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Selected AbstractsQuantifying Plant Population Persistence in Human-Dominated LandscapesCONSERVATION BIOLOGY, Issue 4 2008DAWN M. LAWSON Base de Datos de la Diversidad Natural de California; conservación de plantas; crecimiento de la población; especies en peligro; paisajes urbanos Abstract:,We assessed population performance of rare plants across a gradient from rural to urban landscapes and evaluated 2 hypotheses central to strategic conservation planning: (1) population performance declines with increasing human dominance and (2) small populations perform poorly relative to larger ones. Assessing these hypotheses is critical to strategic conservation planning. The current conservation paradigm adheres to the well-established ecology theory that small isolated populations, particularly those in human-dominated landscapes, are the least likely to succeed over the long term. Consequently, conservation planning has strongly favored large, remote targets for protection. This shift in conservation toward ecosystem-based programs and protection of populations within large, remote systems has been at the expense of protection of the rarest of the rare species, the dominant paradigm for conservation driven by the endangered species act. Yet, avoiding conservation of small populations appears to be based more on theoretical understanding and expert opinion than empiricism. We used Natural Heritage data from California in an assessment of population performance of rare plants across a landscape with an urban-rural gradient. Population performance did not decrease in urban settings or for populations that were initially small. Our results are consistent with a pattern of few species extinctions within these landscapes over the past several decades. We conclude that these populations within compromised landscapes can contribute to overall biodiversity conservation. We further argue that conservation planning for biodiversity preservation should allocate relatively more resources to protecting urban-associated plant taxa because they may provide conservation benefit beyond simply protecting isolated populations; they may be useful in building social interest in conservation. Resumen:,Evaluamos el funcionamiento de la población de plantas raras a lo largo de un gradiente de paisajes rurales a urbanos y evaluamos 2 hipótesis centrales para la planificación estratégica de la conservación: (1) declinaciones en el funcionamiento poblacional con el incremento de la dominancia humana y (2) las poblaciones pequeñas funcionan pobremente en relación con las grandes. La evaluación de estas hipótesis es crítica para la planificación estratégica de la conservación. El paradigma actual de la conservación se adhiere a la teoría ecológica bien establecida que propone que las poblaciones pequeñas aisladas, particularmente en paisajes dominados por humanos, tienen menor probabilidad de sobrevivir a largo plazo. Consecuentemente, la planificación de la conservación ha favorecido objetivos grandes y remotos. Este cambio hacia programas de conservación basados en ecosistemas y la protección de poblaciones en sistemas extensos y remotos ha sido a costa de la protección de las especies más raras entre las raras, el paradigma dominante en la conservación conducida por el acta de especies en peligro. No obstante, la evasión de la conservación de poblaciones pequeñas parece estar basada más en entendimiento teórico y en la opinión de expertos que en el empirismo. Utilizamos datos del Patrimonio Natural de California en una evaluación del funcionamiento de plantas raras en un paisaje con un gradiente urbano a rural. El funcionamiento de la población no decreció en sitios urbanos o en poblaciones que eran pequeñas inicialmente. Nuestros resultados son consistentes con un patrón de extinción de especies en estos paisajes en las últimas décadas. Concluimos que estas poblaciones en paisajes comprometidos pueden contribuir a la conservación de la biodiversidad en general. También argumentamos que la planificación de la conservación para la preservación de la biodiversidad debería asignar más recursos para la protección de taxa de plantas asociadas a ambientes urbanos porque pueden proporcionar beneficios de conservación más allá de simplemente proteger poblaciones aisladas; pueden ser útiles para construir el interés social por la conservación. [source] Medical Error Identification, Disclosure, and Reporting: Do Emergency Medicine Provider Groups Differ?ACADEMIC EMERGENCY MEDICINE, Issue 4 2006Cherri Hobgood MD Abstract Objectives: To determine if the three types of emergency medicine providers,physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs]),differ in their identification, disclosure, and reporting of medical error. Methods: A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Results: Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p < 0.01). Nurses were less likely to disclose an error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p < 0.01). For all provider and error types, identification, disclosure, and reporting increased with increasing severity. Conclusions: Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type. [source] Epidemiology of Adult Psychiatric Visits to U.S. Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 2 2004Sara B. Hazlett MD Objectives: To characterize psychiatric-related emergency department visits (PREDVs) among adults in the United States for the year 2000 and to analyze PREDV trends from 1992 to 2000. Methods: Emergency department (ED) visit data from the National Hospital Ambulatory Medical Care Survey were used to estimate the number of PREDVs for adults aged 18 years and older. A PREDV was defined as any visit with a psychiatric discharge diagnosis (ICD N290, N312) or a suicide attempt (ICD E950,E959). Results: Approximately 4.3 million PREDVs occurred in the United States in the year 2000, yielding an annual rate of 21 visits per 1,000 adults. The PREDV rates increased 15% between 1992 and 2000. The PREDVs accounted for 5.4% of all ED visits. Substance abuse (27%), neuroses (26%), and psychoses (21%) were the most common conditions. African Americans had significantly higher visit rates (29/1,000; 95% CI = 27/1,000 to 31/1,000) compared with whites (23/1,000; 95% CI = 22/1,000 to 25/1,000). Persons with Medicaid (66/1,000; 95% CI = 64/1,000 to 68/1,000) had double the rate of PREDVs than the uninsured (33/1,000; 95% CI = 31/1,000 to 35/1,000) and almost eight times the rate of those privately insured (8/1,000; 95% CI = 7/1,000 to 10/1,000). Patients with psychiatric diagnoses had a higher admission rate (22%) than those with nonpsychiatric diagnoses (15%). The uninsured were the least likely to be admitted for all major psychiatric conditions except suicide (p < 0.0001). Conclusions: Psychiatric-related ED visits represent a substantial and growing number of ED visits each year. Patient characteristics influence the likelihood of a PREDV. Further research is needed to better understand the role that hospital EDs play in the delivery of health care services to those with mental illness. [source] Social inequality and the reduction of ideological dissonance on behalf of the system: evidence of enhanced system justification among the disadvantagedEUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 1 2003John T. Jost According to system justification theory, people are motivated to preserve the belief that existing social arrangements are fair, legitimate, justifiable, and necessary. The strongest form of this hypothesis, which draws on the logic of cognitive dissonance theory, holds that people who are most disadvantaged by the status quo would have the greatest psychological need to reduce ideological dissonance and would therefore be most likely to support, defend, and justify existing social systems, authorities, and outcomes. Variations on this hypothesis were tested in five US national survey studies. We found that (a) low-income respondents and African Americans were more likely than others to support limitations on the rights of citizens and media representatives to criticize the government; (b) low-income Latinos were more likely to trust in US government officials and to believe that ,the government is run for the benefit of all' than were high-income Latinos; (c) low-income respondents were more likely than high-income respondents to believe that large differences in pay are necessary to foster motivation and effort; (d) Southerners in the USA were more likely to endorse meritocratic belief systems than were Northerners and poor and Southern African Americans were more likely to subscribe to meritocratic ideologies than were African Americans who were more affluent and from the North; (e) low-income respondents and African Americans were more likely than others to believe that economic inequality is legitimate and necessary; and (f) stronger endorsement of meritocratic ideology was associated with greater satisfaction with one's own economic situation. Taken together, these findings are consistent with the dissonance-based argument that people who suffer the most from a given state of affairs are paradoxically the least likely to question, challenge, reject, or change it. Implications for theories of system justification, cognitive dissonance, and social change are also discussed. Copyright © 2002 John Wiley & Sons, Ltd. [source] Knowledge of disease and adherence in adult patients with haemophiliaHAEMOPHILIA, Issue 4 2010K. LINDVALL Summary., Patients with moderate and severe haemophilia are evaluated on a regular basis at their haemophilia centres but patients with mild haemophilia are seen less often because of fewer problems related to their disease. The needs of patients with milder forms of haemophilia, however, are often underestimated, both by the patient and staff at healthcare facilities. This study evaluated the knowledge of disease and adherence to treatment among patients with severe, moderate and mild haemophilia. This was a prospective multicentre study performed in Haemophilia Centres in Scandinavia. A total of 413 (67%) of 612 patients aged >25 years with mild, moderate and severe haemophilia completed a self-administered questionnaire. The mean age of the respondents was 49.7 years (range 25,87 years). Of the 413 respondents, 150 had a mild, 86 had a moderate and 177 had a severe form of haemophilia. A total of 22 (5%) patients did not know the severity of their disease, and 230 (56%) patients knew the effect of factor concentrate in the blood. Of the 413 respondents, 53 (13%) of the cohort never treated a haemorrhage. Patients with mild haemophilia, P , 0.001, were the least likely to treat a haemorrhage. The relative number of patients who were afraid of virus transmission by factor concentrate was about similar in the three groups, 27% of those with severe haemophilia, 26% with moderate and 24% with mild haemophilia. This study shows that the amount of knowledge among haemophilia patients about their disease and treatment is somewhat limited, and demonstrates the importance of continually providing information about haemophilia and treatment, especially to patients with a mild form of the disease. [source] Reasons for visiting Polish primary care practices by patients aged 18,44 years: the largest emigrating age groupHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2009Magdalena Ignaszak-Szczepaniak MD PhD Abstract Over 3% of the entire Polish population migrate for a job within the European Union, most are aged 18,44 years. The main destinations are Germany, the United Kingdom and Ireland. Immigration is connected with the use of many public services, including healthcare services. Assuming Polish immigrants require medical consultations in the countries they reside in, the authors have analysed the reasons for patients' visits to general practitioners (GPs) in Poland in order to predict possible reasons why Polish patients living abroad may make appointments with GPs in other countries. Data from 22 769 visits to GP practices between June 2005 and May 2006 by Polish patients aged 18,44 years were collected electronically. Age was categorised into three groups (18,24, 25,34 and 35,44 years) and the reason for the visit was categorised according to the ICD 10 coding system. Among the 12 535 patients registered with GPs, 73.1% of women and 68.6% of men required consultations during the year the study was conducted. The highest percentage of visits was recorded for women aged 35,44 years, while men of the same age were the least likely to visit a GP. The mean number of visits per patient ranged from 1.89 for men aged 25,34 years to 3.11 for women aged 35,44 years. The means were similar for 18- to 24-year-old men and women. Women aged 35,44 years had a higher mean number of visits compared with women aged 18,24 years, whereas the opposite was true for men. The analysis of reasons for visits within the age groups indicated that the percentage of appointments for respiratory problems and general and unspecified problems dropped by more than half from the 18,24-year-olds to the 35,44-years-olds, while visits for musculosceletal, cardiovascular, and mental and behavioural problems increased by a factor of four. The presented results intend to enable healthcare services meet Polish immigrants' healthcare needs. [source] Implications of Racial and Gender Differences In Patterns of Adolescent Risk Behavior for HIV And Other Sexually Transmitted DiseasesPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 6 2004Carolyn Tucker Halpern CONTEXT: Sexual and substance use behaviors covary in adolescence. Prevalence of HIV and other sexually transmitted diseases (STDs) differs according to race and gender, yet few studies have systematically investigated risk behavior patterns by subgroup, particularly with nationally representative data. METHODS: A priori considerations and K-means cluster analysis were used to group 13,998 non-Hispanic black and white participants in the National Longitudinal Study of Adolescent Health, Wave 1, according to self-reported substance use and sexual behavior. Multinomial logit analyses examined racial and gender differences by cluster. RESULTS: Among 16 clusters, the two defined by the lowest risk behaviors (sexual abstinence and little or no substance use) comprised 47% of adolescents; fewer than 1% in these groups reported ever having received an STD diagnosis. The next largest cluster,characterized by sexual activity (on average, with one lifetime partner) and infrequent substance use,contained 15% of participants but nearly one-third of adolescent with STDs. Blacks were more likely than whites to be in this group. Black males also were more likely than white males to be in three small clusters characterized by high-risk sexual behaviors (i.e., having had sex with a male or with at least 14 partners, or for drugs or money). Black females generally were the least likely to be in high-risk behavior clusters but the most likely to report STDs. CONCLUSIONS: Adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Further investigation of adolescents' partners and sexual networks is needed. [source] Listing Price, Time on Market, and Ultimate Selling Price: Causes and Effects of Listing Price ChangesREAL ESTATE ECONOMICS, Issue 2 2002John R. Knight Information about price changes during a home's marketing period is typically missing from data used to investigate the listing price, selling price, and selling time relationship. This paper incorporates price revision information into the study of this relationship. Using a maximum-likelihood probit model, we examine the determinants of list price changes and find evidence consistent with the theory of pricing behavior under demand uncertainty. Homes most likely to undergo list price changes are those with high initial markups and vacant homes, while homes with unusual features are the least likely to experience a price revision. We also explore the impact of missing price change information on estimating a representative model of house price and market time. Our results suggest that mispricing the home in the initial listing is costly to the seller in both time and money. Homes with large percentage changes in list price take longer to sell and ultimately sell at lower prices. [source] Interactions between zoo-housed great apes and local wildlifeAMERICAN JOURNAL OF PRIMATOLOGY, Issue 6 2009S.R. Ross Abstract Although there are published reports of wild chimpanzees, bonobos, and orangutans hunting and consuming vertebrate prey, data pertaining to captive apes remain sparse. In this survey-based study, we evaluate the prevalence and nature of interactions between captive great apes and various indigenous wildlife species that range into their enclosures in North America. Our hypotheses were threefold: (a) facilities housing chimpanzees will report the most frequent and most aggressive interactions with local wildlife; (b) facilities housing orangutans and bonobos will report intermediate frequencies of these interactions with low levels of aggression and killing; and (c) facilities housing gorillas will report the lowest frequency of interactions and no reports of killing local wildlife. Chimpanzees and bonobos demonstrated the most aggressive behavior toward wildlife, which matched our predictions for chimpanzees, but not bonobos. This fits well with expectations for chimpanzees based on their natural history of hunting and consuming prey in wild settings, and also supports new field data on bonobos. Captive gorillas and orangutans were reported to be much less likely to chase, catch and kill wildlife than chimpanzees and bonobos. Gorillas were the least likely to engage in aggressive interactions with local wildlife, matching our predictions based on natural history. However unlike wild gorillas, captive gorillas were reported to kill (and in one case, eat) local wildlife. These results suggest that some behavioral patterns seen in captive groups of apes may be useful for modeling corresponding activities in the wild that may not be as easily observed and quantified. Furthermore, the data highlight the potential for disease transmission in some captive settings, and we outline the associated implications for ape health and safety. Am. J. Primatol. 71:458,465, 2009. © 2009 Wiley-Liss, Inc. [source] Upstream Solutions: Does the Supplemental Security Income Program Reduce Disability in the Elderly?THE MILBANK QUARTERLY, Issue 1 2008PAMELA HERD Context: The robust relationship between socioeconomic factors and health suggests that social and economic policies might substantially affect health, while other evidence suggests that medical care, the main focus of current health policy, may not be the primary determinant of population health. Income support policies are one promising avenue to improve population health. This study examines whether the federal cash transfer program to poor elderly, the Supplemental Security Income (SSI) program, affects old-age disability. Methods: This study uses the 1990 and 2000 censuses, employing state and year fixed-effect models, to test whether within-state changes in maximum SSI benefits over time lead to changes in disability among people aged sixty-five and older. Findings: Higher benefits are linked to lower disability rates. Among all single elderly individuals, 30 percent have mobility limitations, and an increase of $100 per month in the maximum SSI benefit caused the rate of mobility limitations to fall by 0.46 percentage points. The findings were robust to sensitivity analyses. First, analyses limited to those most likely to receive SSI produced larger effects, but analyses limited to those least likely to receive SSI produced no measurable effect. Second, varying the disability measure did not meaningfully alter the findings. Third, excluding the institutionalized, immigrants, individuals living in states with exceptionally large benefit changes, and individuals living in states with no SSI supplements did not change the substantive conclusions. Fourth, Medicaid did not confound the effects. Finally, these results were robust for married individuals. Conclusions: Income support policy may be a significant new lever for improving population health, especially that of lower-income persons. Even though the findings are robust, further analyses are needed to confirm their reliability. Future research should examine a variety of different income support policies, as well as whether a broader range of social and economic policies affect health. [source] Nutrition and exercise behavior among patients with bipolar disorder,BIPOLAR DISORDERS, Issue 5 2007Amy M Kilbourne Objectives:, There have been few comprehensive studies of nutrition and exercise behaviors among patients with bipolar disorder (BPD). Based on a national sample of patients receiving care in the Veterans Affairs (VA) health care system, we compared nutrition and exercise behaviors among individuals diagnosed with BPD, others diagnosed with schizophrenia, and others who did not receive diagnoses of serious mental illness (SMI). Methods:, We conducted a cross-sectional study of patients who completed the VA's Large Health Survey of Veteran Enrollees section on health and nutrition in fiscal year (FY) 1999 and who either received a diagnosis of BPD (n = 2,032) or schizophrenia (n = 1,895), or were included in a random sample of non-SMI VA patients (n = 3,065). We compared nutrition and exercise behaviors using multivariable logistic regression, controlling for patient socio-economic and clinical factors, and adjusting for patients clustered by site using generalized estimating equations. Results:, Patients with BPD were more likely to report poor exercise habits, including infrequent walking (odds ratio, OR = 1.33, p < 0.001) or strength exercises (OR = 1.28, p < 0.001) than those with no SMI. They were also more likely to self-report suboptimal eating behaviors, including having fewer than two daily meals (OR = 1.32, p < 0.001) and having difficulty obtaining or cooking food (OR = 1.48, p < 0.001). Patients with BPD were also more likely to report having gained ,10 pounds in the past 6 months (OR = 1.59, p < 0.001) and were the least likely to report that their health care provider discussed their eating habits (OR = 0.84, p < 0.05) or physical activity (OR = 0.81, p < 0.01). Conclusions:, Greater efforts are needed to reduce the risk of poor nutrition and exercise habits among patients diagnosed with BPD. [source] A Subnational Analysis of Japanese Direct Investment in CanadaCANADIAN JOURNAL OF ADMINISTRATIVE SCIENCES, Issue 1 2000Andrew Delios This study examines longitudinal aspects of Japanese foreign direct investment in Canada. In looking at the longitudinal aspects, the focus was on a descriptive analysis of entry and exit rates and on an econometric analysis of the determinants of subsidiary survival and exit. In these analyses, we find that exit rates are related to subsidiary-level variables such as business size, expatriate employment levels, equity-ownership levels, and entry mode. The sector and region in which the investments are made is also related to subsidiary survival, with manufacturing-sector subsidiaries located in Ontario being the least likely to exit. The results of our study suggest that region and industry interact, both to draw investment to a region and to influence the likeli-hood of survival of foreign-owned businesses. Further-more, the focus on regional issues for Canada shows that even within a small open economy, subnational (interprovincial) variance can have important effects on the characteristics and performance of foreign direct investment. Résumé La présente étude porte sur l'évolution des investissements directs japonais à l'étranger, réalisés au Canada. De façon plus précise, cette recherche s'intéresse, sur une base longitudinale, à l'analyse descriptive des taux d'entrée et de sortie ainsi qu'à l'analyse économétrique des facteurs expliquant la survie ou la sortie de filiales japonaises. A la lumière de ces analyses, il ressort que les taux de sortie sont influencés par certaines caractéristiques des filiales telles que la taille, la proportion d'expatriés, la part du capital-action et le mode d'entrée. Le secteur et la région où l'investissement s'effectue influencent également les chances de survie d'une filiale; la probabilité la plus faible de quitter le pays appartiendrait aux filiales manufacturières situées en Ontario. Les résultats de l'étude suggèrent que la région et l'industrie interagissent de façon à attirer les investissements dans une région donnée et à influencer les chances de survie de compagnies appartenant à des intér,ts étrangers. Ces résultats sur les disparités régionales du Canada suggèrent que, m,me à l'intérieur d'une économie de marché restreinte, la variance sous-nationale (ou interprovinciale) peut avoir d'importantes répercussions sur les caractéristiques et la performance des investissements directs à l'étranger. [source] Progress in cancer screening practices in the United States,CANCER, Issue 6 2003Results from the 2000 National Health Interview Survey Abstract BACKGROUND Understanding differences in cancer screening among population groups in 2000 and successes or failures in reducing disparities over time among groups is important for planning a public health strategy to reduce or eliminate health disparities, a major goal of Healthy People 2010 national cancer screening objectives. In 2000, the new cancer control module added to the National Health Interview Survey (NHIS) collected more detailed information on cancer screening compared with previous surveys. METHODS Data from the 2000 NHIS and earlier surveys were analyzed to discern patterns and trends in cancer screening practices, including Pap tests, mammography, prostate specific antigen (PSA) screening, and colorectal screening. The data are reported for population subgroups that were defined by a number of demographic and socioeconomic characteristics. RESULTS Women who were least likely to have had a mammogram within the last 2 years were those with no usual source of health care (61%), women with no health insurance (67%), and women who immigrated to the United States within the last 10 years (61%). Results for Pap tests within the last 3 years were similar. Among both men and women, those least likely to have had a fecal occult blood test or endoscopy within the recommended screening interval had no usual source of care (14% for men and 18% for women), no health insurance (20% for men and 18% for women), or were recent immigrants (20% for men and 18% for women). An analysis of changes in test use since the 1987 survey indicates that the disparities are widening among groups with no usual source of care. CONCLUSIONS No striking improvements have been observed for the groups with greatest need. Although screening use for most groups has increased since 1987, major disparities remain. Some groups, notably individuals with no usual source of care and the uninsured are falling further behind; and, according to the 2000 data, recent immigrants also experience a significant gap in screening utilization. More attention is needed to overcome screening barriers for these groups if the population benefits of cancer screening are to be achieved. Cancer 2003;97:1528,40. Published 2003 by the American Cancer Society. DOI 10.1002/cncr.11208 [source] | ||||||||||||||||