implementation and evaluation of strategy, inservice training for potential marketing agents, inclusion of marketing as part of the formal education of tutors and nurse managers, as well as an impact study of the scholar as the main consumer.

Investigating the accessibility factors that influence antenatal care services utilisation in Mangwe district, Zimbabwe

PubMed Central

Tugli, Augustine K.; Mpofu, Molyn

2017-01-01

Background Maternal and infant mortality remains a huge public health problem in developing countries. One of the strategies to minimise the risks of both maternal and infant mortality is access to and utilisation of antenatal care (ANC) services. Aim This study aimed to investigate the accessibility factors that influence the use of ANC services in Mangwe district. Methods A qualitative approach using explorative design was adopted to target women who have babies under 1 year of age. The study was conducted in Mangwe district, Matabeleland South province, Zimbabwe. Data were collected through semi-structured interviews and observations. Data saturation was reached after 15 women who were conveniently sampled were interviewed. Field notes were analysed thematically using Tech’s steps. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results Accessibility factors such as lack of transport, high transport costs and long distances to health care facilities, health care workers’ attitudes, type and quality of services as well as delays in receiving care influence women’s utilisation of ANC services in Mangwe district, Zimbabwe. Conclusion The study concluded that women were still facing problems of unavailability of nearby clinics; therefore, it was recommended that the government should avail resources for women to use. Recommendations Mangwe District Health Department should provide mobile clinics rendering ANC services in distant rural areas. PMID:28697619

Effects of environmental and anthropogenic determinants on changes in groundwater levels in selected peat bogs of Slowinski National Park, northern Poland

NASA Astrophysics Data System (ADS)

Chlost, Izabela; Cieśliński, Roman

2018-03-01

The present study focuses on two Baltic-type peat bogs in Slowinski National Park, namely that at Żarnowskie and at Kluki, located in the Lake Łebsko catchment and both characterised by a centrally located dome with a very marshy fringe area featuring an emerging marshy coniferous forest (Vaccinio uliginosi-Pinetum). The Żarnowskie bog is under active protection. A total of 24 flow barriers were installed in drainage ditches during the years 2006 and 2007. The purpose of these barriers was to put a halt to water outflow. In addition, 30 hectares of young pine forest were cleared in order to decrease loss of water via evapotranspiration. Kluki peat bog is only partially protected by Polish law. The lack of efforts to prevent outflow via the canal is due to the fact that the canal is utilised to drain meadows in the vicinity of the village of Łokciowe outside of the national park. Peat formation no longer occurs in this peat bog. The hydrological condition of the bog is catastrophic as a result of its main canal, referred to as Canal C9, which is 2.5 to 3.0 m deep and 10 m wide in places. Both peat bogs are monitored for fluctuations in groundwater. Research has shown that changes in water levels fluctuate based on season of the year and geographical location, which is illustrated quite well using the two studied peat bogs. The water retention rate of the Żarnowskie peat bog may be considered fairly high and is likely to improve due to protective measures enabled by Polish environmental laws. The water retention rate of the bog is consistently improving thanks to these measures, fluctuations in water level are small and the water level does not drop under 0.5 m below ground level even under extreme hydrometeorological conditions. This yields optimum conditions for renewed peat formation in this area. One potential threat is the Krakulice peat extraction facility, which is located in the southern part of the bog close to the boundary with the national park.

Combining random forest and 2D correlation analysis to identify serum spectral signatures for neuro-oncology.

PubMed

Smith, Benjamin R; Ashton, Katherine M; Brodbelt, Andrew; Dawson, Timothy; Jenkinson, Michael D; Hunt, Neil T; Palmer, David S; Baker, Matthew J

2016-06-07

Fourier transform infrared (FTIR) spectroscopy has long been established as an analytical technique for the measurement of vibrational modes of molecular systems. More recently, FTIR has been used for the analysis of biofluids with the aim of becoming a tool to aid diagnosis. For the clinician, this represents a convenient, fast, non-subjective option for the study of biofluids and the diagnosis of disease states. The patient also benefits from this method, as the procedure for the collection of serum is much less invasive and stressful than traditional biopsy. This is especially true of patients in whom brain cancer is suspected. A brain biopsy is very unpleasant for the patient, potentially dangerous and can occasionally be inconclusive. We therefore present a method for the diagnosis of brain cancer from serum samples using FTIR and machine learning techniques. The scope of the study involved 433 patients from whom were collected 9 spectra each in the range 600-4000 cm(-1). To begin the development of the novel method, various pre-processing steps were investigated and ranked in terms of final accuracy of the diagnosis. Random forest machine learning was utilised as a classifier to separate patients into cancer or non-cancer categories based upon the intensities of wavenumbers present in their spectra. Generalised 2D correlational analysis was then employed to further augment the machine learning, and also to establish spectral features important for the distinction between cancer and non-cancer serum samples. Using these methods, sensitivities of up to 92.8% and specificities of up to 91.5% were possible. Furthermore, ratiometrics were also investigated in order to establish any correlations present in the dataset. We show a rapid, computationally light, accurate, statistically robust methodology for the identification of spectral features present in differing disease states. With current advances in IR technology, such as the development of rapid discrete frequency collection, this approach is of importance to enable future clinical translation and enables IR to achieve its potential.

Innovative use of recovered municipal solid waste incineration bottom ash as a component in growing media.

PubMed

Sormunen, Annika; Teo, Kanniainen; Tapio, Salo; Riina, Rantsi

2016-07-01

The utilisation of municipal solid waste incineration bottom ash has been extensively studied, for example, in the unbound layers of roads and the products of cement and concrete industry. On the other hand, less attention has been given to other innovative utilisation possibilities, such as using the municipal solid waste incineration bottom ash as a component in growing media of plants. The municipal solid waste incineration bottom ash contains useful substances, such as calcium, that can influence plant growth in a positive manner. Therefore, the utilisation of this waste-derived material in the growing media may substitute the use of commercial fertilisers. Since the municipal solid waste incineration bottom ash also contains hazardous substances that can be toxic to plants, the main aim of this study was to add different amounts of recovered municipal solid waste incineration bottom ash in the growing media and to evaluate the effect of this material on plant growth. Based on the obtained results, the concentration of, for example copper and zinc, increased in test plants; ryegrass and barley, when recovered municipal solid waste incineration bottom ash was added in their growing media. On the other hand, this did not have a significant effect on plant growth, if compared with the growth of plants in commercially produced growing medium. Furthermore, the replacement of natural sand with municipal solid waste incineration bottom ash had a positive liming effect in the growing media. Overall, these findings suggest that the utilisation of recovered municipal solid waste incineration bottom ash as a component in growing media is possible and, thus, may allow more widespread and innovative use of this waste-derived material. © The Author(s) 2016.

Access and utilisation of social and health services as a social determinant of health: the case of undocumented Latin American immigrant women working in Lleida (Catalonia, Spain).

PubMed

Gea-Sánchez, Montserrat; Gastaldo, Denise; Molina-Luque, Fidel; Otero-García, Laura

2017-03-01

Although Spain has social and healthcare systems based on universal coverage, little is known about how undocumented immigrant women access and utilise them. This is particularly true in the case of Latin Americans who are overrepresented in the informal labour market, taking on traditionally female roles of caregivers and cleaners in private homes. This study describes access and utilisation of social and healthcare services by undocumented Latin American women working and living in rural and urban areas, and the barriers these women may face. An exploratory qualitative study was designed with 12 in-depth interviews with Latin American women living and working in three different settings: an urban city, a rural city and rural villages in the Pyrenees. Interviews were recorded, transcribed and analysed, yielding four key themes: health is a tool for work which worsens due to precarious working conditions; lack of legal status traps Latin American women in precarious jobs; lack of access to and use of social services; and limited access to and use of healthcare services. While residing and working in different areas of the province impacted the utilisation of services, working conditions was the main barrier experienced by the participants. In conclusion, decent working conditions are the key to ensuring undocumented immigrant women's right to social and healthcare. To create a pathway to immigrant women's health promotion, the 'trap of illegality' should be challenged and the impact of being considered 'illegal' should be considered as a social determinant of health, even where the right to access services is legal. © 2016 John Wiley & Sons Ltd.

Healthcare Utilisation and Drug Treatment in a Large Cohort of Patients with Inflammatory Bowel Disease

PubMed Central

Wettermark, Björn; Löfberg, Robert; Eriksson, Irene; Sundström, Johan; Lördal, Mikael

2016-01-01

Background and Aims: Crohn’s disease [CD] and ulcerative colitis [UC] are chronic diseases associated with a substantial utilisation of healthcare resources. We aimed to estimate the prevalence of inflammatory bowel disease [IBD], CD, and UC and to describe and compare healthcare utilisation and drug treatment in CD and UC patients. Methods: This was a cross-sectional study of all patients with a recorded IBD diagnosis in Stockholm County, Sweden. Data on outpatient visits, hospitalisations, surgeries, and drug treatment during 2013 were analysed. Results: A total of 13 916 patients with IBD were identified, corresponding to an overall IBD prevalence of 0.65% [CD 0.27%, UC 0.35%, inflammatory bowel disease unclassified 0.04%]; 49% of all IBD patients were treated with IBD-related drugs. Only 3.6% of the patients received high-dose corticosteroids, whereas 32.4% were treated with aminosalicylates [CD 21.2%, UC 41.0%, p < 0.0001]. More CD patients were treated with biologicals compared with UC patients [CD 9.6%, UC 2.9%, p < 0.0001] and surgery was significantly more common among CD patients [CD 3.0%, UC 0.8%, p < 0.0001]. Conclusions: This study indicates that patients with CD are the group with the highest medical needs. Patients with CD utilised significantly more healthcare resources [including outpatient visits, hospitalisations, and surgeries] than UC patients. Twice as many CD patients received immunomodulators compared with UC patients and CD patients were treated with biologicals three times more often. These results highlight that CD remains a challenge and further efforts are needed to improve care in these patients. PMID:26733406

Variation in the prevalence of urinary catheters: a profile of National Health Service patients in England.

PubMed

Shackley, David Clifford; Whytock, Cameron; Parry, Gareth; Clarke, Laurence; Vincent, Charles; Harrison, Abigail; John, Amber; Provost, Lloyd; Power, Maxine

2017-06-23

Harm from catheter-associated urinary tract infections is a common, potentially avoidable, healthcare complication. Variation in catheter prevalence may exist and provide opportunity for reducing harm, yet to date is poorly understood. This study aimed to determine variation in the prevalence of urinary catheters between patient groups, settings, specialities and over time. A prospective study (July 2012 to April 2016) of National Health Service (NHS) patients surveyed by healthcare professionals, following a standardised protocol to determine the presence of a urinary catheter and duration of use, on 1 day per month using the NHS Safety Thermometer. 1314 organisations (253 NHS trusts) and 9 266 284 patients were included. Overall, 12.9% of patients were catheterised, but utilisation varied. There was higher utilisation of catheters in males (15.7% vs 10.7% p<0.001) and younger people (18-70 year 14.0% vs >70 year 12.8% p<0.001), utilisation was highest in hospital settings (18.6% p<0.001), particularly in critical care (76.6% p<0.001). Most catheters had been in situ <28 days (72.9% p<0.001). No clinically significant changes were seen over time in any setting or specialty. Catheter prevalence in patients receiving NHS-funded care varies according to gender, age, setting and specialty, being most prevalent in males, younger people, hospitals and critical care. Utilisation has changed only marginally over 46 months, and further guidance is indicated to provide clarity for clinicians on the insertion and removal of catheters to supplement the existing guidance on care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Out-of-Pocket Payments, Health Care Access and Utilisation in South-Eastern Nigeria: A Gender Perspective

PubMed Central

Onah, Michael N.; Govender, Veloshnee

2014-01-01

Out-of-pocket (OOP) payments have severe consequences for health care access and utilisation and are especially catastrophic for the poor. Although women comprise the majority of the poor in Nigeria and globally, the implications of OOP payments for health care access from a gender perspective have received little attention. This study seeks to fill this gap by using a combination of quantitative and qualitative analysis to investigate the gendered impact of OOPs on healthcare utilisation in south-eastern Nigeria. 411 households were surveyed and six single-sex Focus Group Discussions conducted. This study confirmed the socioeconomic and demographic vulnerability of female-headed households (FHHs), which contributed to gender-based inter-household differences in healthcare access, cost burden, choices of healthcare providers, methods of funding healthcare and coping strategies. FHHs had higher cost burdens from seeking care and untreated morbidity than male-headed households (MHHs) with affordability as a reason for not seeking care. There is also a high utilisation of patent medicine vendors (PMVs) by both households (PMVs are drug vendors that are unregulated, likely to offer very low-quality treatment and do not have trained personnel). OOP payment was predominantly the means of healthcare payment for both households, and households spoke of the difficulties associated with repaying health-related debt with implications for the medical poverty trap. It is recommended that the removal of user fees, introduction of prepayment schemes, and regulating PMVs be considered to improve access and provide protection against debt for FHHs and MHHs. The vulnerability of widows is of special concern and efforts to improve their healthcare access and broader efforts to empower should be encouraged for them and other poor households. PMID:24728103

The use of light-based (optical) detection systems as adjuncts in the detection of oral cancer and oral potentially malignant disorders: a systematic review.

PubMed

Rashid, A; Warnakulasuriya, S

2015-05-01

In recent decades, optical techniques utilising the principles of chemiluminescence and tissue autofluorescence have emerged to facilitate the early detection of any oral mucosal changes suspicious of cancer. To evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of oral cancer and oral potentially malignant disorders (OPMDs). A systematic review of the published literature to evaluate the effectiveness of the ViziLite(®) and ViziLite(®) Plus with toluidine blue, MicroLux™/DL and the VELscope™ as aids in the detection of oral cancer and OPMDs. Twenty-five primary studies published between 2004 and 2013 satisfied our criteria for selection - 13 utilised chemiluminescence and 12 tissue autofluorescence. Some had utilised both study methods on the same population. Chemiluminescence shows good sensitivity at detecting any OPMDs and oral cancer. However, it preferentially detects leukoplakia and may fail to spot red patches. The additive use of toluidine blue may improve specificity. Tissue autofluorescence is sensitive at detecting white, red and white and red patches, and the area of fluorescence visualisation loss (FVL) often extends beyond the clinically visible lesion. However, in addition to OPMDs, VELScope may detect erythematous lesions of benign inflammation resulting in false-positive test results. There is limited evidence for their use in primary care, and these tools are better suited to specialist clinics in which there is a higher prevalence of disease and where experienced clinicians may better discriminate between benign and malignant lesions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Counting the costs: Comparing depot medroxyprogesterone acetate and norethisterone oenanthate utilisation patterns in South Africa

PubMed Central

2001-01-01

Background In South Africa, where health care resources are limited, it is important to ensure that drugs provision and use is rational. The Essential Drug List includes depot medroxyprogesterone acetate (DMPA) and norethisterone oenanthate (NET-EN) as injectable progestagen-only contraceptives (IPCs), and both products are extensively used. Objectives and Methods Utilisation patterns of the injectable contraceptive products DMPA and NET-EN are compared in the context of current knowledge of the safety and efficacy of these agents. Utilisation patterns were analysed by means of a Pareto (ABC) analysis of IPCs issued from 4 South African provincial pharmaceutical depots over 3 financial years. A case study from rural KwaZulu-Natal, South Africa, is used to examine utilisation patterns and self-reported side effects experienced by 187 women using IPCs. Results IPCs accounted for a substantial share of total state expenditure on drugs. While more DMPA than NET-EN was issued, NET-EN distribution from 2 depots increased over the 3-year period. Since DMPA was cheaper, if all NET-EN clients in the 1999/2000 financial year (annualised) had used DMPA, the 4 depots could have saved 4.95 million South African Rands on product acquisition costs alone. The KZN case study showed slightly more NET-EN (54%) than DMPA (46%) use; no significant differences in self-reported side effects; and that younger women were more likely to use NET-EN than DMPA (p = 0.0001). Conclusions Providing IPCs on the basis of age is not appropriate or cost effective. Rational use of these products should include consideration of the cost of prescribing one over another. PMID:11401729

The role and utilisation of public health evaluations in Europe: a case study of national hand hygiene campaigns

PubMed Central

2014-01-01

Background Evaluations are essential to judge the success of public health programmes. In Europe, the proportion of public health programmes that undergo evaluation remains unclear. The European Centre for Disease Prevention and Control sought to determine the frequency of evaluations amongst European national public health programmes by using national hand hygiene campaigns as an example of intervention. Methods A cohort of all national hand hygiene campaigns initiated between 2000 and 2012 was utilised for the analysis. The aim was to collect information about evaluations of hand hygiene campaigns and their frequency. The survey was sent to nominated contact points for healthcare-associated infection surveillance in European Union and European Economic Area Member States. Results Thirty-six hand hygiene campaigns in 20 countries were performed between 2000 and 2012. Of these, 50% had undergone an evaluation and 55% of those utilised the WHO hand hygiene intervention self-assessment tool. Evaluations utilised a variety of methodologies and indicators in assessing changes in hand hygiene behaviours pre and post intervention. Of the 50% of campaigns that were not evaluated, two thirds reported that both human and financial resource constraints posed significant barriers for the evaluation. Conclusion The study identified an upward trend in the number of hand hygiene campaigns implemented in Europe. It is likely that the availability of the internationally-accepted evaluation methodology developed by the WHO contributed to the evaluation of more hand hygiene campaigns in Europe. Despite this rise, hand hygiene campaigns appear to be under-evaluated. The development of simple, programme-specific, standardised guidelines, evaluation indicators and other evidence-based public health materials could help promote evaluations across all areas of public health. PMID:24507086

Out-of-pocket payments, health care access and utilisation in south-eastern Nigeria: a gender perspective.

PubMed

Onah, Michael N; Govender, Veloshnee

2014-01-01

Out-of-pocket (OOP) payments have severe consequences for health care access and utilisation and are especially catastrophic for the poor. Although women comprise the majority of the poor in Nigeria and globally, the implications of OOP payments for health care access from a gender perspective have received little attention. This study seeks to fill this gap by using a combination of quantitative and qualitative analysis to investigate the gendered impact of OOPs on healthcare utilisation in south-eastern Nigeria. 411 households were surveyed and six single-sex Focus Group Discussions conducted. This study confirmed the socioeconomic and demographic vulnerability of female-headed households (FHHs), which contributed to gender-based inter-household differences in healthcare access, cost burden, choices of healthcare providers, methods of funding healthcare and coping strategies. FHHs had higher cost burdens from seeking care and untreated morbidity than male-headed households (MHHs) with affordability as a reason for not seeking care. There is also a high utilisation of patent medicine vendors (PMVs) by both households (PMVs are drug vendors that are unregulated, likely to offer very low-quality treatment and do not have trained personnel). OOP payment was predominantly the means of healthcare payment for both households, and households spoke of the difficulties associated with repaying health-related debt with implications for the medical poverty trap. It is recommended that the removal of user fees, introduction of prepayment schemes, and regulating PMVs be considered to improve access and provide protection against debt for FHHs and MHHs. The vulnerability of widows is of special concern and efforts to improve their healthcare access and broader efforts to empower should be encouraged for them and other poor households.

Combating desertification: building on traditional knowledge systems of the Thar Desert communities.

PubMed

Gaur, Mahesh K; Gaur, Hemlata

2004-12-01

The Thar Desert of western India is known for its rich and ancient culture system and traditions. The communities have long been part of the Thar Desert ecosystem and have evolved specific strategies to live in harmony with its hostile environment. This culture has provided several miracle plants of immense food and medicinal value to modern civilisation. The ancient rural livelihood knowledge system reflects time-tested techno-scientific knowledge with a proven track record of sustainability, especially during natural hazards like drought and famines. In addition, several of the traditional skills of local communities in arts and crafts, music and instruments have made modern man aware of the art and techniques of sustainably utilising local biological resources and preserving their biodiversity along with using waste products of the forests, without harming the desert ecosystem. Traditional cultural and socio-religious values are fast dwindling under the impact of materialistic approach, industrialisation and development. This paper endeavours to illustrate the need to assist and propagate indigenous rural livelihood systems rather than mindlessly replace or abandon them as a result of state bureaucracies.

The potential for species conservation in tropical secondary forests.

PubMed

Chazdon, Robin L; Peres, Carlos A; Dent, Daisy; Sheil, Douglas; Lugo, Ariel E; Lamb, David; Stork, Nigel E; Miller, Scott E

2009-12-01

In the wake of widespread loss of old-growth forests throughout the tropics, secondary forests will likely play a growing role in the conservation of forest biodiversity. We considered a complex hierarchy of factors that interact in space and time to determine the conservation potential of tropical secondary forests. Beyond the characteristics of local forest patches, spatial and temporal landscape dynamics influence the establishment, species composition, and persistence of secondary forests. Prospects for conservation of old-growth species in secondary forests are maximized in regions where the ratio of secondary to old-growth forest area is relatively low, older secondary forests have persisted, anthropogenic disturbance after abandonment is relatively low, seed-dispersing fauna are present, and old-growth forests are close to abandoned sites. The conservation value of a secondary forest is expected to increase over time, as species arriving from remaining old-growth forest patches accumulate. Many studies are poorly replicated, which limits robust assessments of the number and abundance of old-growth species present in secondary forests. Older secondary forests are not often studied and few long-term studies are conducted in secondary forests. Available data indicate that both old-growth and second-growth forests are important to the persistence of forest species in tropical, human-modified landscapes.

Utilisation of Used Palm Oil as an Alternative Fuel in Thailand

NASA Astrophysics Data System (ADS)

Permchart, W.; Tanatvanit, S.

2007-10-01

This paper summarises the overview of the current situation of alternative energies in Thailand. The utilisation of bio-diesel as an alternative energy in two economic sectors (i.e. transport and industrial sectors), which have the largest energy consumption in the country, is mainly presented because it has seemed to be the most promising project among various energy conservation projects of the Thai government. Actually, there is another bio-fuel project, namely, the ethanol project for blending with gasoline to produce gasohol (E10) used in gasoline engines, which has been developed and already become to an important policy for energy conservation of the country. Due to much more large number of diesel has been utilised, the bio-diesel project has been the first priority one to solve the petroleum crisis problems. However, it is remarked that the utilisation of bio-diesel as an alternative fuel seems to be unsatisfactory because of various reasons. Some issues in terms of both government policies and technical problems have not been clearly addressed. Therefore, this paper not only presents the utilisation of bio-diesel in these two sectors but also discusses the production processes, characterisations and some experimental testing results of bio-diesel.

Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study.

PubMed

Aung, Nyein Chan; Rechel, Bernd; Odermatt, Peter

2010-10-12

An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced difficulties in registering with GP practices. Many of those who have registered prefer to forego GP services in favour of self-medication, partly due to long waiting times and language barriers. To ensure that migrants enjoy the health services they need and to which they are entitled, more proactive steps are required, including those that make health services culturally responsive.

A study of the dry forest communities in the Dominican Republic.

PubMed

García-Fuentes, Antonio; Torres-Cordero, Juan A; Ruiz-Valenzuela, Luis; Lendínez-Barriga, María Lucía; Quesada-Rincón, Juan; Valle-Tendero, Francisco; Veloz, Alberto; León, Yolanda M; Salazar-Mendías, Carlos

2015-03-01

This paper is a floristic and phytosociological study of the dry forest communities of the Dominican Republic. A total of 69 relevés in dry forest biotopes were carried out. The samples were subsequently subjected to Detrended Correspondence Analysis for the determination and study of possible groupings. The study does not cover tree formations growing on serpentines, nor the so-called semideciduous forests, peculiar to areas with higher rainfall. A total of nine phytocoenoses were identified. The most significant results led to the description of six new phytosociological associations: Simaroubetum berteroani (thorny dry forest on coastal dunes), Phyllostylo rhamnoidis-Prosopidetum juliflorae (southern Dominican disturbed dry forest), Consoleo moniliformis-Camerarietum linearifoliae (dry forest on hard limestones), Lemaireocereo hystricis-Prosopidetum juliflorae (northern Dominican disturbed dry forest), Lycio americani-Prosopidetum juliflorae (disturbed dry forest on saline soils) and Guettardo ellipticae-Guapiretum discoloris (dry forest on flat-topped hillocks in Montecristi). This is an important step forward in the phytosociological and floristic studies of the Caribbean territories.

Nutritional composition of suspended particulate matter in a tropical mangrove creek during a tidal cycle (Can Gio, Vietnam)

NASA Astrophysics Data System (ADS)

David, Frank; Marchand, Cyril; Taillardat, Pierre; Thành-Nho, Nguyễn; Meziane, Tarik

2018-01-01

Mangrove forests are highly productive ecosystems and mangrove-derived organic matter has generally been assumed to play a basal role in sustaining coastal food webs. However, the mechanisms of mangrove-derived organic matter utilisation by consumers are not fully understood. In this study, we were interested in hourly changes in the nutritional quality of suspended particulate matter (SPM) entering and departing a mangrove creek during a tidal cycle. We determined the fatty acid composition and δ13C stable isotope signature of SPM during a 26 h tidal cycle in a creek of the Can Gio Mangrove Biosphere Reserve (Southern Vietnam). Regarding fatty acids, the nutritional quality of SPM was low during most of the tidal cycle. However, it greatly increased during the first part of the strongest flood tide, occurring during daytime. The pulse of highly nutritive organic matter brought to the ecosystem was mostly composed of algal cells growing in specific shallow zones of the mangrove, that use nutrients and CO2 exported during the preceding ebb tide and originating from the mineralisation of mangrove-derived organic matter, as evidenced by their δ13C signatures. This study confirms that mangrove-derived carbon plays a basal role in sustaining trophic webs of mangrove tidal creeks, but that its nutritive value is greatly enhanced when a first step of mineralisation is achieved and CO2 is photosynthesised by algal cells.

Fragmentation, topography, and forest age modulate impacts of drought on a tropical forested landscape in eastern Puerto Rico

NASA Astrophysics Data System (ADS)

Uriarte, M.; Schwartz, N.; Budsock, A.

2017-12-01

Naturally regenerating second-growth forests account for ca. 50% of tropical forest cover and provide key ecosystem services. Understanding climate impacts on these ecosystems is critical for developing effective mitigation programs. Differences in environmental conditions and landscape context from old-growth forests may exacerbate climate impacts on second-growth stands. Nearly 70% of forest regeneration is occurring in hilly, upland, or mountain regions; a large proportion of second-growth forests are also fragmented. The effects of drought at the landscape scale, however, and the factors that modulate landscape heterogeneity in drought impacts remain understudied. Heterogeneity in soil moisture, light, and temperature in fragmented, topographically complex landscapes is likely to influence climate impacts on these forests. We examine impacts of a severe drought in 2015 on a forested landscape in Puerto Rico using two anomalies in vegetation indices. The study landscape is fragmented and topographically complex and includes old- and second-growth forests. We consider how topography (slope, aspect), fragmentation (distance to forest edge, patch size), and forest age (old- vs second-growth) modulate landscape heterogeneity of drought impacts and recovery from drought. Drought impacts were more severe in second-growth forests than in old-growth stands. Both topography and forest fragmentation influences the magnitude of drought impacts. Forest growing in steep areas, south facing slopes, small patches, and closer to forest edges exhibited more marked responses to drought. Forest recovery from drought was greater in second-growth forests and south facing slopes but slower in small patches and closer to forest edges. These findings are congruent with studies of drought impacts on tree growth in the study region. Together these results demonstrate the need for a multi-scalar approach to the study of drought impacts on tropical forests.

Effects of stand age on the demography of a temperate forest herb in post-agricultural forests.

PubMed

Jacquemyn, Hans; Brys, Rein

2008-12-01

Changes in land use have been shown to have profound effects on forest plant community structure and diversity. Dispersal limitation has been invoked as a major factor hampering colonization of forest plant species, while seed-sowing experiments and performance observations have provided some evidence for recruitment limitation determining forest plant distribution in post-agricultural forests. However, most of these studies were relatively short-term, and very few studies have investigated long-term growth rates of populations occurring in recent and ancient forests. In this study, matrix models using demographic data collected for four consecutive years were used to study the effect of forest age on population dynamics of the temperate forest herb Primula elatior. A life table response experiment (LTRE) and elasticity analysis were used to analyze the effect of forest age on population growth rate (lambda) and to decompose the effect of forest age on lambda into contributions from each matrix element. Population growth increased logarithmically with increasing forest age. Bootstrap analyses showed that populations located in very recent forests (< 50-years-old) had growth rates that were significantly < 1, whereas populations located in forests > 150-years-old had growth rates that were significantly > 1. Summed elasticities for individual growth significantly decreased with increasing forest age, whereas summed elasticities for survival and fertility significantly increased with increasing forest age. The LTRE analysis showed that the increase in lambda with increasing forest age was mainly due to increased seedling and juvenile growth and increased juvenile and adult survival. Our results indicate that past agricultural land use has long-lasting effects on the demography of forest herbs and may provide an additional mechanistic explanation for the poor colonization capacity of many forest herbs in post-agricultural forests.

Changes in forest biomass and linkage to climate and forest disturbances over Northeastern China.

PubMed

Zhang, Yuzhen; Liang, Shunlin

2014-08-01

The forests of northeastern China store nearly half of the country's total biomass carbon stocks. In this study, we investigated the changes in forest biomass by using satellite observations and found that a significant increase in forest biomass took place between 2001 and 2010. To determine the possible reasons for this change, several statistical methods were used to analyze the correlations between forest biomass dynamics and forest disturbances (i.e. fires, insect damage, logging, and afforestation and reforestation), climatic factors, and forest development. Results showed that forest development was the most important contributor to the increasing trend of forest biomass from 2001 to 2010, and climate controls were the secondary important factor. Among the four types of forest disturbance considered in this study, forest recovery from fires, and afforestation and reforestation during the past few decades played an important role in short-term biomass dynamics. This study provided observational evidence and valuable information for the relationships between forest biomass and climate as well as forest disturbances. © 2014 John Wiley & Sons Ltd.

Automated Burned Area Delineation Using IRS AWiFS satellite data

NASA Astrophysics Data System (ADS)

Singhal, J.; Kiranchand, T. R.; Rajashekar, G.; Jha, C. S.

2014-12-01

India is endowed with a rich forest cover. Over 21% of country's area is covered by forest of varied composition and structure. Out of 67.5 million ha of Indian forests, about 55% of the forest cover is being subjected to fires each year, causing an economic loss of over 440 crores of rupees apart from other ecological effects. Studies carried out by Forest Survey of India reveals that on an average 53% forest cover of the country is prone to fires and 6.17% of the forests are prone to severe fire damage. Forest Survey of India in a countrywide study in 1995 estimated that about 1.45 million hectares of forest are affected by fire annually. According to Forest Protection Division of the Ministry of Environment and Forest (GOI), 3.73 million ha of forests are affected by fire annually in India. Karnataka is one of the southern states of India extending in between latitude 110 30' and 180 25' and longitudes 740 10' and 780 35'. As per Forest Survey of India's State of Forest Report (SFR) 2009, of the total geographic area of 191791sq.km, the state harbors 38284 sq.km of recorded forest area. Major forest types occurring in the study area are tropical evergreen and semi-evergreen, tropical moist and dry deciduous forests along with tropical scrub and dry grasslands. Typical forest fire season in the study area is from February-May with a peak during March-April every year, though sporadic fire episodes occur in other parts of the year sq.km, the state harbors 38284 sq.km of recorded forest area. Major forest types occurring in the study area are tropical evergreen and semi-evergreen, tropical moist and dry deciduous forests along with tropical scrub and dry grasslands. Significant area of the deciduous forests, scrub and grasslands is prone to recurrent forest fires every year. In this study we evaluate the feasibility of burned area mapping over a large area (Karnataka state, India) using a semi-automated detection algorithm applied to medium resolution multi spectral data from the IRS AWiFS sensor. The method is intended to be used by non-specialist users for diagnostic rapid burnt area mapping.

Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review.

PubMed

Larkin, Louise; Gallagher, Stephen; Cramp, Fiona; Brand, Charles; Fraser, Alexander; Kennedy, Norelee

2015-10-01

Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.

Utilisation of podiatry services in Australia under the Medicare Enhanced Primary Care program, 2004-2008.

PubMed

Menz, Hylton B

2009-10-30

In 2004, as an extension of the Enhanced Primary Care (EPC) program, the Australian Government introduced a policy of providing Medicare rebates for allied health services provided to patients with chronic or complex health conditions. The objective of this study was to evaluate the utilisation of podiatry services provided under this scheme between 2004 and 2008. Data pertaining to the Medicare item 10962 for the calendar years 2004-2008 were extracted from the Australian Medicare Benefits Schedule (MBS) database and cross-tabulated by sex and age. Descriptive analyses were undertaken to assess sex and age differences in the number of consultations provided and to assess for temporal trends over the five-year assessment period. The total cost to Medicare over this period was also determined. During the 2004-2008 period, a total of 1,338,044 EPC consultations were provided by podiatrists in Australia. Females exhibited higher utilisation than males (63 versus 37%), and those aged over 65 years accounted for 75% of consultations. There was a marked increase in the number of consultations provided from 2004 to 2008, and the total cost of providing EPC podiatry services during this period was $62.9 M. Podiatry services have been extensively utilised under the EPC program by primary care patients, particularly older women, and the number of services provided has increased dramatically between 2004 and 2008. Further research is required to determine whether the EPC program enhances clinical outcomes compared to standard practice.

Health service utilisation of rural-to-urban migrants in Guangzhou, China: does employment status matter?

PubMed

Song, Xiaolei; Zou, Guanyang; Chen, Wen; Han, Siqi; Zou, Xia; Ling, Li

2017-01-01

To describe the self-reported health status and service utilisation of employed, retired and unemployed migrants in Guangzhou, a megacity in southern China. A cross-sectional study adapted from the National Health Service Survey was conducted between September and December in 2014. Based on the distribution of occupation of migrants, multistage sampling was used to recruit individuals. Logistic regression was applied to explore the factors influencing their service utilisation. Of 2906 respondents, 76.6% were employed, 9.2% retired and 14.2% unemployed. Only 8.1% reported having an illness in the previous 2 weeks, and 6.5% reported having been hospitalised in the previous year. Employed migrants had the lowest recent physician consultation rate (3.4%) and the lowest annual hospitalisation rate (4.5%) (P < 0.05); unemployed migrants had the highest rates (6.8% and 14.5% respectively, P < 0.05). Retired migrants were more likely to return to their hometown for health care (8.6%) than employed (1.5%) and unemployed migrants (3.4%) (P < 0.05). After adjusting for age and gender, employment status remained significant in explaining the recent two-week treatment-seeking behaviour of migrants (P < 0.05). Disparity of service utilisation continues to be a problem for migrants due to the poor health awareness, lack of time and inconvenience of medical insurance reimbursement. Employed migrants make the least use of health services. © 2016 John Wiley & Sons Ltd.

Self-reported illnesses and service utilisation among migrants working in small-to medium sized enterprises in Guangdong, China.

PubMed

Zou, G; Zeng, Z; Chen, W; Ling, L

2015-07-01

As one of the most vulnerable populations in China, many migrants work in the small-to-medium-sized enterprises (SMEs). This study aims to describe the self-reported illnesses and service utilization of the migrants working in the SMEs in Pearl River Delta Areas (PRDA) of Guangdong province, China. Cross-sectional survey. We interviewed 856 migrants working in the SMEs of different manufacturing industries in 2012. Descriptive analysis was employed to report self-reported illnesses and service utilisation among migrants in the last two weeks and in the last year. Statistical tests such as χ2 test were used to explore factors influencing their service utilisation. In the last two weeks, 91(11%) of the respondents reported having any illness. The most reported illness was respiratory problem (69%), while 9.9%, 7.7% and 13% reported having digestive, skin and other problems respectively. The most important symptom was cough (39%). Thirty-seven percent of the respondents who reported any illness had visited health facilities. The lower income group were more likely to visit health facilities than the higher income group (P = 0.006). The most reported reason for not visiting health facilities was 'feeling not serious' (65%). In the last year, 13% reported having respiratory problems and 7.8% reported accidental injuries. Less than 3% received hospitalization care. The proportion of those without hospitalization to those who should have been hospitalized was 31%. Underuse of the health service among migrants working in the SMEs could be associated with the 'healthy migrant' effect. However, when assessed among the ill migrants in the SMEs, the utilisation rate was still low mainly due to their poor health awareness. Improving their risk perception and integration of occupational and general health service is crucial to improve the health conditions and utilisation of service among migrants in the SMES. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study

PubMed Central

McAullay, Daniel; Strobel, Natalie A.; Marriott, Rhonda; Atkinson, David N.; Marley, Julia V.; Stanley, Fiona J.

2016-01-01

Background Indigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants. Methods Our primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation. Findings There were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356). Interpretation WA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live. PMID:27120331

Determinants analysis of outpatient service utilisation in Georgia: can the approach help inform benefit package design?

PubMed

Gotsadze, George; Tang, Wenze; Shengelia, Natia; Zoidze, Akaki

2017-05-02

The healthcare financing reforms initiated by the Government of Georgia in 2007 have positively affected inpatient service utilisation and enhanced financial protection, especially for the poor, but they have failed to facilitate outpatient service use among chronic patients. Non-communicable diseases significantly affect Georgia's ageing population. Consequently, in this paper, we look at the evidence emerging from determinants analysis of outpatient service utilisation and if the finding can help identify possible policy choices in Georgia, especially regarding benefit package design for individuals with chronic conditions. We used Andersen's behavioural model of health service utilisation to identify the critical determinants that affect outpatient service use. A multinomial logistic regression was carried out with complex survey design using the data from two nationally representative cross-sectional population-based health utilisation and expenditure surveys conducted in Georgia in 2007 and 2010, which allowed us to assess the relationship between the determinants and outpatient service use. The study revealed the determinants that significantly impede outpatient service use. Low income, 45- to 64-year-old Georgian males with low educational attainment and suffering from a chronic health problem have the lowest odds for service use compared to the rest of the population. Using Andersen's behavioural model and assessing the determinants of outpatient service use has the potential to inform possible policy responses, especially those driving services use among chronic patients. The possible policy responses include reducing financial access barriers with the help of public subsidies for sub-groups of the population with the lowest access to care; focusing/expanding state-funded benefits for the most prevalent chronic conditions, which are responsible for the greatest disease burden; or supporting chronic disease management programs for the most prevalent chronic diseases and for special age groups aimed at the timely detection, education and management of chronic patients.

Service utilisation by carers of people with dementia in rural Victoria.

PubMed

Ervin, Kaye; Reid, Carol

2015-12-01

To explore the use of community and dementia-specific services by informal carers caring for someone with dementia in a rural setting. Carers of people with dementia were recruited through a variety of rural community services and invited to complete a survey related to the utilisation of community services. A total of 39 carers completed surveys. Despite 84% reporting use of the Aged Care Assessment Service and 61% reporting provision of printed information on the services available, less than half of the carers utilised commonly available support services. Only 46% received financial compensation for their carer role. Rural carers of care recipients with behavioural and psychological symptoms of dementia underutilise community services. Services that may assist with carer stress and depression and services that provide advice on the management of distressing behavioural and psychological symptoms of dementia were utilised by less than half of the carers surveyed. © 2014 AJA Inc.

Univariate and multivariate spatial models of health facility utilisation for childhood fevers in an area on the coast of Kenya.

PubMed

Ouma, Paul O; Agutu, Nathan O; Snow, Robert W; Noor, Abdisalan M

2017-09-18

Precise quantification of health service utilisation is important for the estimation of disease burden and allocation of health resources. Current approaches to mapping health facility utilisation rely on spatial accessibility alone as the predictor. However, other spatially varying social, demographic and economic factors may affect the use of health services. The exclusion of these factors can lead to the inaccurate estimation of health facility utilisation. Here, we compare the accuracy of a univariate spatial model, developed only from estimated travel time, to a multivariate model that also includes relevant social, demographic and economic factors. A theoretical surface of travel time to the nearest public health facility was developed. These were assigned to each child reported to have had fever in the Kenya demographic and health survey of 2014 (KDHS 2014). The relationship of child treatment seeking for fever with travel time, household and individual factors from the KDHS2014 were determined using multilevel mixed modelling. Bayesian information criterion (BIC) and likelihood ratio test (LRT) tests were carried out to measure how selected factors improve parsimony and goodness of fit of the time model. Using the mixed model, a univariate spatial model of health facility utilisation was fitted using travel time as the predictor. The mixed model was also used to compute a multivariate spatial model of utilisation, using travel time and modelled surfaces of selected household and individual factors as predictors. The univariate and multivariate spatial models were then compared using the receiver operating area under the curve (AUC) and a percent correct prediction (PCP) test. The best fitting multivariate model had travel time, household wealth index and number of children in household as the predictors. These factors reduced BIC of the time model from 4008 to 2959, a change which was confirmed by the LRT test. Although there was a high correlation of the two modelled probability surfaces (Adj R 2  = 88%), the multivariate model had better AUC compared to the univariate model; 0.83 versus 0.73 and PCP 0.61 versus 0.45 values. Our study shows that a model that uses travel time, as well as household and individual-level socio-demographic factors, results in a more accurate estimation of use of health facilities for the treatment of childhood fever, compared to one that relies on only travel time.

Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study

PubMed Central

2013-01-01

Background Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not facilitate their involvement. This qualitative study conducted in rural Western Kenya, explored men’s perceptions of antenatal and delivery care services and identified factors that facilitated or constrained their involvement. Methods Eight focus group discussions were conducted with 68 married men between 20-65 years of age in May 2011. Participants were of the Luo ethnic group residing in Asembo, western Kenya. The area has a high HIV-prevalence and polygamy is common. A topic guide was used to guide the discussions and a thematic framework approach for data analysis. Results Overall, men were positive in their views of antenatal and delivery care, as decision makers they often encouraged, some even ‘forced’, their wives to attend for antenatal or delivery care. Many reasons why it was beneficial to accompany their wives were provided, yet few did this in practice unless there was a clinical complication. The three main barriers relating to cultural norms identified were: 1) pregnancy support was considered a female role; and the male role that of provider; 2) negative health care worker attitudes towards men’s participation, and 3) couple unfriendly antenatal and delivery unit infrastructure. Conclusion Although men reported to facilitate their wives’ utilisation of antenatal and delivery care services, this does not translate to practice as adherence to antenatal-care schedules and facility based delivery is generally poor. Equally, reasons proffered why they should accompany their wives are not carried through into practice, with barriers outweighing facilitators. Recommendations to improve men involvement and potentially increase services utilisation include awareness campaigns targeting men, exploring promotion of joint HIV testing and counselling, staff training, and design of couple friendly antenatal and delivery units. PMID:23800139

Selection of roosting habitat by forest bats in a diverse forested landscape

Treesearch

Roger W. Perry; Ronald E. Thill; David M. Leslie

2007-01-01

Many studies of roost selection by forest-dwelling bats have concentrated on microhabitat surrounding roosts without providing forest stand level preferences of bats; thus, those studies have provided only part of the information needed by managers. We evaluated diurnal summer roost selection by the bat community at the forest-stand level in a diversely forested...

Nontimber forest products management on national forests in the United States.

Treesearch

Rebecca J. McLain; Eric T. Jones

2005-01-01

This study provides an overview of nontimber forest products (NTFP) programs on national forests in the United States. We conducted an email survey in 2003 to obtain data on NTFP management activities on national forests across the country. Program characteristics examined in the study included important NTFPs managed on national forests, presence of NTFP coordinators...

History of the Penobscot Experimental Forest, 1950-2010

Treesearch

Laura S. Kenefic; John C. Brissette

2014-01-01

Though the U.S. Department of Agriculture, Forest Service has been studying the forests of the northeastern United States since the late 1800s, long-term studies were not common until experimental forests were introduced in the 20th century. These forests were established for long-term experimentation, and research questions were defined by local forest management...

Roads as edges: Effects on birds in forested landscapes

Treesearch

Yvette K. Ortega; David E. Capen

2002-01-01

Numerous studies have documented that forest edges affect habitat use and reproductive success of forest birds, but few studies have considered edges created by narrow breaks in the forest canopy. We compared predation rates on artificial nests placed within forest habitat along edge transects, 10 m from unpaved roads, and along interior transects, 300 m from forest-...

Determinants of maternal health care services utilization in Pakistan: evidence from Pakistan demographic and health survey, 2012-13.

PubMed

Zakar, Rubeena; Zakar, Muhammad Zakria; Aqil, Nauman; Chaudhry, Ashraf; Nasrullah, Muazzam

2017-04-01

The aim of this study was to determine the association between maternal utilisation of health-care services and socio-demographic factors among reproductive-age women in Pakistan. We used the sample of ever-married reproductive-age women (n = 7446) from the Pakistan Demographic and Health Survey (PDHS), 2012-13. We measured maternal utilisation of health-care services by using three dependent variables: number of antenatal care (ANC) visits, delivery assistance by a skilled health provider, and delivery in a health-care facility. Around 36.6% of women had made four or more ANC visits, 59% had received assistance from skilled health providers during delivery, and 55.3% had given birth in a health-care facility. On multivariable logistic regression, all three variables were positively associated with education and wealth, and negatively associated with birth order and women's autonomy. Policymakers and health planners may use our findings to develop efficient strategies, particularly for uneducated women and those with poor economic status, to improve the utilisation of maternal health-care services in Pakistan.

Do quality improvement systems improve health library services? A systematic review.

PubMed

Gray, Hannah; Sutton, Gary; Treadway, Victoria

2012-09-01

A turbulent financial and political climate requires health libraries to be more accountable than ever. Quality improvement systems are widely considered a 'good thing to do', but do they produce useful outcomes that can demonstrate value? To undertake a systematic review to identify which aspects of health libraries are being measured for quality, what tools are being used and what outcomes are reported following utilisation of quality improvement systems. Many health libraries utilise quality improvement systems without translating the data into service improvements. Included studies demonstrate that quality improvement systems produce valuable outcomes including a positive impact on strategic planning, promotion, new and improved services and staff development. No impact of quality improvement systems on library users or patients is reported in the literature. The literature in this area is sparse and requires updating. We recommend further primary research is conducted in health libraries focusing upon the outcomes of utilising quality improvement systems. An exploration of quality improvement systems in other library sectors may also provide valuable insight for health libraries. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

18 Years of Recovery: Spatial Variation and Structure of a Secondary Forest Analyzed with Airborne Lidar Data in the Brazilian Atlantic Forest

NASA Astrophysics Data System (ADS)

dos-Santos, M. N.; Keller, M. M.; Scaranello, M. A., Sr.; Longo, M.; Daniel, P.

2016-12-01

Ongoing forest fragmentation in the tropics severely reduces the ability of remaining forests to store carbon and provide ecosystem services, however, secondary regeneration could offset the impacts of forest degradation. Previous plot-based forest inventory studies have shown that secondary regeneration is promoted at remnant forest edges. However, this process has not been studied at landscape scale. We used over 450 ha of lidar data to study the forest structure and spatial variation of secondary growth forest 18 years after swidden cultivation abandonment in Serra do Conduro State Park. Lidar data was acquired in December 2015 with a density of 93 points per square meter using an airborne scanning laser system (Optech Orion M-300). Serra do Conduru, a 10 000 ha State Park in Bahia was created in 1997 as part of a network of forest reserves with both old-growth forest and secondary forest aiming at establishing a central corridor of the Atlantic forest. The Brazilian Atlantic forest is a highly human modified and fragmented forest landscape reduced to 12.5% of its original extent. Prior to the establishment of the State Park, the area was a mosaic of forest and agricultural area. We created 10m wide buffers from the edge of the remnant forest into the secondary forest and generated lidar metrics for each strip in order to ask: does the distance from the remnant forest create a gradient effect on the secondary forest structure? We cross-compared the lidar metrics of the samples. Results demonstrate that distance from old-growth forest promotes spatial variation in forest recovery and forest structure.

National health insurance subscription and maternal healthcare utilisation across mothers' wealth status in Ghana.

PubMed

Ameyaw, Edward Kwabena; Kofinti, Raymond Elikplim; Appiah, Francis

2017-12-01

This study is against the backdrop that despite the forty-nine percent decline in Maternal Mortality Rate in Ghana, the situation still remains high averaging 319 per 100,000 live births between 2011 and 2015. To examine the relationship between National Health Insurance and maternal healthcare utilisation across three main wealth quintiles (Poor, Middle and Rich). The study employed data from the 2014 Ghana Demographic and Health Survey. Both descriptive analysis and binary logistic regression were conducted. Descriptively, rich women had high antenatal attendance and health facility deliveries represented by 96.5% and 95.6% respectively. However, the binary logistic regression results revealed that poor women owning NHIS are 7% (CI = 1.76-2.87) more likely to make at least four antenatal care visits compared to women in the middle wealth quintile (5%, CI = 2.12-4.76) and rich women (2%, CI = 1.14-4.14). Similarly, poor women who owned the NHIS are 14% (CI = 1.42-2.13) likely to deliver in health facility than women in the middle and rich wealth quintile. The study has vindicated the claim that NHIS Scheme is pro-poor in Ghana. The Ministry of Health should target women in the rural area to be enrolled on the NHIS to improve maternal healthcare utilisation since poverty is principally a rural phenomenon in Ghana.

Long-term forest resilience to climate change indicated by mortality, regeneration, and growth in semiarid southern Siberia.

PubMed

Xu, Chongyang; Liu, Hongyan; Anenkhonov, Oleg A; Korolyuk, Andrey Yu; Sandanov, Denis V; Balsanova, Larisa D; Naidanov, Bulat B; Wu, Xiuchen

2017-06-01

Several studies have documented that regional climate warming and the resulting increase in drought stress have triggered increased tree mortality in semiarid forests with unavoidable impacts on regional and global carbon sequestration. Although climate warming is projected to continue into the future, studies examining long-term resilience of semiarid forests against climate change are limited. In this study, long-term forest resilience was defined as the capacity of forest recruitment to compensate for losses from mortality. We observed an obvious change in long-term forest resilience along a local aridity gradient by reconstructing tree growth trend and disturbance history and investigating postdisturbance regeneration in semiarid forests in southern Siberia. In our study, with increased severity of local aridity, forests became vulnerable to drought stress, and regeneration first accelerated and then ceased. Radial growth of trees during 1900-2012 was also relatively stable on the moderately arid site. Furthermore, we found that smaller forest patches always have relatively weaker resilience under the same climatic conditions. Our results imply a relatively higher resilience in arid timberline forest patches than in continuous forests; however, further climate warming and increased drought could possibly cause the disappearance of small forest patches around the arid tree line. This study sheds light on climate change adaptation and provides insight into managing vulnerable semiarid forests. © 2016 John Wiley & Sons Ltd.

Diversity of Bats in Contrasting Habitats of Hulu Terengganu Dipterocarp Forest and Setiu Wetland BRIS Forest with a Note on Preliminary Study of Vertical Stratification of Pteropodid Bats.

PubMed

Pounsin, Grace; Wahab, Nur Syahirah; Roslan, Azuan; Zahidin, Muhamad Aidil; Pesiu, Elizabeth; Tamrin, Nur Aida Md; Abdullah, M T

2018-03-01

A study of the bat diversity was conducted in Hulu Terengganu dipterocarp forest and Setiu Wetland Beach Ridges Interspersed with Swales (BRIS) forest in Terengganu, to study the species diversity, composition and stratification of fruit bats from the understorey to the forest canopy. Mist nets were set up at the understorey, sub-canopy and canopy layer while harp traps were set up at the understorey layer. We recorded 170 individuals from six families' compromised 21 species from Hulu Terengganu dipterocarp forests and four species from Setiu Wetland BRIS forests throughout the sampling period. Megaerops ecaudatus and Cynopterus brachyotis were the most dominant species in Hulu Terengganu dipterocarp forest and Setiu Wetland BRIS forests. Our study also recorded two species with new distributional records for the east coast of Peninsular Malaysia, namely, Rhinolophus chiewkweeae and Chaerephon johorensis in Hulu Terengganu dipterocarp forests. Potential factors that might influence the results were in terms of the canopy covers, the structural complexity of canopy, food availability and spatial characteristics. This study was able to increase the knowledge on the species diversity and composition of bats in Hulu Terengganu dipterocarp forest and Setiu Wetland BRIS forest, thus, further aid in the effort of bat conservation in both areas.

Effect of active shortening on the rate of ATP utilisation by rabbit psoas muscle fibres

PubMed Central

Sun, Y-B; Hilber, K; Irving, M

2001-01-01

The rate of ATP utilisation during active shortening of single skinned fibres from rabbit psoas muscle at 10 °C was measured using an NADH-linked assay. Fibres were immersed in silicone oil and illuminated with 365 nm light. The amounts of NADH and carboxytetramethylrhodamine (CTMR) in the illuminated region of the fibre were measured simultaneously from fluorescence emission at 425–475 and 570–650 nm, respectively. The ratio of these two signals was used to determine the intracellular concentration of NADH, and thus the ATP utilisation, without interference from movements of the fibre with respect to the measuring light beam. The total extra ATP utilisation due to shortening (ΔATP) was determined by extrapolation of the steady isometric rates before and after shortening to the mid-point of the shortening period. ΔATP had a roughly linear dependence on the extent of shortening in the range 1–15% fibre length (L0) at a shortening velocity of 0.4 L0 s−1 from initial sarcomere length 2.7 μm. For shortening of 1%L0, ΔATP was 21 ± 1 μm (mean ±s.e.m., n = 3). The mean rate of ATP utilisation during ramp shortening of 10%L0 had a roughly linear dependence on shortening velocity in the range 0.05–1.2 L0 s−1. During unloaded shortening at 1.2 L0 s−1 the mean rate of ATP utilisation was 1.7 mm s−1, about 9 times the isometric rate. ΔATP was roughly independent of shortening velocity, and was 84 ± 9 μm (mean ±s.e.m., n = 6) for shortening of 10%L0. The implications of these results for mechanical-chemical coupling in muscle are discussed. The total ATP utilisation associated with shortening of 1%L0 is only about 17% of the concentration of the myosin heads in the fibre, suggesting that during isometric contraction either less than 17% of the myosin heads are attached to actin, or that heads can detach without commitment to ATP splitting. The fraction of myosin heads attached to actin during unloaded shortening is estimated from the rate of ATP utilisation to be less than 7%. PMID:11251058

The use of standardised short-term and working memory tests in aphasia research: a systematic review

PubMed Central

Murray, Laura; Salis, Christos; Martin, Nadine; Dralle, Jenny

2017-01-01

Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures. PMID:27143500

Utilisation of community pharmacists by the general public in Malaysia.

PubMed

Chua, Siew Siang; Lim, Kien Ping; Lee, Hong Gee

2013-02-01

The study was conducted to assess how the general public in the Klang Valley, Malaysia, utilised community pharmacists. This was a prospective observational study which documented interactions between community pharmacists and their customers. A researcher was stationed in 10 participating community pharmacies around the Klang Valley to observe and record all the interactions, using a structured data-collection form. KEYS FINDINGS: Interactions between 1914 customers and the pharmacists of the 10 community pharmacies were recorded. A total of 2199 requests were made by these customers. The main types of request were for medications by brand name (32.2%), advice on minor health problems (25.9%) and for health supplements (11.7%). Only 65 prescriptions were received by the community pharmacies; that is, fewer than two prescriptions per pharmacy per day. The pharmacists provided counselling for only 54.4% of the requests where a medication or health supplement was dispensed. Counselling by pharmacist was significantly associated with the type of request (P < 0.001). The main reason for the general public to visit a community pharmacy in Malaysia was to purchase a particular medication. Few prescriptions were filled at community pharmacies in Malaysia, indicating the under-utilisation of community pharmacists as a safety net for prescribed medications in primary care. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Effects of a co-financed interdisciplinary collaboration model in primary health care on service utilisation among patients with musculoskeletal disorders.

PubMed

Hultberg, Eva-Lisa; Lönnroth, Knut; Allebeck, Peter

2007-01-01

In 1994 Sweden introduced a trial legislation allowing co-financing between authorities. The legislation aimed to stimulate new ways of collaboration between health and social care providers. One of the specific objectives was to make management of patients with conditions requiring multidisciplinary care more efficient and reduce costs. This study aims to assess if there were any differences in management of patients with musculoskeletal disorders at health centres applying the trial legislation compared to health centre with conventional care with regards to health services utilisation, health care interventions received, and costs. A comparative prospective study was conducted. Consecutive patients aged 16-64 with musculoskeletal disorders attending the health care centres with (n=107) and without (n=31) co-financing model were interviewed at inclusion and after 6 and 12 months. Number of contacts with professionals and interventions received were registered. Patients at the intervention centres had significantly more contact with physiotherapists and physicians than the controls. Contacts with other services such as social insurance office, social services office or hospitals did not differ significantly between the groups. Costs were higher for the interventions centres. The findings do not suggest that the trial legislation reduced health care utilisation or costs for patients with musculoskeletal disorders.

The use of standardised short-term and working memory tests in aphasia research: a systematic review.

PubMed

Murray, Laura; Salis, Christos; Martin, Nadine; Dralle, Jenny

2018-04-01

Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures.

Forest Service National Forest System perceptions of law enforcement and investigations: nationwide study

Treesearch

Deborah J. Chavez; Joanne F. Tynon

2008-01-01

This is the fifth in a series of studies to evaluate perceptions of the roles, responsibilities, and issues entailed in the jobs of U.S. Department of Agriculture Forest Service law enforcement and investigations (LEI) personnel. An e-mail survey was administered to the 537 Forest Service forest supervisors and district rangers (National Forest System [NFS] line...

Examining the Role of Voluntary Associations in Environmental Management: The Case of the Sam Houston National Forest

NASA Astrophysics Data System (ADS)

Lu, Jiaying; Schuett, Michael A.

2012-02-01

The purpose of this study was to gain a better understanding of voluntary associations involved in forest management. The specific areas examined in this study include organizational attributes, membership profile, attitudes toward forest-management priorities, and concerns about forest-management issues. To achieve this purpose, data were collected using a case study approach with mixed-methods (document reviews, personal interviews, and a Web survey) at a national forest in Texas, USA. Overall, the voluntary associations in this study can be described as place-based, small to moderate in scale, activity-oriented, and active groups that are adaptive to sociopolitical and environmental changes. General group members placed high importance on aesthetic, ecological, and recreation management of the national forest. In addition, this study showed five key forest management issues: (1) limited recreation access; (2) financial challenges for forest management; (3) conflict among recreation user groups; (4) inadequate communication by the United States Forest Service to the general public, and (5) sustainability of the forest. Theoretical and managerial implications of the results are discussed.

Edge and area effects on the occurrence of migrant forest songbirds

USGS Publications Warehouse

Parker, T.H.; Stansberry, B.M.; Becker, C.D.; Gipson, P.S.

2005-01-01

Concerns about forest fragmentation and its conservation implications have motivated numerous studies that investigate the influence of forest patch area and forest edge on songbird distribution patterns. The generalized effects of forest patch size and forest edge on animal distributions is still debatable because forest patch size and forest edge are often confounded and because of an incomplete synthesis of available data. To fill a portion of this gap, we incorporated all available published data (33 papers) in meta-analyses of forest edge and area effects on site occupancy patterns for 26 Neotropical migrant forest-nesting songbirds in eastern North America. All reported area effects are confounded or potentially confounded by edge effects, and we refer to these as "confounded" studies. The converse, however, is not true and most reported edge effects are independent of patch area. When considering only nonconfounded studies of edge effects, only 1 of 17 species showed significant edge avoidance and 3 had significant affinity for edges. In confounded studies, 12 of 22 species showed significant avoidance of small patches and edges, and 1 had an affinity for small patches and edges. Furthermore, average effect sizes averaged across studies or species tended to be higher for confounded studies than for edge studies. We discuss three possible reasons for differences in results between these two groups of studies. First, studies of edge effects tended to be carried out in landscapes with greater forest cover than studies of confounded effects; among confounded effects studies, as forest cover increased, we observed a nonsignificant trend towards decreasing strength of small patch or edge avoidance effects. Thus, the weaker effects in edge studies may be due to the fact that these studies were conducted in forest-dominated landscapes. Second, we may have detected strong effects only in confounded studies because area effects are much stronger than edge effects on bird occurrence, and area effects drive the results in confounded studies. Third, edge and area effects may interact in such a way that edge effects become more important as forest patch size decreases; thus, both edge and area effects are responsible for results in confounded studies. These three explanations cannot be adequately separated with existing data. Regardless, it is clear that fragmentation of forests into small patches is detrimental to many migrant songbird species. ??2005 Society for Conservation Biology.

Evaluation of the cosmic-ray neutron method for measuring integral soil moisture dynamics of a forested head water catchment

NASA Astrophysics Data System (ADS)

Bogena, H. R.; Metzen, D.; Baatz, R.; Hendricks Franssen, H.; Huisman, J. A.; Montzka, C.; Vereecken, H.

2011-12-01

Measurements of low-energy secondary neutron intensity above the soil surface by cosmic-ray soil moisture probes (CRP) can be used to estimate soil moisture content. CRPs utilise the fact that high-energy neutrons initiated by cosmic rays are moderated (slowed to lower energies) most effectively by collisions with hydrogen atoms contained in water molecules in the soil. The conversion of neutron intensity to soil moisture content can potentially be complicated because neutrons are also moderated by aboveground water storage (e.g. vegetation water content, canopy storage of interception). Recently, it was demonstrated experimentally that soil moisture content derived from CRP measurements agrees well with average moisture content from gravimetric soil samples taken within the footprint of the cosmic ray probe, which is proposed to be up to several hundred meters in size [1]. However, the exact extension and shape of the CRP integration footprint is still an open question and it is also unclear how CRP measurements are affected by the soil moisture distribution within the footprint both in horizontal and vertical directions. In this paper, we will take advantage of an extensive wireless soil moisture sensor network covering most of the estimated footprint of the CRP. The network consists of 150 nodes and 900 soil moisture sensors which were installed in the small forested Wüstebach catchment (~27 ha) in the framework of the Transregio32 and the Helmholtz initiative TERENO (Terrestrial Environmental Observatories) [2]. This unique soil moisture data set provides a consistent picture of the hydrological status of the catchment in a high spatial and temporal resolution and thus the opportunity to evaluate the CRP measurements in a rigorous way. We will present first results of the comparison with a specific focus on the sensitivity of the CRP measurements to soil moisture variation in both the horizontal and vertical direction. Furthermore, the influence of forest biomass and shallow groundwater table fluctuations on the attenuation of cosmic-ray neutrons will be considered.

Exploring the floristic diversity of tropical Africa.

PubMed

Sosef, Marc S M; Dauby, Gilles; Blach-Overgaard, Anne; van der Burgt, Xander; Catarino, Luís; Damen, Theo; Deblauwe, Vincent; Dessein, Steven; Dransfield, John; Droissart, Vincent; Duarte, Maria Cristina; Engledow, Henry; Fadeur, Geoffrey; Figueira, Rui; Gereau, Roy E; Hardy, Olivier J; Harris, David J; de Heij, Janneke; Janssens, Steven; Klomberg, Yannick; Ley, Alexandra C; Mackinder, Barbara A; Meerts, Pierre; van de Poel, Jeike L; Sonké, Bonaventure; Stévart, Tariq; Stoffelen, Piet; Svenning, Jens-Christian; Sepulchre, Pierre; Zaiss, Rainer; Wieringa, Jan J; Couvreur, Thomas L P

2017-03-07

Understanding the patterns of biodiversity distribution and what influences them is a fundamental pre-requisite for effective conservation and sustainable utilisation of biodiversity. Such knowledge is increasingly urgent as biodiversity responds to the ongoing effects of global climate change. Nowhere is this more acute than in species-rich tropical Africa, where so little is known about plant diversity and its distribution. In this paper, we use RAINBIO - one of the largest mega-databases of tropical African vascular plant species distributions ever compiled - to address questions about plant and growth form diversity across tropical Africa. The filtered RAINBIO dataset contains 609,776 georeferenced records representing 22,577 species. Growth form data are recorded for 97% of all species. Records are well distributed, but heterogeneous across the continent. Overall, tropical Africa remains poorly sampled. When using sampling units (SU) of 0.5°, just 21 reach appropriate collection density and sampling completeness, and the average number of records per species per SU is only 1.84. Species richness (observed and estimated) and endemism figures per country are provided. Benin, Cameroon, Gabon, Ivory Coast and Liberia appear as the botanically best-explored countries, but none are optimally explored. Forests in the region contain 15,387 vascular plant species, of which 3013 are trees, representing 5-7% of the estimated world's tropical tree flora. The central African forests have the highest endemism rate across Africa, with approximately 30% of species being endemic. The botanical exploration of tropical Africa is far from complete, underlining the need for intensified inventories and digitization. We propose priority target areas for future sampling efforts, mainly focused on Tanzania, Atlantic Central Africa and West Africa. The observed number of tree species for African forests is smaller than those estimated from global tree data, suggesting that a significant number of species are yet to be discovered. Our data provide a solid basis for a more sustainable management and improved conservation of tropical Africa's unique flora, and is important for achieving Objective 1 of the Global Strategy for Plant Conservation 2011-2020. In turn, RAINBIO provides a solid basis for a more sustainable management and improved conservation of tropical Africa's unique flora.

Investigating Surface and Near-Surface Bushfire Fuel Attributes: A Comparison between Visual Assessments and Image-Based Point Clouds

PubMed Central

Spits, Christine; Wallace, Luke; Reinke, Karin

2017-01-01

Visual assessment, following guides such as the Overall Fuel Hazard Assessment Guide (OFHAG), is a common approach for assessing the structure and hazard of varying bushfire fuel layers. Visual assessments can be vulnerable to imprecision due to subjectivity between assessors, while emerging techniques such as image-based point clouds can offer land managers potentially more repeatable descriptions of fuel structure. This study compared the variability of estimates of surface and near-surface fuel attributes generated by eight assessment teams using the OFHAG and Fuels3D, a smartphone method utilising image-based point clouds, within three assessment plots in an Australian lowland forest. Surface fuel hazard scores derived from underpinning attributes were also assessed. Overall, this study found considerable variability between teams on most visually assessed variables, resulting in inconsistent hazard scores. Variability was observed within point cloud estimates but was, however, on average two to eight times less than that seen in visual estimates, indicating greater consistency and repeatability of this method. It is proposed that while variability within the Fuels3D method may be overcome through improved methods and equipment, inconsistencies in the OFHAG are likely due to the inherent subjectivity between assessors, which may be more difficult to overcome. This study demonstrates the capability of the Fuels3D method to efficiently and consistently collect data on fuel hazard and structure, and, as such, this method shows potential for use in fire management practices where accurate and reliable data is essential. PMID:28425957

[A review on fundamental studies of secondary forest management].

PubMed

Zhu, Jiaojun

2002-12-01

Secondary forest is also called as natural secondary forest, which regenerates on native forest that has been disturbed by severe natural or anthropogenic disturbances. The structural and dynamic organizations, growth, productivity and stand environment of secondary forests are significantly different from those of natural and artificial forests. Such significant differences make secondary forests have their own special characteristics in forestry. Secondary forests are the main body of forests in China. Therefore, their management plays a very important role in the projects of natural forest conservation and the construction of ecological environment in China or in the world. Based on a wide range of literature collection on secondary forest research, the fundamental studies of secondary forest management were discussed. The major topics are as follows: 1) basic characteristics of secondary forest, 2) principles of secondary forest management, 3) types of secondary forest, 4) community structure and succession dynamics of secondary forest, including niches, biodiversity, succession and so on, 5) main ecological processes of secondary forest, including regeneration, forest soil and forest environment. Additionally, the research needs and tendency related to secondary forest in the future were also given, based on the analyses of the main results and the problems in current management of secondary forest. The review may be helpful to the research of secondary forest management, and to the projects of natural forest conservation in China.

Life-cycle energy impacts for adapting an urban water supply system to droughts.

PubMed

Lam, Ka Leung; Stokes-Draut, Jennifer R; Horvath, Arpad; Lane, Joe L; Kenway, Steven J; Lant, Paul A

2017-12-15

In recent years, cities in some water stressed regions have explored alternative water sources such as seawater desalination and potable water recycling in spite of concerns over increasing energy consumption. In this study, we evaluate the current and future life-cycle energy impacts of four alternative water supply strategies introduced during a decade-long drought in South East Queensland (SEQ), Australia. These strategies were: seawater desalination, indirect potable water recycling, network integration, and rainwater tanks. Our work highlights the energy burden of alternative water supply strategies which added approximately 24% life-cycle energy use to the existing supply system (with surface water sources) in SEQ even for a current post-drought low utilisation status. Over half of this additional life-cycle energy use was from the centralised alternative supply strategies. Rainwater tanks contributed an estimated 3% to regional water supply, but added over 10% life-cycle energy use to the existing system. In the future scenario analysis, we compare the life-cycle energy use between "Normal", "Dry", "High water demand" and "Design capacity" scenarios. In the "Normal" scenario, a long-term low utilisation of the desalination system and the water recycling system has greatly reduced the energy burden of these centralised strategies to only 13%. In contrast, higher utilisation in the unlikely "Dry" and "Design capacity" scenarios add 86% and 140% to life-cycle energy use of the existing system respectively. In the "High water demand" scenario, a 20% increase in per capita water use over 20 years "consumes" more energy than is used by the four alternative strategies in the "Normal" scenario. This research provides insight for developing more realistic long-term scenarios to evaluate and compare life-cycle energy impacts of drought-adaptation infrastructure and regional decentralised water sources. Scenario building for life-cycle assessments of water supply systems should consider i) climate variability and, therefore, infrastructure utilisation rate, ii) potential under-utilisation for both installed centralised and decentralised sources, and iii) the potential energy penalty for operating infrastructure well below its design capacity (e.g., the operational energy intensity of the desalination system is three times higher at low utilisation rates). This study illustrates that evaluating the life-cycle energy use and intensity of these type of supply sources without considering their realistic long-term operating scenario(s) can potentially distort and overemphasise their energy implications. To other water stressed regions, this work shows that managing long-term water demand is also important, in addition to acknowledging the energy-intensive nature of some alternative water sources. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predicting hydrological response to forest changes by simple statistical models: the selection of the best indicator of forest changes with a hydrological perspective

NASA Astrophysics Data System (ADS)

Ning, D.; Zhang, M.; Ren, S.; Hou, Y.; Yu, L.; Meng, Z.

2017-01-01

Forest plays an important role in hydrological cycle, and forest changes will inevitably affect runoff across multiple spatial scales. The selection of a suitable indicator for forest changes is essential for predicting forest-related hydrological response. This study used the Meijiang River, one of the headwaters of the Poyang Lake as an example to identify the best indicator of forest changes for predicting forest change-induced hydrological responses. Correlation analysis was conducted first to detect the relationships between monthly runoff and its predictive variables including antecedent monthly precipitation and indicators for forest changes (forest coverage, vegetation indices including EVI, NDVI, and NDWI), and by use of the identified predictive variables that were most correlated with monthly runoff, multiple linear regression models were then developed. The model with best performance identified in this study included two independent variables -antecedent monthly precipitation and NDWI. It indicates that NDWI is the best indicator of forest change in hydrological prediction while forest coverage, the most commonly used indicator of forest change is insignificantly related to monthly runoff. This highlights the use of vegetation index such as NDWI to indicate forest changes in hydrological studies. This study will provide us with an efficient way to quantify the hydrological impact of large-scale forest changes in the Meijiang River watershed, which is crucial for downstream water resource management and ecological protection in the Poyang Lake basin.

Quantifying edge effect extent and its impacts on carbon stocks across a degraded landscape in the Amazon using airborne lidar.

NASA Astrophysics Data System (ADS)

dos-Santos, M. N.; Keller, M.; Morton, D. C.; Longo, M.; Scaranello, M. A., Sr.; Pinagé, E. R.; Correa Pabon, R.

2017-12-01

Ongoing tropical forest degradation and forest fragmentation increases forest edge area. Forest edges experience hotter, drier, and windier conditions and greater exposure to fires compared to interior areas, which elevate rates of tree mortality. Previous studies have suggested that forests within 100 m from the edge may lose 36% of biomass during the first two decades following fragmentation, although such estimates are based on a limited number of experimental plots. Degraded forests behave differently from intact forests and quantifying edge effect extension in a degraded forest landscape is more challenging compared to experimental studies. To overcome these limitations, we used airborne lidar data to quantify changes in forest structure near 91 edges in a heavily degraded tropical forest in Paragominas Municipality, eastern Brazilian Amazon. Paragominas was a center of timber production in the 1990s. Today, the landscape is a mosaic of different agricultural uses, degraded, secondary and unmanaged forests. A total of 3000 ha of high density (mean density of 17.9 points/m2) lidar data were acquired in August/September 2013 and June/July 2014 over 30 transects (200 x 5000m), systematically distributed over the study area, using the Optech Orion M-200 laser scanning system. We adopted lidar-measured forest heights as the edge effect criteria and found that mean extent of edge effect was highly variable across degraded forests (150 ± 354m) and secondary forest fragments (265 ± 365m). We related the extent of forest edges to the historical disturbances identified in Landsat imagery since 1984. Contrary to previous studies, we found that carbon stocks along forest edges were not significantly lower than forest core biomass when edges were defined by previously estimated range of 100 and 300m. In frontier forests, ecological edge effect may be masked by the cumulative impact of historic forest degradation - an anthropogenic edge effect that extends beyond the scale of changes in forest microclimate from fragmentation.

Evaluating the suitability of planted forests for African forest monkeys: a case study from Kakamega forest, Kenya.

PubMed

Fashing, Peter J; Nguyen, Nga; Luteshi, Patrick; Opondo, Winstone; Cash, Julie F; Cords, Marina

2012-01-01

As natural forest cover declines, planted forests have come to occupy an increasing percentage of the earth's surface, yet we know little about their suitability as alternative habitat for wildlife. Although some primate species use planted forests, few studies have compared primate populations in natural and nearby planted forests. From March 2006 to July 2010, we conducted line transect surveys and assessed group sizes and compositions in natural and nearby 60-70 year old mixed indigenous planted forest to determine the densities of diurnal primate species (Colobus guereza, Cercopithecus mitis, C. ascanius) in these two forest types at Isecheno, Kakamega Forest, Kenya. Line transect data were analyzed using the Encounter Rate, Whitesides, and Distance sampling methods, which all provided broadly consistent results. We found that all three diurnal primate species occupy both natural and planted forest at Isecheno. However, group densities of the two Cercopithecus species were 42-46% lower in planted than in natural forest. Colobus guereza achieved comparable group densities in the two forest types, although the species is found in smaller groups, and thus at lower (35%) individual density, in planted than in natural forest. Following a logging episode in the planted forest mid-way through our study, Cercopithecus ascanius group densities fell by 60% while C. mitis and Colobus guereza group densities remained stable over the next two years. Overall, our results suggest that while primate species vary in their response to habitat disturbance, planted forest has the potential to contribute to the conservation of some African monkey species. Even for the relatively flexible taxa in our study, however, 60-70 year old mixed indigenous planted forest failed to support densities comparable to those in nearby natural forest. From the perspective of Kakamega's primates, planted forests may supplement natural forest, but are not an adequate replacement for it. © 2011 Wiley Periodicals, Inc.

The Missouri Ozark Forest Ecosystem Project: the effects of forest management on the forest ecosystem

Treesearch

Brian Brookshire; Carl Hauser

1993-01-01

The effects of forest management on non-timber resources are of growing concern to forest managers and the public. While many previous studies have reported effects of stand-level treatments (less than 15 ha) on various stand-level attributes, few studies have attempted to document the influence of forest management on the biotic and abiotic characteristics of entire...

An Overview of Hydrologic Studies at Center for Forested Wetlands Research, USDA Forest Service

Treesearch

Devendra M. Amatya; Carl C. Trettin; R. Wayne Skaggs; Timothy J. Callahan; Ge Sun; Masato Miwa; John E. Parsons

2004-01-01

Managing forested wetland landscapes for water quality improvement and productivity requires a detailed understanding of functional linkages between ecohydrological processes and management practices. Studies are being conducted at Center for Forested Wetlands Research (CFWR), USDA Forest Service to understand the fundamental hydrologic and biogeochemical processes...

Development of nanostructured PVD coatings for total knee replacement joints using HIPIMS

NASA Astrophysics Data System (ADS)

Sugumaran, Arunprabhu A.

The aim of this study was to develop thin film coatings for total knee replacement joints using high power impulse magnetron sputtering (HIPIMS). An industrial size four cathode magnetron sputtering system equipped with direct current (DC) and HIPIMS power supplies was used for this purpose. Initially, Plasma diagnostics were carried out using optical emission spectroscopy (OES) while sputtering Ti target in Ar + N2 atmosphere by utilizing various HIP IMS/conventional DCMS (henceforth UBM) source combinations by varying the process parameters such as coil current and N2 flow. Then, single layer titanium nitride (TiN) coating was deposited by varying the degree of HIPIMS utilisation and the process parameters such as bias voltage and coil current to thoroughly understand the effect of degree of HIPIMS utilisation on the microstructure, residual stress, texture, mechanical, tribological and corrosion properties of such coatings. The degree of HIPIMS utilisation was altered by increasing the number of HIPIMS targets used for the deposition. Four different source combinations were used for this purpose, as follows: 4 cathodes in conventional DCMS mode to deposit pure UBM coating, 1 HIPIMS + 3UBM and 2HIPIMS + 2UBM cathodes to deposit combined HIPIMS/UBM coatings and 2HIPIMS cathodes to deposit pure HIPIMS coatings. TiN/NbN, TiCN/NbCN and CrN/NbN multilayer coatings were deposited on CoCr alloy test buttons along with other (HSS, SS and Si) substrates since our intended application is on total knee replacement joints made of CoCr alloy. The knowledge gained by investigating the TiN (Ar + N[2]) plasma and the properties of TiN was used to determine the process parameters for depositing the multilayer coatings. X- ray diffraction (XRD) technique was used for calculating the texture, residual stress and bilayer thickness of the coatings. Nanoindentation method was used to determine the nano hardness of the coatings. The adhesion strength of the coatings was estimated by scratch and Rockwell indentation tests. Pin on disc method was used for the tribological studies such as coefficient of friction and coefficient of wear. Surface roughness measurements were carried out using a surface profiler. Microstructural characterisation of the coatings was carried out using scanning electron microscope (SEM) and transmission electron microscope (TEM). Potentiodynamic polarisation method was utilised to study the corrosion performance of the coatings. Raman spectroscopy was used to study the constituents of the corrosion products and evaluate the corrosion damage. OES measurements revealed that the degree of metal ions (Ti[1+]) increased with increasing degree of HIPIMS utilisation. The hardness, tribological and corrosion properties of TiN coatings improved with increasing degree of HIPIMS utilisation. TiN and multilayer coatings deposited by HIPIMS exhibited a smooth columnar microstructure without any voided region along the column boundaries. TiN/NbN, TiCN/NbCN and CrN/NbN multilayer coatings deposited on CoCr alloy, HSS and SS test buttons exhibited superior mechanical, tribological and corrosion properties as compared to the underlying substrate.

Estimates of Forest Biomass Carbon Storage in Liaoning Province of Northeast China: A Review and Assessment

PubMed Central

Yu, Dapao; Wang, Xiaoyu; Yin, You; Zhan, Jinyu; Lewis, Bernard J.; Tian, Jie; Bao, Ye; Zhou, Wangming; Zhou, Li; Dai, Limin

2014-01-01

Accurate estimates of forest carbon storage and changes in storage capacity are critical for scientific assessment of the effects of forest management on the role of forests as carbon sinks. Up to now, several studies reported forest biomass carbon (FBC) in Liaoning Province based on data from China's Continuous Forest Inventory, however, their accuracy were still not known. This study compared estimates of FBC in Liaoning Province derived from different methods. We found substantial variation in estimates of FBC storage for young and middle-age forests. For provincial forests with high proportions in these age classes, the continuous biomass expansion factor method (CBM) by forest type with age class is more accurate and therefore more appropriate for estimating forest biomass. Based on the above approach designed for this study, forests in Liaoning Province were found to be a carbon sink, with carbon stocks increasing from 63.0 TgC in 1980 to 120.9 TgC in 2010, reflecting an annual increase of 1.9 TgC. The average carbon density of forest biomass in the province has increased from 26.2 Mg ha−1 in 1980 to 31.0 Mg ha−1 in 2010. While the largest FBC occurred in middle-age forests, the average carbon density decreased in this age class during these three decades. The increase in forest carbon density resulted primarily from the increased area and carbon storage of mature forests. The relatively long age interval in each age class for slow-growing forest types increased the uncertainty of FBC estimates by CBM-forest type with age class, and further studies should devote more attention to the time span of age classes in establishing biomass expansion factors for use in CBM calculations. PMID:24586881

Estimates of forest biomass carbon storage inLiaoning Province of Northeast China: a review and assessment.

PubMed

Yu, Dapao; Wang, Xiaoyu; Yin, You; Zhan, Jinyu; Lewis, Bernard J; Tian, Jie; Bao, Ye; Zhou, Wangming; Zhou, Li; Dai, Limin

2014-01-01

Accurate estimates of forest carbon storage and changes in storage capacity are critical for scientific assessment of the effects of forest management on the role of forests as carbon sinks. Up to now, several studies reported forest biomass carbon (FBC) in Liaoning Province based on data from China's Continuous Forest Inventory, however, their accuracy were still not known. This study compared estimates of FBC in Liaoning Province derived from different methods. We found substantial variation in estimates of FBC storage for young and middle-age forests. For provincial forests with high proportions in these age classes, the continuous biomass expansion factor method (CBM) by forest type with age class is more accurate and therefore more appropriate for estimating forest biomass. Based on the above approach designed for this study, forests in Liaoning Province were found to be a carbon sink, with carbon stocks increasing from 63.0 TgC in 1980 to 120.9 TgC in 2010, reflecting an annual increase of 1.9 TgC. The average carbon density of forest biomass in the province has increased from 26.2 Mg ha(-1) in 1980 to 31.0 Mg ha(-1) in 2010. While the largest FBC occurred in middle-age forests, the average carbon density decreased in this age class during these three decades. The increase in forest carbon density resulted primarily from the increased area and carbon storage of mature forests. The relatively long age interval in each age class for slow-growing forest types increased the uncertainty of FBC estimates by CBM-forest type with age class, and further studies should devote more attention to the time span of age classes in establishing biomass expansion factors for use in CBM calculations.

Assessment and monitoring of long-term forest cover changes in Odisha, India using remote sensing and GIS.

PubMed

Reddy, C Sudhakar; Jha, C S; Dadhwal, V K

2013-05-01

Deforestation and fragmentation are important concerns in managing and conserving tropical forests and have global significance. In the Indian context, in the last one century, the forests have undergone significant changes due to several policies undertaken by government as well as increased population pressure. The present study has brought out spatiotemporal changes in forest cover and variation in forest type in the state of Odisha (Orissa), India, during the last 75 years period. The mapping for the period of 1924-1935, 1975, 1985, 1995 and 2010 indicates that the forest cover accounts for 81,785.6 km(2) (52.5 %), 56,661.1 km(2) (36.4 %), 51,642.3 km(2) (33.2 %), 49,773 km(2) (32 %) and 48,669.4 km(2) (31.3 %) of the study area, respectively. The study found the net forest cover decline as 40.5 % of the total forest and mean annual rate of deforestation as 0.69 % year(-1) during 1935 to 2010. There is a decline in annual rate of deforestation during 1995 to 2010 which was estimated as 0.15 %. Forest type-wise quantitative loss of forest cover reveals large scale deforestation of dry deciduous forests. The landscape analysis shows that the number of forest patches (per 1,000) are 2.463 in 1935, 10.390 in 1975, 11.899 in 1985, 12.193 in 1995 and 15.102 in 2010, which indicates high anthropogenic pressure on the forests. The mean patch size (km(2)) of forest decreased from 33.2 in 1935 to 5.5 in 1975 and reached to 3.2 by 2010. The study demonstrated that monitoring of long term forest changes, quantitative loss of forest types and landscape metrics provides critical inputs for management of forest resources.

Integrating a process-based ecosystem model with Landsat imagery to assess impacts of forest disturbance on terrestrial carbon dynamics: Case studies in Alabama and Mississippi

DOE PAGES

Chen, Guangsheng; Tian, Hanqin; Huang, Chengquan; ...

2013-07-01

Forest ecosystems in the southern United States are dramatically altered by three major disturbances: timber harvesting, hurricane, and permanent land conversion. Understanding and quantifying effects of disturbance on forest carbon, nitrogen, and water cycles is critical for sustainable forest management in this region. In this study, we introduced a process-based ecosystem model for simulating forest disturbance impacts on ecosystem carbon, nitrogen, and water cycles. Based on forest mortality data classified from Landsat TM/ETM + images, this model was then applied to estimate changes in carbon storage using Mississippi and Alabama as a case study. Mean annual forest mortality rate formore » these states was 2.37%. Due to frequent disturbance, over 50% of the forest land in the study region was less than 30 years old. Forest disturbance events caused a large carbon source (138.92 Tg C, 6.04 Tg C yr -1; 1 Tg = 10 12 g) for both states during 1984–2007, accounting for 2.89% (4.81% if disregard carbon storage changes in wood products) of the total forest carbon storage in this region. Large decreases and slow recovery of forest biomass were the main causes for carbon release. Forest disturbance could result in a carbon sink in few areas if wood product carbon was considered as a local carbon pool, indicating the importance of accounting for wood product carbon when assessing forest disturbance effects. The legacy effects of forest disturbance on ecosystem carbon storage could last over 50 years. Lastly, this study implies that understanding forest disturbance impacts on carbon dynamics is of critical importance for assessing regional carbon budgets.« less

Litterfall production along successional and altitudinal gradients of subtropical monsoon evergreen broadleaved forests in Guangdong, China

USGS Publications Warehouse

Zhou, G.; Guan, L.; Wei, X.; Zhang, Dongxiao; Zhang, Q.; Yan, J.; Wen, D.; Liu, J.; Liu, S.; Huang, Z.; Kong, G.; Mo, J.; Yu, Q.

2007-01-01

Evaluation of litterfall production is important for understanding nutrient cycling, forest growth, successional pathways, and interactions with environmental variables in forest ecosystems. Litterfall was intensively studied during the period of 1982-2001 in two subtropical monsoon vegetation gradients in the Dinghushan Biosphere Reserve, Guangdong Province, China. The two gradients include: (1) a successional gradient composed of pine forest (PF), mixed pine and broadleaved forest (MF) and monsoon evergreen broadleaved forest (BF), and (2) an altitudinal gradient composed of Baiyunci ravine rain forest (BRF), Qingyunci ravine rain forest (QRF), BF and mountainous evergreen broadleaved forest (MMF). Mean annual litterfall production was 356, 861 and 849 g m-2 for PF, MF and BF of the successional gradient, and 1016, 1061, 849 and 489 g m-2 for BRF, QRF, BF and MMF of the altitudinal gradient, respectively. As expected, mean annual litterfall of the pioneer forest PF was the lowest, but rapidly increased over the observation period while those in other forests were relatively stable, confirming that forest litterfall production is closely related to successional stages and growth patterns. Leaf proportions of total litterfall in PF, MF, BF, BRF, QRF and MMF were 76.4%, 68.4%, 56.8%, 55.7%, 57.6% and 69.2%, respectively, which were consistent with the results from studies in other evergreen broadleaved forests. Our analysis on litterfall monthly distributions indicated that litterfall production was much higher during the period of April to September compared to other months for all studied forest types. Although there were significant impacts of some climate variables (maximum and effective temperatures) on litterfall production in some of the studied forests, the mechanisms of how climate factors (temperature and rainfall) interactively affect litterfall await further study. ?? 2006 Springer Science+Business Media B.V.

Diversity of Bats in Contrasting Habitats of Hulu Terengganu Dipterocarp Forest and Setiu Wetland BRIS Forest with a Note on Preliminary Study of Vertical Stratification of Pteropodid Bats

PubMed Central

Pounsin, Grace; Wahab, Nur Syahirah; Roslan, Azuan; Zahidin, Muhamad Aidil; Pesiu, Elizabeth; Tamrin, Nur Aida Md; Abdullah, M T

2018-01-01

A study of the bat diversity was conducted in Hulu Terengganu dipterocarp forest and Setiu Wetland Beach Ridges Interspersed with Swales (BRIS) forest in Terengganu, to study the species diversity, composition and stratification of fruit bats from the understorey to the forest canopy. Mist nets were set up at the understorey, sub-canopy and canopy layer while harp traps were set up at the understorey layer. We recorded 170 individuals from six families’ compromised 21 species from Hulu Terengganu dipterocarp forests and four species from Setiu Wetland BRIS forests throughout the sampling period. Megaerops ecaudatus and Cynopterus brachyotis were the most dominant species in Hulu Terengganu dipterocarp forest and Setiu Wetland BRIS forests. Our study also recorded two species with new distributional records for the east coast of Peninsular Malaysia, namely, Rhinolophus chiewkweeae and Chaerephon johorensis in Hulu Terengganu dipterocarp forests. Potential factors that might influence the results were in terms of the canopy covers, the structural complexity of canopy, food availability and spatial characteristics. This study was able to increase the knowledge on the species diversity and composition of bats in Hulu Terengganu dipterocarp forest and Setiu Wetland BRIS forest, thus, further aid in the effort of bat conservation in both areas. PMID:29644015

A systematic review of health status, health seeking behaviour and healthcare utilisation of low socioeconomic status populations in urban Singapore.

PubMed

Chan, Catherine Qiu Hua; Lee, Kheng Hock; Low, Lian Leng

2018-04-02

It is well-established that low socioeconomic status (SES) influences one's health status, morbidity and mortality. Housing type has been used as an indicator of SES and social determinant of health in some studies. In Singapore, home ownership is among the highest in the world. Citizens who have no other housing options are offered heavily subsidised rental housings. Residents staying in such rental housings are characterised by low socioeconomic status. Our aim is to review studies on the association between staying in public rental housing in Singapore and health status. A PubMed and Scopus search was conducted in January 2017 to identify suitable articles published from 1 January 2000 to 31 January 2017. Only studies that were done on Singapore public rental housing communities were included for review. A total of 14 articles including 4 prospective studies, 8 cross-sectional studies and 2 retrospective cohort studies were obtained for the review. Topics addressed by these studies included: (1) Health status; (2) Health seeking behaviour; (3) Healthcare utilisation. Staying in public rental housing was found to be associated with poorer health status and outcomes. They had lower participation in health screening, preferred alternative medicine practitioners to western-trained doctors for primary care, and had increased hospital utilisation. Several studies performed qualitative interviews to explore the causes of disparity and concern about cost was one of the common cited reason. Staying in public rental housing appears to be a risk marker of poorer health and this may have important public health implications. Understanding the causes of disparity will require more qualitative studies which in turn will guide interventions and the evaluation of their effectiveness in improving health outcome of this sub-population of patients.

Patterns and determinants of plant biodiversity in non-commercial forests of eastern China

PubMed Central

Wu, Chuping; Vellend, Mark; Yuan, Weigao; Jiang, Bo; Liu, Jiajia; Shen, Aihua; Liu, Jinliang; Zhu, Jinru

2017-01-01

Non-commercial forests represent important habitats for the maintenance of biodiversity and ecosystem function in China, yet no studies have explored the patterns and determinants of plant biodiversity in these human dominated landscapes. Here we test the influence of (1) forest type (pine, mixed, and broad-leaved), (2) disturbance history, and (3) environmental factors, on tree species richness and composition in 600 study plots in eastern China. In total, we found 143 species in 53 families of woody plants, with a number of species rare and endemic in the study region. Species richness in mixed forest and broad-leaved forest was higher than that in pine forest, and was higher in forests with less disturbance. Species composition was influenced by environment factors in different ways in different forest types, with important variables including elevation, soil depth and aspect. Surprisingly, we found little effect of forest age after disturbance on species composition. Most non-commercial forests in this region are dominated by species poor pine forests and mixed young forests. As such, our results highlight the importance of broad-leaved forests for regional plant biodiversity conservation. To increase the representation of broad-leaved non-commercial forests, specific management practices such as thinning of pine trees could be undertaken. PMID:29161324

Patterns and determinants of plant biodiversity in non-commercial forests of eastern China.

PubMed

Wu, Chuping; Vellend, Mark; Yuan, Weigao; Jiang, Bo; Liu, Jiajia; Shen, Aihua; Liu, Jinliang; Zhu, Jinru; Yu, Mingjian

2017-01-01

Non-commercial forests represent important habitats for the maintenance of biodiversity and ecosystem function in China, yet no studies have explored the patterns and determinants of plant biodiversity in these human dominated landscapes. Here we test the influence of (1) forest type (pine, mixed, and broad-leaved), (2) disturbance history, and (3) environmental factors, on tree species richness and composition in 600 study plots in eastern China. In total, we found 143 species in 53 families of woody plants, with a number of species rare and endemic in the study region. Species richness in mixed forest and broad-leaved forest was higher than that in pine forest, and was higher in forests with less disturbance. Species composition was influenced by environment factors in different ways in different forest types, with important variables including elevation, soil depth and aspect. Surprisingly, we found little effect of forest age after disturbance on species composition. Most non-commercial forests in this region are dominated by species poor pine forests and mixed young forests. As such, our results highlight the importance of broad-leaved forests for regional plant biodiversity conservation. To increase the representation of broad-leaved non-commercial forests, specific management practices such as thinning of pine trees could be undertaken.

Oral-health-related background factors and dental service utilisation among Sudanese children with and without a congenital heart defects.

PubMed

Ali, H M; Mustafa, M; Nasir, E F; Lie, S A; Hasabalrasol, S; Elshazali, O H; Ali, R W; Skeie, M S

2016-11-15

Sudanese children with congenital heart defects (CHDs) were found to have poorer oral health than those without CHDs. The aims of this study were to: describe the patterns of oral-health-related background factors in children with and without CHD and explore any differences, and to evaluate the effects of background factors on caries and gingivitis prevalence and dental services utilisation. In this analytical cross-sectional study, caregivers of children aged 3-12 years with (CHD cases n = 111) and without CHDs (Controls n = 182), underwent face-to-face interviews using a structured questionnaire. The questionnaire items covered several oral health background factors (independent variables) including: child's health status, oral hygiene practices, dental services utilization, mother's level of education, and caregiver's perception and awareness of their child's oral health. The relationship between these factors and occurrence of 'caries' and 'gingivitis' as well as 'child's dental services utilisation' (dependent variables) were explored using multiple adjusted and hierarchal logistic regression analyses. Compared with controls, CHD cases had lower frequencies of brushing and use of fluoridated toothpaste, and their caregivers were less knowledgeable about caries. Among CHD cases, the variables (brushing and fluoridated toothpaste use) had significant impacts on caries prevalence (odd ratio (OR) =5.6, 95% confidence interval (CI): 1.4-22.8 and OR = 0.3, 95% CI: 0.1-0.8 for infrequent compared to frequent ones, respectively) as well as the mother's level of education (OR = 2.6, 95% CI: 1.0-6.4). When differences in background factors were controlled for, the adjusted ORs for caries and gingivitis prevalence in CHD cases compared with controls were 1.8, (95% CI: 1.1-3.2) and 5.3 (95% CI: 2.9-9.4), respectively. Among CHD cases, the child's age (8-12 years: OR = 11.9, 95% CI: 1.9-71.6), and the mother's level of education (lower education: OR = 0.2, 95% CI: 0.03-0.9) were significantly associated with the child's dental services utilisation. Lower frequencies of brushing and use of fluoride tooth paste were reported among CHD cases, and brushing had the predominant significant impact on caries prevalence. The child's age and the mother's level of education were the main factors affecting the child's (CHD cases) dental services utilisation.

Geographic region, socioeconomic position and the utilisation of primary total joint replacement for hip or knee osteoarthritis across western Victoria: a cross-sectional multilevel study of the Australian Orthopaedic Association National Joint Replacement Registry.

PubMed

Brennan-Olsen, Sharon; Vogrin, Sara; Holloway, Kara L; Page, Richard S; Sajjad, Muhammad A; Kotowicz, Mark A; Livingston, Patricia M; Khasraw, Mustafa; Hakkennes, Sharon; Dunning, Trish L; Brumby, Susan; Pedler, Daryl; Sutherland, Alasdair; Venkatesh, Svetha; Williams, Lana J; Duque, Gustavo; Pasco, Julie A

2017-11-06

Compared to urban residents, those in rural/regional areas often experience inequitable healthcare from specialist service providers. Independent of small between-area differences in utilisation, socially advantaged groups had the greatest uptake of joint replacement. These data suggest low correlation between 'need' vs. 'uptake' of surgery in rural/regional areas. Compared to urban residents, those in rural and regional areas often experience inequitable healthcare from specialist service providers, often due to geographical issues. We investigated associations between socioeconomic position (SEP), region of residence and utilisation of primary total knee replacement (TKR) and/or total hip replacement (THR) for osteoarthritis. As part of the Ageing, Chronic Disease and Injury study, we extracted data from the Australian Orthopaedic Association National Joint Replacement Registry (2011-2013) for adults that utilised primary TKR (n = 4179; 56% female) and/or THR (n = 3120; 54% female). Residential addresses were matched with the Australian Bureau of Statistics (ABS) 2011 census data: region of residence was defined according to local government areas (LGAs), and area-level SEP (quintiles) defined using an ABS-derived composite index. The ABS-determined control population (n = 591,265; 51% female) excluded individuals identified as cases. We performed multilevel logistic regression modelling using a stratified two-stage cluster design. TKR was higher for those aged 70-79 years (AOR 1.4 95%CI 1.3-1.5; referent = 60-69 years) and in the most advantaged SEP quintile (AOR 2.1, 95%CI 1.8-2.3; referent = SEP quintile 3); results were similar for THR (70-79 years = AOR 1.7, 95%CI 1.5-1.8; SEP quintile 5 = AOR 2.5, 95%CI 2.2-2.8). Total variances contributed by the variance in LGAs were 2% (SD random effects ± 0.28) and 3% (SD ± 0.32), respectively. Independent of small between-LGA differences in utilisation, and in contrast to the expected greater prevalence of osteoarthritis in disadvantaged populations, we report greater TKR and THR in more advantaged groups. Further research should investigate whether more advantaged populations may be over-serviced.

The role country of birth plays in receiving disability pensions in relation to patterns of health care utilisation and socioeconomic differences: a multilevel analysis of Malmo, Sweden

PubMed Central

Beckman, Anders; Hakansson, Anders; Rastam, Lennart; Lithman, Thor; Merlo, Juan

2006-01-01

Background People of low socioeconomic status have worse health and a higher probability of being granted a disability pension than people of high socioeconomic status. It is also known that public and private general physicians and public and private specialists have varying practices for issuing sick leave certificates (which, if longstanding, may become the basis of disability pensions). However, few studies have investigated the influence of a patient's country of birth in this context. Methods We used multilevel logistic regression analysis with individuals (first level) nested within countries of birth (second level). We analysed the entire population between the ages of 40 and 64 years (n = 80 212) in the city of Malmo, Sweden, in 2003, and identified 73% of that population who had visited a physician at least once during that year. We studied the associations between individuals and country of birth socioeconomic characteristics, as well as individual utilisation of different kinds of physicians in relation to having been granted a disability pension. Results Living alone (ORwomen = 1.72, 95% CI: 1.62–1.82; ORmen = 2.64, 95% CI: 2.46–2.83) and having limited educational achievement (ORwomen = 2.14, 95% CI: 2.00–2.29; ORmen = 2.12, 95% CI: 1.98–2.28) were positively associated with having a disability pension. Utilisation of public specialists was associated with a higher probability (ORwomen = 2.11, 95% CI: 1.98–2.25; ORmen = 2.16, 95% CI: 2.01–2.32) and utilisation of private GPs with a lower probability (ORmen = 0.76, 95% CI: 0.69–0.83) of having a disability pension. However, these associations differed by countries of birth. Over and above individual socioeconomic status, men from middle income countries had a higher probability of having a disability pension (ORmen = 1.61, 95% CI: 1.06–2.44). Conclusion The country of one's birth appears to play a significant role in understanding how individual socioeconomic differences bear on the likelihood of receiving a disability pension and on associated patterns of health care utilisation. PMID:16542459

Assessing double counting of carbon emissions between forest land cover change and forest wildfires: a case study in the United States, 1992-2006

Treesearch

Daolan Zheng; Linda S. Heath; Mark J. Ducey; Brad Quayle

2013-01-01

The relative contributions of double counting of carbon emissions between forest-to-nonforest cover change (FNCC) and forest wildfires are an unknown in estimating net forest carbon exchanges at large scales. This study employed land-cover change maps and forest fire data in the four representative states (Arkansas, California, Minnesota, and Washington) of the US for...

Threats to private forest lands in the U.S.A.: a forests on the edge study

Treesearch

Mark H. Hatfield; Ronald E. McRoberts; Dacia M. Meneguzzo; Sara Comas

2010-01-01

The Forests on the Edge project, sponsored by the USDA Forest Service, uses geographic information systems to construct and analyze maps depicting threats to the contributions of America’s private forest lands. For this study, watersheds across the conterminous United States are evaluated with respect to the amount of their private forest land. Watersheds with at least...

Simulating carbon stocks and fluxes of an African tropical montane forest with an individual-based forest model.

PubMed

Fischer, Rico; Ensslin, Andreas; Rutten, Gemma; Fischer, Markus; Schellenberger Costa, David; Kleyer, Michael; Hemp, Andreas; Paulick, Sebastian; Huth, Andreas

2015-01-01

Tropical forests are carbon-dense and highly productive ecosystems. Consequently, they play an important role in the global carbon cycle. In the present study we used an individual-based forest model (FORMIND) to analyze the carbon balances of a tropical forest. The main processes of this model are tree growth, mortality, regeneration, and competition. Model parameters were calibrated using forest inventory data from a tropical forest at Mt. Kilimanjaro. The simulation results showed that the model successfully reproduces important characteristics of tropical forests (aboveground biomass, stem size distribution and leaf area index). The estimated aboveground biomass (385 t/ha) is comparable to biomass values in the Amazon and other tropical forests in Africa. The simulated forest reveals a gross primary production of 24 tcha(-1) yr(-1). Modeling above- and belowground carbon stocks, we analyzed the carbon balance of the investigated tropical forest. The simulated carbon balance of this old-growth forest is zero on average. This study provides an example of how forest models can be used in combination with forest inventory data to investigate forest structure and local carbon balances.

Forest Patch Size, Land Use, and Mesic Forest Herbs in the French Broad River Basin, North Carolina

Treesearch

Scott M. Pearson; Alan B. Smith; Monica G. Turner

1998-01-01

The effect of forest fragmentation on cove-forest herbs was studied in the Southern Blue Ridge Province. Patches of mesic forests were sampled with 4 ha study plots. The coverage and density of herb species were greater in large patches (>200 ha) than in small patches (

Temporal change in fragmentation of continental US forests

Treesearch

James D. Wickham; Kurt H. Riitters; Timothy G. Wade; Collin Homer

2008-01-01

Changes in forest ecosystem function and condition arise from changes in forest fragmentation. Previous studies estimated forest fragmentation for the continental United States (US). In this study, new temporal land-cover data from the National Land Cover Database (NLCD) were used to estimate changes in forest fragmentation at multiple scales for the continental US....

What is access to radiation therapy? A conceptual framework and review of influencing factors.

PubMed

Sundaresan, Puma; Stockler, Martin R; Milross, Christopher G

2016-02-01

Optimal radiation therapy (RT) utilisation rates (RURs) have been defined for various cancer indications through extensive work in Australia and overseas. These benchmarks remain unrealised. The gap between optimal RUR and actual RUR has been attributed to inadequacies in 'RT access'. We aimed to develop a conceptual framework for the consideration of 'RT access' by examining the literature for existing constructs and translating it to the context of RT services. We further aimed to use this framework to identify and examine factors influencing 'RT access'. Existing models of health care access were reviewed and used to develop a multi-dimensional conceptual framework for 'RT access'. A review of the literature was then conducted to identify factors reported to affect RT access and utilisation. The electronic databases searched, the host platform and date range of the databases searched were Ovid MEDLINE, 1946 to October 2014 and PsycINFO via OvidSP,1806 to October 2014. The framework developed demonstrates that 'RT access' encompasses opportunity for RT as well as the translation of this opportunity to RT utilisation. Opportunity for RT includes availability, affordability, adequacy (quality) and acceptability of RT services. Several factors at the consumer, referrer and RT service levels affect the translation of this opportunity for RT to actual RT utilisation. 'Access' is a term that is widely used in the context of health service related research, planning and political discussions. It is a multi-faceted concept with many descriptions. We propose a conceptual framework for the consideration of 'RT access' so that factors affecting RT access and utilisation may be identified and examined. Understanding these factors, and quantifying them where possible, will allow objective evaluation of their impact on RT utilisation and guide implementation of strategies to modify their effects.

A climate change-induced threat to the ecological resilience of a subtropical monsoon evergreen broad-leaved forest in Southern China.

PubMed

Zhou, Guoyi; Peng, Changhui; Li, Yuelin; Liu, Shizhong; Zhang, Qianmei; Tang, Xuli; Liu, Juxiu; Yan, Junhua; Zhang, Deqiang; Chu, Guowei

2013-04-01

Recent studies have suggested that tropical forests may not be resilient against climate change in the long term, primarily owing to predicted reductions in rainfall and forest productivity, increased tree mortality, and declining forest biomass carbon sinks. These changes will be caused by drought-induced water stress and ecosystem disturbances. Several recent studies have reported that climate change has increased tree mortality in temperate and boreal forests, or both mortality and recruitment rates in tropical forests. However, no study has yet examined these changes in the subtropical forests that account for the majority of China's forested land. In this study, we describe how the monsoon evergreen broad-leaved forest has responded to global warming and drought stress using 32 years of data from forest observation plots. Due to an imbalance in mortality and recruitment, and changes in diameter growth rates between larger and smaller trees and among different functional groups, the average DBH of trees and forest biomass have decreased. Sap flow measurements also showed that larger trees were more stressed than smaller trees by the warming and drying environment. As a result, the monsoon evergreen broad-leaved forest community is undergoing a transition from a forest dominated by a cohort of fewer and larger individuals to a forest dominated by a cohort of more and smaller individuals, with a different species composition, suggesting that subtropical forests are threatened by their lack of resilience against long-term climate change. © 2012 Blackwell Publishing Ltd.

Lack of efficacy in a randomised trial of a brief intervention to reduce drug use and increase drug treatment services utilisation among adult emergency department patients over a 12-month period.

PubMed

Merchant, Roland C; Zhang, Zhongli; Zhang, Zihao; Liu, Tao; Baird, Janette R

2018-05-01

Assess the 12-month efficacy of a brief intervention (BI) on reducing drug use and increasing drug treatment services utilisation among adult emergency department (ED) patients. This randomised, controlled trial enrolled 18-64-year-old ED patients needing a drug use intervention. Treatment arm participants received a tailored BI while control arm participants only completed the study questionnaires. Self-reported past 3-month drug use and engagement in drug treatment services were compared by study arm at 3-month intervals over 1 year. Multiple imputations were performed to overcome loss-to-follow-up. Of the 1030 participants, follow-up completion ranged 55%-64% over the four follow-ups. At 12 months, the two study arms were similar in regards to mean: (1) proportion reporting any drug use (treatment: 67.1% (61.6 to 72.6), control: 74.4% (69.4 to 79.4)); (2) drug use frequency on a five-point scale (treatment: 3.7 (3.3 to 4.2), control: 4.6 (4.0 to 5.2)); (3) total days of drug use (treatment: 28.3 (23.2 to 33.4), control: 33.4 (28.5 to 38.2)); (4) most number of times drugs used/day (treatment: 4.6 (3.6 to 5.5), control: 6.1 (4.8 to 7.3)) and (5) typical number of times drugs used/day (treatment: 3.3 (2.5 to 4.1), control: 5.1 (3.9 to 6.2)). Utilisation of drug treatment services also was similar by study arm. In multivariable regression analyses, patients who were homeless or had higher drug use at baseline continued to have greater drug use in follow-up. Among adult ED patients requiring a drug use intervention, this BI did not decrease drug use or increase drug treatment services utilisation over a 12-month period more than the control condition. NCT01124591; Pre-trial. © 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.

Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

PubMed

Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

2017-08-01

To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evidence of the factors that influence the utilisation of Kangaroo Mother Care by parents with low-birth-weight infants in low- and middle-income countries (LMICs): a scoping review protocol.

PubMed

Mathias, Christina T; Mianda, Solange; Ginindza, Themba G

2018-04-05

The Sustainable Development Goal (SDG) 3 emphasises on reducing neonatal deaths caused by low birth weight (LBW) complications by the implementation and utilisation of Kangaroo Mother Care (KMC) in low- and middle-income countries (LMICs). Despite the empirical evidence of KMC optimising low-birth-weight infants' (LBWIs') survival, its advantages and the LMICs implementing the service, studies have shown that LBW infant deaths occurring in LMICs are largely contributing to global child mortality. The aim of this scoping review is to map out the literature on barriers, challenges and facilitators of KMC utilisation by parents with LBWIs. This scoping review will use Endnote X7 reference management software to manage articles. The review search strategy will use SCIELO and LILACS databases. Other databases will be used via EBSCOHost search engine and these are Academic search complete, CINAHL with full text, Education source, Health source: Nursing/Academic Edition, Medline with full text and Medline. We will also use Google Scholar, JSTOR, Open grey search engines and reference lists. A two-phase search mapping out process will be done. In phase 1, one reviewer will perform the title screening and removal of duplicates. Two reviewers will do a parallel abstract screening according to eligibility criteria. Phase 2 will involve the reading of full articles and exclusion of articles, in accordance with the eligibility criteria. Data extraction from the articles will be done by two reviewers independently and parallel to the data extraction form. The data quality assessment of the eligible studies will be done using the Mixed Method Appraisal Tool (MMAT). The extraction of the synthesised results and thematic content analysis of the studies will be done by NVIVO version 10. We expect to find studies on barriers, challenges and facilitating factors of KMC utilisation by parents with LBWIs in LMICs. The review outcomes will guide future research and practice and inform policy. The findings will be disseminated in print, electronic and conference presentations related to maternal child and neonatal health.

Assessment of forest fragmentation in southern New England using remote sensing and geographic information systems technology

USGS Publications Warehouse

Vogelmann, James E.

1995-01-01

Spatial patterns and rates of forest fragmentation were assessed using digital remote sensing data for a region in southern New England that included 157 townships in southern New Hampshire and northeastern Massachusetts. The study area has undergone marked population increases over the last several decades. Following classification of 1973 and 1988 Landsat Multispectral Scanner data into forest and nonforest classes, data were incorporated into a geographic information system. The natural logarithms of forest area to perimeter ratios, referred to as the forest continuity index, were used to assess patterns and trends of forest fragmentation across the region Forest continuity index values were extracted from each township for both data sets and compared with population data. Forest continuity index values were found to decrease with increasing population density until about 200 persons per square kilometer, after which the relationship stabilized. With slight population increases at low densities forest continuity index values declined sharply, implying abrupt increases in forest fragmentation. Results from the study indicated good negative correlations (r2 values of 0.81 and 0.77) between the Multispectral Scanner-derived forest continuity index and natural logs of township population density. Socioeconomic indicators such as affluence and commuting patterns did not appear to correlate well with forest fragmentation estimates. Decreases in forest continuity index values occurred throughout much of the study region between 1973 and 1988, suggesting that forest fragmentation is occurring over large regions within the eastern United States. It is technologically feasible to assess patterns and rates of forest fragmentation across much larger areas than analyzed in this study; such analyses would provide useful overviews enabling objective assessment of the magnitude of forest fragmentation.

Apelin targets gut contraction to control glucose metabolism via the brain

PubMed Central

Fournel, Audren; Drougard, Anne; Duparc, Thibaut; Marlin, Alysson; Brierley, Stuart M; Castro, Joel; Le-Gonidec, Sophie; Masri, Bernard; Colom, André; Lucas, Alexandre; Rousset, Perrine; Cenac, Nicolas; Vergnolle, Nathalie; Valet, Philippe; Cani, Patrice D; Knauf, Claude

2017-01-01

Objective The gut–brain axis is considered as a major regulatory checkpoint in the control of glucose homeostasis. The detection of nutrients and/or hormones in the duodenum informs the hypothalamus of the host's nutritional state. This process may occur via hypothalamic neurons modulating central release of nitric oxide (NO), which in turn controls glucose entry into tissues. The enteric nervous system (ENS) modulates intestinal contractions in response to various stimuli, but the importance of this interaction in the control of glucose homeostasis via the brain is unknown. We studied whether apelin, a bioactive peptide present in the gut, regulates ENS-evoked contractions, thereby identifying a new physiological partner in the control of glucose utilisation via the hypothalamus. Design We measured the effect of apelin on electrical and mechanical duodenal responses via telemetry probes and isotonic sensors in normal and obese/diabetic mice. Changes in hypothalamic NO release, in response to duodenal contraction modulated by apelin, were evaluated in real time with specific amperometric probes. Glucose utilisation in tissues was measured with orally administrated radiolabeled glucose. Results In normal and obese/diabetic mice, glucose utilisation is improved by the decrease of ENS/contraction activities in response to apelin, which generates an increase in hypothalamic NO release. As a consequence, glucose entry is significantly increased in the muscle. Conclusions Here, we identify a novel mode of communication between the intestine and the hypothalamus that controls glucose utilisation. Moreover, our data identified oral apelin administration as a novel potential target to treat metabolic disorders. PMID:26565000

Can a publicly funded home care system successfully allocate service based on perceived need rather than socioeconomic status? A Canadian experience.

PubMed

Laporte, Audrey; Croxford, Ruth; Coyte, Peter C

2007-03-01

The present quantitative study evaluates the degree to which socioeconomic status (SES), as opposed to perceived need, determines utilisation of publicly funded home care in Ontario, Canada. The Registered Persons Data Base of the Ontario Health Insurance Plan was used to identify the age, sex and place of residence for all Ontarians who had coverage for the complete calendar year 1998. Utilisation was characterised in two dimensions: (1) propensity - the probability that an individual received service, which was estimated using a multinomial logit equation; and (2) intensity - the amount of service received, conditional on receipt. Short- and long-term service intensity were modelled separately using ordinary least squares regression. Age, sex and co-morbidity were the best predictors (P < 0.0001) of whether or not an individual received publicly funded home care as well as how much care was received, with sicker individuals having increased utilisation. The propensity and intensity of service receipt increased with lower SES (P < 0.0001), and decreased with the proportion of recent immigrants in the region (P < 0.0001), after controlling for age, sex and co-morbidity. Although the allocation of publicly funded home care service was primarily based on perceived need rather than ability to pay, barriers to utilisation for those from areas with a high proportion of recent immigrants were identified. Future research is needed to assess whether the current mix and level of publicly funded resources are indeed sufficient to offset the added costs associated with the provision of high-quality home care.

How do people with dementia utilise primary care physicians and specialists within dementia networks? Results of the Dementia Networks in Germany (DemNet-D) study.

PubMed

Wübbeler, Markus; Thyrian, Jochen René; Michalowsky, Bernhard; Erdmann, Pia; Hertel, Johannes; Holle, Bernhard; Gräske, Johannes; Schäfer-Walkmann, Susanne; Hoffmann, Wolfgang

2017-01-01

Outpatient dementia healthcare is predominantly fragmented, and dementia networks (DNs) represent an integrated care concept to overcome this problem. Little is known about the patients of these networks with regard to utilisation of physicians and associated factors. We interviewed 560 caregivers of people with dementia in 13 different DNs in Germany in 2013 and assessed socio-demographics, clinical data and physician utilisation. Networks were categorised in predominantly medical DNs and community-oriented DNs. Descriptive and multivariate statistical models were used to identify associated factors between DNs and users' data. Overall, the users of networks received high rates of physician care; 93% of the sample stated at least one contact with a primary care physician within the last 6 months, and 74% had been treated by a specialist (neurology/psychiatry physician). Only 5% of the sample had no contact with a physician in the 6 months preceding the interview. Females showed a lower odds for physician specialist consultations (OR = 0.641). Users of medical DNs receive greater specialist consultations overall (OR = 8.370). Compared to the German general population and people with dementia in other settings, users of DNs receive physician care more regularly, especially with regard to the consultations of neurologist/psychiatrists. Therefore, DNs seem to perform a supportive role within the integration of physician healthcare. More research is needed on the appropriate relationship between the needs of the people with dementia and utilisation behaviour. © 2016 John Wiley & Sons Ltd.

Utilisation of inorganic salts in fungal crop disease management in the U.K.

PubMed

Deliopoulos, T; Kettlewell, P S; Hare, M C

2009-01-01

The overaLl aim of the study described in this communication was to utilise the findings of a global scientific and technical literature survey on the use of inorganic salts against crop fungal diseases in order to assess the potential of using these substances to reduce the reliance of UK growers on conventional fungicides. A summary of the main findings of the Literature survey is provided followed by information on the current commercial use of inorganic salt-based products in fungal disease management. Finally, the scope of potential use of inorganic salts on high disease risk crops in the UK is assessed and specific crop/pathogen combinations are prioritised for further research.

[A review on disturbance ecology of forest].

PubMed

Zhu, Jiaojun; Liu, Zugen

2004-10-01

More than 80% of terrestrial ecosystems have been influenced by natural disasters, human activities and the combination of both natural and human disturbances. Forest ecosystem, as one of the most important terrestrial ecosystems, has also been disturbed without exception. Under the disturbance from natural disasters and human activities, particularly from the unreasonable activities of human beings, forest decline or forest degradation has become more and more severe. For this reason, sustaining or recovering forest service functions is one of the current purposes for managing forest ecosystems. In recent decades, the studies on disturbed ecosystems have been carried out frequently, especially on their ecological processes and their responses to the disturbances. These studies play a very important role in the projects of natural forest conservation and the construction of ecological environment in China. Based on a wide range of literatures collection on forest disturbance research, this paper discussed the fundamental concepts of disturbance ecology, the relationships between forest management and disturbance, and the study contents of forest disturbance ecology. The major research topics of forest disturbance ecology may include: 1) the basic characteristics of disturbed forests; 2) the processes of natural and human disturbances; 3) the responses of forests ecosystem to the disturbances; 4) the main ecological processes or the consequential results of disturbed forests, including the change of biodiversity, soil nutrient and water cycle, eco-physiology and carbon cycle, regeneration mechanism of disturbed forests and so on; 5) the relationships between disturbances and forest management; and 6) the principles and techniques for the management of disturbed forests. This review may be helpful to the management of disturbed forest ecosystem, and to the projects of natural forest conservation in China.

Solar flare induced cosmic noise absorption

NASA Astrophysics Data System (ADS)

Ogunmodimu, Olugbenga; Honary, Farideh; Rogers, Neil; Falayi, E. O.; Bolaji, O. S.

2018-06-01

Solar flare events are a major observing emphasis for space weather because they affect the ionosphere and can eject high-energy particles that can adversely affect Earth's technologies. In this study we model 38.2 MHz cosmic noise absorption (CNA) by utilising measurements from the Imaging Riometer for Ionospheric Studies (IRIS) at Kilpisjärvi, Finland obtained during solar cycle 23 (1996-2009). We utilised X-ray archive for the same period from the Geostationary Operational Environmental Satellite (GOES) to study solar flare induced cosmic noise absorption. We identified the threshold of flare (M4 class) that could bear significant influence on CNA. Through epoch analysis, we show the magnitude of absorption that each class of flare could produce. Using the parameters of flare and absorption we present a model that could provide the basis for nowcast of CNA induced by M and X-class solar flares.

The role of non-need factors in individual GP utilisation analysis and their implications for the pursuance of equity: a cross-country comparison.

PubMed

McGregor, P; McKee, P; O'Neill, C

2008-05-01

A substantial amount of health care resources is allocated within the UK using formulae that relate funding to measures of population need. The aim of this paper is to demonstrate the importance of non-need factors in determining utilisation of services at an individual level and explore the implications inclusion of such factors has in the consideration of equity. In the paper we develop a utility model that accords a role to non-health factors in the determination of service use. A series of functions incorporating non-health factors as explanatory variables in GP utilisation functions are estimated using data from the British Household Panel Survey. The functions are decomposed to ascertain the role of service structure and examine the role of income across the four countries of the UK in explaining utilisation. The implications of our findings for the pursuance of equity in the NHS when individual choice has an explicit role are discussed.

Climate limits across space and time on European forest structure

NASA Astrophysics Data System (ADS)

Moreno, A. L. S.; Neumann, M.; Hasenauer, H.

2017-12-01

The impact climate has on forests has been extensively studied. However, the large scale effect climate has on forest structures, such as average diameters, heights and basal area are understudied in a spatially explicit manner. The limits, tipping points and thresholds that climate places on forest structures dictate the services a forest may provide, the vulnerability of a forest to mortality and the potential value of the timber there within. The majority of current research either investigates climate impacts on forest pools and fluxes, on a tree physiological scale or on case studies that are used to extrapolate results and potential impacts. A spatially explicit study on how climate affects forest structure over a large region would give valuable information to stakeholders who are more concerned with ecosystem services that cannot be described by pools and fluxes but require spatially explicit information - such as biodiversity, habitat suitability, and market values. In this study, we quantified the limits that climate (maximum, minimum temperature and precipitation) places on 3 forest structures, diameter at breast height, height, and basal area throughout Europe. Our results show clear climatic zones of high and low upper limits for each forest structure variable studied. We also spatially analyzed how climate restricts the potential bio-physical upper limits and creates tipping points of each forest structure variable and which climate factors are most limiting. Further, we demonstrated how the climate change has affected 8 individual forests across Europe and then the continent as a whole. We find that diameter, height and basal area are limited by climate in different ways and that areas may have high upper limits in one structure and low upper limits in another limitted by different climate variables. We also found that even though individual forests may have increased their potential upper limit forest structure values, European forests as a whole have lost, on average, 5.0%, 1.7% and 6.5% in potential mean forest diameter, height and basal area, respectively.

[Characteristics of carbon storage of Inner Mongolia forests: a review].

PubMed

Yang, Hao; Hu, Zhong-Min; Zhang, Lei-Ming; Li, Sheng-Gong

2014-11-01

Forests in Inner Mongolia account for an important part of the forests in China in terms of their large area and high living standing volume. This study reported carbon storage, carbon density, carbon sequestration rate and carbon sequestration potential of forest ecosystems in Inner Mongolia using the biomass carbon data from the related literature. Through analyzing the data of forest inventory and the generalized allometric equations between volume and biomass, previous studies had reported that biomass carbon storage of the forests in Inner Mongolia was about 920 Tg C, which was 12 percent of the national forest carbon storage, the annual average growth rate was about 1.4%, and the average of carbon density was about 43 t · hm(-2). Carbon storage and carbon density showed an increasing trend over time. Coniferous and broad-leaved mixed forest, Pinus sylvestris var. mongolica forest and Betula platyphylla forest had higher carbon sequestration capacities. Carbon storage was reduced due to human activities such as thinning and clear cutting. There were few studies on carbon storage of the forests in Inner Mongolia with focus on the soil, showing that the soil car- bon density increased with the stand age. Study on the carbon sequestration potential of forest ecosystems was still less. Further study was required to examine dynamics of carbon storage in forest ecosystems in Inner Mongolia, i. e., to assess carbon storage in the forest soils together with biomass carbon storage, to compute biomass carbon content of species organs as 45% in the allometric equations, to build more species-specific and site-specific allometric equations including root biomass for different dominant species, and to take into account the effects of climate change on carbon sequestration rate and carbon sequestration potential.

Perceptions about Forest Schools: Encouraging and Promoting Archimedes Forest Schools

ERIC Educational Resources Information Center

Nawaz, Haq; Blackwell, Sarah

2014-01-01

The aim of this study was to find out parents' and children's perception of outdoor learning programmes with specific reference to Archimedes Forest Schools, known as Forest Schools. A review of existing research showed that there had been no rigorous evaluation of perception of forest schools. The study was conducted in the UK and mixed method…

The implications of new forest tenure reforms and forestry property markets for sustainable forest management and forest certification in China.

PubMed

Chen, Juan; Innes, John L

2013-11-15

This study examines issues existing in the southern collective forests in China, particularly prior to the implementation of new forest tenure reforms, such as continued illegal logging and timber theft, inadequate availability of finance and inconsistent forest-related policies. Such problems are believed to be hindering the adoption of sustainable forest management (SFM) and forest certification by forest farmers in China. Two strategies were introduced by the Chinese government with the purpose of addressing these issues, namely forest tenure reforms and their associated supporting mechanism, forestry property markets. Through two case studies in southern China, we investigated the effectiveness of the two strategies as well as their implications for the adoption of SFM and forest certification. The two cases were Yong'an in Fujian province and Tonggu in Jiangxi province. Personal interviews with open-ended questions were conducted with small-scale forest farmers who had already benefited from the two strategies as well as market officers working for the two selected forestry property markets. The study identified eight issues constraining the potential adoption of SFM and certification in China, including limited finance, poorly developed infrastructure and transport systems, insecure forest tenures, inconsistent forest policies, low levels of awareness, illegal forest management practices, lack of local cooperative organizations, and inadequate knowledge and technical transfer. We found that the new forest tenure reforms and forestry property markets had generally fulfilled their original objectives and had the capacity to assist in addressing many of the issues facing forests prior to the reforms. Copyright © 2013 Elsevier Ltd. All rights reserved.

Douglas-fir forests in the Cascade Mountains of Oregon and Washington: is the abundance of small mammals related to stand age and moisture?

USGS Publications Warehouse

Coen, P.S.; Bury, R.B.; Spies, T.A.

1988-01-01

Red tree voles (Arborimus longicaudus) were the only small mammal strongly associated with old-growth forests, whereas vagrant shrews (Sorex vagrans) were most abundant in young forests. Pacific marsh shrews (S. bendirii) were most abundant in wet old-growth forests, but abundance of this species in young (wet) forests needs further study. Clearcuts had a mammalian fauna distinct from young forest stands. Abundance of several species was correlated to habitat features unique to naturally regenerated forests, indicated an urgent need to study the long-term effects of forest management to nongame wildlife.

The effect of blurred plot coordinates on interpolating forest biomass: a case study

Treesearch

J. W. Coulston

2004-01-01

Interpolated surfaces of forest attributes are important analytical tools and have been used in risk assessments, forest inventories, and forest health assessments. The USDA Forest Service Forest Inventory and Analysis program (FIA) annually collects information on forest attributes in a consistent fashion nation-wide. Users of these data typically perform...

Advances in Canadian forest hydrology, 1995-1998

NASA Astrophysics Data System (ADS)

Buttle, J. M.; Creed, I. F.; Pomeroy, J. W.

2000-06-01

Approximately 42% of Canada is covered by forests, which in turn can be subdivided into nine distinct forest ecozones. Many forested ecozones are located in northern Canada, where cold winters and cool summers provide forest environments that are less well-understood than those in more temperate locations. A number of major developments in recent years have stressed the need for enhanced understanding of hydrological processes in these forest landscapes. These include an increased emphasis on sustainable forest management in Canada as well as major scientific initiatives (e.g. BOREAS) examining water, carbon and energy fluxes in forest ecosystems, with a particular focus on boreal and subarctic forests. Recent progress in our understanding of forest hydrology across Canada is reviewed. Studies of hydrological processes across the spectrum of forest ecozones are highlighted, as well as work on hydrological responses to forest disturbance and recovery. Links between studies of hydrological processes in Canada's forests and other fields of research are examined, with particular attention paid to ongoing efforts to model hydrological impacts and interactions with the climate, biogeochemistry, geomorphology and ecology of forested landscapes.

Temporal Forest Change Detection and Forest Health Assessment using Remote Sensing

NASA Astrophysics Data System (ADS)

Ya'acob, Norsuzila; Mohd Azize, Aziean Binti; Anis Mahmon, Nur; Laily Yusof, Azita; Farhana Azmi, Nor; Mustafa, Norfazira

2014-03-01

This paper presents the detection of Angsi and Berembun Reserve Forest change for years 1996 and 2013. Forest is an important part of our ecosystem. The main function is to absorb carbon oxide and produce oxygen in their cycle of photosynthesis to maintain a balance and healthy atmosphere. However, forest changes as time changes. Some changes are necessary as to give way for economic growth. Nevertheless, it is important to monitor forest change so that deforestation and development can be planned and the balance of ecosystem is still preserved. It is important because there are number of unfavorable effects of deforestation that include environmental and economic such as erosion of soil, loss of biodiversity and climate change. The forest change detection can be studied with reference of several satellite images using remote sensing application. Forest change detection is best done with remote sensing due to large and remote study area. The objective of this project is to detect forest change over time and to compare forest health indicated by Normalized Difference Vegetation Index (NDVI) using remote sensing and image processing. The forest under study shows depletion of forest area by 12% and 100% increment of deforestation activities. The NDVI value which is associated with the forest health also shows 13% of reduction.

Diversity of Medicinal Plants among Different Forest-use Types of the Pakistani Himalaya.

PubMed

Adnan, Muhammad; Hölscher, Dirk

2012-12-01

Diversity of Medicinal Plants among Different Forest-use Types of the Pakistani Himalaya Medicinal plants collected in Himalayan forests play a vital role in the livelihoods of regional rural societies and are also increasingly recognized at the international level. However, these forests are being heavily transformed by logging. Here we ask how forest transformation influences the diversity and composition of medicinal plants in northwestern Pakistan, where we studied old-growth forests, forests degraded by logging, and regrowth forests. First, an approximate map indicating these forest types was established and then 15 study plots per forest type were randomly selected. We found a total of 59 medicinal plant species consisting of herbs and ferns, most of which occurred in the old-growth forest. Species number was lowest in forest degraded by logging and intermediate in regrowth forest. The most valuable economic species, including six Himalayan endemics, occurred almost exclusively in old-growth forest. Species composition and abundance of forest degraded by logging differed markedly from that of old-growth forest, while regrowth forest was more similar to old-growth forest. The density of medicinal plants positively correlated with tree canopy cover in old-growth forest and negatively in degraded forest, which indicates that species adapted to open conditions dominate in logged forest. Thus, old-growth forests are important as refuge for vulnerable endemics. Forest degraded by logging has the lowest diversity of relatively common medicinal plants. Forest regrowth may foster the reappearance of certain medicinal species valuable to local livelihoods and as such promote acceptance of forest expansion and medicinal plants conservation in the region. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12231-012-9213-4) contains supplementary material, which is available to authorized users.

Current forest conditions of older stands of the mixed mesophytic forest region on the Appalachian Plateaus Province of eastern Kentucky

Treesearch

James F. Jr. Rosson

2008-01-01

E. Lucy Braun coined the term "mixed mesophytic forest" in 1916. These forests are structurally complex and occur extensively across the Appalachian Plateaus Province. This region is considered the epicenter of highest development of the eastern deciduous forest. I used U.S. Forest Service, Forest Inventory and Analysis (FIA) data to study current forest...

Forest structure in low diversity tropical forests: a study of Hawaiian wet and dry forests

Treesearch

R. Ostertag; F. Inman-Narahari; S. Cordell; C.P. Giardina; L. Sack

2014-01-01

The potential influence of diversity on ecosystem structure and function remains a topic of significant debate, especially for tropical forests where diversity can range widely. We used Center for Tropical Forest Science (CTFS) methodology to establish forest dynamics plots in montane wet forest and lowland dry forest on Hawai‘i Island. We compared the species...

[Diversity, structure and regeneration of the seasonally dry tropical forest of Yucatán Peninsula, Mexico].

PubMed

Hernández-Ramírez, Angélica María; García-Méndez, Socorro

2015-09-01

Seasonally dry tropical forests are considered as the most endangered ecosystem in lowland tropics. The aim of this study was to characterize the floristic composition, richness, diversity, structure and regeneration of a seasonally dry tropical forest landscape constituted by mature forest, secondary forest and seasonally inundated forest located in the Northeastern part of the Yucatán Peninsula, Mexico. We used the Gentry's standard inventory plot methodology (0.1 ha per forest type in 2007) for facilitating comparison with other Mesoamerican seasonally dry tropical forests. A total of 77 species belonging to 32 families were observed in the study area. Fabaceae and Euphorbiaceae were the families with the largest taxonomic richness in the three forest types. Low levels of β diversity were observed among forest types (0.19-0.40), suggesting a high turnover of species at landscape level. The non-regenerative species were dominant (50-51 %), followed by regenerative species (30- 28 %), and colonizer species (14-21 %) in the three forest types. Zoochory was the most common dispersal type in the study area. The 88 % of the observed species in the study area were distributed in Central America. Some floristic attributes of the seasonally dry tropical forest of the Yucatán Peninsula, fall into the values reported for Mesoamerican seasonally dry tropical forests. Natural disturbances contributed to explain the high number of individuals, the low number of liana species, as well as the low values of basal area observed in this study. Our results suggested that the seasonally dry tropical forest of Yucatán Peninsula seems to be resilient to natural disturbances (hurricane) in terms of the observed number of species and families, when compared with the reported values in Mesoamerican seasonally dry tropical forests. Nonetheless, the recovery and regeneration of vegetation in long-term depends on animal-dispersed species. This study highlights the importance of establishing multiple protected areas throughout the Mesoamerican seasonally dry tropical forest in order to conserve both α- and β- diversity.

Nationwide classification of forest types of India using remote sensing and GIS.

PubMed

Reddy, C Sudhakar; Jha, C S; Diwakar, P G; Dadhwal, V K

2015-12-01

India, a mega-diverse country, possesses a wide range of climate and vegetation types along with a varied topography. The present study has classified forest types of India based on multi-season IRS Resourcesat-2 Advanced Wide Field Sensor (AWiFS) data. The study has characterized 29 land use/land cover classes including 14 forest types and seven scrub types. Hybrid classification approach has been used for the classification of forest types. The classification of vegetation has been carried out based on the ecological rule bases followed by Champion and Seth's (1968) scheme of forest types in India. The present classification scheme has been compared with the available global and national level land cover products. The natural vegetation cover was estimated to be 29.36% of total geographical area of India. The predominant forest types of India are tropical dry deciduous and tropical moist deciduous. Of the total forest cover, tropical dry deciduous forests occupy an area of 2,17,713 km(2) (34.80%) followed by 2,07,649 km(2) (33.19%) under tropical moist deciduous forests, 48,295 km(2) (7.72%) under tropical semi-evergreen forests and 47,192 km(2) (7.54%) under tropical wet evergreen forests. The study has brought out a comprehensive vegetation cover and forest type maps based on inputs critical in defining the various categories of vegetation and forest types. This spatially explicit database will be highly useful for the studies related to changes in various forest types, carbon stocks, climate-vegetation modeling and biogeochemical cycles.

Hydrological processes in major types of Chinese forest

NASA Astrophysics Data System (ADS)

Wei, X.; Liu, S.; Zhou, G.; Wang, C.

2005-01-01

Overexploitation of forest resources in China has caused serious concerns over its negative impacts on water resources, biodiversity, soil erosion, wildlife habitat and community stability. One key concern is the impact of forestry practices on hydrological processes, particularly the effect of forest harvest on water quality and quantity. Since the mid 1980s, a series of scientific studies on forest hydrology have been initiated in major types of forest across the country, including Korean pine (Pinus koraiensis), Chinese fir (Cunninghamia lanceolata), oak (Quercus mongolica), larch (Larix gmelinii), faber fir (Abies fabri), Chinese pine (Pinus tabulaeformis), armand pine (Pinus arandi), birch (Betula platyphylla) and some tropical forests. These studies measured rainfall interception, streamflow, evapotranspiration and impacts of forest management (clearcutting and reforestation). This paper reviews key findings from these forest hydrological studies conducted over the past 20 years in China.Forest canopy interception rates varied from 15 to 30% of total rainfall, depending on forest canopy and rainfall characteristics. Stemflow is generally a small percentage (<5%) of total rainfall, but it accounts for 15% in the oak forest in northeast China. The high amounts of stemflow, as well as higher amounts of nutrients contained in stemflow, may allow oak trees to adapt to a dry and nutrient-poor environment. Evapotranspiration was a significant component of the water budget in these Chinese forests studied, ranging from 80-90% of total rainfall in the northern temperate forests to 40-50% in the southern tropical forests. Forests substantially reduced surface runoff and erosion. However, no consistent response on total streamflows was observed. The reason for the inconsistency may be due to complexities of streamflow processes and the utilization of different methodologies applied at the various spatial scales. Copyright

Layout Guide for Burnt and Un-burnt Tropical Forest: The Diversity of Forest Plants and Insetcs for Sustainable Environmental

NASA Astrophysics Data System (ADS)

Watiniasih, N. L.; Tambunan, J.; Merdana, I. M.; Antara, I. N. G.

2018-04-01

Forest fire is a common phenomenon in tropical forest likes in Indonesia. Beside the effect of soaring heat and lack of rain during dry season due to the tropical climate, farming system is also reported as one reason of forest fire in Indonesia. People of surrounding areas and neighbouring countries are suffering from the effect of forest fire. Plants and animals are the most suffer from this occurrence that they cannot escape. This study aimed to investigate the effect of previously burnt and un-burnt tropical forest in Borneo Island on the plant and insect diversity of the tropical forest. The result of the study found that the plants in previously burnt forest area was dominated by one species, while higher and more stable plant diversity was found in un-burnt forest. Although the number of individual insects was higher in previously burnt tropical forest, but the insects was more diverse in un-burnt tropical forest. The alteration of environmental conditions in previously burnt and un-burnt forest indicate that the energy held in natural forest support higher number and more stable insects than previously burnt forest.

Simulating Carbon Stocks and Fluxes of an African Tropical Montane Forest with an Individual-Based Forest Model

PubMed Central

Fischer, Rico; Ensslin, Andreas; Rutten, Gemma; Fischer, Markus; Schellenberger Costa, David; Kleyer, Michael; Hemp, Andreas; Paulick, Sebastian; Huth, Andreas

2015-01-01

Tropical forests are carbon-dense and highly productive ecosystems. Consequently, they play an important role in the global carbon cycle. In the present study we used an individual-based forest model (FORMIND) to analyze the carbon balances of a tropical forest. The main processes of this model are tree growth, mortality, regeneration, and competition. Model parameters were calibrated using forest inventory data from a tropical forest at Mt. Kilimanjaro. The simulation results showed that the model successfully reproduces important characteristics of tropical forests (aboveground biomass, stem size distribution and leaf area index). The estimated aboveground biomass (385 t/ha) is comparable to biomass values in the Amazon and other tropical forests in Africa. The simulated forest reveals a gross primary production of 24 tcha-1yr-1. Modeling above- and belowground carbon stocks, we analyzed the carbon balance of the investigated tropical forest. The simulated carbon balance of this old-growth forest is zero on average. This study provides an example of how forest models can be used in combination with forest inventory data to investigate forest structure and local carbon balances. PMID:25915854

Comparison of forest edge effects on throughfall deposition in different forest types.

PubMed

Wuyts, Karen; De Schrijver, An; Staelens, Jeroen; Gielis, Leen; Vandenbruwane, Jeroen; Verheyen, Kris

2008-12-01

This study examined the influence of distance to the forest edge, forest type, and time on Cl-, SO4(2-), NO3(-), and NH4+ throughfall deposition in forest edges. The forests were dominated by pedunculate oak, silver birch, or Corsican/Austrian pine, and were situated in two regions of Flanders (Belgium). Along transects, throughfall deposition was monitored at distances of 0-128 m from the forest edge. A repeated-measures analysis demonstrated that time, forest type, and distance to the forest edge significantly influenced throughfall deposition of the ions studied. The effect of distance to the forest edge depended significantly on forest type in the deposition of Cl-, SO4(2-), and NO3(-): the edge effect was significantly greater in pine stands than in deciduous birch and oak stands. This finding supports the possibility of converting pine plantations into oak or birch forests in order to mitigate the input of nitrogen and potentially acidifying deposition.

The removal of pharmaceuticals, personal care products, endocrine disruptors and illicit drugs during wastewater treatment and its impact on the quality of receiving waters.

PubMed

Kasprzyk-Hordern, Barbara; Dinsdale, Richard M; Guwy, Alan J

2009-02-01

A 5-month monitoring program was undertaken in South Wales in the UK to determine the fate of 55 pharmaceuticals, personal care products, endocrine disruptors and illicit drugs (PPCPs) in two contrasting wastewater plants utilising two different wastewater treatment technologies: activated sludge and trickling filter beds. The impact of treated wastewater effluent on the quality of receiving waters was also assessed. PPCPs were found to be present at high loads reaching 10kgday(-1) in the raw sewage. Concentrations of PPCPs in raw sewage were found to correlate with their usage/consumption patterns in Wales and their metabolism. The efficiency of the removal of PPCPs was found to be strongly dependent on the technology implemented in the wastewater treatment plant (WWTP). In general, the WWTP utilising trickling filter beds resulted in, on average, less than 70% removal of all 55 PPCPs studied, while the WWTP utilising activated sludge treatment gave a much higher removal efficiency of over 85%. The monitoring programme revealed that treated wastewater effluents were the main contributors to PPCPs concentrations (up to 3kg of PPCPsday(-1)) in the rivers studied. Bearing in mind that in the cases examined here the WWTP effluents were also major contributors to rivers' flows (dilution factor for the studied rivers did not exceed 23 times) the effect of WWTP effluent on the quality of river water is significant and cannot be underestimated.

Arsenic detection in water: YPO{sub 4}:Eu{sup 3+} nanoparticles

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

Ghosh, Debasish; Luwang, Meitram Niraj, E-mail: mn.luwang@ncl.res.in; Academy of Scientific and Innovative Research

This work reports on the novel technique of detection of arsenic in aqueous solution utilising the luminescence properties of lanthanide doped nanomaterials. Eu{sup 3+} (5%) doped YPO{sub 4}nanorodswere utilised for the said experiment. Co-precipitation method was used for the synthesis of the materials and characterised them with different instrumental techniques like X-ray diffraction (XRD), Infra-red (IR), UV-absorption, scanning electron microscope (SEM), transmission electron microscope (TEM), X-ray photoelectron spectroscopy (XPS) and photoluminescence studies. This nanoparticle can adsorb both arsenic and arsenious acids. We studied the effect of arsenic adsorption on the luminescence behaviour of the nanoparticles. Arsenic acid enhanced the luminescencemore » intensity whereas arsenious acid quenched the luminescence. This luminescence enhancement or quenching is related with arsenic concentration. This relation of luminescence property with concentration of arsenic can be used to detect arsenic in industrial waste. - Graphical abstract: Novel technique of detection of Arsenic ion in aqueous solution utilising the luminescence properties of lanthanide doped nanomaterials. Potential application for detection of arsenic in drinking and industrial waste water. - Highlights: • Novel technique of detection of Arsenic in aqueous solution by YPO{sub 4}:Eu{sup 3+} nanomaterials. • The effect of arsenic adsorption on the luminescence behaviour of the nanoparticles was studied. • Arsenic acid enhance whereas arsenious acid quenches the luminescence intensity. • This technique can be used to detect arsenic in industrial waste.« less

Experiences of homosexual patients' access to primary health care services in Umlazi, KwaZulu-Natal.

PubMed

Cele, Nokulunga H; Sibiya, Maureen N; Sokhela, Dudu G

2015-09-28

Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk. The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province ofKwaZulu-Natal (KZN). A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis. Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel. Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

Protecting the Moon for research: ILEWG report

NASA Astrophysics Data System (ADS)

Foing, Bernard H.

We give a report on recommendations with emphasis on environment protection, and since last COSPAR from ILEWG International conferences Exploration and Utilisation of the Moon on held at Cape Canaveral in 2008 (ICEUM10), and in Beijing in May 2010 with IAF (GLUC -ICEUM11). We discuss the different rationale for Moon exploration, as debated at ILEWG. ILEWG Science task group has listed priorities for scientific investigations: clues on the formation and evolution of rocky planets, accretion and bombardment in the inner solar system, comparative planetology processes (tectonic, volcanic, impact cratering, volatile delivery), records astrobiology, survival of organics; past, present and future life; sciences from a biology lunar laboratory. We discuss how to preserve Moon research potential in these areas while operating with instruments, landers, rover during a cooperative robotic village, and during the transition form lunar human outpost to permanent sustainable human base. We discuss how Moon-Mars Exploration can inspire solutions to global Earth sustained development with the trade-off of In-Situ Utilisation of resources; Establishment of permanent robotic infrastructures, Environmental and planetary protection aspects and lessons for Mars; Life sciences laboratories, and support to human exploration. Co-authors: ILEWG Task Groups on Science, Technology and Human Lunar Bases ILEWG Reference documents: http://sci.esa.int/ilewg -10th ILEWG Conference on Exploration and Utilisation of the Moon, NASA Lunar Ex-ploration Analysis Group-PSace Resources Roundtable, Cape Canaveral October 2008, pro-gramme online at http://sci.esa.int/ilewg/ -9th ILEWG Conference on Exploration and Utilisation of the Moon, ICEUM9 Sorrento 2007, programme online at http://sci.esa.int/ilewg/ -8th ILEWG Conference on Exploration and Utilisation of the Moon, Beijing July 2006, programme online at http://sci.esa.int/ilewg/ -The Moon and Near Earth Objects (P. Ehrenfreund , B.H. Foing, A. Cellino Editors), Ad-vances in Space Research, Volume 37, Issue 1, pp 1-192, 2006 -7th ILEWG Conference on Exploration and Utilisation of the Moon, Toronto Sept 2005, Programme and Proceedings on line at www.ilewg.org, R. Richards et al Editors -6th ILEWG Conference on Exploration and Utilisation of the Moon, Udaipur Nov. 2004, Proceedings ( N. Bhandari Editor), Journal Earth System Science, India, 114, No6, Dec 2005, pp. 573-841 -5th ILEWG Conference on Exploration and Utilisation of the Moon, Hawaii Nov 2003, Pro-ceedings ILC2005/ICEUM5 (S.M. Durst et al Editors), Vol 108, 1-576 pp, Science and Tech-nology Series, American Astronautical Society, 2004 -'The next steps in exploring deep space -A cosmic study by the IAA', W. Huntress, D. Stetson, R. Farquhar, J. Zimmerman, B. Clark, W. O'Neil, R. Bourke and B. Foing, Acta Astronautica, Vol 58, Issues 6-7, March-April 2006, p302-377 -IAA/ESA workshop on "Next Steps in Exploring Deep Space", ESTEC 22-23 sept. 2003 (B.H. Foing W. Huntress, conveners) Lunar Exploration, Planetary and Space Science, Vol 50, issue 14-15, Dec 2002 (B.H. Foing al) -ESLAB36 symposium on "Earth-like Planets and Moons", 2002, ESA-SP514, pp. 1-356, (B.H.Foing B. Battrick, editors) -'Lunar Exploration 2000', (B.H. Foing, D. Heather, Editors), Adv. Space Research Vol 30, Nr 8, 2002 -'Earth-Moon Relationships', Proceedings of the Conference held in Padova, Italy at the Ac-cademia Galileiana di Scienze Lettere ed Arti, Nov. 2000, (C. Barbieri and F. Rampazzi, Editors), in Earth, Moon , Planets Vol. 85-86, Nos 1-3, pp 1-575, 2001 -4th International Conference on Exploration and Utilisation of the Moon, ESTEC, 2000, ESA SP-462 (B.H. Foing M. Perry, editors) -Investing in Space: The Challenge for Europe. Long-Term Space Policy Committee, Second Report, May 1999. ESA-SP-2000 -2nd International Lunar Workshop, held at Kyoto in October 1996, Proceedings, H. Mizutani, editor, Japan Space Forum Publisher, 1997 International Lunar Workshop, 1994 May 31-June 3, Beatenberg, Switzerland. Proceedings. Ed. Balsiger, H. et al. European Space Agency, 1994. ESA-SP-1170 -Astronomy and Space Science from the Moon', Proceedings of COSPAR/IAF session at World Congress, Washington, (B.H. Foing et al editors), Advances in Space Research, Volume 14, Issue 6, 1994 -Mission to the Moon, Europe's Priorities for Scientific Exploration and Utilisation of the Moon', R.M. Bonnet et al, European Space Agency, ESA SP-1150, June 1992

Guidelines and sample protocol for sampling forest gaps.

Treesearch

J.R. Runkle

1992-01-01

A protocol for sampling forest canopy gaps is presented. Methods used in published gap studies are reviewed. The sample protocol will be useful in developing a broader understanding of forest structure and dynamics through comparative studies across different forest ecosystems.

Effects of road network on diversiform forest cover changes in the highest coverage region in China: An analysis of sampling strategies.

PubMed

Hu, Xisheng; Wu, Zhilong; Wu, Chengzhen; Ye, Limin; Lan, Chaofeng; Tang, Kun; Xu, Lu; Qiu, Rongzu

2016-09-15

Forest cover changes are of global concern due to their roles in global warming and biodiversity. However, many previous studies have ignored the fact that forest loss and forest gain are different processes that may respond to distinct factors by stressing forest loss more than gain or viewing forest cover change as a whole. It behooves us to carefully examine the patterns and drivers of the change by subdividing it into several categories. Our study includes areas of forest loss (4.8% of the study area), forest gain (1.3% of the study area) and forest loss and gain (2.0% of the study area) from 2000 to 2012 in Fujian Province, China. In the study area, approximately 65% and 90% of these changes occurred within 2000m of the nearest road and under road densities of 0.6km/km(2), respectively. We compared two sampling techniques (systematic sampling and random sampling) and four intensities for each technique to investigate the driving patterns underlying the changes using multinomial logistic regression. The results indicated the lack of pronounced differences in the regressions between the two sampling designs, although the sample size had a great impact on the regression outcome. The application of multi-model inference indicated that the low level road density had a negative significant association with forest loss and forest loss and gain, the expressway density had a positive significant impact on forest loss, and the road network was insignificantly related to forest gain. The model including socioeconomic and biophysical variables illuminated potentially different predictors of the different forest change categories. Moreover, the multiple comparisons tested by Fisher's least significant difference (LSD) were a good compensation for the multinomial logistic model to enrich the interpretation of the regression results. Copyright © 2016 Elsevier B.V. All rights reserved.

Forest/non-forest mapping using inventory data and satellite imagery

Treesearch

Ronald E. McRoberts

2002-01-01

For two study areas in Minnesota, USA, one heavily forested and one sparsely forested, maps of predicted proportion forest area were created using Landsat Thematic Mapper imagery, forest inventory plot data, and two prediction techniques, logistic regression and a k-Nearest Neighbours technique. The maps were used to increase the precision of forest area estimates by...

The effects of forest fragmentation on forest stand attributes

Treesearch

Ronald E. McRoberts; Greg C. Liknes

2002-01-01

For two study areas in Minnesota, USA, one heavily forested and one sparsely forested, maps of predicted proportion forest area were created using Landsat Thematic Mapper imagery, forest inventory plot data, and a logistic regression model. The maps were used to estimate quantitative indices of forest fragmentation. Correlations between the values of the indices and...

Centerpiece of research on the Penobscot Experimental Forest: the US Forest Service long-term silvicultural study

Treesearch

John C. Brissette; Laura S. Kenefic

2014-01-01

Established between 1952 and 1957, the U.S. Department of Agriculture, Forest Service experiment comparing several silvicultural treatments is not only the centerpiece of research on the Penobscot Experimental Forest in Maine, it is also one of the longest-running, replicated studies of how management techniques influence forest dynamics in North America. Ten...

Effects of rapid urban sprawl on urban forest carbon stocks: integrating remotely sensed, GIS and forest inventory data.

PubMed

Ren, Yin; Yan, Jing; Wei, Xiaohua; Wang, Yajun; Yang, Yusheng; Hua, Lizhong; Xiong, Yongzhu; Niu, Xiang; Song, Xiaodong

2012-12-30

Research on the effects of urban sprawl on carbon stocks within urban forests can help support policy for sustainable urban design. This is particularly important given climate change and environmental deterioration as a result of rapid urbanization. The purpose of this study was to quantify the effects of urban sprawl on dynamics of forest carbon stock and density in Xiamen, a typical city experiencing rapid urbanization in China. Forest resource inventory data collected from 32,898 patches in 4 years (1972, 1988, 1996 and 2006), together with remotely sensed data (from 1988, 1996 and 2006), were used to investigate vegetation carbon densities and stocks in Xiamen, China. We classified the forests into four groups: (1) forest patches connected to construction land; (2) forest patches connected to farmland; (3) forest patches connected to both construction land and farmland and (4) close forest patches. Carbon stocks and densities of four different types of forest patches during different urbanization periods in three zones (urban core, suburb and exurb) were compared to assess the impact of human disturbance on forest carbon. In the urban core, the carbon stock and carbon density in all four forest patch types declined over the study period. In the suburbs, different urbanization processes influenced forest carbon density and carbon stock in all four forest patch types. Urban sprawl negatively affected the surrounding forests. In the exurbs, the carbon stock and carbon density in all four forest patch types tended to increase over the study period. The results revealed that human disturbance played the dominant role in influencing the carbon stock and density of forest patches close to the locations of human activities. In forest patches far away from the locations of human activities, natural forest regrowth was the dominant factor affecting carbon stock and density. Copyright © 2012 Elsevier Ltd. All rights reserved.

Impact of Noncommunicable Disease Multimorbidity on Healthcare Utilisation and Out-Of-Pocket Expenditures in Middle-Income Countries: Cross Sectional Analysis.

PubMed

Lee, John Tayu; Hamid, Fozia; Pati, Sanghamitra; Atun, Rifat; Millett, Christopher

2015-01-01

The burden of non-communicable disease (NCDs) has grown rapidly in low- and middle-income countries (LMICs), where populations are ageing, with rising prevalence of multimorbidity (more than two co-existing chronic conditions) that will significantly increase pressure on already stretched health systems. We assess the impact of NCD multimorbidity on healthcare utilisation and out-of-pocket expenditures in six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Secondary analyses of cross-sectional data from adult participants (>18 years) in the WHO Study on Global Ageing and Adult Health (SAGE) 2007-2010. We used multiple logistic regression to determine socio-demographic correlates of multimorbidity. Association between the number of NCDs and healthcare utilisation as well as out-of-pocket spending was assessed using logistic, negative binominal and log-linear models. The prevalence of multimorbidity in the adult population varied from 3.9% in Ghana to 33.6% in Russia. Number of visits to doctors in primary and secondary care rose substantially for persons with increasing numbers of co-existing NCDs. Multimorbidity was associated with more outpatient visits in China (coefficient for number of NCD = 0.56, 95% CI = 0.46, 0.66), a higher likelihood of being hospitalised in India (AOR = 1.59, 95% CI = 1.45, 1.75), higher out-of-pocket expenditures for outpatient visits in India and China, and higher expenditures for hospital visits in Russia. Medicines constituted the largest proportion of out-of-pocket expenditures in persons with multimorbidity (88.3% for outpatient, 55.9% for inpatient visit in China) in most countries. Multimorbidity is associated with higher levels of healthcare utilisation and greater financial burden for individuals in middle-income countries. Our study supports the WHO call for universal health insurance and health service coverage in LMICs, particularly for vulnerable groups such as the elderly with multimorbidity.

Communally Nesting Migratory Birds Create Ecological Hot-Spots in Tropical Australia.

PubMed

Natusch, Daniel J D; Lyons, Jessica A; Brown, Gregory; Shine, Richard

2016-01-01

Large numbers of metallic starlings (Aplonis metallica) migrate annually from New Guinea to the rainforests of tropical Australia, where they nest communally in single emergent trees (up to 1,000 birds). These aggregations create dense and species-rich faunal "hot-spots", attracting a diverse assemblage of local consumers that utilise this seasonal resource. The starlings nested primarily in poison-dart trees (Antiaris toxicaria) near the rainforest-woodland boundary. Surveys underneath these colonies revealed that bird-derived nutrients massively increased densities of soil invertebrates and mammals (primarily wild pigs) beneath trees, year-round. Flying invertebrates, nocturnal birds, reptiles, and amphibians congregated beneath the trees when starlings were nesting (the wet-season). Diurnal birds (primarily cockatoos and bush turkeys) aggregated beneath the trees during the dry-season to utilise residual nutrients when the starlings were not nesting. The abundance of several taxa was considerably higher (to > 1000-fold) under colony trees than under nearby trees. The system strikingly resembles utilisation of bird nesting colonies by predators in other parts of the world but this spectacular system has never been described, emphasizing the continuing need for detailed natural-history studies in tropical Australia.

Communally Nesting Migratory Birds Create Ecological Hot-Spots in Tropical Australia

PubMed Central

Natusch, Daniel J. D.; Lyons, Jessica A.; Brown, Gregory; Shine, Richard

2016-01-01

Large numbers of metallic starlings (Aplonis metallica) migrate annually from New Guinea to the rainforests of tropical Australia, where they nest communally in single emergent trees (up to 1,000 birds). These aggregations create dense and species-rich faunal “hot-spots”, attracting a diverse assemblage of local consumers that utilise this seasonal resource. The starlings nested primarily in poison-dart trees (Antiaris toxicaria) near the rainforest-woodland boundary. Surveys underneath these colonies revealed that bird-derived nutrients massively increased densities of soil invertebrates and mammals (primarily wild pigs) beneath trees, year-round. Flying invertebrates, nocturnal birds, reptiles, and amphibians congregated beneath the trees when starlings were nesting (the wet-season). Diurnal birds (primarily cockatoos and bush turkeys) aggregated beneath the trees during the dry-season to utilise residual nutrients when the starlings were not nesting. The abundance of several taxa was considerably higher (to > 1000-fold) under colony trees than under nearby trees. The system strikingly resembles utilisation of bird nesting colonies by predators in other parts of the world but this spectacular system has never been described, emphasizing the continuing need for detailed natural-history studies in tropical Australia. PMID:27706197

Social media in health professional education: a student perspective on user levels and prospective applications.

PubMed

Maloney, Stephen; Moss, Alan; Ilic, Dragan

2014-12-01

Social Networking Sites (SNS) have seen exponential growth in recent years. The high utilisation of SNS by tertiary students makes them an attractive tool for educational institutions. This study aims to identify health professional students' use and behaviours with SNS, including students' perspectives on potential applications within health professional curricula. Students enrolled in an undergraduate physiotherapy program were invited to take part in an anonymous, online questionnaire at the end of 2012. The survey consisted of 20 items, gathering demographic data, information on current use of SNS, and opinions regarding the application of SNS into education. Both quantitative and qualitative data were gathered. A total of 142 students, from all years of study, completed the online questionnaire. Only two participants were not current users of social media. Facebook and YouTube had been utilised for educational purposes by 97 and 60 % of participants respectively; 85 % believed that SNS could benefit their learning experience. Only five respondents were not interested in following peers, academic staff, clinicians or professional associations on Facebook. Four key themes emerged: peer collaboration, need for separation between personal and professional realms, complimentary learning and enhanced communication. Students wish to make educational connections via SNS, yet expressed a strong desire to maintain privacy, and a distinction between personal and professional lives. Educational utilisation of SNS may improve communication speed and accessibility. Any educator involvement should be viewed with caution.

Acceptance and utilisation of the Incident Command System in first response and allied disciplines: an Ohio study.

PubMed

Decker, Russell J

2011-10-01

In response to the terrorist attacks of September 11th, 2001, an effort was made to establish a common and uniform command structure for use by the nation's first responder organisations, as well as those disciplines generally expected to assist first responders during a major incident or disaster. The result was the issuance of the National Incident Management System1 or NIMS by the US Department of Homeland Security in 2004. Included in the NIMS document was an embracing of the Incident Command System or ICS, long utilised in the fire service for the effective management of emergency response. The NIMS doctrine also identified certain allied disciplines that needed to adopt this new system for responding to major events. Some of these disciplines included specialised first response units, such as, bomb squads and hazardous materials teams. Other partner disciplines not usually associated with emergency response to include public health and public works were also included. This study will attempt to look at a single component of NIMS, specifically the Incident Command System, and measure its acceptance and utilisation by first responder organisations and selected allied disciplines in the state of Ohio. This is particularly important at this time since the US government is being forced to reduce budgets significantly and determine which laudable policies and programmes will be cut.

The Ottawa ankle rules for the use of diagnostic X-ray in after hours medical centres in New Zealand.

PubMed

Wynn-Thomas, Simon; Love, Tom; McLeod, Deborah; Vernall, Sue; Kljakovic, Marjan; Dowell, Antony; Durham, John

2002-09-27

The aims of this study were to measure baseline use of Ottawa ankle rules (OAR), validate the OAR and, if appropriate, explore the impact of implementing the Rules on X-ray rates in a primary care, after hours medical centre setting. General practitioners (GPs) were surveyed to find their awareness of ankle injury guidelines. Data concerning diagnosis and X-ray utilisation were collected prospectively for patients presenting with ankle injuries to two after hours medical centres. The OAR were applied retrospectively, and the sensitivity and specificity of the OAR were compared with GPs clinical judgement in ordering X-rays. The outcome measures were X-ray utilisation and diagnosis of fracture. Awareness of the OAR was low. The sensitivity of the OAR for diagnosis of fractures was 100% (95% CI: 75.3 - 100) and the specificity was 47% (95% CI: 40.5 - 54.5). The sensitivity of GPs clinical judgement was 100% (95% CI: 75.3 - 100) and the specificity was 37% (95% CI: 30.2 - 44.2). Implementing the OAR would reduce X-ray utilisation by 16% (95% CI: approx 10.8 - 21.3). The OAR are valid in a New Zealand primary care setting. Further implementation of the rules would result in some reduction of X-rays ordered for ankle injuries, but less than the reduction found in previous studies.

Contraceptive Utilisation Among Mothers of Reproductive Age in Ajman, United Arab Emirates.

PubMed

Kanwal, Naila; Muttappallymyalil, Jayakumary; Al-Sharbatti, Shatha; Ismail, Iman

2017-02-01

This study aimed to determine contraceptive utilisation among mothers aged 18-49 years old in Ajman, United Arab Emirates (UAE). This cross-sectional study was carried out from May to November 2013. A total of 400 participants were recruited from two primary healthcare centres and one private hospital in Ajman. An interviewer-administered validated questionnaire was used for data collection. The frequency of previous and current contraceptive use was 68.0% and 61.8%, respectively. Expatriates more frequently used contraceptives in comparison to Emiratis (77.3% versus 54.3%, respectively). Contraceptive use increased significantly with age (75.5% among >35-year-olds versus 57.3% among ≤25-year-olds; P <0.050) and education level (83.3% among postgraduates versus 60.0% among those with primary education; P <0.050). In addition, contraceptive use was significantly higher among those living in a nuclear family system ( P <0.050). A univariate analysis indicated significant associations between contraceptive use and age, nationality, education level, type of family system, employment sector, parity, knowledge of birth control measures and source of birth control information ( P <0.050 each). However, no significant associations were found via multivariate analysis. Healthcare practitioners can play a pivotal role in providing contraceptive advice which could lead to an improvement in contraceptive utilisation. Efforts are recommended to raise awareness regarding newer forms of contraceptives among mothers of reproductive age in the UAE.

Why do forest products become less available?A pan-tropical comparison of drivers of forest-resource degradation

NASA Astrophysics Data System (ADS)

Hermans-Neumann, Kathleen; Gerstner, Katharina; Geijzendorffer, Ilse R.; Herold, Martin; Seppelt, Ralf; Wunder, Sven

2016-12-01

Forest products provide an important source of income and wellbeing for rural smallholder communities across the tropics. Although tropical forest products frequently become over-exploited, only few studies explicitly address the dynamics of degradation in response to socio-economic drivers. Our study addresses this gap by analyzing the factors driving changes in tropical forest products in the perception of rural smallholder communities. Using the poverty and environment network global dataset, we studied recently perceived trends of forest product availability considering firewood, charcoal, timber, food, medicine, forage and other forest products. We looked at a pan-tropical sample of 233 villages with forest access. Our results show that 90% of the villages experienced declining availability of forest resources over the last five years according to the informants. Timber and fuelwood together with forest foods were featured as the most strongly affected, though with marked differences across continents. In contrast, availability of at least one main forest product was perceived to increase in only 39% of the villages. Furthermore, the growing local use of forest resources is seen as the main culprit for the decline. In villages with both growing forest resource use and immigration—vividly illustrating demographic pressures—the strongest forest resources degradation was observed. Conversely, villages with little or no population growth and a decreased use of forest resources were most likely to see significant forest-resource increases. Further, villages are less likely to perceive resource declines when local communities own a significant share of forest area. Our results thus suggest that perceived resource declines have only exceptionally triggered adaptations in local resource-use and management patterns that would effectively deal with scarcity. Hence, at the margin this supports neo-Malthusian over neo-Boserupian explanations of local resource-use dynamics.

Redirecting Under-Utilised Computer Laboratories into Cluster Computing Facilities

ERIC Educational Resources Information Center

Atkinson, John S.; Spenneman, Dirk H. R.; Cornforth, David

2005-01-01

Purpose: To provide administrators at an Australian university with data on the feasibility of redirecting under-utilised computer laboratories facilities into a distributed high performance computing facility. Design/methodology/approach: The individual log-in records for each computer located in the computer laboratories at the university were…

76 FR 82279 - Electronic Delivery of Search Results From the United States Patent and Trademark Office to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... 141 EPC and new Rule 70b EPC--utilisation scheme, OJ EPO 2010, 410. To assist U.S. applicants who... exemption under Rule 141(2) EPC from filing a copy of the search results--utilisation scheme, OJ EPO 2011...

Beyond Problem-Based Learning: Using Dynamic PBL in Chemistry

ERIC Educational Resources Information Center

Overton, Tina L.; Randles, Christopher A.

2015-01-01

This paper describes the development and implementation of a novel pedagogy, dynamic problem-based learning. The pedagogy utilises real-world problems that evolve throughout the problem-based learning activity and provide students with choice and different data sets. This new dynamic problem-based learning approach was utilised to teach…

Spatio-temporal changes in biomass carbon sinks in China's forests from 1977 to 2008.

PubMed

Guo, Zhaodi; Hu, Huifeng; Li, Pin; Li, Nuyun; Fang, Jingyun

2013-07-01

Forests play a leading role in regional and global carbon (C) cycles. Detailed assessment of the temporal and spatial changes in C sinks/sources of China's forests is critical to the estimation of the national C budget and can help to constitute sustainable forest management policies for climate change. In this study, we explored the spatio-temporal changes in forest biomass C stocks in China between 1977 and 2008, using six periods of the national forest inventory data. According to the definition of the forest inventory, China's forest was categorized into three groups: forest stand, economic forest, and bamboo forest. We estimated forest biomass C stocks for each inventory period by using continuous biomass expansion factor (BEF) method for forest stands, and the mean biomass density method for economic and bamboo forests. As a result, China's forests have accumulated biomass C (i.e., biomass C sink) of 1896 Tg (1 Tg=10(12) g) during the study period, with 1710, 108 and 78 Tg C in forest stands, and economic and bamboo forests, respectively. Annual forest biomass C sink was 70.2 Tg C a(-1), offsetting 7.8% of the contemporary fossil CO2 emissions in the country. The results also showed that planted forests have functioned as a persistent C sink, sequestrating 818 Tg C and accounting for 47.8% of total C sink in forest stands, and that the old-, mid- and young-aged forests have sequestrated 930, 391 and 388 Tg C from 1977 to 2008. Our results suggest that China's forests have a big potential as biomass C sink in the future because of its large area of planted forests with young-aged growth and low C density.

Mapping Historic Gypsy Moth Defoliation with MODIS Satellite Data: Implications for Forest Threat Early Warning System

NASA Technical Reports Server (NTRS)

Spurce, Joseph P.; Hargrove, William; Ryan, Robert E.; Smooth, James C.; Prados, Don; McKellip, Rodney; Sader, Steven A.; Gasser, Jerry; May, George

2008-01-01

This viewgraph presentation reviews a project, the goal of which is to study the potential of MODIS data for monitoring historic gypsy moth defoliation. A NASA/USDA Forest Service (USFS) partnership was formed to perform the study. NASA is helping USFS to implement satellite data products into its emerging Forest Threat Early Warning System. The latter system is being developed by the USFS Eastern and Western Forest Threat Assessment Centers. The USFS Forest Threat Centers want to use MODIS time series data for regional monitoring of forest damage (e.g., defoliation) preferably in near real time. The study's methodology is described, and the results of the study are shown.

Acceleration and novelty: community restoration speeds recovery and transforms species composition in Andean cloud forest.

PubMed

Wilson, Sarah Jane; Rhemtulla, Jeanine M

2016-01-01

Community-based tropical forest restoration projects, often promoted as a win-win solution for local communities and the environment, have increased dramatically in number in the past decade. Many such projects are underway in Andean cloud forests, which, given their extremely high biodiversity and history of extensive clearing, are understudied. This study investigates the efficacy of community-based tree-planting projects to accelerate cloud forest recovery, as compared to unassisted natural regeneration. This study takes place in northwest Andean Ecuador, where the majority of the original, highly diverse cloud forests have been cleared, in five communities that initiated tree-planting projects to restore forests in 2003. In 2011, we identified tree species along transects in planted forests (n = 5), naturally regenerating forests (n = 5), and primary forests (n = 5). We also surveyed 120 households about their restoration methods, tree preferences, and forest uses. We found that tree diversity was higher in planted than in unplanted secondary forest, but both were less diverse than primary forests. Ordination analysis showed that all three forests had distinct species compositions, although planted forests shared more species with primary forests than did unplanted forests. Planted forests also contained more animal-dispersed species in both the planted canopy and in the unplanted, regenerating understory than unplanted forests, and contained the highest proportion of species with use value for local people. While restoring forest increased biodiversity and accelerated forest recovery, restored forests may also represent novel ecosystems that are distinct from the region's previous ecosystems and, given their usefulness to people, are likely to be more common in the future.

Forest edges: Effects on vegetation, environmental gradients and local avian communities in the Sierra Juarez, Oaxaca, Mexico

NASA Astrophysics Data System (ADS)

Burcsu, Theresa Katherine

Edge effects are among the most serious threats to forest integrity because as global forest cover decreases overall, forest edge influence increases proportionally, driving habitat change and loss. Edge effects occur at the division between adjacent habitat types. Our understanding of edge effects comes mainly from tropical wet, temperate and boreal forests. Because forest structure in moisture-limited forests differs from wetter forest types, edge dynamics are likely to differ as well. Moreover, dry forests in the tropics have been nearly eliminated or exist only as forest fragments, making edge influence an important conservation and management concern for remaining dry forests. This study addresses this gap in the edge influence knowledge by examining created, regenerating edges associated with forest management in a seasonally dry pine-oak forest of Oaxaca, creating a new data point in edge effects research. In this study I used Landsat TM imagery and a modified semivariance analysis to estimate the distance of edge influence for vegetation. I also used field methods to characterize forest structure and estimate edge influence on canopy and subcanopy vegetation. To finalize the project I extended the study to bird assemblages to identify responses and habitat preferences to local-scale changes associated with regenerating edges created by group-selection timber harvest. Remote sensing analysis estimated that the distance of edge influence was 30-90 m from the edge. Vegetation analysis suggested that edge effects were weak relative to wetter forest types and that remote sensing data did not provide an estimate that was directly applicable to field-measured vegetative edge effects. The bird assemblages likewise responded weakly to habitat change associated with edge effect. Open canopy structure, simple vertical stratigraphy, and topographic variation create forest conditions in which small openings do not create a high contrast to undisturbed forest. Thus, in this seasonally dry, open forest, vegetation and bird communities respond less to small openings than they do in wetter, more closed-canopy forests. Management practices and historical land-use interact and interfere with the detectability of edge influence in our study area. These results support hypotheses proposed for open forest types and suggest that patterns in edge influence in wet forest types may not be applicable to dry sites.

The uptake of dental services by elderly Germans.

PubMed

Nitschke, I; Müller, F; Hopfenmüller, W

2001-12-01

The aim of the study was to assess the uptake of dental services by the old and very old population within the scope of the Berlin Aging Study (Berliner Altersstudie BASE). A multi-disciplinary structured interview was performed on 928 subjects, aged from 70 to 103 years of whom 516 persons volunteered to take part in a 14-session intensive protocol. Six representative study groups were matched for age and gender. Subjects were asked to recall the timing of their most recent dental visit. Data were validated by sending for dental records and compared with all study participants from the multi-disciplinary intake assessment. Data were related to age group, dental state, dementia and education. Reported last contact with dental services ranged from 2 weeks to 52 years (median 18 months) with a higher time lapse in the study groups aged 85 and older. Dentate subjects had seen their dentist more recently than edentate subjects. Higher education correlated with an increased dental utilisation. Subjective memory on the time lapse since the last dental appointment coincided in 13% of the subjects with available dental records (n=84), was misjudged between one and six months in 55%, and by more than six months in the remainder. Moderately or severely demented subjects who remembered their last dental appointment (n=48 of 70) showed no consistently different utilisation to healthy or mildly demented study participants. Edentate old and very old subjects show the least frequent utilisation of dental services. Data on motivation and barriers to care are needed to develop strategies to improve the use of dental services and thus promote oral health in late life.

Measures of upper limb function for people with neck pain: a systematic review of measurement and practical properties (protocol).

PubMed

Alreni, Ahmad Salah Eldin; Harrop, Deborah; Gumber, Anil; McLean, Sionnadh

2015-04-07

Upper limb disability is a common musculoskeletal condition frequently associated with neck pain. Recent literature has reported the need to utilise validated upper limb outcome measures in the assessment and management of patients with neck pain. However, there is a lack of clear guidance about the suitability of available measures, which may impede utilisation. This review will identify all available measures of upper limb function developed for use in neck pain patients and evaluate their measurement and practical properties in order to identify those measures that are most appropriate for use in clinical practice and research. This review will be performed in two phases. Phase one will identify all measures used to assess upper limb function for patients with neck pain. Phase two will identify all available studies of the measurement and practical properties of identified instrument. The COnsensus-based Standards for selection of health Measurement INstrument (COSMIN) will be used to evaluate the methodological quality of the included studies. To ensure methodological rigour, the findings of this review will be reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline. Optimal management of patients with neck pain should incorporate upper limb rehabilitation. The findings of this study will assist clinicians who seek to utilise suitable and accurate measures to assess upper limb function for a patient with neck pain. In addition, the findings of this study may suggest new research directions to support the development of upper limb outcome measures for patients with neck pain. PROSPERO CRD42015016624.

Have we been successful? Monitoring horizontal forest complexity for forest restoration projects

Treesearch

Yvette L. Dickinson; Kristen A. Pelz; Emma Giles; Josh Howie

2016-01-01

Forest management today often seeks to restore ecological integrity and enhance human well-being by increasing forest complexity, resilience, and functionality. However, effective and financially expedient monitoring of forest complexity is challenging. In this study, we developed a practical and inexpensive technique to measure horizontal forest complexity....

Effect of dietary calcium level and source on mineral utilisation by piglets fed diets containing exogenous phytase.

PubMed

Schlegel, P; Gutzwiller, A

2017-10-01

Calcium and phosphorus are essential minerals, closely linked in digestive processes and metabolism. With widespread use of low P diets containing exogenous phytase, the optimal dietary Ca level was verified. The 40-day study evaluated the effects of Ca level (4, 7 and 10 g/kg diet) and Ca source (Ca from CaCO 3 and from Lithothamnium calcareum) on mineral utilisation in 72 piglets (7.9 ± 1.0 kg BW) fed an exogenous phytase containing diet with 2.9 g digestible P/kg. Measured parameters were growth performance, stomach mineral solubility, bone breaking strength and urinary, serum and bone mineral concentration. The apparent total tract digestibility of minerals was also assessed in the two diets with 7 g Ca/kg, using 12 additional pigs. Regardless of Ca source, increasing dietary Ca impaired feed conversion ratio, increased urinary pH, increased serum and urinary Ca, decreased serum and urinary P, decreased serum Mg and increased urinary Mg, increased serum AP activity, decreased bone Mg increased bone Zn. Bone breaking strength was improved with 7 compared to 4 g Ca/kg. Compared to CaCO 3 , Ca from Lithothamnium calcareum increased serum Mg and with, 10 g Ca/kg, it limited body weight gain. The dose response of Ca in a diet with 2.9 g digestible P/kg and including exogenous phytase indicated that: (i) a low dietary Ca was beneficial for piglet growth, but was limiting the metabolic use of P; (ii) a high dietary Ca level impaired P utilisation; (iii) the optimal P utilisation and bone breaking strength was obtained with a dietary Ca-to-digestible P ratio of 2.1 to 2.4:1; (iv). Increasing dietary Ca reduced Mg utilisation, but not Zn status, when fed at adequate level. Finally, Ca from Lithothamnium calcareum had similar effects on Ca and P metabolism as CaCO 3 , but impaired growth when fed at the highest inclusion level. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

Spanish nurses' attitudes towards research and perceived barriers and facilitators of research utilisation: a comparative survey of nurses with and without experience as principal investigators.

PubMed

Moreno-Casbas, Teresa; Fuentelsaz-Gallego, Carmen; de Miguel, Angel Gil; González-María, Esther; Clarke, Sean P

2011-07-01

To examine attitudes towards research and perceived barriers and facilitators of research utilisation in clinical practice in a broad cross-section of Spanish nurses. Nurses' attitudes towards research are critical in determining whether study findings are used to improve practice. Cross-sectional comparative survey in Hospitals, Primary Care Centres and University-affiliated schools of nursing. Surveys were completed by 917 nurses: 69 who received funding from the Spanish national agency (1998-2004) and a nationally representative sample of 848 nurses who did not have the same research experience (the Comparison group). Two instruments (BARRIERS and Attitudes towards nursing research) were translated and culturally adapted for use in Spain. A descriptive analysis of demographic and practice characteristics was performed. Total scale scores, as well as subscale scores, were computed and compared across the two groups using one-way analysis of variance (anova) and multivariate analysis of variance (manova) with post hoc tests. Pearson product-moment correlation coefficients were computed between the total tool scores and subscales measuring barriers and attitudes in both groups. The investigators differed from other nurses on several demographic and work characteristics (more males, older age and more likely to work a fixed day shift schedule). On the whole, investigators showed more favourable attitudes but perceived several elements as posing greater barriers to research utilisation than the Comparison groups. Across all respondents, issues related to the quality of research were rated as the greatest barriers to research utilisation, followed by organisational barriers, barriers involving the communication of findings and finally, those related to nurses' values, awareness and skills. Very similar profiles of perceptions and attitudes regarding research were found in these samples of Spanish nurses relative to those from other countries in earlier reports. Nurses who had experience conducting research demonstrated more favourable research-related attitudes and perceived barriers differently than those without such experience. Understanding different organisational and experience perspectives is important to identify challenges and opportunities to ensure research utilisation in clinical practice. © 2011 Blackwell Publishing Ltd.

Utilisation of antithrombotic therapy for stroke prevention in atrial fibrillation in a Sydney hospital: then and now.

PubMed

Bajorek, Beata V; Ren, Shu

2012-02-01

Evidence from pivotal clinical trials conducted more than a decade ago supports the use of antithrombotic therapy, particularly warfarin, for stroke prevention in atrial fibrillation (AF). Despite the wide dissemination of this evidence since that time, there is anecdotal evidence that utilisation of therapy remains suboptimal, especially in the target elderly population, which is reflected in the development of practice tools such as the TAG Clinical Indicator ('Antithrombotics in AF' Indicator 1.6, 2007). Therefore, the objective of this study was to determine the current utilisation of antithrombotic therapy for elderly patients with AF in the local setting, and to compare this utilisation with the results of a prior audit (AUDIT 1), as well as against the recommendations of the TAG Clinical Indicator (TAG IND). A major teaching hospital in Sydney, Australia. A retrospective audit (AUDIT 2) of medical records of hospital inpatients (aged 65 years, with a significant diagnosis of AF), pertaining to admissions over the 12-month period 1st June 2006-31st May 2007, was conducted. Proportion of patients receiving antithrombotic therapy at the point of discharge from hospital. A total of 201 patients (mean age 79.8 ± 7.8 years) were reviewed in AUDIT 2. Most (85%) patients received antithrombotic therapy (vs. 79.2%, AUDIT 1), with "warfarin ± antiplatelets" most frequently (46.3%) used (vs. 34.5%, AUDIT 1), followed by "aspirin ± other antiplatelet" (33.3% AUDIT 2 vs. 43.1% AUDIT 1). Patients aged 80 years were significantly less likely to receive warfarin therapy, compared to those <80 years (40.2% vs. 52.5%, P = 0.01). Of those patients who were deemed 'eligible' for warfarin according to AUDIT 2 (n = 155), only 55.0% of patients were actually prescribed this treatment. Results obtained by AUDIT 2 and TAG IND were overall comparable. Whilst there have been temporal improvements in the overall utilisation of antithrombotic therapy, including warfarin, there are still significant gaps in the translation of evidence from clinical trials to clinical practice. Further sustainable intervention is warranted to help apply treatment recommendations to the target population.

Consumer access to clozapine in Australia: how does this compare to New Zealand and the United Kingdom?

PubMed

Knowles, Sally-Anne; Mcmillan, Sara S; Wheeler, Amanda J

2016-01-01

Clozapine is an antipsychotic medication used in treatment resistant schizophrenia. However, clozapine is associated with a significant adverse effect profile and extensive monitoring is required to optimise consumer safety. Traditionally, clozapine can only be prescribed by a psychiatrist and dispensed at a hospital or hospital affiliated pharmacy in Australia. These restrictions could result in significant treatment burden for consumers taking clozapine. To identify (1) the different models of supply that exist for people living in the community taking clozapine in Australia and compare to those in New Zealand and the United Kingdom, and (2) explore how these supply models may impact on consumer burden from the perspective of professionals involved in the supply of clozapine. Key informants were interviewed (n=8) from Australia, New Zealand and the United Kingdom regarding how consumers, who lived in the community, accessed clozapine. Data were analysed and led to the development of four clozapine supply models. These four models were further validated by an online survey of a wider sample (n=30). Data were analysed thematically and via simple descriptive statistics. Clozapine supply varied depending on location. A secondary care model was utilised in the United Kingdom compared to a community based (primary care) model in New Zealand; Australia utilised a mixture of both secondary and primary care. A key theme from all study participants was that community pharmacy should be utilised to dispense clozapine to consumers living in the community, provided adequate training and safeguards are in place. It was noted that the utilisation of community pharmacies could improve access and flexibility, thereby reducing treatment burden for these consumers. There are predominately two models for supply of clozapine to consumers living in the community in Australia, New Zealand and the United Kingdom. One model utilises secondary care facilities and the other community services. Community pharmacy is ideally placed to increase access to clozapine for consumers living in the community, provided appropriate training and support is given to pharmacists providing this professional service.

Does increasing rotation length lead to greater forest carbon storage?

NASA Astrophysics Data System (ADS)

Ter-Mikaelian, M. T.; Colombo, S. J.; Chen, J.

2016-12-01

Forest management is a key factor affecting climate change mitigation by forests. Increasing the age of harvesting (also referred to as rotation length) is a management practice that has been proposed as a means of increasing forest carbon sequestration and storage. However, studies of the effects of increasing harvest age on forest carbon stocks have mostly been limited to forest plantations. In contrast, this study assesses the effects of increased harvest age of managed natural forests of Ontario (Canada) at two scales. At the stand level, we assess merchantable volume yield curves to differentiate those for which increasing the age of harvest results in an increase in total forest carbon stocks versus those for which increased harvest age reduces carbon stocks. The stand level results are then applied to forest landscapes to demonstrate that the effect of increasing the age of harvest on forest carbon storage is specific to the forest growth rates for a given forest landscape and depends on the average age at which forests are harvested under current (business-as-usual) management practice. We discuss the implications of these results for forest management aimed at mitigating climate change.

Structure and composition of altered riparian forests in an agricultural Amazonian landscape.

PubMed

Nagy, R Chelsea; Porder, Stephen; Neill, Christopher; Brando, Paulo; Quintino, Raimundo Mota; do Nascimento, Sebastiâo Aviz

2015-09-01

Deforestation and fragmentation influence the microclimate, vegetation structure, and composition of remaining patches of tropical forest. In the southern Amazon, at the frontier of cropland expansion, forests are converted and fragmented in a pattern that leaves standing riparian forests whose dimensions are mandated by the Brazilian National Forest Code. These altered riparian forests share many characteristics of well-studied upland forest fragments, but differ because they remain connected to larger areas of forest downstream, and because they may experience wetter soil conditions because reduction of forest cover in the surrounding watershed raises groundwater levels and increases stream runoff. We compared forest regeneration, structure, composition, and diversity in four areas of intact riparian forest and four areas each of narrow, medium, and wide altered riparian forests that have been surrounded by agriculture since the early 1980s. We found that seedling abundance was reduced by as much as 64% and sapling abundance was reduced by as much as 67% in altered compared to intact riparian forests. The most pronounced differences between altered and intact forest occurred near forest edges and within the narrowest sections of altered riparian forests. Woody plant species composition differed and diversity was reduced in altered forests compared to intact riparian forests. However, despite being fragmented for several decades, large woody plant biomass and carbon storage, the number of live or dead large woody plants, mortality rates, and the size distribution of woody plants did not differ significantly between altered and intact riparian forests. Thus, even in these relatively narrow forests with high edge: area ratios, we saw no evidence of the increases in mortality and declines in biomass that have been found in other tropical forest fragment studies. However, because of the changes in both species community and reduced regeneration, it is unclear how long this relative lack of change will be sustained. Additionally, Brazil recently passed a law in their National Forest Code allowing narrower riparian buffers than those studied here in restored areas, which could affect their long-term sustainability.

Uncertainty of large-area estimates of indicators of forest structural gamma diversity: A study based on national forest inventory data

Treesearch

Susanne Winter; Andreas Böck; Ronald E. McRoberts

2012-01-01

Tree diameter and height are commonly measured forest structural variables, and indicators based on them are candidates for assessing forest diversity. We conducted our study on the uncertainty of estimates for mostly large geographic scales for four indicators of forest structural gamma diversity: mean tree diameter, mean tree height, and standard deviations of tree...

Long-term research on classical silvicultural approaches in the Acadian Forest: Penobscot Experimental Forest Part I

Treesearch

John C. Brissette; Michael R. Saunders; Laura S. Kenefic; Paul E. Sendak

2006-01-01

The most comprehensive study of stand dynamics in the Acadian Forest Region is an experiment by the USDA Forest Service at the Penobscot Experimental Forest (PEF) in Maine. It was established from 1952-1957 to study changes in structure, composition, and productivity from an array of silvicultural treatments. Ingrowth, accretion, and mortality of individual trees (!Y0....

Forest Dynamics in the Eastern Ghats of Tamil Nadu, India

NASA Astrophysics Data System (ADS)

Jayakumar, S.; Ramachandran, A.; Bhaskaran, G.; Heo, J.

2009-02-01

The primary deciduous forests in the Eastern Ghats (EG) of Tamil Nadu (TN) India have undergone many changes owing to various need-based forest managements, such as timber extraction for industry, railway sleepers, charcoal, and forest clearance for hydroelectric projects and agriculture, during preindependence and postindependence periods (i.e., from 1800 to 1980). The enactment of a forest conservation act during the 1980s changed the perception of forest managers from utilization to conservation. This study was taken up to assess the forests dynamics in the EG of TN spatially between 1990 and 2003 and nonspatially between 1900 and the 1980s. Landsat Thematic Mapper (TM) and Indian Remote Sensing satellite (IRS) 1D Linear Imaging and Self Scanning (LISS III) data were used to assess forests during 1990 and 2003, respectively. Field floristic survey and secondary data (such as published literature, floras, books, and forest working plans) were used to assess the forest dynamics in terms of forest type and species composition among the preindependence period, the postindependence period, and the present (i.e., before and after 1980). The satellite data analysis revealed a considerable amount of changes in all forest types during the 13 years. The comparison of species composition and forest types between the past and present revealed that need-based forest management along with anthropogenic activity have altered the primary deciduous forest in to secondary and postextraction secondary forests such as southern thorn and southern thorn scrub forests in the middle [400-900 m above mean sea level (MSL)] and lower slopes (<400 m MSL). However, the evergreen forests present at the upper slope (>900 m MSL) and plateau seemed not to be much affected by the forest management. The changes estimated by the satellite data processing in the major forest types such as evergreen, deciduous, southern thorn, and southern thorn scrub are really alarming because these changes have occurred after the implementation of a forest conservation act. The dependence of local people on forests for various purposes in this region is also considerably high, which might be a key factor for the changes in the forests. The results of this study not only provide an outlook on the present status of the forests and the change trends but also provide the basis for further studies on forests in the EG of TN.

Forest dynamics in the Eastern Ghats of Tamil Nadu, India.

PubMed

Jayakumar, S; Ramachandran, A; Bhaskaran, G; Heo, J

2009-02-01

The primary deciduous forests in the Eastern Ghats (EG) of Tamil Nadu (TN) India have undergone many changes owing to various need-based forest managements, such as timber extraction for industry, railway sleepers, charcoal, and forest clearance for hydroelectric projects and agriculture, during preindependence and postindependence periods (i.e., from 1800 to 1980). The enactment of a forest conservation act during the 1980s changed the perception of forest managers from utilization to conservation. This study was taken up to assess the forests dynamics in the EG of TN spatially between 1990 and 2003 and nonspatially between 1900 and the 1980s. Landsat Thematic Mapper (TM) and Indian Remote Sensing satellite (IRS) 1D Linear Imaging and Self Scanning (LISS III) data were used to assess forests during 1990 and 2003, respectively. Field floristic survey and secondary data (such as published literature, floras, books, and forest working plans) were used to assess the forest dynamics in terms of forest type and species composition among the preindependence period, the postindependence period, and the present (i.e., before and after 1980). The satellite data analysis revealed a considerable amount of changes in all forest types during the 13 years. The comparison of species composition and forest types between the past and present revealed that need-based forest management along with anthropogenic activity have altered the primary deciduous forest in to secondary and postextraction secondary forests such as southern thorn and southern thorn scrub forests in the middle [400-900 m above mean sea level (MSL)] and lower slopes (<400 m MSL). However, the evergreen forests present at the upper slope (>900 m MSL) and plateau seemed not to be much affected by the forest management. The changes estimated by the satellite data processing in the major forest types such as evergreen, deciduous, southern thorn, and southern thorn scrub are really alarming because these changes have occurred after the implementation of a forest conservation act. The dependence of local people on forests for various purposes in this region is also considerably high, which might be a key factor for the changes in the forests. The results of this study not only provide an outlook on the present status of the forests and the change trends but also provide the basis for further studies on forests in the EG of TN.

Drivers of forest cover dynamics in smallholder farming systems: the case of northwestern Vietnam.

PubMed

Jadin, Isaline; Vanacker, Veerle; Hoang, Huong Thi Thu

2013-04-01

The national-scale forest recovery of Vietnam started in the early 1990s and is associated with a shift from net deforestation to net reforestation. Large disparities in forest cover dynamics are, however, observed at the local scale. This study aims to unravel the mechanisms driving forest cover change for a mountainous region located in northwest Vietnam. Statistical analyses were used to explore the association between forest cover change and household characteristics. In Sa Pa district, deforestation rates are decreasing, but forest degradation continues at similar rates. Deforestation is not necessarily associated with impoverished ethnic communities or high levels of subsistence farming, and the largest forest cover dynamics are found in villages with the best socio-economic conditions. Our empirical study does not provide strong evidence of a dominant role of agriculture in forest cover dynamics. It shows that empirical studies on local-scale forest dynamics remain important to unravel the complexity of human-environment interactions.

Rainforest Pharmacopeia in Madagascar Provides High Value for Current Local and Prospective Global Uses

PubMed Central

Golden, Christopher D.; Rasolofoniaina, B. J. Rodolph; Anjaranirina, E. J. Gasta; Nicolas, Lilien; Ravaoliny, Laurent; Kremen, Claire

2012-01-01

Botanical diversity provides value to humans through carbon sequestration, air and water purification, and the provisioning of wild foods and ethnomedicines. Here we calculate the value of botanical ethnomedicines in a rainforest region of Madagascar, the Makira Protected Area, using a substitution method that combines replacement costs and choice modeling. The Makira watershed may comprise approximately 0.8% of global botanical diversity and possesses enormous value both in its ability to provision botanical ethnomedicines to local people and as a source of potentially novel pharmaceutical drugs for society as a whole. Approximately 241 locally-recognized species are used as ethnomedicines, including 113 agricultural or weed species. We equated each ethnomedicinal treatment to the monetary value of a comparable pharmaceutical treatment adjusted by personal preferences in perceived efficacy (rather than from known or assumed medicinal equivalency). The benefit value of these botanical ethnomedicines per individual is $5.40–7.90 per year when using the value of highly subsidized Malagasy pharmaceuticals and $100.60–287.40 when using the value of American pharmaceuticals. Using local pharmaceuticals as substitutes, the value per household is $30.24–44.30 per year, equivalent to 43–63% of median annual household income, demonstrating their local importance. Using the value of American pharmaceuticals, the amount is equivalent to 22–63% of the median annual health care expenditures for American adults under 45 in 2006. The potential for developing novel biomedicines from the Makira watershed’s unique flora ranges in untapped benefit value from $0.3–5.7 billion for American pharmaceutical companies, non-inclusive of the importance of providing novel medicines and improved healthcare to society. This study provides evidence of the tremendous current local and prospective global value of botanical ethnomedicines and furthers arguments for the conservation of tropical forests for sustainable use. Botanique de la diversité apporte de la valeur à l’homme par la séquestration du carbone, de l’air et de purification de l’eau, et le provisionnement des aliments sauvages et ethnomedicines. Ici, nous calculons la valeur de ethnomedicines botaniques dans une région de forêt de Madagascar, la zone protégée de Makira, en utilisant une méthode de substitution qui combine les coûts de remplacement et la modélisation des choix. Le bassin versant de Makira peut comprendre environ 0,8% de la diversité botanique mondiale et possède une valeur énorme à la fois dans sa capacité à fournir ethnomedicines botaniques à la population locale et en tant que source de nouveaux médicaments potentiellement pharmaceutiques pour la société dans son ensemble. Environ 241 espèces localement reconnus sont utilisés comme ethnomedicines, y compris 113 espèces d’agricoles ou de mauvaises herbes. Nous assimilé chaque traitement ethnomédicales à la valeur monétaire d’un traitement comparable pharmaceutique ajusté en fonction des préférences personnelles en matière d’efficacité perçue (plutôt que de l’équivalence médicament connu ou supposé). La valeur de l’avantage de ces ethnomedicines botaniques par individu est de $5,40 à 7.90 par année lors de l’utilisation de la valeur des produits pharmaceutiques malgaches fortement subventionnés et de $100,60 à 287,40 lors de l’utilisation de la valeur des produits pharmaceutiques américains. Utilisation de produits pharmaceutiques locales comme des substituts, la valeur par ménage est de $30.24 à 44.30 par an, équivalent à 43–63% du revenu médian des ménages annuelle, ce qui démontre leur importance locale. Utilisation de la valeur des produits pharmaceutiques américaines, le montant est équivalent à 22–63% de la médiane des dépenses annuelles de soins de santé pour les adultes américains de moins de 45 en 2006. Le potentiel de développement de nouveaux biomédicaments des fourneaux dans le bassin versant de la flore Makira unqiue de la valeur des avantages inexploité de $0,3 à 5,7 milliards pour les sociétés pharmaceutiques américaines, non compris l’importance de fournir de nouveaux médicaments et de soins de santé amélioré à la société. Cette étude fournit une preuve de l’énorme valeur actuelle globale locale et prospective de ethnomedicines botaniques et des arguments fait avancer pour la conservation des forêts tropicales pour l’utilisation durable. PMID:22848447

A study on the utilization of forest policy to review from the aspect of climate change

NASA Astrophysics Data System (ADS)

Ardhana, I. Putu Gede

2017-11-01

The purpose of this study was to review the utilization of forests from the policy aspects of climate change. This was then associated with the implementation of governmental commitment to carry out REDD+ to cope with the impact of climate change and to achieve sustainable development. Firstly, the author studied this problem from data and information about vast forest areas and conservative water areas in Indonesia. According to provincial governments, there have been several decision letters from the Minister of Forestry from different years ranging from 1999-2014. Comparing the forest areas in letters of 2005, 2008, and 2015, it can be suggested that the areas allocated as productive forest exceeded the areas of conserved or protected forest. This indicates that the utilization of forest as a development resource has occurred, and will continue to become an important element in Indonesia. Furthermore, Indonesian forests continue to suffer deforestation and forest degradation. Therefore, the author presented data and information about deforestation and forest degradation that occurred from forest damage and forest fires. Thirdly, the author presented data and information about the deforestation rate from 2000-2014. In 1989, rehabilitation activities were carried out for critical lands, and from 2012-2014, rehabilitation of forest and riverside areas occurred. This research uses descriptive methods with an approximation of legislation and an approach to librarianship. Then, this study is described in a narrative as well as an interpretive style, and compiled in the form of a working paper. From the results of this research, it can be concluded that Indonesian governmental policy regarding forest utilization has wide potential mitigations, and it is absolutely necessary to consistently implement a number of such programs related to climate change.

Implementing Feminist Theory in Engineering: Obstacles within the Gender Studies Tradition

ERIC Educational Resources Information Center

Udén, Maria K.

2017-01-01

Scholars have noted that there is hesitation to utilise findings from gender studies in engineering education. Issues within gender studies may be part of the matching problem. Debates concerning two concepts for new engineering paradigms are investigated: "care" and "heterogeneity." Their appeals and the respective…

Psychological Determinants of University Students' Academic Performance: An Empirical Study

ERIC Educational Resources Information Center

Gebka, Bartosz

2014-01-01

This study utilises an integrated conceptual model of academic performance which captures a series of psychological factors: cognitive style; self-theories such as self-esteem and self-efficacy; achievement goals such as mastery, performance, performance avoidance and work avoidance; study-processing strategies such as deep and surface learning;…

Supervisor Behaviours that Facilitate Training Transfer

ERIC Educational Resources Information Center

Lancaster, Sue; Di Milia, Lee; Cameron, Roslyn

2013-01-01

Purpose: The purpose of this paper is to describe the supervisor behaviours that employees found to be helpful and unhelpful in facilitating training transfer. The study aims to provide rich qualitative data from the employee's perspective. Design/methodology/approach: This study utilises a cross-sectional design. A case study and a qualitative…

Forest dynamics in the U.S. indicate disproportionate attrition in western forests, rural areas and public lands

PubMed Central

2017-01-01

Forests are experiencing significant changes; studying geographic patterns in forests is critical in understanding the impact of forest dynamics to biodiversity, soil erosion, water chemistry and climate. Few studies have examined forest geographic pattern changes other than fragmentation; however, other spatial processes of forest dynamics are of equal importance. Here, we study forest attrition, the complete removal of forest patches, that can result in complete habitat loss, severe decline of population sizes and species richness, and shifts of local and regional environmental conditions. We aim to develop a simple yet insightful proximity-based spatial indicator capturing forest attrition that is independent of spatial scale and boundaries with worldwide application potential. Using this proximity indicator, we evaluate forest attrition across ecoregions, land ownership and urbanization stratifications across continental United States of America. Nationally, the total forest cover loss was approximately 90,400 km2, roughly the size of the state of Maine, constituting a decline of 2.96%. Examining the spatial arrangement of this change the average FAD was 3674m in 1992 and increased by 514m or 14.0% in 2001. Simulations of forest cover loss indicate only a 10m FAD increase suggesting that the observed FAD increase was more than an order of magnitude higher than expected. Furthermore, forest attrition is considerably higher in the western United States, in rural areas and in public lands. Our mathematical model (R2 = 0.93) supports estimation of attrition for a given forest cover. The FAD metric quantifies forest attrition across spatial scales and geographic boundaries and assesses unambiguously changes over time. The metric is applicable to any landscape and offers a new complementary insight on forest landscape patterns from local to global scales, improving future exploration of drivers and repercussions of forest cover changes and supporting more informative management of forest carbon, changing climate and species biodiversity. PMID:28225787

Forests growing under dry conditions have higher hydrological resilience to drought than do more humid forests.

PubMed

Helman, David; Lensky, Itamar M; Yakir, Dan; Osem, Yagil

2017-07-01

More frequent and intense droughts are projected during the next century, potentially changing the hydrological balances in many forested catchments. Although the impacts of droughts on forest functionality have been vastly studied, little attention has been given to studying the effect of droughts on forest hydrology. Here, we use the Budyko framework and two recently introduced Budyko metrics (deviation and elasticity) to study the changes in the water yields (rainfall minus evapotranspiration) of forested catchments following a climatic drought (2006-2010) in pine forests distributed along a rainfall gradient (P = 280-820 mm yr -1 ) in the Eastern Mediterranean (aridity factor = 0.17-0.56). We use a satellite-based model and meteorological information to calculate the Budyko metrics. The relative water yield ranged from 48% to 8% (from the rainfall) in humid to dry forests and was mainly associated with rainfall amount (increasing with increased rainfall amount) and bedrock type (higher on hard bedrocks). Forest elasticity was larger in forests growing under drier conditions, implying that drier forests have more predictable responses to drought, according to the Budyko framework, compared to forests growing under more humid conditions. In this context, younger forests were shown more elastic than older forests. Dynamic deviation, which is defined as the water yield departure from the Budyko curve, was positive in all forests (i.e., less-than-expected water yields according to Budyko's curve), increasing with drought severity, suggesting lower hydrological resistance to drought in forests suffering from larger rainfall reductions. However, the dynamic deviation significantly decreased in forests that experienced relatively cooler conditions during the drought period. Our results suggest that forests growing under permanent dry conditions might develop a range of hydrological and eco-physiological adjustments to drought leading to higher hydrological resilience. In the context of predicted climate change, such adjustments are key factors in sustaining forested catchments in water-limited regions. © 2016 John Wiley & Sons Ltd.

Forest dynamics in the U.S. indicate disproportionate attrition in western forests, rural areas and public lands.

PubMed

Yang, Sheng; Mountrakis, Giorgos

2017-01-01

Forests are experiencing significant changes; studying geographic patterns in forests is critical in understanding the impact of forest dynamics to biodiversity, soil erosion, water chemistry and climate. Few studies have examined forest geographic pattern changes other than fragmentation; however, other spatial processes of forest dynamics are of equal importance. Here, we study forest attrition, the complete removal of forest patches, that can result in complete habitat loss, severe decline of population sizes and species richness, and shifts of local and regional environmental conditions. We aim to develop a simple yet insightful proximity-based spatial indicator capturing forest attrition that is independent of spatial scale and boundaries with worldwide application potential. Using this proximity indicator, we evaluate forest attrition across ecoregions, land ownership and urbanization stratifications across continental United States of America. Nationally, the total forest cover loss was approximately 90,400 km2, roughly the size of the state of Maine, constituting a decline of 2.96%. Examining the spatial arrangement of this change the average FAD was 3674m in 1992 and increased by 514m or 14.0% in 2001. Simulations of forest cover loss indicate only a 10m FAD increase suggesting that the observed FAD increase was more than an order of magnitude higher than expected. Furthermore, forest attrition is considerably higher in the western United States, in rural areas and in public lands. Our mathematical model (R2 = 0.93) supports estimation of attrition for a given forest cover. The FAD metric quantifies forest attrition across spatial scales and geographic boundaries and assesses unambiguously changes over time. The metric is applicable to any landscape and offers a new complementary insight on forest landscape patterns from local to global scales, improving future exploration of drivers and repercussions of forest cover changes and supporting more informative management of forest carbon, changing climate and species biodiversity.

Forest Cover Estimation in Ireland Using Radar Remote Sensing: A Comparative Analysis of Forest Cover Assessment Methodologies.

PubMed

Devaney, John; Barrett, Brian; Barrett, Frank; Redmond, John; O Halloran, John

2015-01-01

Quantification of spatial and temporal changes in forest cover is an essential component of forest monitoring programs. Due to its cloud free capability, Synthetic Aperture Radar (SAR) is an ideal source of information on forest dynamics in countries with near-constant cloud-cover. However, few studies have investigated the use of SAR for forest cover estimation in landscapes with highly sparse and fragmented forest cover. In this study, the potential use of L-band SAR for forest cover estimation in two regions (Longford and Sligo) in Ireland is investigated and compared to forest cover estimates derived from three national (Forestry2010, Prime2, National Forest Inventory), one pan-European (Forest Map 2006) and one global forest cover (Global Forest Change) product. Two machine-learning approaches (Random Forests and Extremely Randomised Trees) are evaluated. Both Random Forests and Extremely Randomised Trees classification accuracies were high (98.1-98.5%), with differences between the two classifiers being minimal (<0.5%). Increasing levels of post classification filtering led to a decrease in estimated forest area and an increase in overall accuracy of SAR-derived forest cover maps. All forest cover products were evaluated using an independent validation dataset. For the Longford region, the highest overall accuracy was recorded with the Forestry2010 dataset (97.42%) whereas in Sligo, highest overall accuracy was obtained for the Prime2 dataset (97.43%), although accuracies of SAR-derived forest maps were comparable. Our findings indicate that spaceborne radar could aid inventories in regions with low levels of forest cover in fragmented landscapes. The reduced accuracies observed for the global and pan-continental forest cover maps in comparison to national and SAR-derived forest maps indicate that caution should be exercised when applying these datasets for national reporting.

Forest Cover Estimation in Ireland Using Radar Remote Sensing: A Comparative Analysis of Forest Cover Assessment Methodologies

PubMed Central

Devaney, John; Barrett, Brian; Barrett, Frank; Redmond, John; O`Halloran, John

2015-01-01

Quantification of spatial and temporal changes in forest cover is an essential component of forest monitoring programs. Due to its cloud free capability, Synthetic Aperture Radar (SAR) is an ideal source of information on forest dynamics in countries with near-constant cloud-cover. However, few studies have investigated the use of SAR for forest cover estimation in landscapes with highly sparse and fragmented forest cover. In this study, the potential use of L-band SAR for forest cover estimation in two regions (Longford and Sligo) in Ireland is investigated and compared to forest cover estimates derived from three national (Forestry2010, Prime2, National Forest Inventory), one pan-European (Forest Map 2006) and one global forest cover (Global Forest Change) product. Two machine-learning approaches (Random Forests and Extremely Randomised Trees) are evaluated. Both Random Forests and Extremely Randomised Trees classification accuracies were high (98.1–98.5%), with differences between the two classifiers being minimal (<0.5%). Increasing levels of post classification filtering led to a decrease in estimated forest area and an increase in overall accuracy of SAR-derived forest cover maps. All forest cover products were evaluated using an independent validation dataset. For the Longford region, the highest overall accuracy was recorded with the Forestry2010 dataset (97.42%) whereas in Sligo, highest overall accuracy was obtained for the Prime2 dataset (97.43%), although accuracies of SAR-derived forest maps were comparable. Our findings indicate that spaceborne radar could aid inventories in regions with low levels of forest cover in fragmented landscapes. The reduced accuracies observed for the global and pan-continental forest cover maps in comparison to national and SAR-derived forest maps indicate that caution should be exercised when applying these datasets for national reporting. PMID:26262681

Changes in determinants of deforestation and forest degradation in Popa Mountain Park, Central Myanmar.

PubMed

Htun, Naing Zaw; Mizoue, Nobuya; Yoshida, Shigejiro

2013-02-01

Implementing effective conservation requires an understanding of factors affecting deforestation and forest degradation. Previous studies have investigated factors affecting deforestation, while few studies have examined the determinants of both of deforestation and forest degradation for more than one period. To address this gap, this study examined factors influencing deforestation and forest degradation during 1989-2000 and 2000-2005 in the Popa Mountain Park, Myanmar. We applied multinomial logistic regression (MNL) using land cover maps derived from Landsat images as the dependent variables as well as spatial and biophysical factors as the independent variables. The MNL models revealed influences of the determinants on deforestation and forest degradation changes over time. For example, during 1989-2000, deforestation from closed forest was positively correlated to the distance from the park boundary and was negatively correlated with distance from villages, roads, the park circular road, slope, western aspect and elevation. On the other hand, during 2000-2005, deforestation of closed forest was positively correlated with distance from villages, roads, the park circular road, slope and western aspect, and negatively correlated with distance from the park boundary and elevation. Similar scenarios were observed for the deforestation of open forest and forest degradation of closed forest. The study also found most of the determinants influenced deforestation and forest degradation differently. The changes in determinants of deforestation and forest degradation over time might be attributable to the general decrease in resource availability and to the effect of conservation measures conducted by the park.

Changes in Determinants of Deforestation and Forest Degradation in Popa Mountain Park, Central Myanmar

NASA Astrophysics Data System (ADS)

Htun, Naing Zaw; Mizoue, Nobuya; Yoshida, Shigejiro

2013-02-01

Implementing effective conservation requires an understanding of factors affecting deforestation and forest degradation. Previous studies have investigated factors affecting deforestation, while few studies have examined the determinants of both of deforestation and forest degradation for more than one period. To address this gap, this study examined factors influencing deforestation and forest degradation during 1989-2000 and 2000-2005 in the Popa Mountain Park, Myanmar. We applied multinomial logistic regression (MNL) using land cover maps derived from Landsat images as the dependent variables as well as spatial and biophysical factors as the independent variables. The MNL models revealed influences of the determinants on deforestation and forest degradation changes over time. For example, during 1989-2000, deforestation from closed forest was positively correlated to the distance from the park boundary and was negatively correlated with distance from villages, roads, the park circular road, slope, western aspect and elevation. On the other hand, during 2000-2005, deforestation of closed forest was positively correlated with distance from villages, roads, the park circular road, slope and western aspect, and negatively correlated with distance from the park boundary and elevation. Similar scenarios were observed for the deforestation of open forest and forest degradation of closed forest. The study also found most of the determinants influenced deforestation and forest degradation differently. The changes in determinants of deforestation and forest degradation over time might be attributable to the general decrease in resource availability and to the effect of conservation measures conducted by the park.

Relational Communication in Intercultural Couples

ERIC Educational Resources Information Center

Cools, Carine A.

2006-01-01

This qualitative study utilises the relational dialectics of Baxter and Montgomery (1996) to examine the relationship communication of six heterosexual intercultural couples living in Finland. In this study, I attempt to answer the following questions: what cultural issues are relevant in the couples' relationship? What intercultural relational…

Modelling Down Syndrome

ERIC Educational Resources Information Center

Buckley, Frank

2008-01-01

Animal models are extensively used in genetics, neuroscience and biomedical research. Recent studies illustrate the usefulness and the challenges of research utilising genetically engineered mice to explore the developmental biology of Down syndrome. These studies highlight many of the issues at the centre of what we understand about Down…

Factors influencing consumption of nutrient rich forest foods in rural Cameroon.

PubMed

Fungo, Robert; Muyonga, John H; Kabahenda, Margaret; Okia, Clement A; Snook, Laura

2016-02-01

Studies show that a number of forest foods consumed in Cameroon are highly nutritious and rich in health boosting bioactive compounds. This study assessed the knowledge and perceptions towards the nutritional and health promoting properties of forest foods among forest dependent communities. The relationship between knowledge, perceptions and socio-demographic attributes on consumption of forest foods was also determined. A total of 279 females in charge of decision making with respect to food preparation were randomly selected from 12 villages in southern and eastern Cameroon and interviewed using researcher administered questionnaires. Multivariate logistic regression analysis was used to identify the factors affecting consumption of forest foods. Baillonella toxisperma (98%) and Irvingia gabonesis (81%) were the most known nutrient rich forest foods by the respondents. About 31% of the respondents were aware of the nutritional value and health benefits of forest foods. About 10%-61% of the respondents expressed positive attitudes to questions related with health benefits of specific forest foods. Consumption of forest foods was found to be higher among polygamous families and also positively related to length of stay in the forest area and age of respondent with consumption of forest foods. Education had an inverse relationship with use of forest foods. Knowledge and positive attitude towards the nutritional value of forest foods were also found to positively influence consumption of forest foods. Since knowledge was found to influence attitude and consumption, there is need to invest in awareness campaigns to strengthen the current knowledge levels among the study population. This should positively influence the attitudes and perceptions towards increased consumption of forest foods. Copyright © 2015 Elsevier Ltd. All rights reserved.

Gis-Based Multi-Criteria Decision Analysis for Forest Fire Risk Mapping

NASA Astrophysics Data System (ADS)

Akay, A. E.; Erdoğan, A.

2017-11-01

The forested areas along the coastal zone of the Mediterranean region in Turkey are classified as first-degree fire sensitive areas. Forest fires are major environmental disaster that affects the sustainability of forest ecosystems. Besides, forest fires result in important economic losses and even threaten human lives. Thus, it is critical to determine the forested areas with fire risks and thereby minimize the damages on forest resources by taking necessary precaution measures in these areas. The risk of forest fire can be assessed based on various factors such as forest vegetation structures (tree species, crown closure, tree stage), topographic features (slope and aspect), and climatic parameters (temperature, wind). In this study, GIS-based Multi-Criteria Decision Analysis (MCDA) method was used to generate forest fire risk map. The study was implemented in the forested areas within Yayla Forest Enterprise Chiefs at Dursunbey Forest Enterprise Directorate which is classified as first degree fire sensitive area. In the solution process, "extAhp 2.0" plug-in running Analytic Hierarchy Process (AHP) method in ArcGIS 10.4.1 was used to categorize study area under five fire risk classes: extreme risk, high risk, moderate risk, and low risk. The results indicated that 23.81 % of the area was of extreme risk, while 25.81 % was of high risk. The result indicated that the most effective criterion was tree species, followed by tree stages. The aspect had the least effective criterion on forest fire risk. It was revealed that GIS techniques integrated with MCDA methods are effective tools to quickly estimate forest fire risk at low cost. The integration of these factors into GIS can be very useful to determine forested areas with high fire risk and also to plan forestry management after fire.

Quality of care and the demand for health services in Bamako, Mali: the specific roles of structural, process, and outcome components.

PubMed

Mariko, Mamadou

2003-03-01

The public finance and foreign exchange crisis of the 1980s aggravated the unfavourable economic trends in many developing countries and resulted in budget cuts in the health sector. Policymakers, following the suggestions of World Bank experts, introduced user fees. Economic analysis of the demand for health care in these countries focused on the impact of price and income on health service utilisation. But the lesson to date from experiences in cost recovery is that without visible and fairly immediate improvements in the quality of care, the implementation of user fees will cause service utilisation to drop. For this reason, the role of quality of health care has been recently a subject of investigation in a number of health care demand studies. In spite of using the data from both households and facilities, recent studies are quite limited because they measure quality only by structural attributes (availability of drugs, equipment, number and qualifications of staff, and so on). Structural attributes of quality are necessary but not sufficient conditions for demand. A unique feature of this study is that it also considers the processes followed by practitioners and the outcome of care, to determine simultaneously the respective influence of price and quality on decision making. A nested multinomial logit was used to examine the choice between six alternatives (self-treatment, modern treatment at home, public hospital, public dispensary, for-profit facility and non-profit facility). The estimations are based on data from a statistically representative sample of 1104 patients from 1191 households and the data from a stratified random sample of 42 out of 84 facilities identified. The results indicate that omitting the process quality variables from the demand model produces a bias not only in the estimated coefficient of the "price" variable but also in coefficients of some structural attributes of the quality. The simulations suggest that price has a minor effect on utilisation of health services, and that health authorities can simultaneously double user fees and increase utilisation by emphasising improvement of both the structural and process quality of care in public health facilities.

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia.

PubMed

Alfaqeeh, Ghadah; Cook, Erica J; Randhawa, Gurch; Ali, Nasreen

2017-02-02

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA. A questionnaire survey was carried out to identify the barriers and enablers to accessing PHCS in rural (n = 5) and urban (n = 5) areas of Riyadh province, selected on the classification of the population density of the governorates. An adapted version of the NHS National Survey Programme was administered that included 50 questions over 11 sections that assessed a wide range of factors related to respondent's access and experience of the PHCS. A total of 935 responses were obtained with 52.9% (n = 495) from urban areas and the remaining 47.1% (n = 440) from rural areas of Riyadh province. This study highlights that there are high levels of satisfaction among patients among all PHCS. In relation to differences between urban and rural respondents, the findings indicated that there were significant variations in relation to: education level, monthly income, medical investigations, receiving blood tests on time, extra opening hours, distance, cleanliness and health prevention. Core barriers for rural patients related to the distance to reach PHCS, cleanliness of the PHCS, receiving health prevention and promotion services, which should serve to improve health outcomes. This study highlighted important differences in access to and utilisation of PHCS between urban and rural populations in Riyadh province in the KSA. These findings have implications for policy and planning of PHCCs and reducing inequalities in health care between rural and urban populations and contributing to a reduction in the chronic disease burden in Riyadh province.

High-throughput quantum cascade laser (QCL) spectral histopathology: a practical approach towards clinical translation.

PubMed

Pilling, Michael J; Henderson, Alex; Bird, Benjamin; Brown, Mick D; Clarke, Noel W; Gardner, Peter

2016-06-23

Infrared microscopy has become one of the key techniques in the biomedical research field for interrogating tissue. In partnership with multivariate analysis and machine learning techniques, it has become widely accepted as a method that can distinguish between normal and cancerous tissue with both high sensitivity and high specificity. While spectral histopathology (SHP) is highly promising for improved clinical diagnosis, several practical barriers currently exist, which need to be addressed before successful implementation in the clinic. Sample throughput and speed of acquisition are key barriers and have been driven by the high volume of samples awaiting histopathological examination. FTIR chemical imaging utilising FPA technology is currently state-of-the-art for infrared chemical imaging, and recent advances in its technology have dramatically reduced acquisition times. Despite this, infrared microscopy measurements on a tissue microarray (TMA), often encompassing several million spectra, takes several hours to acquire. The problem lies with the vast quantities of data that FTIR collects; each pixel in a chemical image is derived from a full infrared spectrum, itself composed of thousands of individual data points. Furthermore, data management is quickly becoming a barrier to clinical translation and poses the question of how to store these incessantly growing data sets. Recently, doubts have been raised as to whether the full spectral range is actually required for accurate disease diagnosis using SHP. These studies suggest that once spectral biomarkers have been predetermined it may be possible to diagnose disease based on a limited number of discrete spectral features. In this current study, we explore the possibility of utilising discrete frequency chemical imaging for acquiring high-throughput, high-resolution chemical images. Utilising a quantum cascade laser imaging microscope with discrete frequency collection at key diagnostic wavelengths, we demonstrate that we can diagnose prostate cancer with high sensitivity and specificity. Finally we extend the study to a large patient dataset utilising tissue microarrays, and show that high sensitivity and specificity can be achieved using high-throughput, rapid data collection, thereby paving the way for practical implementation in the clinic.

Distribution and Characterization of Forested Wetlands in the Carolinas and Virginia

Treesearch

Mark J. Brown

1995-01-01

Recent forest inventories of North Carolina, South Carolina, and Virginia, included sampled for hydric soils, and wetland hydrology. Forest samples that met all 3 of these criteria were classified as forested wetland.This study characterizes wetland forests by extent, owner, age, forest type, physiography, volume, growth, and removals, and evaluates its contribution...

Timber products production in West Virginia 1965

Treesearch

Neal P. Kingsley; David R. Dickson

1968-01-01

This study was funded through the Appalachian Regional Development Act of 1965 and was conducted by the Forest Survey Project of the Northeastern Forest Experiment Station with the assistance of the State Forester and the Extension Forester of West Virginia, and the Monongahela Power Company. The State Forester's office and the Extension Forester provided lists of...

Structural dynamics of tropical moist forest gaps

Treesearch

Maria O. Hunter; Michael Keller; Douglas Morton; Bruce Cook; Michael Lefsky; Mark Ducey; Scott Saleska; Raimundo Cosme de Oliveira; Juliana Schietti

2015-01-01

Gap phase dynamics are the dominant mode of forest turnover in tropical forests. However, gap processes are infrequently studied at the landscape scale. Airborne lidar data offer detailed information on three-dimensional forest structure, providing a means to characterize fine-scale (1 m) processes in tropical forests over large areas. Lidar-based estimates of forest...

[The concentration and distribution of 137Cs in soils of forest and agricultural ecosystems of Tula Region].

PubMed

Lipatov, D N; Shcheglov, A I; Tsvetnova, O B

2007-01-01

The paper deals with a comparative study of 137Cs contamination in forest, old arable and cultivated soils of Tula Region. Initial interception of Chernobyl derived 137Cs is higher in forest ecosystems: oak-forest > birch-forest > pine-forest > agricultural ecosystems. Vertical migration of 137Cs in deeper layers of soils was intensive in agricultural ecosystems: cultivated soils > old arable soils > birch-forest soils > oak-forest soils > pine-forest soils. In study have been evaluated spatial variability of 137Cs in soil and asymmetrical distribution, that is a skew to the right. Spatial heterogeneity of 137Cs in agricultural soils is much lower than in forest soils. For cultivated soil are determined the rate of resuspension, which equal to 6.1 x 10(-4) day(-1). For forest soils are described the 137Cs concentration in litter of different ecosystems. The role of main accumulation and barrier of 137Cs retain higher layers of soils (horizon A1(A1E) in forest, horizon Ap in agricultural ecosystems) in long-term forecast after Chernobyl accident.

Genetic disorders of vitamin B12 metabolism: eight complementation groups – eight genes

PubMed Central

Froese, D. Sean; Gravel, Roy A.

2010-01-01

Vitamin B12 (cobalamin, Cbl) is an essential nutrient in human metabolism. Genetic diseases of vitamin B12 utilisation constitute an important fraction of inherited newborn disease. Functionally, B12 is the cofactor for methionine synthase and methylmalonyl CoA mutase. To function as a cofactor, B12 must be metabolised through a complex pathway that modifies its structure and takes it through subcellular compartments of the cell. Through the study of inherited disorders of vitamin B12 utilisation, the genes for eight complementation groups have been identified, leading to the determination of the general structure of vitamin B12 processing and providing methods for carrier testing, prenatal diagnosis and approaches to treatment. PMID:21114891

An assessment of the effects of casemix funding on hospital utilisation: a Northern Territory perspective.

PubMed

Xiao, J; Lee, A; Vemuri, S R; Beaver, C

2000-01-01

This article is concerned with the methodological issues of assessing the effects of casemix funding on hospital utilisation. Time-series analysis and intervention analysis are proposed to ascertain the effects. It was found there had been a decline in average length of stay and number of bed-days, an increase in weighted separations for teaching and non-teaching hospitals, and no apparent increase of costliness in terms of a comprehensive casemix index. No evidence of decline in quality of care can be established in terms of readmission rates. The long-term effects of casemix funding, and specific issues in terms of the funding model used, patients and cost shifting between hospital services and community health services, remain to be studied.

Study-MATE: Using Text Messaging to Support Student Transition to University Study

ERIC Educational Resources Information Center

Cahir, Jayde; Huber, Elaine; Handal, Boris; Dutch, Justin; Nixon, Mark

2012-01-01

Students are most likely to drop out of university when first attending. This article analyses the use of technology in supporting the transition process of "first time" university students enrolled in a second-year accounting course. Study-MATE, a study skills program utilising the university's learning management system (LMS)--Blackboard, Google…

Knowledge and Knowing in Mathematics and Pedagogy: A Case Study of Mathematics Student Teachers' Epistemological Beliefs

ERIC Educational Resources Information Center

Löfström, Erika; Pursiainen, Tuomas

2015-01-01

This study focuses on mathematics student teachers' epistemological beliefs in mathematics and education. The study aimed at gaining insight into the challenges that students experience in the consolidation of knowledge in the two disciplines. The case study with three mathematics pre-service teachers utilised mathematical and pedagogical…

Diverse responses of different structured forest to drought in Southwest China through remotely sensed data

NASA Astrophysics Data System (ADS)

Xu, Peipei; Zhou, Tao; Zhao, Xiang; Luo, Hui; Gao, Shan; Li, Zheng; Cao, Leyao

2018-07-01

Global climate change leads to gradual increases in the frequency, intensity, and duration of extreme drought events. Human activities such as afforestation and deforestation have led to spatial variation in forest structure, causing forests to exhibit an age-spatial structure relationship. Thus, it is of great importance to accurately evaluate the effects of drought stress on forest ecosystems with different forest age structures. Because the spatial heterogeneity varies with drought stress intensity, forest age, there are still a lot of uncertainties in current studies. In this study, based on the field measurement, and the proxy index of stand age (based on forest canopy height from LiDAR and stock volume from inventory) at the regional scale, we analyzed the different drought responses of forest ecosystems with various forest ages across different scales in Yunnan province, southwest China from 2001 to 2014. At the local scale, significant differences in the effects of drought stress were found among forests with various ages, suggesting that older forests suffer more under drought stress than younger forests. At the regional scale, the investigation statistics of forest damage indicated a maximum damage ratio in the forest with tall trees (>32 m), whereas damage was minimal in the forest with short trees (<25 m). The stock volume of the forest exhibited the same pattern, that is, the forest damage ratio increased as the stock volume increased. These data demonstrate that the responses of forest drought could be affected by forest age. Under drought stress, older forests show greater vulnerability and risk of damage, which will require special attention for forest managers, as well as improved risk assessments, in the context of future climate change.

Changes in necromass and nutrients on the forest floor of a palm floodplain forest in the Luquillo mountains of Puerto Rico.

Treesearch

ARIEL E. LUGO; JORGE L. FRANGI

2003-01-01

We studied changes that occurred between 1980 and 2000 in forest floor biomass (necromass+ biomass of herbaceous plants), nutrient stocks, and plant composition of a Prestoea montana floodplain forest. The forest was located in the Luquillo Mountains of Puerto Rico. Several storms and hurricanes passed near the study site during that period, the most severe being...

The intertwining paths of the density managment and riparian buffer study and the Northwest Forest Plan

Treesearch

Kenneth J. Ruzicka; Deanna H. Olson; Klaus J. Puettmann

2013-01-01

Initiated simultaneously, the Density Management and Riparian Buff er Study of western Oregon and the Northwest Forest Plan have had intertwining paths related to federal forest management and policy changes in the Pacifi c Northwest over the last 15 to 20 years. We briefl y discuss the development of the Northwest Forest Plan and how it changed the way forest policy...

Critical Analysis of Forest Degradation in the Southern Eastern Ghats of India: Comparison of Satellite Imagery and Soil Quality Index

PubMed Central

Ramachandran, Andimuthu; Radhapriya, Parthasarathy; Jayakumar, Shanmuganathan; Dhanya, Praveen; Geetha, Rajadurai

2016-01-01

India has one of the largest assemblages of tropical biodiversity, with its unique floristic composition of endemic species. However, current forest cover assessment is performed via satellite-based forest surveys, which have many limitations. The present study, which was performed in the Eastern Ghats, analysed the satellite-based inventory provided by forest surveys and inferred from the results that this process no longer provides adequate information for quantifying forest degradation in an empirical manner. The study analysed 21 soil properties and generated a forest soil quality index of the Eastern Ghats, using principal component analysis. Using matrix modules and geospatial technology, we compared the forest degradation status calculated from satellite-based forest surveys with the degradation status calculated from the forest soil quality index. The Forest Survey of India classified about 1.8% of the Eastern Ghats’ total area as degraded forests and the remainder (98.2%) as open, dense, and very dense forests, whereas the soil quality index results found that about 42.4% of the total area is degraded, with the remainder (57.6%) being non-degraded. Our ground truth verification analyses indicate that the forest soil quality index along with the forest cover density data from the Forest Survey of India are ideal tools for evaluating forest degradation. PMID:26812397

Apelin targets gut contraction to control glucose metabolism via the brain.

PubMed

Fournel, Audren; Drougard, Anne; Duparc, Thibaut; Marlin, Alysson; Brierley, Stuart M; Castro, Joel; Le-Gonidec, Sophie; Masri, Bernard; Colom, André; Lucas, Alexandre; Rousset, Perrine; Cenac, Nicolas; Vergnolle, Nathalie; Valet, Philippe; Cani, Patrice D; Knauf, Claude

2017-02-01

The gut-brain axis is considered as a major regulatory checkpoint in the control of glucose homeostasis. The detection of nutrients and/or hormones in the duodenum informs the hypothalamus of the host's nutritional state. This process may occur via hypothalamic neurons modulating central release of nitric oxide (NO), which in turn controls glucose entry into tissues. The enteric nervous system (ENS) modulates intestinal contractions in response to various stimuli, but the importance of this interaction in the control of glucose homeostasis via the brain is unknown. We studied whether apelin, a bioactive peptide present in the gut, regulates ENS-evoked contractions, thereby identifying a new physiological partner in the control of glucose utilisation via the hypothalamus. We measured the effect of apelin on electrical and mechanical duodenal responses via telemetry probes and isotonic sensors in normal and obese/diabetic mice. Changes in hypothalamic NO release, in response to duodenal contraction modulated by apelin, were evaluated in real time with specific amperometric probes. Glucose utilisation in tissues was measured with orally administrated radiolabeled glucose. In normal and obese/diabetic mice, glucose utilisation is improved by the decrease of ENS/contraction activities in response to apelin, which generates an increase in hypothalamic NO release. As a consequence, glucose entry is significantly increased in the muscle. Here, we identify a novel mode of communication between the intestine and the hypothalamus that controls glucose utilisation. Moreover, our data identified oral apelin administration as a novel potential target to treat metabolic disorders. 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/.

Research utilisation and critical thinking among newly graduated nurses: predictors for research use. A quantitative cross-sectional study.

PubMed

Wangensteen, Sigrid; Johansson, Inger S; Björkström, Monica E; Nordström, Gun

2011-09-01

The aim was to describe research utilisation among newly graduated nurses and to explore critical thinking dispositions and other individual and contextual factors as possible predictors for research use. Nurses are expected to be research users, and variations in research utilisation are explained by individual and contextual factors. To our knowledge, critical thinking dispositions have not earlier been explored as predictors for research use. A cross-sectional design was chosen. Data collection was carried out from October 2006 to April 2007 using the Research Utilization Questionnaire (RUQ) and the California Critical Thinking Disposition Inventory (CCTDI). The response rate was 33% (n =617). Pearson's chi-square test and regression analyses were used for statistical calculations. The respondents reported a positive attitude towards research, but only 24% (n = 148) were defined as research users. A significantly higher proportion of research users reported high critical thinking scores. Critical thinking explained 20% of the variance in attitude towards research and 11% of the variance in research use. Availability and support to implement research findings was the second strongest predictor for research use. Critical thinking, a significant predictor for attitude towards research and for the use of research, should be recognised and strengthened in nursing education and clinical practice. Contextual factors seem to be important for newly graduated nurses' use of research. Nurse leaders play an important role in nurturing newly graduated nurses' critical thinking and assisting them in transferring their positive attitude towards research into research use. Nurse educators play a significant role in supporting, challenging and supervising nursing students to be critical thinkers and strong believers in research utilisation. © 2011 Blackwell Publishing Ltd.

Macronutrient supply, uptake and recycling in the coastal ocean of the west Antarctic Peninsula

NASA Astrophysics Data System (ADS)

Henley, Sian F.; Tuerena, Robyn E.; Annett, Amber L.; Fallick, Anthony E.; Meredith, Michael P.; Venables, Hugh J.; Clarke, Andrew; Ganeshram, Raja S.

2017-05-01

Nutrient supply, uptake and cycling underpin high primary productivity over the continental shelf of the west Antarctic Peninsula (WAP). Here we use a suite of biogeochemical and isotopic data collected over five years in northern Marguerite Bay to examine these macronutrient dynamics and their controlling biological and physical processes in the WAP coastal ocean. We show pronounced nutrient drawdown over the summer months by primary production which drives a net seasonal nitrate uptake of 1.83 mol N m-2 yr-1, equivalent to net carbon uptake of 146 g C m-2 yr-1. High primary production fuelled primarily by deep-sourced macronutrients is diatom-dominated, but non-siliceous phytoplankton also play a role. Strong nutrient drawdown in the uppermost surface ocean has the potential to cause transient nitrogen limitation before nutrient resupply and/or regeneration. Interannual variability in nutrient utilisation corresponds to winter sea ice duration and the degree of upper ocean mixing, implying susceptibility to physical climate change. The nitrogen isotope composition of nitrate (δ15NNO3) shows a utilisation signal during the growing seasons with a community-level net isotope effect of 4.19 ± 0.29‰. We also observe significant deviation of our data from modelled and observed utilisation trends, and argue that this is driven primarily by water column nitrification and meltwater dilution of surface nitrate. This study is important because it provides a detailed description of the nutrient biogeochemistry underlying high primary productivity at the WAP, and shows that surface ocean nutrient inventories in the Antarctic sea ice zone can be affected by intense recycling in the water column, meltwater dilution and sea ice processes, in addition to utilisation in the upper ocean.

Healthcare utilisation of pregnant women who experience sciatica, leg cramps and/or varicose veins: A cross-sectional survey of 1835 pregnant women.

PubMed

Hall, Helen; Lauche, Romy; Adams, Jon; Steel, Amie; Broom, Alex; Sibbritt, David

2016-02-01

Common discomforts of pregnancy experienced in the lower extremity include sciatica, leg cramps and varicose veins. Whilst research attention has focused on aetiology and outcomes, the health service utilisation of pregnant women suffering from these complaints has been largely overlooked. To examine the health status and health service utilisation profile of pregnant women experiencing sciatica, leg cramps or varicose veins. Linear and logistic regression was applied to a cross-sectional survey of a pregnant women drawn from the 1973 to 1978 cohort (aged 31-36 years in 2009), of the Australian Longitudinal Study on Women's Health (n=1835). Participant's demographics, health status and health service utilisation were compared for all three complaints based upon three subgroups (yes, sought help; yes, did not seek help; no). A number of women experienced sciatica (22.1%), leg cramps (18.2%) or varicose veins (9.4%). Of these, a greater proportion of women with sciatica (79.3%) or varicose veins (71.5%) sought help for their condition compared with women with leg cramps (46.7%). Comparisons between women with the conditions of interest who did seek help and those who did not only found that women with a university degree were 0.29 (95% CI: 0.10, 0.85) times less likely to seek help for their condition compared to women with a school only education. Further research examining all health seeking behaviour and treatment use of pregnant women who experience lower extremity problems is required in order to facilitate safe, effective and coordinated maternity care to further support these women during pregnancy. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Children's use of general practitioner services in the five Nordic countries

PubMed Central

Virtanen, J I; Berntsson, L T; Lahelma, E; Köhler, L

2006-01-01

Objective To compare socioeconomic, sociodemographic, and living area differences in children's use of GP services in five Nordic countries from the 1980s to the 1990s and to analyse trends during the period. Design Cross sectional population surveys using random samples comprising 3000 children aged 2–17 years were conducted in 1984 and 1996 in five Nordic countries. Time trends in use of GP services were studied in each country by age, sex, parents' highest level of education, and living area. Setting Five Nordic countries, Denmark, Finland, Iceland, Norway, and Sweden in 1984 and 1996. Participants A total sample of 15 000 children aged 2–17 years. Altogether 3000 children were selected at random from the national population registers of the national bureaus of statistics in each country. Main outcome Health services utilisation on the basis of responses to a questionnaire item asking whether the parents had consulted a GP with regard to their children's health during the previous three months. Main results The prevalence of children's utilisation of GP services varied from 14% in 1984 in Sweden to 28% in 1996 in Iceland. A clear time trend towards increasing utilisation of GP services (p<0.05) was found in all countries except in Denmark. Odds ratios for time trends (1984 = 1.00) varied from 1.22 (1.02 to 1.46) in Sweden to 1.92 (1.62 to 2.30) in Norway. After adjusting for independent variables, a statistically borderline significant declining utilisation trend (OR = 0.85 (0.70 to 1.03)) was found for Denmark. Conclusion Children's use of GP services has increased significantly in four of the five Nordic countries. PMID:16415268

Surfactant exfoliated 2D hexagonal Boron Nitride (2D-hBN) explored as a potential electrochemical sensor for dopamine: surfactants significantly influence sensor capabilities.

PubMed

Khan, Aamar F; Brownson, Dale A C; Foster, Christopher W; Smith, Graham C; Banks, Craig E

2017-05-21

Surfactant exfoliated 2D hexagonal Boron Nitride (2D-hBN) nanosheets are explored as a potential electrochemical sensing platform and evaluated towards the electroanalytical sensing of dopamine (DA) in the presence of the common interferents, ascorbic acid (AA) and uric acid (UA). Surfactant exfoliated 2D-hBN nanosheets (2-4 layers) fabricated using sodium cholate in aqueous media are electrically wired via a drop-casting modification process onto disposable screen-printed graphite electrodes (SPEs). We critically evaluate the performance of these 2D-hBN modified SPEs and demonstrate the effect of 'mass coverage' towards the detection of DA, AA and UA. Previous studies utilising surfactant-free (pristine) 2D-hBN modified SPEs have shown a beneficial effect towards the detection of DA, AA and UA when compared to the underlying/unmodified graphite-based electrode. We show that the fabrication route utilised to prepare 2D-hBN is a vital experimental consideration, such that the beneficial effect previously reported is considerably reduced when surfactant exfoliated 2D-hBN is utilised. We demonstrate for the first time, through implementation of control experiments in the form of surfactant modified graphite electrodes, that sodium cholate is a major contributing factor to the aforementioned detrimental behaviour. The significance here is not in the material per se, but the fundamental knowledge of the surfactant and surface coverage changing the electrochemical properties of the material under investigation. Given the wide variety of ionic and non-ionic surfactants that are utilised in the manufacture of novel 2D materials, the control experiments reported herein need to be performed in order to de-convolute the electrochemical response and effectively evaluate the 'underlying surface/surfactant/2D materials' electrocatalytic contribution.

Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

PubMed

Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

2016-02-09

This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. 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/

Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review

PubMed Central

Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

2016-01-01

Objective This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Setting Early prehospital phase of a major incident. Design Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and ‘major incidents’ to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. Results The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. Conclusions HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. Trial registration number CRD42013004473. PMID:26861938

Anthelmintic utilisation practices and prevalence of gastrointestinal helminth infections in sheep kept in the urban and peri-urban areas of Bishoftu Town.

PubMed

Datiko, Jallale; Terefe, Getachew; Bekele, Jemere

2013-02-01

Assessment of the anthelmintic (AH) utilisation practices and estimation of the prevalence of gastrointestinal helminth infections in sheep were carried out from November 2010 to April 2011 in urban and peri-urban areas of Bishoftu Town, central Ethiopia. A structured questionnaire was employed to assess the AH utilisation practices in sheep of 310 owners/households, while floatation and sedimentation techniques were used to study the prevalence of helminth infections. Faecal examinations revealed that 53.9 % of sheep harboured gastrointestinal helminth infections with a high frequency due to strongyles (77.3 %). The questionnaire survey revealed that sources of AH for sheep were government and private veterinary clinics for 98.5 % of urban and 65.4 % peri-urban respondents. In peri-urban areas, AH were also purchased from open markets and illegal dealers. Albendazole was the most common (75.5 %) drug used in sheep followed by ivermectin (18.7 %) and tetramisole (5.8 %). The criteria for selecting AH were: prescription by veterinarians (51.6 %), efficacy (31.9 %), price (12.3 %) and arbitrary reasons (4.2 %). Treatment frequency was minimal with 51.3, 32.3 and 15.8 % of the owners treating their sheep once, twice and less than once per year, respectively. Treatments mainly depended on manifestations of general (45.8 %) and digestive (23.3 %) symptoms. Irrespective of the body weight of the sheep, albendazole was the only drug reported to be given at half bolus/sheep (14.1 %). Owing to this practice, albendazole faces the risk of reduced efficacy or AH resistance due to its wide spread utilisation, handling by untrained personnel and suspected underdosage, which altogether support the perception of sheep owners on its lower effect on the performance of treated sheep.

Long-Term Post-Disturbance Forest Recovery in the Greater Yellowstone Ecosystem Analyzed Using Landsat Time Series Stack

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

Zhao, Feng R.; Meng, Ran; Huang, Chengquan

Forest recovery from past disturbance is an integral process of ecosystem carbon cycles, and remote sensing provides an effective tool for tracking forest disturbance and recovery over large areas. Although the disturbance products (tracking the conversion from forest to non-forest type) derived using the Landsat Time Series Stack-Vegetation Change Tracker (LTSS-VCT) algorithm have been validated extensively for mapping forest disturbances across the United States, the ability of this approach to characterize long-term post-disturbance recovery (the conversion from non-forest to forest) has yet to be assessed. Here in this study, the LTSS-VCT approach was applied to examine long-term (up to 24more » years) post-disturbance forest spectral recovery following stand-clearing disturbances (fire and harvests) in the Greater Yellowstone Ecosystem (GYE). Using high spatial resolution images from Google Earth, we validated the detectable forest recovery status mapped by VCT by year 2011. Validation results show that the VCT was able to map long-term post-disturbance forest recovery with overall accuracy of ~80% for different disturbance types and forest types in the GYE. Harvested areas in the GYE have higher percentages of forest recovery than burned areas by year 2011, and National Forests land generally has higher recovery rates compared with National Parks. The results also indicate that forest recovery is highly related with forest type, elevation and environmental variables such as soil type. Findings from this study can provide valuable insights for ecosystem modeling that aim to predict future carbon dynamics by integrating fine scale forest recovery conditions in GYE, in the face of climate change. Lastly, with the availability of the VCT product nationwide, this approach can also be applied to examine long-term post-disturbance forest recovery in other study regions across the U.S.« less

Long-Term Post-Disturbance Forest Recovery in the Greater Yellowstone Ecosystem Analyzed Using Landsat Time Series Stack

DOE PAGES

Zhao, Feng R.; Meng, Ran; Huang, Chengquan; ...

2016-10-29

Forest recovery from past disturbance is an integral process of ecosystem carbon cycles, and remote sensing provides an effective tool for tracking forest disturbance and recovery over large areas. Although the disturbance products (tracking the conversion from forest to non-forest type) derived using the Landsat Time Series Stack-Vegetation Change Tracker (LTSS-VCT) algorithm have been validated extensively for mapping forest disturbances across the United States, the ability of this approach to characterize long-term post-disturbance recovery (the conversion from non-forest to forest) has yet to be assessed. Here in this study, the LTSS-VCT approach was applied to examine long-term (up to 24more » years) post-disturbance forest spectral recovery following stand-clearing disturbances (fire and harvests) in the Greater Yellowstone Ecosystem (GYE). Using high spatial resolution images from Google Earth, we validated the detectable forest recovery status mapped by VCT by year 2011. Validation results show that the VCT was able to map long-term post-disturbance forest recovery with overall accuracy of ~80% for different disturbance types and forest types in the GYE. Harvested areas in the GYE have higher percentages of forest recovery than burned areas by year 2011, and National Forests land generally has higher recovery rates compared with National Parks. The results also indicate that forest recovery is highly related with forest type, elevation and environmental variables such as soil type. Findings from this study can provide valuable insights for ecosystem modeling that aim to predict future carbon dynamics by integrating fine scale forest recovery conditions in GYE, in the face of climate change. Lastly, with the availability of the VCT product nationwide, this approach can also be applied to examine long-term post-disturbance forest recovery in other study regions across the U.S.« less

Distribution and role of mat-forming saprobic basidiomycetes in a tropical forest

Treesearch

D. Jean Lodge; William H. McDowell; Jordan Macy; Sarah Katherine Ward; Rachel Leisso; Karla Claudio-Campos; Kerstin Kuhnert

2007-01-01

This chapter provides a brief synopsis of previous studies on the ecology of agaric decomposers that form litter 'mats' in tropical forests, augmented by data from temperate forest studies. Description of several experiments in tropical forests of the Luquillo Mountains in Puerto Rico is included. These studies showed higher rates of mass loss in leaves that...

Caspar Creek Watershed Study--North Fork Phase, Jackson Demonstration State Forest, Status and Plans, 1983-1990

Treesearch

Norm Henry; Karen Sendek

1985-01-01

Abstract - The California Department of Forestry and U.S. Forest Service, Pacific Southwest Forest and Range Experiment Station have been conducting a paired watershed study on Jackson Demonstration State Forest for 24 years. The South Fork watershed phase of the study involved monitoring the impacts of road construction (1967) and selective tractor logging (1971-1973...

[Early responses of soil fauna in three typical forests of south subtropical China to simulated N deposition addition].

PubMed

Xu, Guolian; Mo, Jiangming; Zhou, Guoyi

2005-07-01

In this paper, simulated N deposition addition (0, 50, 100 and 150 kg x hm(-2) x yr(-1)) by spreading water or NH4NO3 was conducted to study the early responses of soil fauna in three typical native forests (monsoon evergreen broadleaf forest, pine forest, and broadleaf-pine mixed forest) of subtropical China. The results showed that in monsoon evergreen broadleaf forest, N deposition addition had an obviously negative effect on the three indexes for soil fauna, but in pine forest, the positive effect was significant (P < 0. 05), and the soil fauna community could reach the level in mixed forest, even that in monsoon evergreen broadleaf forest at sometime. The responses in mixed forest were not obvious. In monsoon evergreen broadleaf forest, the negative effects were significant (P < 0.05) under medium N deposition, but not under low N deposition. In pine forest, the positive effect was significant (P < 0.05) under high N deposition, especially for the number of soil fauna groups. The results obtained might imply the N saturation-response mechanisms of forest ecosystems in subtropical China, and the conclusions from this study were also consisted with some related researches.

Teaching Harmonic Motion in Trigonometry: Inductive Inquiry Supported by Physics Simulations

ERIC Educational Resources Information Center

Sokolowski, Andrzej; Rackley, Robin

2011-01-01

In this article, the authors present a lesson whose goal is to utilise a scientific environment to immerse a trigonometry student in the process of mathematical modelling. The scientific environment utilised during this activity is a physics simulation called "Wave on a String" created by the PhET Interactive Simulations Project at…

Enhancing Student Employability through Ethics-Based Outreach Activities and Open Educational Resources

ERIC Educational Resources Information Center

Lewis, David I.

2011-01-01

This paper reports on how science communication final year undergraduate research projects and educational internships can be utilised to provide opportunities for students to develop and utilise key employability skills. In the current difficult economic climate, the report "Working towards your future: Making the most of your time in higher…

Utilising Planning and Financing Strategies in the Management of Community Development Projects in Enugu State, Nigeria

ERIC Educational Resources Information Center

Obetta, Chukwuemeka K.; Oreh, Catherine I.

2017-01-01

Utilisation of community management strategies is an approach to governance that is based on community and organisational involvement. Communities with development projects have formed community projects management committees (CPMCs) that are encouraged to adopt the community management strategy in the planning and financing of community…

Utilisation of Local Inputs in the Funding and Administration of Education in Nigeria

ERIC Educational Resources Information Center

Akiri, Agharuwhe A.

2014-01-01

The article discussed how, why and who is in charge of administering and funding schools in Nigeria. The author utilised the relevant statistical approach which examined and discussed various political and historical trends affecting education. Besides this, relevant documented statistical data were used to both buttress and substantiate related…

A Qualitative Exploration of Primary School Students' Experience and Utilisation of Mindfulness

ERIC Educational Resources Information Center

Bannirchelvam, Bavani; Bell, Karen L.; Costello, Shane

2017-01-01

Despite the increasing utilisation of mindfulness-based interventions in children, research investigating the impact of these interventions in children is still in its infancy. One significant gap in the literature is the general omission of the child's voice in how they experience and benefit from mindfulness-based intervention. Therefore, the…

Improving the Utilisation of Management Information Systems in Secondary Schools

ERIC Educational Resources Information Center

Bosker, R. J.; Branderhorst, E. M.; Visscher, A. J.

2007-01-01

Although most secondary schools do use management information systems (MISs), these systems tend not to be used to support higher order managerial activities but are currently primarily used for clerical purposes. This situation is unsatisfactory as MISs fully utilised could offer invaluable support to schools, which are increasingly being granted…

Closing the Gap between Research Evidence and Clinical Practice: Jordanian Nurses' Perceived Barriers to Research Utilisation

ERIC Educational Resources Information Center

Al Khalaileh, Murad; Al Qadire, Mohammad; Musa, Ahmad S.; Al-Khawaldeh, Omar A.; Al Qudah, Hani; Alhabahbeh, Atalla

2016-01-01

Background: The nursing profession is a combination of theory and practical skill, and nurses are required to generate and develop knowledge through implementing research into clinical practice. Considerable number of barriers could hind implementing research findings into practice. Barriers to research utilisation are not identified in the…

Creating a data exchange strategy for radiotherapy research: towards federated databases and anonymised public datasets.

PubMed

Skripcak, Tomas; Belka, Claus; Bosch, Walter; Brink, Carsten; Brunner, Thomas; Budach, Volker; Büttner, Daniel; Debus, Jürgen; Dekker, Andre; Grau, Cai; Gulliford, Sarah; Hurkmans, Coen; Just, Uwe; Krause, Mechthild; Lambin, Philippe; Langendijk, Johannes A; Lewensohn, Rolf; Lühr, Armin; Maingon, Philippe; Masucci, Michele; Niyazi, Maximilian; Poortmans, Philip; Simon, Monique; Schmidberger, Heinz; Spezi, Emiliano; Stuschke, Martin; Valentini, Vincenzo; Verheij, Marcel; Whitfield, Gillian; Zackrisson, Björn; Zips, Daniel; Baumann, Michael

2014-12-01

Disconnected cancer research data management and lack of information exchange about planned and ongoing research are complicating the utilisation of internationally collected medical information for improving cancer patient care. Rapidly collecting/pooling data can accelerate translational research in radiation therapy and oncology. The exchange of study data is one of the fundamental principles behind data aggregation and data mining. The possibilities of reproducing the original study results, performing further analyses on existing research data to generate new hypotheses or developing computational models to support medical decisions (e.g. risk/benefit analysis of treatment options) represent just a fraction of the potential benefits of medical data-pooling. Distributed machine learning and knowledge exchange from federated databases can be considered as one beyond other attractive approaches for knowledge generation within "Big Data". Data interoperability between research institutions should be the major concern behind a wider collaboration. Information captured in electronic patient records (EPRs) and study case report forms (eCRFs), linked together with medical imaging and treatment planning data, are deemed to be fundamental elements for large multi-centre studies in the field of radiation therapy and oncology. To fully utilise the captured medical information, the study data have to be more than just an electronic version of a traditional (un-modifiable) paper CRF. Challenges that have to be addressed are data interoperability, utilisation of standards, data quality and privacy concerns, data ownership, rights to publish, data pooling architecture and storage. This paper discusses a framework for conceptual packages of ideas focused on a strategic development for international research data exchange in the field of radiation therapy and oncology. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Creating a data exchange strategy for radiotherapy research: Towards federated databases and anonymised public datasets

PubMed Central

Skripcak, Tomas; Belka, Claus; Bosch, Walter; Brink, Carsten; Brunner, Thomas; Budach, Volker; Büttner, Daniel; Debus, Jürgen; Dekker, Andre; Grau, Cai; Gulliford, Sarah; Hurkmans, Coen; Just, Uwe; Krause, Mechthild; Lambin, Philippe; Langendijk, Johannes A.; Lewensohn, Rolf; Lühr, Armin; Maingon, Philippe; Masucci, Michele; Niyazi, Maximilian; Poortmans, Philip; Simon, Monique; Schmidberger, Heinz; Spezi, Emiliano; Stuschke, Martin; Valentini, Vincenzo; Verheij, Marcel; Whitfield, Gillian; Zackrisson, Björn; Zips, Daniel; Baumann, Michael

2015-01-01

Disconnected cancer research data management and lack of information exchange about planned and ongoing research are complicating the utilisation of internationally collected medical information for improving cancer patient care. Rapidly collecting/pooling data can accelerate translational research in radiation therapy and oncology. The exchange of study data is one of the fundamental principles behind data aggregation and data mining. The possibilities of reproducing the original study results, performing further analyses on existing research data to generate new hypotheses or developing computational models to support medical decisions (e.g. risk/benefit analysis of treatment options) represent just a fraction of the potential benefits of medical data-pooling. Distributed machine learning and knowledge exchange from federated databases can be considered as one beyond other attractive approaches for knowledge generation within “Big Data”. Data interoperability between research institutions should be the major concern behind a wider collaboration. Information captured in electronic patient records (EPRs) and study case report forms (eCRFs), linked together with medical imaging and treatment planning data, are deemed to be fundamental elements for large multi-centre studies in the field of radiation therapy and oncology. To fully utilise the captured medical information, the study data have to be more than just an electronic version of a traditional (un-modifiable) paper CRF. Challenges that have to be addressed are data interoperability, utilisation of standards, data quality and privacy concerns, data ownership, rights to publish, data pooling architecture and storage. This paper discusses a framework for conceptual packages of ideas focused on a strategic development for international research data exchange in the field of radiation therapy and oncology. PMID:25458128

Linking Bacillus cereus Genotypes and Carbohydrate Utilization Capacity.

PubMed

Warda, Alicja K; Siezen, Roland J; Boekhorst, Jos; Wells-Bennik, Marjon H J; de Jong, Anne; Kuipers, Oscar P; Nierop Groot, Masja N; Abee, Tjakko

2016-01-01

We characterised carbohydrate utilisation of 20 newly sequenced Bacillus cereus strains isolated from food products and food processing environments and two laboratory strains, B. cereus ATCC 10987 and B. cereus ATCC 14579. Subsequently, genome sequences of these strains were analysed together with 11 additional B. cereus reference genomes to provide an overview of the different types of carbohydrate transporters and utilization systems found in B. cereus strains. The combined application of API tests, defined growth media experiments and comparative genomics enabled us to link the carbohydrate utilisation capacity of 22 B. cereus strains with their genome content and in some cases to the panC phylogenetic grouping. A core set of carbohydrates including glucose, fructose, maltose, trehalose, N-acetyl-glucosamine, and ribose could be used by all strains, whereas utilisation of other carbohydrates like xylose, galactose, and lactose, and typical host-derived carbohydrates such as fucose, mannose, N-acetyl-galactosamine and inositol is limited to a subset of strains. Finally, the roles of selected carbohydrate transporters and utilisation systems in specific niches such as soil, foods and the human host are discussed.

Linking Bacillus cereus Genotypes and Carbohydrate Utilization Capacity

PubMed Central

Warda, Alicja K.; Siezen, Roland J.; Boekhorst, Jos; Wells-Bennik, Marjon H. J.; de Jong, Anne; Kuipers, Oscar P.; Nierop Groot, Masja N.; Abee, Tjakko

2016-01-01

We characterised carbohydrate utilisation of 20 newly sequenced Bacillus cereus strains isolated from food products and food processing environments and two laboratory strains, B. cereus ATCC 10987 and B. cereus ATCC 14579. Subsequently, genome sequences of these strains were analysed together with 11 additional B. cereus reference genomes to provide an overview of the different types of carbohydrate transporters and utilization systems found in B. cereus strains. The combined application of API tests, defined growth media experiments and comparative genomics enabled us to link the carbohydrate utilisation capacity of 22 B. cereus strains with their genome content and in some cases to the panC phylogenetic grouping. A core set of carbohydrates including glucose, fructose, maltose, trehalose, N-acetyl-glucosamine, and ribose could be used by all strains, whereas utilisation of other carbohydrates like xylose, galactose, and lactose, and typical host-derived carbohydrates such as fucose, mannose, N-acetyl-galactosamine and inositol is limited to a subset of strains. Finally, the roles of selected carbohydrate transporters and utilisation systems in specific niches such as soil, foods and the human host are discussed. PMID:27272929

Impacts of forest restoration on water yield: A systematic review

PubMed Central

Filoso, Solange; Bezerra, Maíra Ometto; Weiss, Katherine C. B.; Palmer, Margaret A.

2017-01-01

Background Enhancing water provision services is a common target in forest restoration projects worldwide due to growing concerns over freshwater scarcity. However, whether or not forest cover expansion or restoration can improve water provision services is still unclear and highly disputed. Purpose The goal of this review is to provide a balanced and impartial assessment of the impacts of forest restoration and forest cover expansion on water yields as informed by the scientific literature. Potential sources of bias on the results of papers published are also examined. Data sources English, Spanish and Portuguese peer-review articles in Agricola, CAB Abstracts, ISI Web of Science, JSTOR, Google Scholar, and SciELO. Databases were searched through 2015. Search terms Intervention terms included forest restoration, regeneration/regrowth, forest second-growth, forestation/afforestation, and forestry. Target terms included water yield/quantity, streamflow, discharge, channel runoff, and annual flow. Study selection and eligibility criteria Articles were pre-selected based on key words in the title, abstract or text. Eligible articles addressed relevant interventions and targets and included quantitative information. Results Most studies reported decreases in water yields following the intervention, while other hydrological benefits have been observed. However, relatively few studies focused specifically on forest restoration, especially with native species, and/or on projects done at large spatial or temporal scales. Information is especially limited for the humid tropics and subtropics. Conclusions and implications of key findings While most studies reported a decrease in water yields, meta-analyses from a sub-set of studies suggest the potential influence of temporal and/or spatial scales on the outcomes of forest cover expansion or restoration projects. Given the many other benefits of forest restoration, improving our understanding of when and why forest restoration can lead to recovery of water yields is crucial to help improve positive outcomes and prevent unintended consequences. Our study identifies the critical types of studies and associated measurements needed. PMID:28817639

Analysis of Urban Forest Needs as Anthropogenic (CO2) Gas Absorbent in Semarang City

NASA Astrophysics Data System (ADS)

Febriani, Anisa Putri; Retnaningsih Soeprobowati, Tri; Maryono

2018-02-01

Green open space in cities in significant needs to maintenance environment quality. On of the critical function is to absorb increasing number of gas CO2. Therefore, developing urban forest in cities is very importance. The objective of the study is to determine the area of urban forest as CO2 gas anthropogenic absorb which is formed from fuel, diesel fuel, liquid petroleum gas. The study consists of (1) Analyzing the number of CO2 gas emission by calculating the needs of petroleum and gas based on the number of population, (2) Analyzing the power of gas absorption, (3) Measuring the air concentration of CO2 gas ambient based on daily traffic activities. This study shown that from year 2013 to year 2017, the increasing of urban forest is not so significant. For year 2013 the green open space in Semarang City are 373.67 hectares (7.5 percent from Semarang City area), consists of 239 parks, 11 public cemeteries, production forests, community forests, and urban forests, however the area of urban forest is not increase. The study assess that Antidesmabunius is one of the green species which high absorb capacity planted for Semarang. This trees produce 31,31 ton annually. This study proposed to fostering Antidesmabunius as one principle threes in Semarang urban forest.

Current forest and woodland carbon storage and flux in California: An estimate for the 2010 statewide assessment

Treesearch

Timothy A. Robards

2012-01-01

This study used USDA Forest Service Forest Inventory and Analysis (FIA) plot data, forest growth models, wildland fire emission estimates and timber harvest data to estimate the live tree carbon storage and flux of California's forests and woodlands. Approximately 30 Tg C02e per year was estimated as the annual flux for all California forests. The forest inventory...

Quantifying forest LAI succession in sub-tropical forests using time-series of Landsat data, 1987 -2015

NASA Astrophysics Data System (ADS)

Wu, Q.; Song, J.; Wang, J.; Chen, S.; Yu, B.; Liao, L.

2016-12-01

Monitoring the dynamics of leaf area index (LAI) throughout the life-cycle of forests (from seeding to maturity) is vital for simulating forest growth and quantifying carbon sequestration. However, all current global LAI produts show extremely low accuracy in forests and the coarse spatial resolution(nearly 1-km) mismatch with the spatial scale of forest inventory plots (nearly 26m*26m). To date, several studies have explored the possibility of satellite data to classify forest succession or predict stand age. And a few studies have explored the potential of using long term Landsat data to monitor the growing trend of forests, but no studies have quantified the inter-annual and intra-annual LAI dynamics along with forest succession. Vegetation indexes are not perfect variables in quantifying forest foliage dynamics. Hallet (1995) suggested remote sensing of biophysical characteristics should shift away from direct inference from vegetation indices toward more physically based algorithms. This work intends to be a pioneer example for improving the accuracy of forests LAI and providing temporal-spatial matching LAI datasets for monitoring forest processes. We integrates the Geometric-Optical and Radiative Transfer (GORT) model with the Physiological Principles Predicting Growth (3-PG) model to improve the estimation of the forest canopy LAI dynamics. Reflectance time-series data from 1987 to 2015 were collected and preprocessed for forests in southern China, using all available Landsat data (with <80% cloud). Effective LAI and true LAI were field measured to validate our results using various instruments, including digital hemispheric photographs (DHP), LAI-2000 Plant Canopy Analyzer (LI-COR), and Tracing radiation and Architecture of Canopies (TRAC). Results show that the relationship between spectral metrics of satellite images and forest LAI is clear in early stages before maturity. 3-PG provide accurate inter-annual trend of forest LAI, while satellite images provide clear intra-annual LAI dynamics. We concluded that the GORT-3PG model improved the LAI estimation significantly of forest stands. Improving forest LAI estimates will help inform forest management policy and such methods may be applied in other similar forests.

Identifying patterns of general practitioner service utilisation and their relationship with potentially preventable hospitalisations in people with diabetes: The utility of a cluster analysis approach.

PubMed

Ha, Ninh Thi; Harris, Mark; Preen, David; Robinson, Suzanne; Moorin, Rachael

2018-04-01

We aimed to characterise use of general practitioners (GP) simultaneously across multiple attributes in people with diabetes and examine its impact on diabetes related potentially preventable hospitalisations (PPHs). Five-years of panel data from 40,625 adults with diabetes were sourced from Western Australian administrative health records. Cluster analysis (CA) was used to group individuals with similar patterns of GP utilisation characterised by frequency and recency of services. The relationship between GP utilisation cluster and the risk of PPHs was examined using multivariable random-effects negative binomial regression. CA categorised GP utilisation into three clusters: moderate; high and very high usage, having distinct patient characteristics. After adjusting for potential confounders, the rate of PPHs was significantly lower across all GP usage clusters compared with those with no GP usage; IRR = 0.67 (95%CI: 0.62-0.71) among the moderate, IRR = 0.70 (95%CI 0.66-0.73) high and IRR = 0.76 (95%CI 0.72-0.80) very high GP usage clusters. Combination of temporal factors with measures of frequency of use of GP services revealed patterns of primary health care utilisation associated with different underlying patient characteristics. Incorporation of multiple attributes, that go beyond frequency-based approaches may better characterise the complex relationship between use of GP services and diabetes-related hospitalisation. Copyright © 2018 Elsevier B.V. All rights reserved.

Drug safety and the impact of drug warnings: An interrupted time series analysis of diabetes drug prescriptions in Germany and Denmark.

PubMed

Hostenkamp, Gisela; Fischer, Katharina Elisabeth; Borch-Johnsen, Knut

2016-12-01

To analyse the impact of drug safety warnings from the European Medicines Agency (EMA) on drug utilisation and their interaction with information released through national reimbursement bodies. Insurance claims data on anti-diabetic drug prescriptions in primary care in Germany and Denmark were analysed using interrupted time series analysis, with EMA drug warnings for thiazolidinediones (TZDs) in 2007 and 2011 as the intervention. Monthly drug utilisation data per substance in defined daily dosages (DDD) consumed per 1000 insurees were retrieved from the Danish national drug prescriptions register and one large statutory sickness fund in Germany. TZDs were generally reimbursed in Germany but restricted to individual reimbursement in Denmark. Consequently, utilisation of TZDs was much higher in Germany in 2007 compared with Denmark. For rosiglitazone, the drug warning had a significant impact on utilisation, reducing the number of DDD per 1000 insurees per day by -0.0105 in Denmark and -0.0312 in Germany (p-values<0.05). For pioglitazone, neither of the drug warnings had a significant effect on utilisation. The impact of EMA drug warnings differed across countries and might be mediated by information released through national reimbursement bodies and physician associations. Increasing complexity of new drugs and modified approval procedures require a strengthening of information exchange between drug regulation bodies and physicians to ensure patient safety. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Etude de faisabilite d'un systeme eolien diesel avec stockage d'air comprime

NASA Astrophysics Data System (ADS)

Benchaabane, Youssef

Le Systeme Hybride Eolien-Diesel avec Stockage d'Air Comprime (SHEDAC) utilise l'hybridation pneumatique pour remplacer la consommation des combustibles fossiles par de l'energie renouvelable, plus particulierement de l'energie eolienne. Le surplus de l'energie eolienne est utilise pour comprimer et stocker de l'air qui est utilise ensuite pour suralimenter le moteur diesel. Le memoire de maitrise est constitue de deux articles scientifiques. Le premier article presente le developpement d'un logiciel dedie a l'etude de faisabilite d'un systeme eolien-diesel avec stockage d'air comprime. Cette etude est basee sur l'analyse des couts et des revenus, des couts des equipements (eolienne, moteur diesel, systeme de stockage d'air). Elle est completee par une analyse de sensibilite aux differents parametres, une analyse des risques et des emissions des gaz a effet de serre (GES). Le deuxieme article est une application de ce logiciel pour l'installation d'un systeme SHEDAC au camp minier Esker au Quebec en remplacement des sources actuelles de production d'energie. L'utilisation du stockage d'air comprime a l'aide d'un systeme SHEDAC est le plus rentable par rapport a l'utilisation de l'energie eolienne seule ou d'une centrale thermique au diesel seule ou des deux combinees. Avec une valeur actuelle nette et un taux de rendement interne plus eleves, cette solution permet d'obtenir le plus bas cout de l'energie pour cette region eloignee. None None None

Influence of Different Forest System Management Practices on Leaf Litter Decomposition Rates, Nutrient Dynamics and the Activity of Ligninolytic Enzymes: A Case Study from Central European Forests

PubMed Central

Schulz, Elke; Schloter, Michael; Buscot, François; Hofrichter, Martin; Krüger, Dirk

2014-01-01

Leaf litter decomposition is the key ecological process that determines the sustainability of managed forest ecosystems, however very few studies hitherto have investigated this process with respect to silvicultural management practices. The aims of the present study were to investigate the effects of forest management practices on leaf litter decomposition rates, nutrient dynamics (C, N, Mg, K, Ca, P) and the activity of ligninolytic enzymes. We approached these questions using a 473 day long litterbag experiment. We found that age-class beech and spruce forests (high forest management intensity) had significantly higher decomposition rates and nutrient release (most nutrients) than unmanaged deciduous forest reserves (P<0.05). The site with near-to-nature forest management (low forest management intensity) exhibited no significant differences in litter decomposition rate, C release, lignin decomposition, and C/N, lignin/N and ligninolytic enzyme patterns compared to the unmanaged deciduous forest reserves, but most nutrient dynamics examined in this study were significantly faster under such near-to-nature forest management practices. Analyzing the activities of ligninolytic enzymes provided evidence that different forest system management practices affect litter decomposition by changing microbial enzyme activities, at least over the investigated time frame of 473 days (laccase, P<0.0001; manganese peroxidase (MnP), P = 0.0260). Our results also indicate that lignin decomposition is the rate limiting step in leaf litter decomposition and that MnP is one of the key oxidative enzymes of litter degradation. We demonstrate here that forest system management practices can significantly affect important ecological processes and services such as decomposition and nutrient cycling. PMID:24699676

Influence of different forest system management practices on leaf litter decomposition rates, nutrient dynamics and the activity of ligninolytic enzymes: a case study from central European forests.

PubMed

Purahong, Witoon; Kapturska, Danuta; Pecyna, Marek J; Schulz, Elke; Schloter, Michael; Buscot, François; Hofrichter, Martin; Krüger, Dirk

2014-01-01

Leaf litter decomposition is the key ecological process that determines the sustainability of managed forest ecosystems, however very few studies hitherto have investigated this process with respect to silvicultural management practices. The aims of the present study were to investigate the effects of forest management practices on leaf litter decomposition rates, nutrient dynamics (C, N, Mg, K, Ca, P) and the activity of ligninolytic enzymes. We approached these questions using a 473 day long litterbag experiment. We found that age-class beech and spruce forests (high forest management intensity) had significantly higher decomposition rates and nutrient release (most nutrients) than unmanaged deciduous forest reserves (P<0.05). The site with near-to-nature forest management (low forest management intensity) exhibited no significant differences in litter decomposition rate, C release, lignin decomposition, and C/N, lignin/N and ligninolytic enzyme patterns compared to the unmanaged deciduous forest reserves, but most nutrient dynamics examined in this study were significantly faster under such near-to-nature forest management practices. Analyzing the activities of ligninolytic enzymes provided evidence that different forest system management practices affect litter decomposition by changing microbial enzyme activities, at least over the investigated time frame of 473 days (laccase, P<0.0001; manganese peroxidase (MnP), P = 0.0260). Our results also indicate that lignin decomposition is the rate limiting step in leaf litter decomposition and that MnP is one of the key oxidative enzymes of litter degradation. We demonstrate here that forest system management practices can significantly affect important ecological processes and services such as decomposition and nutrient cycling.

Measuring impacts of community forestry program through repeat photography and satellite remote sensing in the Dolakha district of Nepal.

PubMed

Niraula, Rabin Raj; Gilani, Hammad; Pokharel, Bharat Kumar; Qamer, Faisal Mueen

2013-09-15

During the 1990's community-based forest management gained momentum in Nepal. This study systematically evaluates the impacts that this had on land cover change and other associated aspects during the period 1990-2010 using repeat photography and satellite imagery in combination with interviews with community members. The results of the study clearly reflect the success of community-based forest management in the Dolakha district of the mid-hills of Nepal: during the study period, the rate of conversion of sparse forest into dense forest under community-based management was found to be between 1.13% and 3.39% per year. Similarly, the rate of conversion of non-forest area into forest was found to be between 1.11% and 1.96% per year. Community-based forest management has resulted in more efficient use of forest resources, contributed to a decline in the use of slash-and-burn agricultural practices, reduced the incidence of forest fires, spurred tree plantation, and encouraged the conservation and protection of trees on both public and private land. The resulting reclamation of forest in landside areas and river banks and the overall improvement in forest cover in the area has reduced flash floods and associated landslides. Copyright © 2013 Elsevier Ltd. All rights reserved.

Bulgarian Rila mountain forest ecosystems study site: site description and SO42-, NO3- deposition

Treesearch

Karl Zeller; Christo Bojinov; Evgeny Donev; Nedialko Nikolov

1998-01-01

Bulgaria's forest ecosystems (31 percent of the country's area) are considered vulnerable to dry and wet pollution deposition. Coniferous forests that cover one-third of the total forest land are particularly sensitive to pollution loads. The USDA Forest Service, Sofia University, and the Bulgarian Forest Research Institute (FRI) established a cooperative...

Family forest owner preferences for biomass harvesting in Massachusetts

Treesearch

Marla Markowski-Lindsay; Thomas Stevens; David B. Kittredge; Brett J. Butler; Paul Catanzaro; David Damery

2012-01-01

U.S. forests, including family-owned forests, are a potential source of biomass for renewable energy. Family forest owners constitute a significant portion of the overall forestland in the U.S., yet little is known about family forest owners' preferences for supplying wood-based biomass. The goal of this study is to understand how Massachusetts family forest...

Dispersal of forest insects

NASA Technical Reports Server (NTRS)

Mcmanus, M. L.

1979-01-01

Dispersal flights of selected species of forest insects which are associated with periodic outbreaks of pests that occur over large contiguous forested areas are discussed. Gypsy moths, spruce budworms, and forest tent caterpillars were studied for their massive migrations in forested areas. Results indicate that large dispersals into forested areas are due to the females, except in the case of the gypsy moth.

Why Forest Gardening for Children? Swedish Forest Garden Educators' Ideas, Purposes, and Experiences

ERIC Educational Resources Information Center

Almers, Ellen; Askerlund, Per; Kjellström, Sofia

2018-01-01

Utilizing forest gardens as urban settings for outdoor environmental education in Sweden is a new practice. These forest gardens combine qualities of a forest, e.g., multi-layered polyculture vegetation, with those of a school garden, such as accessibility and food production. The study explores both the perceived qualities of forest gardens in…

Soil physical changes associated with forest harvesting operations on a organic soil

Treesearch

Johnny M. Grace; R.W. Skaggs; D.K. Cassel

2006-01-01

The influence of forest operations on forest soil and water continues to be an issue of concern in forest management. Research has focused on evaluating forest operation effects on numerous soil and water quality indicators. However, poorly drained forested watersheds with organic soil surface horizons have not been extensively investigated. A study was initiated in...

Effects of forest fire and logging on forest degradation in Mongolia

Treesearch

Yeong Dae Park; Don Koo Lee; Jamsran Tsogtbaatar; John A. Stanturf

2010-01-01

Forests in Mongolia have been severely degraded by forest fire and exploitive logging. This study investigate changes in vegetation and soil properties after forest fire or clearfelling. Microclimate conditions such as temperature and relative humidity (RH) changed drastically after forest fire or logging; temperature increased 1.6-1.7 ºC on average, whereas...

[A French tool for evaluation of home palliative care: adaptation of the Support Team Assessment Schedule].

PubMed

Lagabrielle, D; Guyot, F; Jasso, G; Couturier, P; Poussin, G; Frossard, M; Szabo, P; Franco, A

2001-09-01

The authors describe the utilisation of a quality assessment tool for palliative care administered at home. The questionnaire entitled Support Team Assessment Schedule (STAS) was translated from English for this study. It was then utilised comparatively with different quality of life evaluation instruments. Only the results of the STAS are described here. The approach allows for the unresolved problems in the care to come to the surface week after week. The STAS comprises nine items pertaining to the patient and his/her family, and seven items concerning the services provided. The study exhibits the results of 107 evaluations completed from 50 patients stricken with cancer or AIDS in an advanced phase. The availability of this auto clinical audit tool, employable at home or in a hospital, constitutes an essential initial step in the field of French-speaking clinical evaluation of palliative care.

Utilisation of the c-fos immunohistochemical method: a 2004 quantitative study.

PubMed

Robert, C; Arreto, C D; Gaudy, J F; Wilson, C S

2007-10-01

The aim of this study was to provide a quantitative view of the utilisation of the c-fos immunohistochemical method. Articles including the term "c-fos" in their title, abstract or keywords and published in 2004 were retrieved from the Current Content/Life Sciences or Current Content/Clinical Medicine collection of the SCI database. The 933 article-type documents retained were distributed in almost all the sub-disciplines of the Life Sciences and Clinical Medicine, but were principally published in the field of neuroscience. They were authored by researchers from 44 countries - the most prolific were the USA (435 articles), Japan (135) and the UK (55). The 933 articles were published in 283 different journals; all but one of the top-20 most prolific journals are in the Life Sciences discipline, and their Impact Factors ranged from 2.0 to 7.9. A comparison of the USA and the European Union scientific profiles is also made.

Comparison and Characterisation of Regenerated Chitosan from 1-Butyl-3-methylimidazolium Chloride and Chitosan from Crab Shells

PubMed Central

Arnold, Lyndon

2015-01-01

Chitosan is a biopolymer derived from chitin which is naturally occurring in the exoskeleton of crustaceans. This paper reports dissolution and regeneration of chitosan by directly dissolving in an ionic liquid solvent, 1-butyl-3-methylimidazolium chloride (BMIMCl). This will provide an ideal platform to solubilise these kinds of polymers to achieve the dissolution. The current study dissolved chitosan from crab shell utilising BMIMCl as a solvent and characterised the resultant regenerated polymer. The regenerated chitosan showed increased hydrogen bonding when characterised by Fourier transform infrared (FTIR) spectral analysis. In addition, the study also compared the characteristics of regenerated and generic chitosan. The regenerated chitosan was also evaluated for antimicrobial properties and showed to possess antibacterial features similar to the commercial grade. This method can be utilised in future for blending of polymers with chitosan in a dissolved phase. PMID:26090452

A Business Analytics Software Tool for Monitoring and Predicting Radiology Throughput Performance.

PubMed

Jones, Stephen; Cournane, Seán; Sheehy, Niall; Hederman, Lucy

2016-12-01

Business analytics (BA) is increasingly being utilised by radiology departments to analyse and present data. It encompasses statistical analysis, forecasting and predictive modelling and is used as an umbrella term for decision support and business intelligence systems. The primary aim of this study was to determine whether utilising BA technologies could contribute towards improved decision support and resource management within radiology departments. A set of information technology requirements were identified with key stakeholders, and a prototype BA software tool was designed, developed and implemented. A qualitative evaluation of the tool was carried out through a series of semi-structured interviews with key stakeholders. Feedback was collated, and emergent themes were identified. The results indicated that BA software applications can provide visibility of radiology performance data across all time horizons. The study demonstrated that the tool could potentially assist with improving operational efficiencies and management of radiology resources.

The carbon debt from Amazon forest degradation: integrating airborne lidar, field measurements, and an ecosystem demography model.

NASA Astrophysics Data System (ADS)

Longo, M.; Keller, M. M.; dos-Santos, M. N.; Scaranello, M. A., Sr.; Pinagé, E. R.; Leitold, V.; Morton, D. C.

2016-12-01

Amazon deforestation has declined over the last decade, yet forest degradation from logging, fire, and fragmentation continue to impact forest carbon stocks and fluxes. The magnitude of this impact remains uncertain, and observation-based studies are often limited by short time intervals or small study areas. To better understand the long-term impact of forest degradation and recovery, we have been developing a framework that integrates field plot measurements and airborne lidar surveys into an individual- and process-based model (Ecosystem Demography model, ED). We modeled forest dynamics for three forest landscapes in the Amazon with diverse degradation histories: conventional and reduced-impact logging, logging and burning, and multiple burns. Based on the initialization with contemporary forest structure and composition, model results suggest that degraded forests rapidly recover (30 years) water and energy fluxes compared with old-growth, even at sites that were affected by multiple fires. However, degraded forests maintained different carbon stocks and fluxes even after 100 years without further disturbances, because of persistent differences in forest structure and composition. Recurrent disturbances may hinder the recovery of degraded forests. Simulations using a simple fire model entirely dependent on environmental controls indicate that the most degraded forests would take much longer to reach biomass typical of old-growth forests, because drier conditions near the ground make subsequent fires more intense and more recurrent. Fires in tropical forests are also closely related to nearby human activities; while results suggest an important feedback between fires and the microenvironment, additional work is needed to improve how the model represents the human impact on current and future fire regimes. Our study highlights that recovery of degraded forests may act as an important carbon sink, but efficient recovery depends on controlling future disturbances.

Estimating forest biomass and identifying low-intensity logging areas using airborne scanning lidar in Antimary State Forest, Acre State, Western Brazilian Amazon

Treesearch

Marcus V.N. d' Oliveira; Stephen E. Reutebuch; Robert J. McGaughey; Hans-Erik. Andersen

2012-01-01

The objectives of this study were to estimate above ground forest biomass and identify areas disturbed by selective logging in a 1000 ha Brazilian tropical forest in the Antimary State Forest using airborne lidar data. The study area consisted of three management units, two of which were unlogged, while the third unit was selectively logged at a low intensity. A...

Software applications to three-dimensional visualization of forest landscapes -- A case study demontrating the use of visual nature studio (VNS) in visualizing fire spread in forest landscapes

Treesearch

Brian J. Williams; Bo Song; Chou Chiao-Ying; Thomas M. Williams; John Hom

2010-01-01

Three-dimensional (3D) visualization is a useful tool that depicts virtual forest landscapes on computer. Previous studies in visualization have required high end computer hardware and specialized technical skills. A virtual forest landscape can be used to show different effects of disturbances and management scenarios on a computer, which allows observation of forest...

Influence of In Vitro Assay pH and Extractant Composition on As Bioaccessibility in Contaminated Soils

EPA Science Inventory

In vitro bioaccessibility assays are often utilised to determine the potential human exposure to soil contaminants through soil ingestion. Comparative studies have identified inconsistencies in the results obtained with different in vitro assays. In this study we investigated the...

[Dialin: infection surveillance network for haemodialysis patients. First results].

PubMed

Ayzac, Louis; Béruard, Michel; Girard, Raphaële; Hannoun, Jacques; Kuentz, François; Marc, Jean-Michel; Moreau-Gaudry, Xavier; Roche, Catherine; Tressières, Benoît; Uzan, Marc

2009-02-01

To show results of the first year of an infection surveillance network for haemodialysis patients (Dialin). In order to improve the security and quality of care, six haemodialysis centers have organized an infection watching network. The purpose of the network is to compare of the watching results between centers. This comparison includes vascular access infection (VAI), bacteraemia and C viral hepatitis. The heterogeneous pattern has been also taken into account. SURVEY TYPE: Multicenter prospective permanent survey. Six hundred and sixty-four haemodialyzed chronic patients, followed during one year (2005), in six voluntary haemodialysis centers. This survey has based on 71,688 treatment sessions corresponding to 6257.5 months of haemodialysis (HM). As with the heterogeneity among centers, the acquired infection standardized ratios (observed/expected) (AISR) and 95% confidence interval are computed with Cox model which includes confounding factors found in literature or in the preliminary stage of the survey. VAI crude rate was 0.47 per 100HM, 0.10 per 1000 native fistulae utilisation days, 0.45 per 1000 days of prosthetic graft utilisation and 0.44 per 1000 days of catheter utilisation. Bacteraemia crude incidence rate was 0.69 per 100HM, 0.02 per 1000 days of native fistulae utilisation, 0.00 per 1000 days of prosthetic graft utilisation and 0.39 per 1000 days of catheter utilisation. No new case of C viral hepatitis was found. Prevalence rate at the beginning of the survey was 5.3% (35 over 664). Two centers had a significantly high AISR for VAI and two centers had a significantly low AISR for VAI. One center had a significantly high AISR for bacteraemia and one center had a significantly low AISR for bacteraemia. The first year of Dialin running demonstrates the importance of standardised surveillance method in VAI and bacteraemia surveillance but not for viral hepatitis.

Simulation d'ecoulements internes compressibles laminaires et turbulents par une methode d'elements finis

NASA Astrophysics Data System (ADS)

Rebaine, Ali

1997-08-01

Ce travail consiste en la simulation numerique des ecoulements internes compressibles bidimensionnels laminaires et turbulents. On s'interesse, particulierement, aux ecoulements dans les ejecteurs supersoniques. Les equations de Navier-Stokes sont formulees sous forme conservative et utilisent, comme variables independantes, les variables dites enthalpiques a savoir: la pression statique, la quantite de mouvement et l'enthalpie totale specifique. Une formulation variationnelle stable des equations de Navier-Stokes est utilisee. Elle est base sur la methode SUPG (Streamline Upwinding Petrov Galerkin) et utilise un operateur de capture des forts gradients. Un modele de turbulence, pour la simulation des ecoulements dans les ejecteurs, est mis au point. Il consiste a separer deux regions distinctes: une region proche de la paroi solide, ou le modele de Baldwin et Lomax est utilise et l'autre, loin de la paroi, ou une formulation nouvelle, basee sur le modele de Schlichting pour les jets, est proposee. Une technique de calcul de la viscosite turbulente, sur un maillage non structure, est implementee. La discretisation dans l'espace de la forme variationnelle est faite a l'aide de la methode des elements finis en utilisant une approximation mixte: quadratique pour les composantes de la quantite de mouvement et de la vitesse et lineaire pour le reste des variables. La discretisation temporelle est effectuee par une methode de differences finies en utilisant le schema d'Euler implicite. Le systeme matriciel, resultant de la discretisation spatio-temporelle, est resolu a l'aide de l'algorithme GMRES en utilisant un preconditionneur diagonal. Les validations numeriques ont ete menees sur plusieurs types de tuyeres et ejecteurs. La principale validation consiste en la simulation de l'ecoulement dans l'ejecteur teste au centre de recherche NASA Lewis. Les resultats obtenus sont tres comparables avec ceux des travaux anterieurs et sont nettement superieurs concernant les ecoulements turbulents dans les ejecteurs.

Caries experience, dental health behaviour and social status--three comparative surveys among Danish military recruits in 1972, 1982 and 1993.

PubMed

Antoft, P; Rambusch, E; Antoft, B; Christensen, H W

1999-06-01

To compare caries experience among young Danish men in 1972, 1982 and 1993; and on the same occasions to describe relationship between their utilisation of regular dental care and social status, as well as the relationship between their caries experience, utilisation of dental services and social status. During their routine health examinations in 1972, 1982 and 1993 all recruits enlisted in the Danish Air Force were subjected to an additional oral examination combined with a structured socio-dental questionnaire. Identical methods were applied in each of the three surveys. Dental clinics at air bases in Denmark. 4,103 male military recruits, aged 18 to 25 years. Caries was registered in accordance with the WHO Basic Methods 1971. The questionnaire provided information on age, place of residence during childhood, social origin, and patterns of utilisation of dental services. The findings indicated a considerable decrease in average caries experience from 16.6 DMFT in 1972 to 11.8 in 1982 and 6.2 in 1993. The results further documented markedly increased availability of public school dental health services, the coverage rising from 33% in 1972 to 65% in 1982 and 100% in 1993, as well as moderately increased utilisation of regular dental care with private practitioners, rising from 71% in 1972 to 86% in 1982 and 84% in 1993. In 1993 as in 1982 and 1972, recruits who used the public school dental health services and also received regular dental care after their school leaving age showed the lowest average caries experience. The findings indicate a marked decrease in average caries experience and an increased utilisation of dental services among Danish young men from 1972 to 1993. However, in 1993 the least privileged social group continued to maintain the highest average caries experience and the lowest rate of utilisation of regular dental care.

Does insurance enrolment increase healthcare utilisation among rural-dwelling older adults? Evidence from the National Health Insurance Scheme in Ghana.

PubMed

van der Wielen, Nele; Channon, Andrew Amos; Falkingham, Jane

2018-01-01

This paper examines the relationship between national health insurance enrolment and the utilisation of inpatient and outpatient healthcare for older adults in rural areas in Ghana. The Ghanaian National Health Insurance Scheme (NHIS) aims to improve affordability and increase the utilisation of healthcare. However, the system has been criticised for not being responsive to the needs of older adults. The majority of older adults in Ghana live in rural areas with poor accessibility to healthcare. With an ageing population, a specific assessment of whether the scheme has benefitted older adults, and also if the benefit is equitable, is needed. Using the Ghanaian Living Standards Survey from 2012 to 2013, this paper uses propensity score matching to estimate the effect of enrolment within the NHIS on the utilisation of inpatient and outpatient care among older people aged 50 and over. The raw results show higher utilisation of healthcare among NHIS members, which persists after matching. NHIS members were 6% and 9% more likely to use inpatient and outpatient care, respectively, than non-members. When these increases were disaggregated for outpatient care, the non-poor and females were seen to benefit more than their poor and male counterparts. For inpatient care, the benefits of enrolment were equal by poverty status and sex. However, overall, poor older adults use health services much less than the non-poor older adults even when enrolled. The results indicate that NHIS coverage does increase healthcare utilisation among rural older adults but that inequalities remain. The poor are still at a great disadvantage in their use of health services overall and benefit less from enrolment for outpatient care. The receipt of healthcare is significantly influenced by a set of auxiliary barriers to access to healthcare even where insurance should remove the financial burden of ad hoc out of pocket payments.

Does insurance enrolment increase healthcare utilisation among rural-dwelling older adults? Evidence from the National Health Insurance Scheme in Ghana

PubMed Central

van der Wielen, Nele; Channon, Andrew Amos; Falkingham, Jane

2018-01-01

Introduction This paper examines the relationship between national health insurance enrolment and the utilisation of inpatient and outpatient healthcare for older adults in rural areas in Ghana. The Ghanaian National Health Insurance Scheme (NHIS) aims to improve affordability and increase the utilisation of healthcare. However, the system has been criticised for not being responsive to the needs of older adults. The majority of older adults in Ghana live in rural areas with poor accessibility to healthcare. With an ageing population, a specific assessment of whether the scheme has benefitted older adults, and also if the benefit is equitable, is needed. Methods Using the Ghanaian Living Standards Survey from 2012 to 2013, this paper uses propensity score matching to estimate the effect of enrolment within the NHIS on the utilisation of inpatient and outpatient care among older people aged 50 and over. Results The raw results show higher utilisation of healthcare among NHIS members, which persists after matching. NHIS members were 6% and 9% more likely to use inpatient and outpatient care, respectively, than non-members. When these increases were disaggregated for outpatient care, the non-poor and females were seen to benefit more than their poor and male counterparts. For inpatient care, the benefits of enrolment were equal by poverty status and sex. However, overall, poor older adults use health services much less than the non-poor older adults even when enrolled. Conclusion The results indicate that NHIS coverage does increase healthcare utilisation among rural older adults but that inequalities remain. The poor are still at a great disadvantage in their use of health services overall and benefit less from enrolment for outpatient care. The receipt of healthcare is significantly influenced by a set of auxiliary barriers to access to healthcare even where insurance should remove the financial burden of ad hoc out of pocket payments. PMID:29527348

Types and rates of forest disturbance in Brazilian Legal Amazon, 2000–2013

PubMed Central

Tyukavina, Alexandra; Hansen, Matthew C.; Potapov, Peter V.; Stehman, Stephen V.; Smith-Rodriguez, Kevin; Okpa, Chima; Aguilar, Ricardo

2017-01-01

Deforestation rates in primary humid tropical forests of the Brazilian Legal Amazon (BLA) have declined significantly since the early 2000s. Brazil’s national forest monitoring system provides extensive information for the BLA but lacks independent validation and systematic coverage outside of primary forests. We use a sample-based approach to consistently quantify 2000–2013 tree cover loss in all forest types of the region and characterize the types of forest disturbance. Our results provide unbiased forest loss area estimates, which confirm the reduction of primary forest clearing (deforestation) documented by official maps. By the end of the study period, nonprimary forest clearing, together with primary forest degradation within the BLA, became comparable in area to deforestation, accounting for an estimated 53% of gross tree cover loss area and 26 to 35% of gross aboveground carbon loss. The main type of tree cover loss in all forest types was agroindustrial clearing for pasture (63% of total loss area), followed by small-scale forest clearing (12%) and agroindustrial clearing for cropland (9%), with natural woodlands being directly converted into croplands more often than primary forests. Fire accounted for 9% of the 2000–2013 primary forest disturbance area, with peak disturbances corresponding to droughts in 2005, 2007, and 2010. The rate of selective logging exploitation remained constant throughout the study period, contributing to forest fire vulnerability and degradation pressures. As the forest land use transition advances within the BLA, comprehensive tracking of forest transitions beyond primary forest loss is required to achieve accurate carbon accounting and other monitoring objectives. PMID:28439536

Quantification of soil respiration in forest ecosystems across China

NASA Astrophysics Data System (ADS)

Song, Xinzhang; Peng, Changhui; Zhao, Zhengyong; Zhang, Zhiting; Guo, Baohua; Wang, Weifeng; Jiang, Hong; Zhu, Qiuan

2014-09-01

We collected 139 estimates of the annual forest soil CO2 flux and 173 estimates of the Q10 value (the temperature sensitivity) assembled from 90 published studies across Chinese forest ecosystems. We analyzed the annual soil respiration (Rs) rates and the temperature sensitivities of seven forest ecosystems, including evergreen broadleaf forests (EBF), deciduous broadleaf forests (DBF), broadleaf and needleleaf mixed forests (BNMF), evergreen needleleaf forests (ENF), deciduous needleleaf forests (DNF), bamboo forests (BF) and shrubs (SF). The results showed that the mean annual Rs rate was 33.65 t CO2 ha-1 year-1 across Chinese forest ecosystems. Rs rates were significantly different (P < 0.001) among the seven forest types, and were significantly and positively influenced by mean annual temperature (MAT), mean annual precipitation (MAP), and actual evapotranspiration (AET); but negatively affected by latitude and elevation. The mean Q10 value of 1.28 was lower than the world average (1.4-2.0). The Q10 values derived from the soil temperature at a depth of 5 cm varied among forest ecosystems by an average of 2.46 and significantly decreased with the MAT but increased with elevation and latitude. Moreover, our results suggested that an artificial neural network (ANN) model can effectively predict Rs across Chinese forest ecosystems. This study contributes to better understanding of Rs across Chinese forest ecosystems and their possible responses to global warming.

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.

Application of Modis Data to Assess the Latest Forest Cover Changes of Sri Lanka

NASA Astrophysics Data System (ADS)

Perera, K.; Herath, S.; Apan, A.; Tateishi, R.

2012-07-01

Assessing forest cover of Sri Lanka is becoming important to lower the pressure on forest lands as well as man-elephant conflicts. Furthermore, the land access to north-east Sri Lanka after the end of 30 years long civil war has increased the need of regularly updated land cover information for proper planning. This study produced an assessment of the forest cover of Sri Lanka using two satellite data based maps within 23 years of time span. For the old forest cover map, the study used one of the first island-wide digital land cover classification produced by the main author in 1988. The old land cover classification was produced at 80 m spatial resolution, using Landsat MSS data. A previously published another study by the author has investigated the application feasibility of MODIS and Landsat MSS imagery for a selected sub-section of Sri Lanka to identify the forest cover changes. Through the light of these two studies, the assessment was conducted to investigate the application possibility of MODIS 250 m over a small island like Sri Lanka. The relation between the definition of forest in the study and spatial resolution of the used satellite data sets were considered since the 2012 map was based on MODIS data. The forest cover map of 1988 was interpolated into 250 m spatial resolution to integrate with the GIS data base. The results demonstrated the advantages as well as disadvantages of MODIS data in a study at this scale. The successful monitoring of forest is largely depending on the possibility to update the field conditions at regular basis. Freely available MODIS data provides a very valuable set of information of relatively large green patches on the ground at relatively real-time basis. Based on the changes of forest cover from 1988 to 2012, the study recommends the use of MODIS data as a resalable method to forest assessment and to identify hotspots to be re-investigated. It's noteworthy to mention the possibility of uncounted small isolated pockets of forest, or sub-pixel size forest patches when MODIS 250 m x 250 m data used in small regions.