By State (by + state)

Distribution by Scientific Domains

Selected Abstracts

sofsog: a suite of programs to avoid inbreeding in plantation designs

Abstract Cost-effective ways of controlling inbreeding in conservation or productive plantations imply the allocation of individuals reducing the possibility of close relatives' mating and, consequently, limiting inbreeding. sofsog is a suite of programs, which helps to design plantation sites. First, if the plantation scheme involves several plots, it allows distribution of individuals available among different sites minimizing within-site global coancestry. Then, it yields a plantation design for each site, either following the classical permutated neighbourhood strategy or the recently developed method by Fernández and González-Martínez. This new method allows the implementation of different pollen dispersion kernels, and to include in the designing strategy any available information on individual relationships, reproductive success, differences in phenology, etc., via weighting or penalization matrices. Additionally, the package includes a tool for calculating the molecular coancestry (Identity By State) from codominant marker data. [source]

Rates of breastfeeding in Australia by State and socio-economic status: Evidence from the 1995 National Health Survey

S Donath
Objective: To estimate rates of breastfeeding in the first year of life in Australia, according to state and socio-economic status. Methodology: Analysis of data from the 1995 Australian National Health Survey. Results: Estimated breastfeeding rates are 81.8% on discharge from hospital, 57.1% fully breastfed at 3 months and 62.6% fully or partially breastfed at 3 months. At 6 months, it is estimated that 18.6% of babies are fully breastfed and 46.2% fully or partially breastfed. At 1 year, 21.2% of infants are receiving some breast milk. Comparison between states demonstrates that there is considerable variation in breastfeeding practice within Australia. Rates of breastfeeding also vary according to the socio-economic status of the geographic area in which the child is living, with a strong inverse relationship between rates of breastfeeding and socio-economic status. Conclusion: Australia's target for breastfeeding in the year 2000 is to have 80% of babies at least partially breastfed for the first 6 months of life. Although Australia has good rates of initiation of breastfeeding, these levels are not maintained over time, and it seems unlikely that we will reach the year 2000 targets. [source]

Effects of active-learning experiences on achievement, attitudes, and behaviors in high school biology

Roman Taraban
Abstract Active-learning labs for two topics in high school biology were developed through the collaboration of high school teachers and university faculty and staff and were administered to 408 high school students in six classrooms. The content of instruction and testing was guided by State of Texas science objectives. Detailed teacher records describing daily classroom activities were used to operationalize two types of instruction: active learning, which used the labs; and traditional, which used the teaching resources ordinarily available to the teacher. Teacher records indicated that they used less independent work and fewer worksheets, and more collaborative and lab-based activities, with active-learning labs compared to traditional instruction. In-class test data show that students gained significantly more content knowledge and knowledge of process skills using the labs compared to traditional instruction. Questionnaire data revealed that students perceived greater learning gains after completing the labs compared to covering the same content through traditional methods. An independent questionnaire administered to a larger sample of teachers who used the lab-based curriculum indicated that they perceived changing their behaviors as intended by the student-centered principles of the labs. The major implication of this study is that active-learning,based laboratory units designed and developed collaboratively by high school teachers and university faculty, and then used by high school teachers in their classrooms, can lead to increased use of student-centered instructional practices as well as enhanced content knowledge and process learning for students. © 2007 Wiley Periodicals, Inc. J Res Sci Teach 44: 960,979, 2007 [source]

Mortality variation across Australia: descriptive data for States and Territories, and statistical divisions

David Wilkinson
ABSTRACT OBJECTIVE: To describe variation in all cause and selected cause,specific mortality rates across Australia. METHODS: Mortality and population data for 1997 were obtained from the Australian Bureau of Statistics. All cause and selected cause,specific mortality rates were calculated and directly standardised to the 1997 Australian population in 5,year age groups. Selected major causes of death included cancer, coronary artery disease, cerebrovascular disease, diabetes, accidents and suicide. Rates are reported by statistical division, and State and Territory. RESULTS: All cause age,standardised mortality was 6.98 per 1000 in 1997 and this varied 2,fold from a low in the statistical division of Pilbara, Western Australia (5.78, 95% confidence interval 5.06,6.56), to a high in Northern Territory,excluding Darwin (11.30, 10.67,11.98). Similar mortality variation (all p<0.0001) exists for cancer (1.01,2.23 per 1000) and coronary artery disease (0.99,2.23 per 1000), the two biggest killers. Larger variation (all p<0.0001) exists for cerebrovascular disease (0.7,11.8 per 10,000), diabetes (0.7,6.9 per 10,000), accidents (1.7,7.2 per 10,000) and suicide (0.6,3.8 per 10,000). Less marked variation was observed when analysed by State and Territory, but Northern Territory consistently has the highest age,standardised mortality rates. CONCLUSIONS: Analysed by statistical division, substantial mortality gradients exist across Australia, suggesting an inequitable distribution of the determinants of health. Further research is required to better understand this heterogeneity. [source]

Complementary and integrative medical therapies, the FDA, and the NIH: definitions and regulation

Michael H. Cohen
ABSTRACT: ,,The National Center for Complementary and Alternative Medicine (NCCAM) presently defines complementary and alternative medicine (CAM) as covering "a broad range of healing philosophies (schools of thought), approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available. The research landscape, including NCCAM-funded research, is continually changing and subject to vigorous methodologic and interpretive debates. Part of the impetus for greater research dollars in this arena has been increasing consumer reliance on CAM to dramatically expand. State (not federal) law controls much of CAM practice. However, a significant federal role exists in the regulation of dietary supplements. The U.S. Food and Drug Administration (FDA) regulates foods, drugs, and cosmetics in interstate commerce. No new "drug" may be introduced into interstate commerce unless proven "safe" and "effective" for its intended use, as determined by FDA regulations. "Foods", however, are subject to different regulatory requirements, and need not go through trials proving safety and efficacy. The growing phenomenon of consumer use of vitamins, minerals, herbs, and other "dietary supplements" challenged the historical divide between drugs and foods. The federal Dietary Supplements Health Education Act (DSHEA) allows manufacturers to distribute dietary supplements without having to prove safety and efficacy, so long as the manufacturers make no claims linking the supplements to a specific disease. State law regulates the use of CAM therapies through a variety of legal rules. Of these, several major areas of concern for clinicians are professional licensure, scope of practice, and malpractice. Regarding licensure, each state has enacted medical licensing that prohibits the unlicensed practice of medicine and thereby criminalizes activity by unlicensed CAM providers who offer health care services to patients. Malpractice is defined as unskillful practice which fails to conform to a standard of care in the profession and results in injury. The definition is no different in CAM than in general medicine; its application to CAM, however, raises novel questions. Courts rely on medical consensus regarding the appropriateness of a given therapy. A framework for assessing potential liability risk involves assessing the medical evidence concerning safety and efficacy, and then aligning clinical decisions with liability concerns. Ultimately research will or will not establish a specific CAM therapy as an important part of the standard of care for the condition in question. Legal rules governing CAM providers and practices are, in many cases, new and evolving. Further, laws vary by state and their application depends on the specific clinical scenario in question. New research is constantly emerging, as are federal and state legislative developments and judicial opinions resulting from litigation. [source]

Food and Poverty: Insights from the ,North'

Elizabeth Dowler
The role that food and nutrition play in the material definitions of poverty are contrasted with the social construction of malnutrition and poverty, drawing largely on British experience. The consequences for poor health and premature death are briefly examined; in particular, the connection is made to the world-wide growth in obesity, and in cardio-vascular disease, cancers and diabetes. The lived experience of those defined as poor in the North, and the implications of contemporary policy initiatives and responses by state, private and voluntary sectors, are explored. The challenges of the dominant policy framework remain consumer and individual choice, rather than public health and citizenship, which militates against the realisation of true food security. [source]

MR imaging methods for assessing fetal brain development

Mary Rutherford
Abstract Fetal magnetic resonance imaging provides an ideal tool for investigating growth and development of the brain in vivo. Current imaging methods have been hampered by fetal motion but recent advances in image acquisition can produce high signal to noise, high resolution 3-dimensional datasets suitable for objective quantification by state of the art post acquisition computer programs. Continuing development of imaging techniques will allow a unique insight into the developing brain, more specifically process of cell migration, axonal pathway formation, and cortical maturation. Accurate quantification of these developmental processes in the normal fetus will allow us to identify subtle deviations from normal during the second and third trimester of pregnancy either in the compromised fetus or in infants born prematurely. © 2008 Wiley Periodicals, Inc. Develop Neurobiol, 2008 [source]

The Quality of Content Analyses of State Student Achievement Tests and Content Standards

Andrew C. Porter
This article examines the reliability of content analyses of state student achievement tests and state content standards. We use data from two states in three grades in mathematics and English language arts and reading to explore differences by state, content area, grade level, and document type. Using a generalizability framework, we find that reliabilities for four coders are generally greater than .80. For the two problematic reliabilities, they are partly explained by an odd rater out. We conclude that the content analysis procedures, when used with at least five raters, provide reliable information to researchers, policymakers, and practitioners about the content of assessments and standards. [source]

Effects of Circadian Regulation and Rest,Activity State on Spontaneous Seizures in a Rat Model of Limbic Epilepsy

EPILEPSIA, Issue 5 2000
Mark Quigg
Summary: Purpose: Circadian regulation via the suprachiasmatic nuclei and rest,activity state may influence expression of limbic seizures. Methods: Male rats (n = 14) were made epileptic by electrical stimulation of the hippocampus, causing limbic status epilepticus and subsequent seizures. We monitored seizures with intrahippocampal electrodes in 12,12-h light/dark (LD) cycles and in continuous dark (DD). We used radiotelemetry monitoring of activity to measure state and body temperature to determine circadian phase. Cosinor analysis and ,2 tests determined whether seizures occurred rhythmically when plotted by phase. State was defined as inactive or active in 10-min epochs based on whether activity count was below or above a cut-off value validated from video observation. Results: In LD, the peak seizure occurrence was 14:59 h after circadian temperature peak (95% confidence limit, 13:37,16:19). Phasic seizure occurrence persisted in DD for 14:05 (12:31,15:38), p < 0.0001, against uniform mean distribution. In LD, 14,787 epochs contained 1,268 seizures; seizures preferentially occurred during inactive epochs (965 observed, 878 expected in proportion to the overall distribution of inactive versus active epochs; p < 0.001). In DD, 20,664 epochs contained 1,609 seizures; seizures had no preferential occurrence by state (999 observed, 1,025 expected; p = 0.16). Conclusions: Limbic seizures occurred with an endogenous circadian rhythm. Seizures preferentially struck during inactivity during entrainment to the light,dark cycle. [source]

Estimating substance abuse treatment need by state

ADDICTION, Issue 8 2004
No abstract is available for this article. [source]

Monuments, Memory and Marginalisation in Adelaide's Prince Henry Gardens

Iain Hay
Abstract Social and cultural dominance is (re)produced in the landscape by the exclusion or marginalisation of subordinate and minority groups. This paper illustrates the long-standing and ongoing exclusion of representations of indigeneity in and around Prince Henry Gardens, part of one of the most significant cultural and memorial sites in South Australia. Prince Henry Gardens is home to a large number of monuments and memorials that commemorate almost solely non-indigenous people and events. This is a selective and deliberate landscape of the dominant culture. It confirms a legacy of indigenous dispossession and is symbolic of ongoing marginalisation. While there have been recent compensatory initiatives by state and city agencies to create landscapes of reconciliation through symbolic gestures such as renaming parkland areas, these are argued to be contentious. They associate indigeneity with the city's margins, with violent places and public drunkenness, and perpetuate problematic associations between ,real' indigeneity and nature. The paper concludes with some ideas for new memorial landscapes intended to help construct a postcolonial Australian city. [source]

Change in the Concentration of Employment in Computer Services: Spatial Estimation at the U.S. Metro County Level

ABSTRACT This article models the concentration of computer services activity across the U.S. with factors that incorporate spatial relationships. Specifically, we enhance the standard home-area study with an analysis that allows conditions in neighboring counties to affect the concentration of employment in the home county. We use county-level data for metropolitan areas between 1990 and 1997. To measure change in employment concentration, we use the change in location quotients for SIC 737, which captures employment concentration changes caused by both the number of firms and the scale of their activity relative to the national average. After controlling for local demand for computer services, our results support the importance of the presence of a qualified labor supply, interindustry linkages, proximity to a major airport, and spatial processes in explaining changes in computer services employment concentration, finding little support for the influence of cost factors. Our enhanced model reveals interjurisdictional relationships among these metro counties that could not be captured with standard estimates by state, metropolitan statistical area (MSA), or county. Using counties within MSAs, therefore, provides more general results than case studies but still allows measurement of local interactions. [source]

Globalisation and outsourcing: confronting new human resource challenges in India's business process outsourcing industry

Sarosh Kuruvilla
ABSTRACT In this article, we argue that the rapid growth of the outsourcing industry has resulted in both high turnover and labour shortages and at the same time provided employment opportunities to a new group of employees: young upwardly mobile college graduates. We argue that this particular demographic profile is prone to high turnover and presents new managerial challenges. We then examine the variety of recruitment and retention strategies that companies in the business process outsourcing industry are experimenting with and show that many novel HR strategies are being crafted to address the needs of this young middle-class workforce. We also examine macro efforts by state and central governments and the industry association to help resolve some of these problems. [source]

Computer-Mediated Communication and The Public Sphere: A Critical Analysis

Lincoln Dahlberg
In recent times much has been said about the possibility that the two-way, decentralized communications of cyberspace can provide sites of rational-critical discourse autonomous from state and economic interests and thus extending the public sphere at large. In this paper the extent to which the Internet does in fact enhance the public sphere is evaluated. Online deliberative practices are compared with a normative model of the public sphere developed from the work of Jürgen Habermas. The evaluation proceeds at a general level, drawing upon more specific Internet research to provide a broad understanding of the democratic possibilities and limitations of the present Internet. The analysis shows that vibrant exchange of positions and rational critique does take place within many online fora. However, there are a number of factors limiting the expansion of the public sphere online. These factors include the increasing colonization of cyberspace by state and corporate interests, a deficit of reflexivity, a lack of respectful listening to others, the difficulty of verifying identity claims and information put forward, the exclusion of many from online political fora, and the domination of discourse by certain individuals and groups. The article concludes by calling for more focused Internet-democracy research to address these problems further, research for which the present paper provides a starting point. [source]

A Broken System: The Persistent Patterns of Reversals of Death Sentences in the United States

Andrew Gelman
We collected data on the appeals process for all death sentences in U.S. states between 1973 and 1995. The reversal rate was high, with an estimated chance of at least two-thirds that any death sentence would be overturned by a state or federal appeals court. Multilevel regression models fit to the data by state and year indicate that high reversal rates are strongly associated with higher death-sentencing rates and lower rates of apprehending and imprisoning violent offenders. In light of our empirical findings, we discuss potential remedies including "streamlining" the appeals process and restricting the death penalty to the "worst of the worst" offenders. [source]

Notification of patients with acute flaccid paralysis since certification of Australia as polio-free

K Whitfield
Objective: Surveillance of patients presenting with acute flaccid paralysis (AFP) is the World Health Organization (WHO) recommended method for the detection of incident cases of poliovirus infection. Australia was certified free of circulating poliovirus in 2000 but is required to continue AFP surveillance until global certification. Although Australia reached the WHO nominated surveillance target in 2000 and 2001, it was not reached in 2002. Notification rates between states have been variable. We aim to investigate the difference in notification rates by state to determine whether different rates reflect different patterns of disease or different approaches to reporting. Methods: Notification rates were reviewed by state for the years 1997,2002. The completeness of case ascertainment was reviewed from published studies. Key informants described differences in AFP reporting in states with consistent differences in notification rates. Results: Australia achieved 75% of the WHO surveillance target for AFP cases between 1997 and 1999 and 98% between 2000 and 2002. After 2000, Queensland achieved 150% of its target while Victoria achieved less than 50%. New South Wales reached its target over the entire 6 years but other states and territories were not as consistent. Although the formal process for AFP reporting is uniform throughout Australia, many differences in approach were identified between Victoria and Queensland. Conclusion: Maintaining AFP surveillance at the required WHO standard will be more likely in Australia if the populous states are able to notify cases at the same rate as Queensland (since 2000) and New South Wales (in general). [source]

A Calibrated, High-Resolution GOES Satellite Solar Insolation Product for a Climatology of Florida Evapotranspiration,

Simon J. Paech
Paech, Simon J., John R. Mecikalski, David M. Sumner, Chandra S. Pathak, Quinlong Wu, Shafiqul Islam, and Taiye Sangoyomi, 2009. A Calibrated, High-Resolution GOES Satellite Solar Insolation Product for a Climatology of Florida Evapotranspiration. Journal of the American Water Resources Association (JAWRA) 45(6):1328-1342. Abstract:, Estimates of incoming solar radiation (insolation) from Geostationary Operational Environmental Satellite observations have been produced for the state of Florida over a 10-year period (1995-2004). These insolation estimates were developed into well-calibrated half-hourly and daily integrated solar insolation fields over the state at 2 km resolution, in addition to a 2-week running minimum surface albedo product. Model results of the daily integrated insolation were compared with ground-based pyranometers, and as a result, the entire dataset was calibrated. This calibration was accomplished through a three-step process: (1) comparison with ground-based pyranometer measurements on clear (noncloudy) reference days, (2) correcting for a bias related to cloudiness, and (3) deriving a monthly bias correction factor. Precalibration results indicated good model performance, with a station-averaged model error of 2.2 MJ m,2/day (13%). Calibration reduced errors to 1.7 MJ m,2/day (10%), and also removed temporal-related, seasonal-related, and satellite sensor-related biases. The calibrated insolation dataset will subsequently be used by state of Florida Water Management Districts to produce statewide, 2-km resolution maps of estimated daily reference and potential evapotranspiration for water management-related activities. [source]

Diversity in academic medicine no. 3 struggle for survival among leading diversity programs

A. Hal Strelnick MD
Abstract Since efforts to increase the diversity of academic medicine began shortly after the Civil War, the efforts have been characterized by a ceaseless struggle of old and new programs to survive. In the 40 years after the Civil War, the number of minority-serving institutions grew from 2 to 9, and then the number fell again to 2 in response to an adverse evaluation by the Carnegie Foundation for the Advancement of Teaching. For 50 years, the programs grew slowly, picking up speed only after the passage of landmark civil rights legislation in the 1960s. From 1987 through 2005, they expanded rapidly, fueled by such new federal programs as the Centers of Excellence and Health Careers Opportunity Programs. Encompassing majority-white institutions as well as minority-serving institutions, the number of Centers of Excellence grew to 34, and the number of Health Careers Opportunity Programs grew to 74. Then, in 2006, the federal government cut its funding abruptly and drastically, reducing the number of Centers of Excellence and Health Careers Opportunity Programs to 4 each. Several advocacy groups, supported by think tanks, have striven to restore federal funding to previous levels, so far to no avail. Meanwhile, the struggle to increase the representation of underrepresented minorities in the health professions is carried on by the surviving programs, including the remaining Centers of Excellence and Health Careers Opportunity Programs and new programs that, funded by state, local, and private agencies, have arisen from the ashes. Mt Sinai J Med 75:504,516, © 2008 Mount Sinai School of Medicine [source]

Exact methods based on node-routing formulations for undirected arc-routing problems

R. Baldacci
Abstract This article proposes a new transformation of undirected arc-routing problems into equivalent node-routing problems, with emphasis on the transformation of Capacitated Arc Routing Problems (CARP) into Capacitated Vehicle Routing Problems (CVRP). For this last case, an analogue transformation has already been proposed in Pearn et al., where each required CARP edge is mapped onto a triplet of CVRP nodes. In our case, only two CVRP nodes are needed for every CARP required edge. The transformed instances have a structure and a dimension that make most CARP benchmarks solvable by state of the art CVRP techniques. We thus propose a general purpose transformation of arc into node-routing problems and new results on lower bounds and exact methods for CARP instances. © 2005 Wiley Periodicals, Inc. NETWORKS, Vol. 47(1), 52,60 2006 [source]

Using surveillance data to promote occupational health and safety policies and practice at the state level: A case study,,

Geoffrey M. Calvert MD
Abstract Background Following the investigation of a birth defects cluster involving migrant farmworkers employed in North Carolina and Florida, it became clear that greater efforts were needed to protect agricultural workers from pesticide exposure. Methods Documentation is drawn from peer-reviewed published articles, government reports and news accounts. Results The birth defects cluster was identified and investigated by state and federal pesticide poisoning surveillance system staff. Following the investigation, efforts were initiated to highlight pesticides as an important public health issue needing more attention. A series of subsequent events led to the creation and passage of important legislation recently enacted in North Carolina. The legislation resulted in funding to promote various activities to prevent harm from pesticides including strengthening surveillance, improving the quality of pesticide compliance inspections, and increasing and improving pesticide safety training. The legislation also broadened the coverage of anti-retaliation rules to include agricultural workers, and increased recordkeeping requirements pertaining to pesticide applications. Conclusion The important and positive impacts that can occur through surveillance activities are highlighted. As such, it is important to continue to support and improve occupational illness and injury surveillance programs. Am. J. Ind. Med. 53:188,193 2010. Published 2009 Wiley-Liss, Inc. [source]

Nationalism in Ukraine: Towards A New Framework

POLITICS, Issue 2 2000
Taras Kuzio
Nationalism is the most abused term in contemporary Ukrainian studies. The majority of scholars have failed to place its use within either a theoretical or comparative framework due to the dominance of area studies and the Russo-centricity of Sovietology and post-Sovietology. Instead of defining it within political science parameters, ,nationalism' has been used in a subjective and negative manner by equating it solely in an ethno-cultural sense with Ukrainophones. As a result, scholars tend to place Ukrainophones on the right of the political spectrum. This article argues that this is fundamentally at odds with theory and comparative politics on two counts. First, ,nationalism' is a thin ideology and can function through all manner of ideologies ranging from communism to fascism. Second, all liberal democracies are composed of ethno-cultural and civic features and are therefore permeated by state (civic) nationalism. The article proposes an alternative three-fold framework for understanding ,nationalism' in Ukraine. [source]

Twenty-three years of hypersensitivity pneumonitis mortality surveillance in the United States,,

Ki Moon Bang PhD
Abstract Background There are few population-based studies addressing hypersensitivity pneumonitis (HP) in the United States. The National Institute for Occupational Safety and Health (NIOSH) has nationally comprehensive longitudinal mortality data that can contribute to a better understanding of the epidemiology of HP. Methods The National Center for Health Statistics multiple cause-of-death data were analyzed for the period 1980,2002. Annual death rate was age-adjusted to the 2000 U.S. standard population. Death rate time-trends were calculated using a linear regression model and geographic distribution of death rates were mapped by state and county. Proportionate mortality ratios (PMRs) by usual industry and occupation adjusted for age, sex, and race, were based on data from 26 states reporting industry and occupation during 1985,1999. Results Overall age-adjusted death rates increased significantly (P,<,0.0001) between 1980 and 2002, from 0.09 to 0.29 per million. Wisconsin had the highest rate at 1.04 per million. Among industries, PMR for HP was significantly high for agricultural production, livestock (PMR, 19.3; 95% CI, 14.0,25.9) and agricultural production, crops (PMR, 4.3; 95% CI, 3.0,6.0). Among occupations, PMR for HP was significantly elevated for farmers, except horticulture (PMR, 8.1; 95% CI, 6.4,10.2). Conclusions These findings indicate that agricultural industries are closely associated with HP mortality and preventive strategies are needed to protect workers in these industries. Am. J. Ind. Med. 2006. © 2006 Wiley-Liss, Inc. [source]

The Challenge of Strengthening Nonprofits and Civil Society

Steven Rathgeb Smith
The Winter Commission Report was centrally concerned with improving the performance of state and local governments. Since the issuance of the commission's report in 1993, the delivery of services by state and local government has been substantially changed by the growing role of nonprofit organizations in providing public services and representing citizen interests. As a result, state and local governments and nonprofit agencies are faced with complex governance challenges. The central argument of this paper is that despite the dramatic changes in the relationship between government and nonprofit organizations in recent years, the key tenets of the Winter Commission report,the need for improved training and education, greater transparency and accountability, more emphasis on performance, and improved citizen engagement,remain deeply relevant in improving the governance of the public services in an increasingly complex policy process and service delivery system at the state and local levels. [source]

How Should We Estimate Public Opinion in The States?

Jeffrey R. Lax
We compare two approaches for estimating state-level public opinion: disaggregation by state of national surveys and a simulation approach using multilevel modeling of individual opinion and poststratification by population share. We present the first systematic assessment of the predictive accuracy of each and give practical advice about when and how each method should be used. To do so, we use an original data set of over 100 surveys on gay rights issues as well as 1988 presidential election data. Under optimal conditions, both methods work well, but multilevel modeling performs better generally. Compared to baseline opinion measures, it yields smaller errors, higher correlations, and more reliable estimates. Multilevel modeling is clearly superior when samples are smaller,indeed, one can accurately estimate state opinion using only a single large national survey. This greatly expands the scope of issues for which researchers can study subnational opinion directly or as an influence on policymaking. [source]

Kidney and Pancreas Transplantation in the United States, 1998,2007: Access for Patients with Diabetes and End-Stage Renal Disease

K. P. McCullough
Although the number of candidates on the kidney transplant waiting list at year-end rose from 40 825 to 76 070 (86%) between 1998 and 2007, recent growth principally reflects increases in the number of patients in inactive status. The number of active patients increased by ,only' 4510 between 2002 and 2007, from 44 263 to 48 773. There were 6037 living donor and 10 082 deceased donor kidney transplants in 2007. Patient and allograft survival was best for recipients of living donor kidneys, least for expanded criteria donor (ECD) deceased donor kidneys, and intermediate for non-ECD deceased donor kidneys. The total number of pancreas transplants peaked at 1484 in 2004 and has since declined to 1331. Among pancreas recipients, those with simultaneous pancreas-kidney (SPK) transplants experienced the best pancreas graft survival rates: 86% at 1 year and 53% at 10 years. Between 1998 and 2006, among diabetic patients with end-stage renal disease (ESRD) who were under the age of 50 years, 23% of all and 62% of those waitlisted received a kidney-alone or SPK transplant. In contrast, 6% of diabetic patients aged 50,75 years with ESRD were transplanted, representing 46% of those waitlisted from this cohort. Access to kidney-alone or SPK transplantation varies widely by state. [source]

Supply and Demand of Board-certified Emergency Physicians by U.S. State, 2005

Ashley F. Sullivan MS
Abstract Objectives:, The objective was to estimate the emergency medicine (EM) board-certified emergency physician (EP) workforce supply and demand by U.S. state. Methods:, The 2005 National Emergency Department Inventories-USA provided annual visit volumes for U.S. emergency departments (EDs). We estimated full-time equivalent (FTE) EP demand at each ED by dividing the actual number of visits by the estimated average EP visit volume (3,548 visits/year) and then summing FTEs by state. Our model assumed that at least one EP should be present 24/7 in each ED. The number of EM board-certified EPs per state was provided by the American Board of Medical Specialties (American Board of Emergency Medicine, American Board of Pediatrics) and the American Osteopathic Board of Emergency Medicine. We used U.S. Census Bureau civilian population estimates to calculate EP population density by state. Results:, The supply of EM board-certified EPs was 58% of required FTEs to staff all EDs nationally and ranged from 10% in South Dakota to 104% in Hawai'i (i.e., there were more EPs than the estimated need). Texas and Florida had the largest absolute shortages of EM board-certified EPs (2,069 and 1,146, respectively). The number of EM board-certified EPs per 100,000 U.S. civilian population ranged from 3.6 in South Dakota to 13.8 in Washington, DC. States with a higher population density of EM board-certified EPs had higher percent high school graduates and a lower percent rural population and whites. Conclusions:, The supply and demand of EM board-certified EPs varies by state. Only one state had an adequate supply of EM board-certified EPs to fully staff its EDs. [source]

North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) and the National Hospital Ambulatory Medical Care Survey (NHAMCS): Comparison of Emergency Department Data

Anne M. Hakenewerth MS
Abstract The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) is a near-real-time database of emergency department (ED) visits automatically extracted from hospital information system(s) in the state of North Carolina. The National Hospital Ambulatory Medical Care Survey (NHAMCS) is a retrospective probability sample survey of visits to U.S. hospital EDs. This report compares data from NC DETECT (2006) with NHAMCS (2005) ED visit data to determine if the two data sets are consistent. Proportions, rates, and confidence intervals (CIs) were calculated for ED visits by age and gender; arrival method and age; expected source of payment; disposition; hospital admissions; NHAMCS top 20 diagnosis groups and top five primary diagnoses by age group; International Classifications of Disease, 9th revision, Clinical Modification (ICD-9-CM) primary diagnosis codes; and cause of injury. North Carolina DETECT captured 79% of statewide ED visits. Twenty-eight persons for every 100 North Carolina residents visited a North Carolina ED that reports to NC DETECT at least once in 2006, compared to 20% nationally. Twenty-seven percent of ED visits in North Carolina had private insurance as the expected payment source, compared with 40% nationwide. The proportion of injury-related ED visits in North Carolina is 25%, compared to 36.4% nationally. Rates and proportions of disease groups are similar. Similarity of NC DETECT rates and proportions to NHAMCS provides support for the face and content validity of NC DETECT. The development of statewide near-real-time ED databases is an important step toward the collection, aggregation, and analysis of timely, population-based data by state, to better define the burden of illness and injury for vulnerable populations. [source]