26 CFR 301.7503-1 - Time for performance of acts where last day falls on Saturday, Sunday, or legal holiday.

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2010-04-01

... falls on Saturday, Sunday, or legal holiday. 301.7503-1 Section 301.7503-1 Internal Revenue INTERNAL... where last day falls on Saturday, Sunday, or legal holiday. (a) In general. Section 7503 provides that... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

Injuries to Aboriginal populations living on- and off-reserve in metropolitan and non-metropolitan areas in British Columbia, Canada: Incidence and trends, 1986-2010

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Mariana Brussoni

2016-05-01

Full Text Available Abstract Background Disparities in injury rates between Aboriginal and non-Aboriginal populations in British Columbia (BC are well established. Information regarding the influence of residence on disparities is scarce. We sought to fill these gaps by examining hospitalization rates for all injuries, unintentional injuries and intentional injuries across 24 years among i Aboriginal and total populations; ii populations living in metropolitan and non-metropolitan areas; and iii Aboriginal populations living on- and off-reserve. Methods We used data spanning 1986 through 2010 from BC’s universal health care insurance plan, linked to vital statistics databases. Aboriginal people were identified by insurance premium group and birth and death record notations, and their residence was determined by postal code. “On-reserve” residence was established by postal code areas associated with an Indian reserve or settlement. Health Service Delivery Areas (HSDAs were classified as “metropolitan” if they contained a population of at least 100,000 with a density of 400 or more people per square kilometre. We calculated the crude hospitalization incidence rate and the Standardized Relative Risk (SRR of hospitalization due to injury standardizing by gender, 5-year age group, and HSDA. We assessed cumulative change in SRR over time as the relative change between the first and last years of the observation period. Results Aboriginal metropolitan populations living off-reserve had the lowest SRR of injury (2.0, but this was 2.3 times greater than the general British Columbia metropolitan population (0.86. For intentional injuries, Aboriginal populations living on-reserve in non-metropolitan areas were at 5.9 times greater risk than the total BC population. In general, the largest injury disparities were evident for Aboriginal non-metropolitan populations living on-reserve (SRR 3.0; 2.5 times greater than the general BC non-metropolitan population (1

Hospital distribution in a metropolitan city: assessment by a geographical information system grid modelling approach

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Kwang-Soo Lee

2014-05-01

Full Text Available Grid models were used to assess urban hospital distribution in Seoul, the capital of South Korea. A geographical information system (GIS based analytical model was developed and applied to assess the situation in a metropolitan area with a population exceeding 10 million. Secondary data for this analysis were obtained from multiple sources: the Korean Statistical Information Service, the Korean Hospital Association and the Statistical Geographical Information System. A grid of cells measuring 1 × 1 km was superimposed on the city map and a set of variables related to population, economy, mobility and housing were identified and measured for each cell. Socio-demographic variables were included to reflect the characteristics of each area. Analytical models were then developed using GIS software with the number of hospitals as the dependent variable. Applying multiple linear regression and geographically weighted regression models, three factors (highway and major arterial road areas; number of subway entrances; and row house areas were statistically significant in explaining the variance of hospital distribution for each cell. The overall results show that GIS is a useful tool for analysing and understanding location strategies. This approach appears a useful source of information for decision-makers concerned with the distribution of hospitals and other health care centres in a city.

[Cleaning and disinfection of surfaces in hospitals: Data on structure, process and result in the Frankfurt/Main Metropolitan Area].

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Hausemann, A; Hofmann, H; Otto, U; Heudorf, Ursel

2015-06-01

In addition to hand hygiene and reprocessing of medical products, cleaning and disinfection of surfaces is also an important issue in the prevention of germ transmission and by implication infections. Therefore, in 2014, the quality of the structure, process and result of surface preparation of all hospitals in Frankfurt am Main, Germany, was monitored. All 17 hospitals transferred information on the quality of structure. Process quality was obtained through direct observation during cleaning and disinfection of rooms and their plumbing units. Result quality was gained using the fluorescent method, i.e. marking surfaces with a fluorescent liquid and testing if this mark has been sufficiently removed by cleaning. Structure quality: in all hospitals the employees were trained regularly. In 12 of them, the foremen had the required qualifications, in 6 hospitals unclarity as to the intersection of the cleaning and care services remained. In 14 hospitals only visible contamination was cleaned on the weekends, whereas complete cleaning was reported to take place in 12 hospitals on Saturdays and in 2 hospitals on Sundays. The contractually stipulated cleaning (observations specified in brackets) averaged 178 m(2)/h (148 m(2)/h) per patient room and 69 m(2)/h (33 m(2)/h) for bathrooms. Process quality: during process monitoring, various hand contact surfaces were prepared insufficiently. Result quality: 63 % of fluorescent markings were appropriately removed. The need for improvement is given especially in the area of the qualification of the foremen and a in a clear definition of the intersection between cleaning and care services, as well as in the regulations for weekends and public holidays.

Surgical education and training in an outer metropolitan hospital: a qualitative study of surgical trainers and trainees.

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Nestel, Debra; Harlim, Jennifer; Bryant, Melanie; Rampersad, Rajay; Hunter-Smith, David; Spychal, Bob

2017-08-01

The landscape of surgical training is changing. The anticipated increase in the numbers of surgical trainees and the shift to competency-based surgical training places pressures on an already stretched health service. With these pressures in mind, we explored trainers' and trainees' experiences of surgical training in a less traditional rotation, an outer metropolitan hospital. We considered practice-based learning theories to make meaning of surgical training in this setting, in particular Actor-network theory. We adopted a qualitative approach and purposively sampled surgical trainers and trainees to participate in individual interviews and focus groups respectively. Transcripts were made and thematically analysed. Institutional human research ethics approval was obtained. Four surgical trainers and fourteen trainees participated. Almost without exception, participants' report training needs to be well met. Emergent inter-related themes were: learning as social activity; learning and programmatic factors; learning and physical infrastructure; and, learning and organizational structure. This outer metropolitan hospital is suited to the provision of surgical training with the current rotational system for trainees. The setting offers experiences that enable consolidation of learning providing a rich and varied overall surgical training program. Although relational elements of learning were paramount they occurred within a complex environment. Actor-network theory was used to give meaning to emergent themes acknowledging that actors (both people and objects) and their interactions combine to influence training quality, shifting the focus of responsibility for learning away from individuals to the complex interactions in which they work and learn.

The Child Opportunity Index and Disparities in Pediatric Asthma Hospitalizations Across One Ohio Metropolitan Area, 2011-2013.

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Beck, Andrew F; Huang, Bin; Wheeler, Kathryn; Lawson, Nikki R; Kahn, Robert S; Riley, Carley L

2017-11-01

To determine whether the Child Opportunity Index (COI), a nationally available measure of relative educational, health/environmental, and social/economic opportunity across census tracts within metropolitan areas, is associated with population- and patient-level asthma morbidity. This population-based retrospective cohort study was conducted between 2011 and 2013 in a southwest Ohio county. Participants included all children aged 1-16 years with hospitalizations or emergency department visits for asthma or wheezing at a major pediatric hospital. Patients were identified using discharge diagnosis codes and geocoded to their home census tract. The primary population-level outcome was census tract asthma hospitalization rate. The primary patient-level outcome was rehospitalization within 12 months of the index hospitalization. Census tract opportunity was characterized using the COI and its educational, health/environmental, and social/economic domains. Across 222 in-county census tracts, there were 2539 geocoded hospitalizations. The median asthma-related hospitalization rate was 5.0 per 1000 children per year (IQR, 1.9-8.9). Median hospitalization rates in very low, low, moderate, high, and very high opportunity tracts were 9.1, 7.6, 4.6, 2.1, and 1.8 per 1000, respectively (P asthma morbidity. The details provided by the COI may inform interventions aimed at increasing opportunity and reducing morbidity across regions. Copyright © 2017 Elsevier Inc. All rights reserved.

Online self-expression and experimentation as 'reflectivism': Using text analytics to examine the participatory forum Hello Sunday Morning.

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Carah, Nicholas; Meurk, Carla; Angus, Daniel

2017-03-01

Hello Sunday Morning is an online health promotion organisation that began in 2009. Hello Sunday Morning asks participants to stop consuming alcohol for a period of time, set a goal and document their progress on a personal blog. Hello Sunday Morning is a unique health intervention for three interrelated reasons: (1) it was generated outside a clinical setting, (2) it uses new media technologies to create structured forms of participation in an iterative and open-ended way and (3) participants generate a written record of their progress along with demographic, behavioural and engagement data. This article presents a text analysis of the blog posts of Hello Sunday Morning participants using the software program Leximancer. Analysis of blogs illustrates how participants' expressions change over time. In the first month, participants tended to set goals, describe their current drinking practices in individual and cultural terms, express hopes and anxieties and report on early efforts to change. After month 1, participants continued to report on efforts to change and associated challenges and reflect on their place as individuals in a drinking culture. In addition to this, participants evaluated their efforts to change and presented their 'findings' and 'theorised' them to provide advice for others. We contextualise this text analysis with respect to Hello Sunday Morning's development of more structured forms of online participation. We offer a critical appraisal of the value of text analytics in the development of online health interventions.

Efficient Metropolitan Resource Allocation

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Richard Arnott

2016-05-01

Full Text Available Over the past 30 years Calgary has doubled in size, from a population of 640,645 in 1985 to 1,230,915 in 2015. During that time the City has had five different mayors, hosted the Winter Olympics, and expanded the C-Train from 25 platforms to 45. Calgary’s Metropolitan Area has grown too, with Airdrie, Chestermere, Okotoks and Cochrane growing into full-fledged cities, ripe with inter-urban commuters.* And with changes to provincial legislation in the mid-’90s, rural Rocky View County and the Municipal District of Foothills are now real competitors for residential, commercial and industrial development that in the past would have been considered urban. In this metropolitan system, where people live, their household structure, and their place of work informs the services they need to conduct their daily lives, and directly impacts the spatial character of the City and the broader region. In sum, Metropolitan Calgary is increasingly complex. Calgary and the broader metropolitan area will continue to grow, even with the current economic slowdown. Frictions within Calgary, between the various municipalities in the metropolitan area, and the priorities of other local authorities (such as the School Boards and Alberta Health Services will continue to impact the agendas of local politicians and their ability to answer to the needs of their residents. How resources – whether it is hard infrastructure, affordable housing, classrooms, or hospital beds – are allocated over space and how these resources are funded, directly impacts these relationships. This technical paper provides my perspective as an urban economist on the efficient allocation of resources within a metropolitan system in general, with reference to Calgary where appropriate, and serves as a companion to the previously released “Reflections on Calgary’s Spatial Structure: An Urban Economists Critique of Municipal Planning in Calgary.” It is hoped that the concepts reviewed

Factors that affect job satisfaction and intention to leave of allied health professionals in a metropolitan hospital.

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Wilson, Natalie A

2015-06-01

The purpose of the present study was to determine the aspects of the allied health professional's job that contribute most to job satisfaction and intention to leave in a metropolitan hospital. Data were collected via a questionnaire that was emailed to all clinical allied health staff at Campbelltown and Camden Hospitals in New South Wales, Australia. The participants then rated their level of satisfaction with various job.aspects. A significant correlation was found between several job satisfaction factors and intention to leave in this study group, including quality of supervision, level of competency to do the job, recognition for doing the job, advancement opportunities, autonomy, feelings of worthwhile accomplishment, communication and support from the manager. In relation to Herzberg's job satisfaction theory, both intrinsic and extrinsic work factors have been shown to have a significant correlation with intention to leave in this study group. This information can assist workforce planners to implement strategies to improve retention levels of allied health professionals in the work place.

Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study.

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Aldridge, Cassie; Bion, Julian; Boyal, Amunpreet; Chen, Yen-Fu; Clancy, Mike; Evans, Tim; Girling, Alan; Lord, Joanne; Mannion, Russell; Rees, Peter; Roseveare, Chris; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Temple, Mark; Watson, Sam; Lilford, Richard

2016-07-09

Increased mortality rates associated with weekend hospital admission (the so-called weekend effect) have been attributed to suboptimum staffing levels of specialist consultants. However, evidence for a causal association is elusive, and the magnitude of the weekend specialist deficit remains unquantified. This uncertainty could hamper efforts by national health systems to introduce 7 day health services. We aimed to examine preliminary associations between specialist intensity and weekend admission mortality across the English National Health Service. Eligible hospital trusts were those in England receiving unselected emergency admissions. On Sunday June 15 and Wednesday June 18, 2014, we undertook a point prevalence survey of hospital specialists (consultants) to obtain data relating to the care of patients admitted as emergencies. We defined specialist intensity at each trust as the self-reported estimated number of specialist hours per ten emergency admissions between 0800 h and 2000 h on Sunday and Wednesday. With use of data for all adult emergency admissions for financial year 2013-14, we compared weekend to weekday admission risk of mortality with the Sunday to Wednesday specialist intensity ratio within each trust. We stratified trusts by size quintile. 127 of 141 eligible acute hospital trusts agreed to participate; 115 (91%) trusts contributed data to the point prevalence survey. Of 34,350 clinicians surveyed, 15,537 (45%) responded. Substantially fewer specialists were present providing care to emergency admissions on Sunday (1667 [11%]) than on Wednesday (6105 [42%]). Specialists present on Sunday spent 40% more time caring for emergency patients than did those present on Wednesday (mean 5·74 h [SD 3·39] vs 3·97 h [3·31]); however, the median specialist intensity on Sunday was only 48% (IQR 40-58) of that on Wednesday. The Sunday to Wednesday intensity ratio was less than 0·7 in 104 (90%) of the contributing trusts. Mortality risk among patients

An audit of the pharmacological management of ischaemic stroke patients in a metropolitan Australian hospital.

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Khalil, Viviane; Li, Matthew; Hua, Qiantong Amanda

2015-02-01

According to the Australian Bureau of Statistics, stroke is the second leading cause of death in Australia. The clinical Guidelines for stroke management published by the National Stroke Foundation provide a series of evidence based recommendations to assist clinicians in the management of stroke patients. Appropriate management of patients admitted to stroke units reduces death and disability by 20 %. Moreover, a multidisciplinary team approach also improves patient outcomes. To retrospectively review the pharmacological management of ischaemic stroke patients in a metropolitan Australian hospital, and to compare adherence with the guidelines for stroke management with the national stroke foundation data with and without pharmacist intervention. A retrospective audit of medical records was undertaken of all patients admitted to a large teaching hospital with the diagnosis of stroke or cerebral infarction from January 2013 to May 2013. A total of 124 patients were included in the study. Most patients were discharged on appropriate pharmacological intervention for the prevention of secondary stroke: antihypertensive agents (71 %), lipid lowering agents (67 %) and antithrombotic (85 %) medications. The majority of the cohort was discharged on the appropriate evidence based medications for the management of secondary stroke. Further improvement may be achieved by pharmacist intervening as part of a multidisciplinary team.

Don’t miss the Passport to the Big Bang event this Sunday!

CERN Multimedia

CERN Bulletin

2013-01-01

Word has been going around for weeks now about the inauguration of the Passport to the Big Bang on Sunday 2 June. Ideal for a family day out or a day with friends, this is a CERN event not to be missed!   The Passport to the Big Bang is a 54-km scientific tourist trail comprising ten exhibition platforms in front of ten CERN sites in the Pays de Gex and the Canton of Geneva. Linked by cycle routes, these ten platforms will mark the same number of stages in the rally for competitive cyclists and the bicycle tour for families taking place this Sunday from 9 a.m. to 12 p.m. But that’s not all: from 2 p.m., you will also have the chance to take part in a huge range of activities provided by clubs and associations from CERN and the local region. Watch an oriental dance show, have a go at building detectors out of Kapla blocks and Lego, meet different reptile species, learn about wind instruments, try your hand at Nordic walking or Zumba fitness, get a better understanding of road safety...

Perceptions by medical students of their educational environment for obstetrics and gynaecology in metropolitan and rural teaching sites.

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Carmody, Dianne F; Jacques, Angela; Denz-Penhey, Harriet; Puddey, Ian; Newnham, John P

2009-12-01

Medical student education in Western Australia is expanding to secondary level metropolitan hospitals and rural sites to accommodate workforce demands and increasing medical student numbers. To determine if students' perceptions of the teaching environment for obstetrics and gynaecology differ between tertiary, secondary level metropolitan hospitals and rural sites, and to determine if students' perceptions of their learning environment are associated with improved academic performance. An evaluation was conducted of medical students' perceptions of their learning environment during an obstetrics and gynaecology program at a variety of sites across metropolitan and rural Western Australia. The evaluation was based on the Dundee Ready Education Environmental Measure (DREEM) questionnaire. There were no significant differences in students' perceptions of their learning environment between the tertiary hospital, combined programs involving a tertiary and secondary metropolitan hospital, rural sites with a population of more than 25,000 and rural sites with a population less than 25,000 people. Perceptions were similar in male and female students. The overall mean score for all perceptions of the learning environment in obstetrics and gynaecology were in the range considered to be favorable. Higher scores of perceptions of the learning environment were associated positively with the measures of academic achievement in the clinical, but not written, examination. Medical students' perceptions of their learning environment in obstetrics and gynaecology were not influenced by the geographical site of delivery or their gender but were positively related to higher academic achievement. Providing appropriate academic and clinical support systems have been put in place the education of medical students can be extended outside major hospitals and into outer metropolitan and rural communities without any apparent reduction in perceptions of the quality of their learning

Hospital staffing and hospital costs.

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Andrew, R R

1976-08-07

A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

Where are the Sunday babies? II. Declining weekend birth rates in Switzerland

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Lerchl, Alexander; Reinhard, Sarah C.

2008-02-01

Birth dates from almost 3 million babies born between 1969 and 2005 in Switzerland were analyzed for the weekday of birth. As in other countries but with unprecedented amplitude, a very marked non-random distribution was discovered with decreasing numbers of births on weekends, reaching -17.9% in 2005. While most of this weekend births avoidance rate is due to fewer births on Sundays (up to -21.7%), the downward trend is primarily a consequence of decreasing births on Saturdays (up to -14.5%). For 2005, these percentages mean that 3,728 fewer babies are born during weekends than could be expected from equal distribution. Most interestingly and surprisingly, weekend birth-avoiding rates are significantly correlated with birth numbers ( r = 0.86), i.e. the lower the birth number per year, the lower the number of weekend births. The increasing avoidance of births during weekends is discussed as being a consequence of increasing numbers of caesarean sections and elective labor induction, which in Switzerland reach 29.2 and 20.5%, respectively, in 2004. This hypothesis is supported by the observation that both primary and secondary caesarean sections are significantly correlated with weekend birth avoidance rates. It is therefore likely that financial aspects of hospitals are a factor determining the avoidance of weekend births by increasing the numbers of caesarean sections.

Examination of the relative importance of hospital employment in non-metropolitan counties using location quotients.

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Smith, Jon L

2013-01-01

The US Health Care and Social Services sector (North American Industrial Classification System 'sector 62') has become an extremely important component of the nation's economy, employing approximately 18 million workers and generating almost $753 billion in annual payrolls. At the county level, the health care and social services sector is typically the largest or second largest employer. Hospital employment is often the largest component of the sector's total employment. Hospital employment is particularly important to non-metropolitan or rural communities. A high quality healthcare sector serves to promote economic development and attract new businesses and to provide stability in economic downturns. The purpose of this study was to examine the intensity of hospital employment in rural counties relative to the nation as a whole using location quotients and to draw conclusions regarding how potential changes in Medicare and Medicaid might affect rural populations. Estimates for county-level hospital employment are not commonly available. Estimates of county-level hospital employment were therefore generated for all counties in the USA the Census Bureau's County Business Pattern Data for 2010. These estimates were used to generate location quotients for each county which were combined with demographic data to generate a profile of factors that are related to the magnitude of location quotients. The results were then used to draw inferences regarding the possible impact of the Patient Protection and Affordable Care Act 2010 (ACA) and the possible imposition of aspects of the Budget Control Act 2011 (BCA). Although a very high percentage of rural counties contain medically underserved areas, an examination of location quotients indicates that the percentage of the county workforce employed by hospitals in the most rural counties tends to be higher than for the nation as a whole, a counterintuitive finding. Further, when location quotients are regressed upon data

Googling Service Boundaries for Endovascular Clot Retrieval Hub Hospitals in a Metropolitan Setting: Proof-of-Concept Study.

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Phan, Thanh G; Beare, Richard; Chen, Jian; Clissold, Benjamin; Ly, John; Singhal, Shaloo; Ma, Henry; Srikanth, Velandai

2017-05-01

There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub. Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval-capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface. Boundary maps generated based on traveling time at various times of day for combinations of hubs. In a 2-hub model, catchment was best distributed when RMH was paired with MMC (model 1a, RMH 1765 km 2 and MMC 1164 km 2 ) or with AUS (model 1c, RMH 1244 km 2 and AUS 1685 km 2 ), with no statistical difference between models ( P =0.20). Catchment was poorly distributed when RMH was paired with ALF (model 1b, RMH 2252 km 2 and ALF 676 km 2 ), significantly different from both models 1a and 1c (both P AUS was superior to that of RMH, MMC, and ALF in catchment distribution and travel time. The method was also successfully applied to the city of Adelaide demonstrating wider applicability. We provide proof of concept for a novel computational method to objectively designate service boundaries for endovascular clot retrieval hubs. © 2017 American Heart Association, Inc.

MRSA Causing Infections in Hospitals in Greater Metropolitan New York: Major Shift in the Dominant Clonal Type between 1996 and 2014.

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Maria Pardos de la Gandara

Full Text Available A surveillance study in 1996 identified the USA100 clone (ST5/SCCmecII-also known as the "New York/Japan" clone-as the most prevalent MRSA causing infections in 12 New York City hospitals. Here we update the epidemiology of MRSA in seven of the same hospitals eighteen years later in 2013/14. Most of the current MRSA isolates (78 of 121 belonged to the MRSA clone USA300 (CC8/SCCmecIV but the USA100 clone-dominant in the 1996 survey-still remained the second most frequent MRSA (25 of the 121 isolates causing 32% of blood stream infections. The USA300 clone was most common in skin and soft tissue infections (SSTIs and was associated with 84.5% of SSTIs compared to 5% caused by the USA100 clone. Our data indicate that by 2013/14, the USA300 clone replaced the New York/Japan clone as the most frequent cause of MRSA infections in hospitals in Metropolitan New York. In parallel with this shift in the clonal type of MRSA, there was also a striking change in the types of MRSA infections from 1996 to 2014.

MPLS for metropolitan area networks

CERN Document Server

Tan, Nam-Kee

2004-01-01

METROPOLITAN AREA NETWORKS AND MPLSRequirements of Metropolitan Area Network ServicesMetropolitan Area Network OverviewThe Bandwidth DemandThe Metro Service Provider's Business ApproachesThe Emerging Metro Customer Expectations and NeedsSome Prevailing Metro Service OpportunitiesService Aspects and RequirementsRoles of MPLS in Metropolitan Area NetworksMPLS PrimerMPLS ApplicationsTRAFFIC ENGINEERING ASPECTS OF METROPOLITAN AREA NETWORKSTraffic Engineering ConceptsNetwork CongestionHyper Aggregation ProblemEasing CongestionNetwork ControlTactical versus Strategic Traffic EngineeringIP/ATM Overl

Spatial variations in US poverty: beyond metropolitan and non-metropolitan.

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Wang, Man; Kleit, Rachel Garshick; Cover, Jane; Fowler, Christopher S

2012-01-01

Because poverty in rural and urban areas of the US often has different causes, correlates and solutions, effective anti-poverty policies depend on a thorough understanding of the ruralness or urbanness of specific places. This paper compares several widely used classification schemes and the varying magnitudes of poverty that they reveal in the US. The commonly used ‘metropolitan/non-metropolitan’ distinction obscures important socioeconomic differences among metropolitan areas, making our understanding of the geography of poverty imprecise. Given the number and concentration of poor people living in mixed-rural and rural counties in metropolitan regions, researchers and policy-makers need to pay more nuanced attention to the opportunities and constraints such individuals face. A cross-classification of the Office of Management and Budget’s metro system with a nuanced RUDC scheme is the most effective for revealing the geographical complexities of poverty within metropolitan areas.

Short and Long-Term Temporal Changes in Air Quality in a Seoul Urban Area: The Weekday/Sunday Effect

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Jan E. Szulejko

2018-04-01

Full Text Available We present evidence on the short-term differences in airborne pollution levels in terms of weekday/weekend (WD/WN and weekday/Sunday (WD/Sun intervals. To this end, we analyzed the hourly data of important pollutants (nitric oxide (NO, nitrogen dioxide (NO2, ozone (O3 and carbon monoxide (CO using the data acquired in the Yong-San district of Seoul, Korea from 2009 to 2013. For each week, the pollutant ratio (Rw was estimated through either WD/WN or WD/Sun. Here, a week is defined as Sunday through Saturday, WD as Monday through Friday and WN as Sunday and Saturday. The WD/Sun Rw geometric means (and range were 2.02 (0.27–15.5 for NO, 1.29 (0.49–5.7 for NO2 and 0.89 (0.17–7.2 for O3 while the fraction of Rw (WD/Sun > 1 were 81, 71 and 38%, respectively. NO and CO levels were much higher in October through March (during Autumn and Winter than April through September (during Spring and Summer, reflecting the potential effect of fuel consumption (e.g., in terms of use patterns of nationwide city natural gas. Thus, we provide a broader interpretation on the occurrence patterns of the major pollutants (e.g., NO, NO2, O3 and CO in relation to temporal changes in man-made activities.

Retaining nurses in metropolitan areas: insights from senior nurse and human resource managers.

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Drennan, Vari M; Halter, Mary; Gale, Julia; Harris, Ruth

2016-11-01

To investigate the views of senior nurse and human resource managers of strategies to retain hospital nurses in a metropolitan area. Against a global shortage, retaining nurses is a management imperative for the quality of hospital services. Semi-structured interviews, thematically analysed. Metropolitan areas have many health organisations in geographical proximity, offering nurses choices in employer and employment. Senior nurse and human resource managers recognised the complexity of factors influencing nurse turnover, including those that 'pulled' nurses out of their jobs to other posts and factors that 'pushed' nurses to leave. Four themes emerged in retaining nurses: strategy and leadership, including analysis of workforce and leavers' data, remuneration, the type of nursing work and career development and the immediate work environment. In contexts where multiple organisations compete for nurses, addressing retention through strategic leadership is likely to be important in paying due attention and apportioning resources to effective strategies. Aside from good human resource management practices for all, strategies tailored to different segments of the nursing workforce are likely to be important. This metropolitan study suggests attention should be paid to strategies that address remuneration, progressing nursing careers and the immediate work environment. © 2016 The Authors Journal of Nursing Management Published by John Wiley & Sons Ltd.

Do Blue Laws Save Lives? The Effect of Sunday Alcohol Sales Bans on Fatal Vehicle Accidents

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Lovenheim, Michael F.; Steefel, Daniel P.

2011-01-01

This paper analyzes the effect of state-level Sunday alcohol sales restrictions ("blue laws") on fatal vehicle accidents, which is an important parameter in assessing the desirability of these laws. Using a panel data set of all fatal vehicle accidents in the U.S. between 1990 and 2009 combined with 15 state repeals of blue laws, we show that…

Marconi to McLuhan: A Select Biliography of N. Y. Times Sunday Magazine Articles on Communication, 1900-1980.

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Flannery, Gerald V., Comp.

Containing over 1,800 entries, this index to articles appearing in the "New York Times Sunday Magazine," is arranged by year (1900-1980), by author, decades, and general topic (radio, rhetoric, film). Among the topics covered are newspapers, music, theatre, telegraph, wireless, telephone, photography, public relations, advertising,…

Weekend hospitalization and additional risk of death: an analysis of inpatient data.

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Freemantle, N; Richardson, M; Wood, J; Ray, D; Khosla, S; Shahian, D; Roche, W R; Stephens, I; Keogh, B; Pagano, D

2012-02-01

To assess whether weekend admissions to hospital and/or already being an inpatient on weekend days were associated with any additional mortality risk. Retrospective observational survivorship study. We analysed all admissions to the English National Health Service (NHS) during the financial year 2009/10, following up all patients for 30 days after admission and accounting for risk of death associated with diagnosis, co-morbidities, admission history, age, sex, ethnicity, deprivation, seasonality, day of admission and hospital trust, including day of death as a time dependent covariate. The principal analysis was based on time to in-hospital death. National Health Service Hospitals in England. 30 day mortality (in or out of hospital). There were 14,217,640 admissions included in the principal analysis, with 187,337 in-hospital deaths reported within 30 days of admission. Admission on weekend days was associated with a considerable increase in risk of subsequent death compared with admission on weekdays, hazard ratio for Sunday versus Wednesday 1.16 (95% CI 1.14 to 1.18; P < .0001), and for Saturday versus Wednesday 1.11 (95% CI 1.09 to 1.13; P < .0001). Hospital stays on weekend days were associated with a lower risk of death than midweek days, hazard ratio for being in hospital on Sunday versus Wednesday 0.92 (95% CI 0.91 to 0.94; P < .0001), and for Saturday versus Wednesday 0.95 (95% CI 0.93 to 0.96; P < .0001). Similar findings were observed on a smaller US data set. Admission at the weekend is associated with increased risk of subsequent death within 30 days of admission. The likelihood of death actually occurring is less on a weekend day than on a mid-week day.

Smoking behavior among patients and staff: a snapshot from a major metropolitan hospital in Melbourne, Australia

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Rahman MA

2014-01-01

Full Text Available Muhammad Aziz Rahman,1,2 Andrew M Wilson,2–4 Rhonda Sanders,3 David Castle,2–4 Karen Daws,3 David R Thompson,2 Chantal F Ski,2 Sarah Matthews,3 Christine Wright,2 Linda Worrall-Carter1–31St Vincent's Centre for Nursing Research (SVCNR, Australian Catholic University, Melbourne, VIC, Australia; 2The Cardiovascular Research Centre (CvRC, Australian Catholic University, Melbourne, VIC, Australia; 3St Vincent's Hospital, Melbourne, VIC, Australia; 4The University of Melbourne, Melbourne, VIC, AustraliaBackground: A cross-sectional study was conducted to provide a snapshot of smoking behavior among staff and patients at a major metropolitan hospital in Melbourne.Methods: Patients and staff were surveyed using a questionnaire exploring demographics, nicotine dependence (Fagerstrom test, readiness to quit, and preference for smoking cessation options.Results: A total of 1496 people were screened within 2 hours; 1,301 participated (1,100 staff, 199 patients. Mean age was 42 years, 68% were female. There were 113 (9% current smokers and 326 (25% ex-smokers. Seven percent of the staff were current smokers compared with 19% of the patients. The Fagerstrom test showed that 47% of patients who smoked were moderately nicotine dependent compared with 21% of staff. A third of the staff who smoked did not anticipate health problems related to smoking. Most patients (79% who smoked disagreed that their current health problems were related to smoking. Although more than half of the current smokers preferred pharmacotherapy, one in two of them did not prefer behavior counseling; with consistent results among staff and patients. Multivariate analyses showed that patients were three times more likely (odds ratio 3.0, 95% confidence interval 1.9–4.7 to smoke than staff.Conclusion: This study reports lower prevalence of smoking among hospital staff compared with national data. It also indicates an under-appreciation of health effects of smoking, and a

Hospitalization of abused and neglected children.

Science.gov (United States)

Marshall, W N

1997-03-01

To describe the use of inpatient hospitalization for abused and neglected children living in a metropolitan area. Retrospective record review of abused and neglected children admitted in 1992 and 1993 to hospitals with 87% of metropolitan area pediatric admissions; comparison of these data with population, crisis nursery, and child protective services data. Thirty-four abused and neglected children were admitted to hospital, representing 0.3% (34/11,066; 95% confidence interval, 0%-1.2%) of pediatric admissions and 0.2% (34/19,950; 95% confidence interval, 0%-0.6%) of child protective services reports. This represents a rate of hospitalization for child abuse of 10 children (95% confidence interval, 0-46) per 100,000 child population per year. Seven hundred fifteen children were admitted to the crisis nursery by child protective services. Of those admitted to the hospital, 12 needed intensive care, 5 of whom died. Only 3 of 34 hospital-admitted children had private health insurance; 19 of 34 were younger than 1 year. Inpatient hospitalization for abuse represented a small fraction of total pediatric admissions and of child protective services reports. Comprehensive medical care for most abused children and medical education about child abuse must occur in outpatient settings.

Prevalence of CMV infection among staff in a metropolitan children’s hospital – occupational health screening findings

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Stranzinger, Johanna

2016-09-01

Full Text Available Background: Staff in children’s hospitals may run an increased risk of cytomegalovirus (CMV contact infection leading to a congenital CMV fetopathy during pregnancy. The main risk factor is close contact with inapparent carriers of CMV among infants (<3 years. We therefore examined CMV seroprevalence (SP and possible risk factors for CMV infection among staff at a children’s hospital.Method: In 2014, staff at a metropolitan children’s hospital were offered a CMV antibody test in the context of occupational health screening. Besides of anti-CMV immunoglobulin G (anti-CMV IgG gender, age, profession, number of children and migration background were assessed and used as independent variables in multiple logistic regression. Women without a migration background (MIG were considered as a separate group.Results: The study included 219 employees. Women showed a significant higher risk than men of being CMV-positive (adjusted odds ratio [aOR] 3.0; 95% CI 1.1–7.8. The risk among age groups of 30 and over was double that of the under-30s (aOR 2.0; 95% CI 1.0–3.9; among those aged 40-plus it was aOR 2.3 (95% CI 1.1–4.7. Staff with an MIG tested more often positive than those without an MIG (95.5% versus 45.7%. CMV SP was 47.7% among women without an MIG. In this subgroup the probability of CMV infection increased with age (p=0.08 as well. Conclusion: In the staff group as a whole there was a significant correlation between CMV SP, country of origin and age. We found no significant differences between occupational groups; perhaps our random sample was too small. Given the low CMV SP particularly in those without MIG, women who want to have children in particular must be protected from CMV infection. Follow-up studies should be undertaken to test whether good workplace hygiene offers sufficient protection for pregnant women and could be an alternative to prohibiting certain activities.

HMO penetration: has it hurt public hospitals?

Science.gov (United States)

Clement, J P; Grazier, K L

2001-01-01

The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals in 321 metropolitan statistical areas (MSAs) in 1995. Although hospitals located in markets with higher HMO penetration have lower financial performance as reflected in revenues, expenses and operating margin, public hospitals are not more disadvantaged than other hospitals by managed care.

The struggle for Sunday lunch: gastropolitics in the life of Nelson Mandela.

Science.gov (United States)

Trapido, Anna

2011-01-01

This paper explores the political, economic, and social life of Nelson Mandela through his food choices from 1918 to the present. A description of the minutiae of one particular 1950s Sunday lunch is used to examine the broader role of first colonial and later apartheid legislation in determining the dietary choices and options of South Africans past and present. How such policies shaped attitudes and access to Nelson Mandela’s ancestral Xhosa cuisine is assessed. The long-term cultural, economic, and political impact of a lack of access to core indigenous African ingredients is evaluated. Most of all this paper offers a snapshot portrayal of two families (one white, one black) trying to sustain a normal friendship within a grossly abnormal society.

[Morbidity and mortality associated to influenza A (H1N1) 2009 admissions in two hospitals of the Metropolitan area and analysis of its economic impact].

Science.gov (United States)

Armstrong, Macarena; Fica, Alberto; Dabanch, Jeannette; Olivares, Felipe; Fasce, Rodrigo; Triantafilo, Vjera

2012-12-01

Influenza A (H1N1) 2009 infection was an important cause of morbidity and mortality in Chile. To characterize the clinical pattern of hospitalized patients, identify risk factors associated with ICU admission or death, and evaluate its economic impact. Twenty five adult patients admitted to 2 hospitals in the Metropolitan Area from May 2009 to December 2010 with PCR confirmed H1N1 infection were analyzed. Total hospital charges were obtained and, using data of registered cases, expenses for the whole country during the first epidemic wave were estimated. Aill cases presented a risk factor: age over 60 years old (n = 13, 52%), co-morbid conditions (n = 24, 96%) or pregnancy (n = 1, 4%). Pneumonia was present in 64% (n = 16) and 16% (n = 4) had hypotension. Only 6 patients (24%) had a CURB-65 score ≥ 2 and 36% (n = 9) requiring ICU admission. Case fatality rate was 16% (n = 4). By multivariate analysis, diabetes mellitus type 2 was independently associated with ICU admission or death (OR 8.12; IC95 1.11-59.2, p Chile during the first wave. The CURB-65 score was inappropriate to recognize patients at risk of hospitalization or ICU admission.

Classical Imagery and the Joy of the Resurrection. Arsenios' Stichoi on the Sunday of the Resurrection

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Nicholas Newman

2016-12-01

Full Text Available In the Stichoi on the Sunday of the Resurrection, Arsenios of Corfu alludes to several couples from Classical mythology in the context of a springtime idyll. These mythological couples are not the ideal lovers the paradisic context of the poem makes them seem to be. This paper examines these allusions and discusses how Arsenios uses their mythological context to create a juxtaposition of the frustrated eroticism of Classical myth and the fulfillment of Pascha.

Premises for Shaping Metropolitan Areas in Romania

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RAULARIAN RUSU

2012-01-01

Full Text Available The setting up of metropolitan areas is a process which is still in progress in Romania. The legislative framework for the creation of these areas has been built up only since 2001, and there are still a number of juridical inconsistencies concerning the association of administrative units to form metropolitan areas. On the other hand, political reasons and the fear of losing a certain degree of authority and to become subordinates of the large cities (in the case of rural municipalities also hindered the development of metropolitan areas in Romania. Nevertheless, the metropolitan areas already in existence are running a number of projects that are beneficial for most members of the association. Such positive examples may trigger the creation of the other metropolitan areas. Although the existing metropolitan areas did not yield spectacular results, the time passed since their foundation is yet too short to correctly assess their usefulness and territorial meaning. For the moment, the following metropolitan areas exist in Romania: Iaşi, Oradea, Braşov, Constanţa, Bacău, Cluj-Napoca, Târgu Mureş and Craiova. Bucharest, Timişoara, Ploieşti and Galaţi-Brăila metropolitan areas are still in process of setting up.

Radiation therapy for Kaposi's sarcoma associated with acquired immunodeficiency syndrome. Tokyo Metropolitan Komagome Hospital experience

International Nuclear Information System (INIS)

Ebara, Takeshi; Karasawa, Katsuyuki; Maebayashi, Katsuya; Kurosaki, Hiromasa; Ishikawa, Hitoshi; Kaizu, Toshihide; Tanaka, Yoshiaki; Akagi, Kumiko; Masuda, Gota

2000-01-01

Kaposi's sarcoma is frequently found in association with acquired immunodeficiency syndrome (AIDS). We report on radiotherapy for patients with AIDS-related Kaposi's sarcoma at Tokyo Metropolitan Komagome Hospital. Between April 1991 and May 1997, radiotherapy was given to 11 lesions in eight men with AIDS-related Kaposi's sarcoma to relieve their symptoms. The lesions involved the head and neck region, the legs, and the gastrointestinal tract. Radiotherapy was carried out with 4-MV photon through parallel opposed field or high energy electrons. Total doses ranged from 20 to 38 Gy, with a median of 30 Gy, delivered in 2- to 3-Gy fractions. Four patients were given other treatments prior to the radiotherapy. Acute reaction was evaluated according to the modified acute radiation morbidity scoring criteria of the Radiation Therapy Oncology Group (RTOG). Radiotherapy had relieved the symptoms in all patients at completion of this therapy. Lesions that involved the hard palate and vocal cords had completely disappeared. The lesions that received radiotherapy were controlled without symptoms until the patients died. Patients who had the head and neck region treated exhibited severe acute mucosal reaction (at a dose of 30 Gy, there was grade 2 morbidity by modified RTOG criteria, in two patients, and grade 3 in three patients) although the radiation therapy was completed for these patients. Radiotherapy promises a favorable outcome for symptom relief in AIDS-related Kaposi's sarcoma. (author)

“To Live in Hearts We Leave Behind is Not to Die.” Remembrance Sunday at Pusey House, Oxford University, A Review of Worship at Oxford University

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Peter L. Kraus

2017-04-01

Full Text Available In recent years, religious participation by students of all faiths at Universities in the United Kingdom has seen a steady increase in attendance. This brief essay is a case study of worship by members of the University Community at Pusey House at the University of Oxford, which reflects the trend. On a crisp fall, November day, the twenty-third Sunday after Trinity (8th of November 2015 I had the opportunity to attend services at Pusey House, Oxford on Remembrance Sunday while on sabbatical at The University of Oxford (St. Stephen’s House.

The burden of healthcare-associated Clostridium difficile infection in a non-metropolitan setting.

Science.gov (United States)

Bond, S E; Boutlis, C S; Yeo, W W; Pratt, W A B; Orr, M E; Miyakis, S

2017-04-01

Healthcare-associated Clostridium difficile infection (HCA-CDI) remains a major cause of morbidity and mortality in industrialized countries. However, few data exist on the burden of HCA-CDI in multi-site non-metropolitan settings. This study examined the introduction of an antimicrobial stewardship programme (ASP) in relation to HCA-CDI rates, and the effect of HCA-CDI on length of stay (LOS) and hospital costs. A comparative before-and-after intervention study of patients aged ≥16 years with HCA-CDI from December 2010 to April 2016 across the nine hospitals of a non-metropolitan health district in New South Wales, Australia was undertaken. The intervention comprised a multi-site ASP supported by a clinical decision support system, with subsequent introduction of email feedback of HCA-CDI cases to admitting medical officers. HCA-CDI rates, comparative LOS and hospital costs, prior use of antimicrobials and proton pump inhibitors, and appropriateness of CDI treatment. HCA-CDI rates rose from 3.07 to 4.60 cases per 10,000 occupied bed-days pre-intervention, and remained stable at 4 cases per 10,000 occupied bed-days post-intervention (P=0.24). Median LOS (17 vs six days; P<0.01) and hospital costs (AU$19,222 vs $7861; P<0.01) were significantly greater for HCA-CDI cases (N=91) than for matched controls (N=172). Half of the patients with severe HCA-CDI (4/8) did not receive initial appropriate treatment (oral vancomycin). HCA-CDI placed a significant burden on the regional and rural health service through increased LOS and hospital costs. Interventions targeting HCA-CDI could be employed to consolidate the effects of ASPs. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Hello Sunday Morning: Alcohol, (non)consumption and selfhood.

Science.gov (United States)

Pennay, Amy; MacLean, Sarah; Rankin, Georgia

2016-02-01

Hello Sunday Morning (HSM) is an online program that encourages people to commit to a period of non-drinking and blog about their experiences. The purpose of this paper is to explore how HSM members negotiated their periods of abstention, with a focus on how not drinking influenced their narratives of selfhood. Thematic analysis was undertaken of 2844 blog posts from 154 Victorians who signed up to HSM in 2013 or 2014. Analysis revealed three key narratives of selfhood offered by participants: (1) abstinence resulting in a disrupted sense of self, (2) non-consumption facilitating the development of a new healthy self, and (3) anti-consumption facilitating the development of a resistant self. Individuals construct and maintain their sense of self through consumption (or non-consumption) activities, and this occurs within the broader context of the relationship between selfhood, consumption and culture. HSM members developed narratives of self by drawing on a range of wider discursive structures concerning pleasure, healthism and resistance. The typologies of non-drinking selves identified in this paper could be disseminated through platforms such as HSM to support people who are new to non-drinking in choosing how they might construct and enact alternative selfhoods in contexts where alcohol consumption is deeply embedded. Copyright © 2015 Elsevier B.V. All rights reserved.

Influence of Intimate Partner Violence on Domestic Relocation in Metropolitan and Non-Metropolitan Young Australian Women

NARCIS (Netherlands)

Dillon, Gina; Hussain, Rafat; Kibele, Eva; Rahman, Saifur; Loxton, Deborah

2016-01-01

Data from a national, population-based longitudinal study of Australian women (26-34 years) were analyzed to investigate the association between domestic relocation and multiple explanatory factors, namely intimate partner violence (IPV), metropolitan versus non-metropolitan residence, education,

Reconstructing apology: David Cameron's Bloody Sunday apology in the press.

Science.gov (United States)

McNeill, Andrew; Lyons, Evanthia; Pehrson, Samuel

2014-12-01

While there is an acknowledgement in apology research that political apologies are highly mediated, the process of mediation itself has lacked scrutiny. This article suggests that the idea of reconstruction helps to understand how apologies are mediated and evaluated. David Cameron's apology for Bloody Sunday is examined to see how he constructs four aspects of apology: social actors, consequences, categorization, and reasons. The reconstruction of those aspects by British, Unionist, and Nationalist press along with reconstructions made by soldiers in an online forum are considered. Data analysis was informed by thematic analysis and discourse analysis which helped to explore key aspects of reconstruction and how elements of Cameron's apology are altered in subsequent mediated forms of the apology. These mediated reconstructions of the apology allowed their authors to evaluate the apology in different ways. Thus, in this article, it is suggested that the evaluation of the apology by different groups is preceded by a reconstruction of it in accordance with rhetorical goals. This illuminates the process of mediation and helps to understand divergent responses to political apologies. © 2013 The British Psychological Society.

Roaming Through Hafta Bazaar: A Walk-Route for Old Delhi’s Sunday Markets

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Abhishek K. Sharma

2017-08-01

Full Text Available Delhi is well positioned in the tourism circuit. However, the heritage monuments are over-crowded especially during the weekends. The potential of weekly market (Hafta Bazaar as a combination of cultural and heritage tourism is hitherto unexplored and can augment Delhi’s tourism space. This research contribution attempts to document the weekly markets of Delhi. Sunday Markets around Old Delhi have been identified and mapped since this is one part of the city visited by large number of tourist groups. Developing these markets for tourists, by combining their historical, cultural and architectural heritage, and addition of photography or culinary delicacies in these walks could open up a new avenue for the tourists as well as tour operators.

Rural hospital wages

Science.gov (United States)

Hendricks, Ann M.

1989-01-01

Average fiscal year 1982 wages from 2,302 rural American hospitals were used to test for a gradient descending from hospitals in counties adjacent to metropolitan areas to those not adjacent. Considerable variation in the ratios of adjacent to nonadjacent averages existed. No statistically significant difference was found, however. Of greater importance in explaining relative wages within States were occupational mix, mix of part-time and full-time workers, case mix, presence of medical residencies, and location in a high-rent county within the State. Medicare already adjusts payments for only two of these variables. PMID:10313454

Metropolitan migration and population growth in selected developing countries.

Science.gov (United States)

1983-01-01

The purpose of this article is to estimate the components of metropolitan population growth in selected developing countries during 1960-1970 period. The study examines population growth in 26 cities: 5 are in Africa, 8 in Asia, and 13 in Latin America, using data from national census publications. These cities in general are the political capitals of their countries, but some additional large cities were selected in Brazil, Mexico, and South Africa. All cities, at the beginning of the 1960-1970 decade had over 500,000 population; Accra, the only exception, reached this population level during the 1960s. Some cities had over 4 million residents in 1970. Net migration contributed about 37% to total metropolitan population growth; the remainder of the growth is attributable to natural increase. Migration has a much stronger impact on metropolitan growth than suggested by the above figure: 1) Several metropolitan areas, for various reasons, are unlikely to receive many migrants; without those cities, the share of metropolitan growth from net migration is 44%. 2) Estimates of the natural increase of migrants after their arrival in the metropolitan areas, when added to migration itself, changes the total contribution of migration to 49% in some metropolitan areas. 3) Even where net migration contributes a smaller proportion to metropolitan growth than natural increase, the rates of net migration are generally high and should be viewed in the context of rapid metropolitan population growth from natural increase alone. Finally, the paper also compares the components of metropolitan growth with the components of growth in the remaining urban areas. The results show that the metropolitan areas, in general, grow faster than the remaining urban areas, and that this more rapid growth is mostly due to a higher rate of net migration. Given the significance of migration for metropolitan growth, further investigations of the effects of these migration streams, particularly with

The impact of non-IPA HMOs on the number of hospitals and hospital capacity.

Science.gov (United States)

Chernew, M

1995-01-01

Concentration in the hospital market could limit the success of health care reform strategies that rely on managed care to constrain costs. Hospital market capacity also is important because capacity affects both costs and the degree of price competition. Because managed care plans, particularly non-individual practice association (non-IPA) model HMOs, practice a less hospital-intensive style of care, consolidation and downsizing in the hospital market potentially will accompany managed care growth, influencing the long-run effectiveness of managed care cost-containment strategies. Using Standard Metropolitan Statistical Area (SMSA) data from 1982 and 1987, a 10-percentage point increase in non-IPA HMO market share is estimated to reduce the number of hospitals by about 4%, causing an approximate 5% reduction in the number of hospital beds. No statistically significant relationship is found between non-IPA HMO penetration rates and hospital occupancy rates.

Metropolitan water management

National Research Council Canada - National Science Library

Milliken, J. Gordon; Taylor, Graham C

1981-01-01

This monograph is intended to inform interested and capable pesons, who happen not to be specialists in water resources planning, of the issues and alternative strategies related to metropolitan water supply...

‘New urbanism' or metropolitan-level centralization?

DEFF Research Database (Denmark)

Næss, Petter

2011-01-01

Based on a study in Copenhagen Metropolitan Area, this paper compares the influences of macro-level and micro-level urban form characteristics on the respondents' traveling distance by car on weekdays. The Copenhagen study shows that metropolitan-scale urban structural variables generally exert...... stronger influences than neighborhood-scale built environment characteristics on the amount of car travel. In particular, the location of the residence relative to the main city center of the metropolitan region shows a strong effect. Some local scale variables often mentioned in the literature...

Radiation therapy for Kaposi's sarcoma associated with acquired immunodeficiency syndrome. Tokyo Metropolitan Komagome Hospital experience

Energy Technology Data Exchange (ETDEWEB)

Ebara, Takeshi [Municipal Kanbara General Hospital, Fujikawa, Shizuoka (Japan); Karasawa, Katsuyuki; Maebayashi, Katsuya; Kurosaki, Hiromasa; Ishikawa, Hitoshi; Kaizu, Toshihide; Tanaka, Yoshiaki; Akagi, Kumiko; Masuda, Gota

2000-12-01

Kaposi's sarcoma is frequently found in association with acquired immunodeficiency syndrome (AIDS). We report on radiotherapy for patients with AIDS-related Kaposi's sarcoma at Tokyo Metropolitan Komagome Hospital. Between April 1991 and May 1997, radiotherapy was given to 11 lesions in eight men with AIDS-related Kaposi's sarcoma to relieve their symptoms. The lesions involved the head and neck region, the legs, and the gastrointestinal tract. Radiotherapy was carried out with 4-MV photon through parallel opposed field or high energy electrons. Total doses ranged from 20 to 38 Gy, with a median of 30 Gy, delivered in 2- to 3-Gy fractions. Four patients were given other treatments prior to the radiotherapy. Acute reaction was evaluated according to the modified acute radiation morbidity scoring criteria of the Radiation Therapy Oncology Group (RTOG). Radiotherapy had relieved the symptoms in all patients at completion of this therapy. Lesions that involved the hard palate and vocal cords had completely disappeared. The lesions that received radiotherapy were controlled without symptoms until the patients died. Patients who had the head and neck region treated exhibited severe acute mucosal reaction (at a dose of 30 Gy, there was grade 2 morbidity by modified RTOG criteria, in two patients, and grade 3 in three patients) although the radiation therapy was completed for these patients. Radiotherapy promises a favorable outcome for symptom relief in AIDS-related Kaposi's sarcoma. (author)

The perils of healthcare workforce forecasting: a case study of the Philadelphia metropolitan area.

Science.gov (United States)

Smith, David Barton; Aaronson, William

2003-01-01

In 1996, a widely circulated and influential forecast for the Philadelphia Metropolitan Area stated that a decline in hospital and healthcare employment in the region would occur over the next five years. It also suggested that this decline would exacerbate the problem of an oversupply of nurses seeking hospital employment. The forecast reflected a regional leadership and expert consensus on the impact of the managed care transformation on workforce needs and was supported by short-term statistical trends in regional utilization and employment. Confounding these predictions was the fact that hospital and healthcare employment actually grew. By the end of 2001, hospitals in the region were experiencing problems in recruiting sufficient numbers of nurses, pharmacists, and technicians. The forecast failed to anticipate the impact of a strong regional economy on supply and underestimated the resilience of underlying forces that have driven the long-term growth in healthcare workforce demand. More effective ongoing monitoring can help moderate the fluctuation of workforce shortages and surpluses.

Metropolitan Lima: area profile.

Science.gov (United States)

Hakkert, R

1986-11-01

-help construction. Only 2.7% of the metropolitan population over age 15 is illiterate, down from 5.4% in 1972 and 7.7% in 1961. In 1981 Lima had 93 hospitals with a total of 12,640 beds. In addition there were 102 health centers and 10 sanitary posts. Lima's economically active population totaled 1.53 million in 1981, 71% of whom were men. On average, each household has 1.8 income earners, and only 17% have more than 2. A 1978 survey revealed that the families of Lima spend an average of 45.2% of their incomes on food, 15.6% on housing and utilities, 9.8% on transport and communication, 7.4% on education, sports, and cultural activities, 7.3% on clothing, and 7.0% on furniture and housing maintenance.

Reconceptualization Sexuality and Rethinking Homophobia in Metropolitan Campus Spaces

Science.gov (United States)

Deniz, Caglar

2017-01-01

The Metropolitan city gives non-metropolitan students an opportunity to meet new social groups. In this article, the perceptions of sexuality of those students who come from provincial areas to a metropolitan city for university education are examined within a framework of semi-structured interviews. The study on which this article is based used a…

Pediatric disaster preparedness of a hospital network in a large metropolitan region.

Science.gov (United States)

Ferrer, Rizaldy R; Balasuriya, Darshi; Iverson, Ellen; Upperman, Jeffrey S

2010-01-01

We describe pediatric-related emergency experiences and responses, disaster preparation and planning, emergency plan execution and evaluation, and hospital pediatric capabilities and vulnerabilities among a disaster response network in a large urban county in the West Coast of the United States. Using semistructured key informant interviews, the authors conducted qualitative research between March and April 2008. Eleven hospitals and a representative from the community clinic association agreed to participate (86 percent response rate) and a total of 22 key informant interviews were completed. Data were analyzed using ATLAS.ti.v.5.0, a qualitative analytical software program. Although hospitals have infrastructure to respond in the event of a large-scale disaster, well-established disaster preparedness plans have not fully accounted for the needs of children. The general hospitals do not anticipate a surge of pediatric victims in the event of a disaster, and they expect that children will be transported to a children's hospital as their conditions become stable. Even hospitals with well-established disaster preparedness plans have not fully accounted for the needs of children during a disaster. Improved communication between disaster network hospitals is necessary as incorrect information still persists.

Spatiotemporal patterns of childhood asthma hospitalization and utilization in Memphis Metropolitan Area from 2005 to 2015.

Science.gov (United States)

Oyana, Tonny J; Podila, Pradeep; Wesley, Jagila Minso; Lomnicki, Slawo; Cormier, Stephania

2017-10-01

To identify the key risk factors and explain the spatiotemporal patterns of childhood asthma in the Memphis metropolitan area (MMA) over an 11-year period (2005-2015). We hypothesize that in the MMA region this burden is more prevalent among urban children living south, downtown, and north of Memphis than in other areas. We used a large-scale longitudinal electronic health record database from an integrated healthcare system, Geographic information systems (GIS), and statistical and space-time models to study the spatiotemporal distributions of childhood asthma at census tract level. We found statistically significant spatiotemporal clusters of childhood asthma in the south, west, and north of Memphis city after adjusting for key covariates. The results further show a significant increase in temporal gradient in frequency of emergency department (ED) visits and inpatient hospitalizations from 2009 to 2013, and an upward trajectory from 4 per 1,000 children in 2005 to 16 per 1,000 children in 2015. The multivariate logistic regression identified age, race, insurance, admit source, encounter type, and frequency of visits as significant risk factors for childhood asthma (p asthma burden and healthcare utilization for African American (AA) patients living in a high-risk area than those living in a low-risk area in comparison to the white patients: AA vs. white [odds ratio (OR) = 3.03, 95% confidence interval (CI): 2.75-3.34]; and Hispanic vs. white (OR = 1.62, 95% CI: 1.21-2.17). These findings provide a strong basis for developing geographically tailored population health strategies at the neighborhood level for young children with chronic respiratory conditions.

Metropolitan City: the Italian experience

Directory of Open Access Journals (Sweden)

Giuseppe Franco Ferrari

2013-12-01

Full Text Available Due to the fact that the definitions of territorial organization are no longer adequate, the concept of “metropolitan areas” arises as a solution to resolve such deficit. This study shows the beginnings of this figure in Italy and the problems of identification and delimitation caused by the abstraction of the norms, therefore entailing a difficult implementation of the concept of metropolitan cities. By identifying these obstacles, this paper presents an analysis where it is possible to ensure compliance with this new reality in the near future.

Metropolitan Optical Networks 1995 Annual Report

DEFF Research Database (Denmark)

Kristensen, Martin; Jouanno, Jean-Marc; Malone, Kevin

1996-01-01

The annual report describes the research carried out in the ACTS-project METON (Metropolitan Optical Networks) in 1995. L.M. Ericsson is prime contractor and 12 partners including DTU is involved in the project.......The annual report describes the research carried out in the ACTS-project METON (Metropolitan Optical Networks) in 1995. L.M. Ericsson is prime contractor and 12 partners including DTU is involved in the project....

Initiatives towards Carbon Neutrality in the Helsinki Metropolitan Area

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Karna Dahal

2016-07-01

Full Text Available Carbon neutrality represents one climate strategy adopted by many cities, including the city of Helsinki and the Helsinki metropolitan area in Finland. This study examines initiatives adopted by the Helsinki metropolitan area aimed at reducing energy-related carbon emissions and achieving carbon neutrality through future actions. Various sectorial energy consumption rates per year and carbon emissions from various sectors within the city of Helsinki and the metropolitan area were extracted from an online database and re-calculated (in GWh, MWh/inhabitant and MtCO2e, KtCO2e/inhabitant. We employed a backcasting scenario method to explore the various carbon reduction measures in the Helsinki metropolitan area. About 96% of the emissions produced in the Helsinki metropolitan area are energy-based. District heating represents the primary source of emissions, followed by transportation and electricity consumption, respectively. We also found that accomplishing the carbon reduction strategies of the Helsinki metropolitan area by 2050 remains challenging. Technological advancement for clean and renewable energy sources, smart policies and raising awareness resulting in behavioral changes greatly affect carbon reduction actions. Thus, strong political commitments are also required to formulate and implement stringent climate actions.

African urbanization in metropolitan South Africa--differential urbanization perspectives.

Science.gov (United States)

Geyer, H S

1993-07-01

"As a potentially important urban development policy consideration, attention is focused in this paper on differential urbanization trends in South Africa at the metropolitan level. Recent informal urban settlement patterns of the African population within the major metropolitan areas are contrasted against these differential urbanization trends to determine the implications of both for residential development in the metropolitan areas during the post-apartheid era." excerpt

Deprivation and mortality in non-metropolitan areas of England and Wales.

Science.gov (United States)

Jessop, E G

1996-10-01

To test the hypothesis that the relationship between deprivation and mortality is weaker among residents of non-metropolitan areas of England and Wales than among residents of metropolitan areas. This study compared mortality, expressed as standardised mortality ratios (SMRs), in residents of metropolitan and non-metropolitan districts at three levels of deprivation classified by an electoral ward deprivation score and by home and car ownership. SMRs were computed for all causes of death, for bronchitis and asthma (ICD9 codes 490-493), and for accident, violence, and poisoning (ICD9 codes 800-999). England and Wales. Members of the longitudinal study of the Office of Population Censuses and Surveys, a quasi-random 1% sample of the population of England and Wales. There was an association between deprivation and mortality which was clear for all cause mortality, more noticeable for respiratory disease, and less clear for deaths from accident, violence, and poison. In general, the results showed a remarkable similarity between metropolitan and non-metropolitan areas. This study does not support the hypothesis that the relationship between mortality and deprivation differs between residents of metropolitan and non-metropolitan areas of England and Wales.

Alcohol Consumption Reduction Among a Web-Based Supportive Community Using the Hello Sunday Morning Blog Platform: Observational Study.

Science.gov (United States)

Kirkman, Jessica Jane Louise; Leo, Briony; Moore, Jamie Christopher

2018-05-17

Alcohol misuse is a major social and public health issue in Australia, with an estimated cost to the community of Aus $30 billion per annum. Until recently, a major barrier in addressing this significant public health issue is the fact that the majority of individuals with alcohol use disorders and alcohol misuse are not receiving treatment. This study aimed to assess whether alcohol consumption changes are associated with participation in Hello Sunday Morning's blog platform, an online forum discussing experiences in abstaining from alcohol. The study reports on Hello Sunday Morning participants who signed up for a 3-month period of abstinence from November 2009 to November 2016. The sample comprised 1917 participants (female: 1227/1917, 64.01%; male: 690/1917, 35.99%). Main outcome measures were Alcohol Use Disorders Identification Test (AUDIT) scores, mood, program engagement metrics, and slip-ups. Individuals who reported hazardous (preprogram AUDIT mean 11.92, SD 2.25) and harmful consumption levels (preprogram AUDIT mean 17.52, SD 1.08) and who engaged in the Hello Sunday Morning program reported a significant decrease in alcohol consumption, moving to lower risk consumption levels (hazardous, mean 7.59, SD 5.70 and harmful, mean 10.38, SD 7.43), 4 months following program commencement (P<.001). Those who reported high-risk or dependent consumption levels experienced the biggest reduction (preprogram mean 25.38, SD 4.20), moving to risky consumption (mean 15.83, SD 11.11), 4 months following program commencement (P<.001). These reductions in risk were maintained by participants in each group, 7 months following program commencement. Furthermore, those who engaged in the program more (as defined by more sign-ins, blogs posted, check-ins completed, and engagement with the community through likes and following) had lower alcohol consumption. Finally, those who experienced more slip-ups had lower alcohol consumption. Participation in an online forum can support

Analysis of hospital logistics and costs of the Clinical Engineering Sector in a Philanthropic Hospital

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Antônio Artur de Souza

2014-12-01

Full Text Available Hospitals are considered complex organizations mainly due to the high cost of the health care structure employed for care. Reducing operating costs is a challenge for hospital managers. Particularly in the clinical engineering sector, adequate hospital logistics can reduce costs. In this context, the aim of the research was to analyze the activities of hospital logistics of the Clinical Engineering department at a charity hospital, focusing on cost reduction. The paper presents a case study in a large charity hospital located in the metropolitan region of Belo Horizonte, MG. The analysis focuses on the activities of hospital logistics at this hospital clinical engineering sector. The work in this sector is concentrated in the realization and implementation of equipment maintenance, to the detriment of efforts to reduce costs and increase safety for all streams managed by the sector. It was also found that there are risks of increased costs with inadequate routines: (i acquisition of new and large equipment; (ii maintenance and release schedule for use; and (iii the theft of equipment.

Metropolitan Optical Networks 1996 Annual Report

DEFF Research Database (Denmark)

Kristensen, Martin; Jouanno, Jean-Marc; Malone, Kevin

1997-01-01

The report desribes the reasearch carried out in the ACTS-project METON (Metropolitan Optical Networks) in 1996. L.M. Ericsson is prime contractor and 12 partners are involved in the project including DTU, i.e. EMI and MIC.......The report desribes the reasearch carried out in the ACTS-project METON (Metropolitan Optical Networks) in 1996. L.M. Ericsson is prime contractor and 12 partners are involved in the project including DTU, i.e. EMI and MIC....

The influence of population on the economic efficiency of the metropolitan governance

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Yuriy V. Pavlov

2017-01-01

Full Text Available Research purpose. In order to implement the optimal metropolitan governance model, it is important to understand the conditions under which this or that model is economically effective. There is a need to develop a quantitatively justified methodology for choosing the optimal metropolitan governance model for different types of metropolitan areas. It has been emphasized in some federal documents of Russia, for example, in the “Recommendations for the selection of pilot projects for approbation and improvement of mechanisms for managing the development of metropolitan areas in the Russian Federation”.Materials and methods. Domestic researchers (N. Zubarevich, K. Gonchar, etc. and foreign researchers (Glaeser Edward L., Nakamura, Ciccone A., Hall R., etc. carried out the study of quantitative relationships between the economic growth of cities and the characteristics of cities.However, for metropolitan areas, the analysis of the relationship has not yet been implemented between the outpacing economic growth of the metropolitan area relative to the average country values (labor productivity and GDP per capita, the institutional factor (the type of metropolitan governance model, andthe non-institutional factor (population size. To identify the dependencies we are interested in, we used the OECD statistical database and OECD researches to identify the metropolitan governance model in the sample of metropolitan areas in the world. The sample in this research was 87 metropolitan areas in Europe and was divided into groups, depending on the population and the introduced metropolitan governance model. For each group, a correlation-regression analysis was performed and a weighted average was calculated from the indexes of the economic growth. As the leading index of the economic growth, labor productivity was used, as the final - GDP per capita. Then a comparison was made between the real value of economic growth in each surveyed metropolitan area and

Metropolitan planning from an international comparative perspective

DEFF Research Database (Denmark)

Galland, Daniel; Grønning, Marius

2016-01-01

policies, and thus also to the instrumental orientation within planning. A challenge stemming from this comparison is to understand how similar policies are implemented at a strategic and metropolitan level. Within the institutional framework of Copenhagen, the problem with the Finger Plan directive might...... (Faludi & van der Valk, 1994), thus integrating the archetypal land-use character of municipal plans and the strategic and growth-oriented pursuit of regional plans. A number of questions may be deduced: How explicit is the metropolitan scale? How local and how regional is the knowledge basis? Within......Over the last few years new practices of spatial strategy making at different planning scales have emerged. At the metropolitan level, such spatial strategies are reminiscent of national and supranational competitive strategies (e.g. EU policies) as well as ratifications of international...

A tale of two hospitals: assessing cultural landscapes and compositions.

Science.gov (United States)

Braithwaite, Jeffrey; Westbrook, Mary T; Iedema, Rick; Mallock, Nadine A; Forsyth, Rowena; Zhang, Kai

2005-03-01

Clinical directorate service structures (CDs) have been widely implemented in acute settings in the belief that they will enhance efficiency and patient care by bringing teams together and involving clinicians in management. We argue that the achievement of such goals depends not only on changing its formalized structural arrangements but also the culture of the organisation concerned. We conducted comparative observational studies and questionnaire surveys of two large Australian teaching hospitals similar in size, role and CD structure. Martin's conceptualization of culture in terms of integration, differentiation and fragmentation was applied in the analysis of the data. The ethnographic work revealed that compared to Metropolitan Hospital, Royal Hospital was better supported and more favourably viewed by its staff across six categories identified in both settings: leadership, structure, communication, change, finance and human resource management. Royal staff were more optimistic about their organisation's ability to meet future challenges. The surveys revealed that both staff groups preferred CD to traditional structures and shared some favourable and critical views of them. However Royal staff were significantly more positive, reporting many more benefits from CDs e.g. improved working relations, greater accountability and efficiency, better cost management, more devolvement of management to clinicians and a hospital more strategically placed and patient focused. Metropolitan staff were more likely to claim that CDs failed to solve problems and created a range of others including disunity and poor working relationships. There was greater consensus of views among Royal staff and more fragmentation at Metropolitan where both intensely held and uncertain attitudes were more common. The outcomes of implementing CDs in these two similar organisations differed considerably indicating the need to address cultural issues when introducing structural change. Martin

40 CFR 81.17 - Metropolitan Los Angeles Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Regions § 81.17 Metropolitan Los Angeles Air Quality Control Region. The Metropolitan Los Angeles Air Quality Control Region consists of the following territorial area (including the territorial... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Los Angeles Air Quality...

Modeling Metropolitan Detroit transit.

Science.gov (United States)

2010-10-01

"The seven-county Southeast Michigan region, that encompasses the Detroit Metropolitan Area, : ranks fifth in population among top 25 regions in the nation. It also ranks among bottom five in : the transit service provided, measured in miles or hours...

The Last Case and Death of «Moscow Metropolitan» Boris (Rukin: to the Issue of His Suicide

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A. MAZYRIN

2014-02-01

Full Text Available The author investigates circumstances of the last arrest and the death of bishop (in schism — «the Moscow metropolitan» Boris (Rukin in detention in 1931 on the basis of his Case from the documents of the Central archive of FSB of the Russian Federation. The author studies the arrest’s reason (the attempt to bribe a soviet clerk, assorts in details the course of investigation and analyzes its result — death of bishop Boris in the hospital of the Butyrsky insulator. In the article the basic attention was occupied with checking of the official version of church-historical literature about suicide of the bishop. The author considers the death of the prisoner, «the metropolitan Moscow», has followed soon after accusing him of a counterrevolutionary propaganda. It was his words to «churchmen» about the possibility to bribe the Soviet power. Materials of the investigatory case do not contain any data to support the version of suicide. At the same time, they allow to assume the interest of the OGPU bodies in the distribution of this version with the purpose to justify the refusal to give out the body of late «metropolitan» Boris for his church burial. The materials have also indirectly testified to the interest in elimination of «the Moscow metropolitan» of some «churchmen» connecting with him. First of all, it was «metropolitan» Bessarion (Zorin who headed the Gregorian split. He obtained a Boris’s apartment under the decision of VCIK. The article can be useful at drawing up of biographic directories, at writing of historical monographies about the Gregorian split, the Moscow diocese and the Russian Orthodox Church as a whole.

A systematic review of professional supervision experiences and effects for allied health practitioners working in non-metropolitan health care settings

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Ducat WH

2015-08-01

Full Text Available Wendy H Ducat,1,3 Saravana Kumar2 1Cunningham Centre, Darling Downs Hospital and Health Service, Australia; 2School of Health Sciences, International Centre for Allied Health Evidence, Sansom Institute, University of South Australia, Adelaide, SA, Australia; 3Rural Clinical School, School of Medicine, University of Queensland, Brisbane, QLD, Australia Introduction: In regional, rural, and remote settings, allied health professional supervision is one organizational mechanism designed to support and retain the workforce, provide clinical governance, and enhance service delivery. A systematic approach to evaluating the evidence of the experience and effects of professional supervision for non-metropolitan allied health practitioners and their service delivery is needed. Methods: Studies investigating the experience and effects of professional supervision across 17 allied health disciplines in non-metropolitan health services were systematically searched for using standardized keywords across seven databases. The initial search identified 1,574 references. Of these studies, five met inclusion criteria and were subject to full methodological appraisal by both reviewers. Two studies were primarily qualitative with three studies primarily quantitative in their approach. Studies were appraised using McMaster critical appraisal tools and data were extracted and synthesized. Results: Studies reported the context specific benefits and challenges of supervision in non-metropolitan areas and the importance of supervision in enhancing satisfaction and support in these areas. Comparison of findings between metropolitan and non-metropolitan settings within one study suggested that allied health in non-metropolitan settings were more satisfied with supervision though less likely to access it and preferred supervision with other non-metropolitan practitioners over access to more experienced supervisors. One study in a regional health service identified the lack

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

OpenAIRE

Baltazar, J. C.; Tiglao, T. V.; Tempongko, S. B.

1993-01-01

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoe...

Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study

Science.gov (United States)

Robinson, Emily J; Power, Geraldine S; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

2016-01-01

Background Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. Objective To describe IHCA demographics during three day/time periods—weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)—and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. Methods We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Results Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. Conclusions IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during

Hospital capacity and management preparedness for pandemic influenza in Victoria.

Science.gov (United States)

Dewar, Ben; Barr, Ian; Robinson, Priscilla

2014-04-01

This study was designed to investigate acute hospital pandemic influenza preparedness in Victoria, Australia, particularly focussing on planning and management efforts. A prospective study was conducted by questionnaire and semi-structured interview of health managers across the Victorian hospital system from July to October 2011. Participants with responsibility for emergency management, planning and operations were selected from every hospital in Victoria with an emergency department to complete a questionnaire (response rate 22/43 = 51%). Each respondent was invited to participate in a phone-based semi-structured interview (response rate 11/22 = 50%). Rural/regional hospitals demonstrated higher levels of clinical (86%) and non-clinical (86%) staff contingency planning than metropolitan hospitals (60% and 40% respectively). Pandemic plans were not being sufficiently tested in exercises or drills, which is likely to undermine their effectiveness. All respondents reported hand hygiene and standard precautions programs in place, although only one-third (33%) of metropolitan respondents and no rural/regional respondents reported being able to meet patient needs with high levels of staff absenteeism. Almost half Victoria's healthcare workers were unvaccinated against influenza. Hospitals across Victoria demonstrated different levels of influenza pandemic preparedness and planning. If a more severe influenza pandemic than that of 2009 arose, Victorian hospitals would struggle with workforce and infrastructure problems, particularly in rural/regional areas. Staff absenteeism threatens to undermine hospital pandemic responses. Various strategies, including education and communication, should be included with in-service training to provide staff with confidence in their ability to work safely during a future pandemic. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

Effects of long-range transported air pollution from vegetation fires on daily mortality and hospital admissions in the Helsinki metropolitan area, Finland.

Science.gov (United States)

Kollanus, Virpi; Tiittanen, Pekka; Niemi, Jarkko V; Lanki, Timo

2016-11-01

Fine particulate matter (PM 2.5 ) emissions from vegetation fires can be transported over long distances and may cause significant air pollution episodes far from the fires. However, epidemiological evidence on health effects of vegetation-fire originated air pollution is limited, particularly for mortality and cardiovascular outcomes. We examined association between short-term exposure to long-range transported PM 2.5 from vegetation fires and daily mortality due to non-accidental, cardiovascular, and respiratory causes and daily hospital admissions due to cardiovascular and respiratory causes in the Helsinki metropolitan area, Finland. Days significantly affected by smoke from vegetation fires between 2001 and 2010 were identified using air quality measurements at an urban background and a regional background monitoring station, and modelled data on surface concentrations of vegetation-fire smoke. Associations between daily PM 2.5 concentration and health outcomes on i) smoke-affected days and ii) all other days (i.e. non-smoke days) were analysed using Poisson time series regression. All statistical models were adjusted for daily temperature and relative humidity, influenza, pollen, and public holidays. On smoke-affected days, 10µg/m 3 increase in PM 2.5 was associated with a borderline statistically significant increase in cardiovascular mortality among total population at a lag of three days (12.4%, 95% CI -0.2% to 26.5%), and among the elderly (≥65 years) following same-day exposure (13.8%, 95% CI -0.6% to 30.4%) and at a lag of three days (11.8%, 95% CI -2.2% to 27.7%). Smoke day PM 2.5 was not associated with non-accidental mortality or hospital admissions due to cardiovascular causes. However, there was an indication of a positive association with hospital admissions due to respiratory causes among the elderly, and admissions due to chronic obstructive pulmonary disease or asthma among the total population. In contrast, on non-smoke days PM 2.5 was

49 CFR 613.100 - Metropolitan transportation planning and programming.

Science.gov (United States)

2010-10-01

... programming. 613.100 Section 613.100 Transportation Other Regulations Relating to Transportation (Continued... Metropolitan Transportation Planning and Programming § 613.100 Metropolitan transportation planning and programming. The regulations in 23 CFR 450, subpart C, shall be followed in complying with the requirements of...

Planning Assignments of the Italian Metropolitan Cities. Early Trends

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Giuseppe Mazzeo

2017-04-01

Full Text Available The last stage of the process of establishment of the Italian Metropolitan Cities, which took place in 2014, follows of a few decades the start of this institutional reform. In 1990, in fact, the Act 142 (Local Autonomies Reform had planned metropolitan areas as the administrative organization more suitable to provide these territories of structures for the management and the strategic development alike the best international models. The paper proposes to analyse the first activities taken by the Italian Metropolitan Cities in the sector of territorial government, three years after the enactment in 2014 of Act nr. 56.  Focal point of the analysis is the jurisdiction in the formation of two plans (the Strategic Plan and the Metropolitan Territorial Plan and the following relationships among them, in the logical assumption that between them a necessary and strict consistency there should be. In the first part, the paper analyses some factors characterizing the metropolitan areas and the functions that the law assigns to the new institution in the territorial government sector. The second part outlines the updated situation with regard to the formation of the sectoral tools (Strategic Plan, Territorial Plan and homogeneous zones. The third part analyses the progresses in three Metropolitan Cities taken as sample (Milan, Genoa and Bologna and, in general, to those of Southern Italy. In the last part, the paper exposes some considerations regarding the issues raised in the article, particularly about the innovativeness of the tools and the timeline for the implementation of the act.

The impact of heat on mortality and morbidity in the Greater Metropolitan Sydney Region: a case crossover analysis

OpenAIRE

Wilson, Leigh Ann; Gerard Morgan, Geoffrey; Hanigan, Ivan Charles; Johnston, Fay H; Abu-Rayya, Hisham; Broome, Richard; Gaskin, Clive; Jalaludin, Bin

2013-01-01

Background This study examined the association between unusually high temperature and daily mortality (1997?2007) and hospital admissions (1997?2010) in the Sydney Greater Metropolitan Region (GMR) to assist in the development of targeted health programs designed to minimise the public health impact of extreme heat. Methods Sydney GMR was categorized into five climate zones. Heat-events were defined as severe or extreme. Using a time-stratified case-crossover design with a conditional logisti...

40 CFR 81.38 - Metropolitan Houston-Galveston Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Houston-Galveston... Designation of Air Quality Control Regions § 81.38 Metropolitan Houston-Galveston Intrastate Air Quality Control Region. The Metropolitan Houston-Galveston Intrastate Air Quality Control Region (Texas) has been...

Impact of the 2001 Tohoku-oki earthquake to Tokyo Metropolitan area observed by the Metropolitan Seismic Observation network (MeSO-net)

Science.gov (United States)

Hirata, N.; Hayashi, H.; Nakagawa, S.; Sakai, S.; Honda, R.; Kasahara, K.; Obara, K.; Aketagawa, T.; Kimura, H.; Sato, H.; Okaya, D. A.

2011-12-01

The March 11, 2011 Tohoku-oki earthquake brought a great impact to the Tokyo metropolitan area in both seismological aspect and seismic risk management although Tokyo is located 340 km from the epicenter. The event generated very strong ground motion even in the metropolitan area and resulted severe requifaction in many places of Kanto district. National and local governments have started to discuss counter measurement for possible seismic risks in the area taking account for what they learned from the Tohoku-oki event which is much larger than ever experienced in Japan Risk mitigation strategy for the next greater earthquake caused by the Philippine Sea plate (PSP) subducting beneath the Tokyo metropolitan area is of major concern because it caused past mega-thrust earthquakes, such as the 1703 Genroku earthquake (M8.0) and the 1923 Kanto earthquake (M7.9). An M7 or greater (M7+) earthquake in this area at present has high potential to produce devastating loss of life and property with even greater global economic repercussions. The Central Disaster Management Council of Japan estimates that an M7+ earthquake will cause 11,000 fatalities and 112 trillion yen (about 1 trillion US$) economic loss. In order to mitigate disaster for greater Tokyo, the Special Project for Earthquake Disaster Mitigation in the Tokyo Metropolitan Area was launched in collaboration with scientists, engineers, and social-scientists in nationwide institutions. We will discuss the main results that are obtained in the respective fields which have been integrated to improve information on the strategy assessment for seismic risk mitigation in the Tokyo metropolitan area; the project has been much improved after the Tohoku event. In order to image seismic structure beneath the Metropolitan Tokyo area we have developed Metropolitan Seismic Observation network (MeSO-net; Hirata et al., 2009). We have installed 296 seismic stations every few km (Kasahara et al., 2011). We conducted seismic

non-metropolitan stars

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Elena Grigoryeva

2017-06-01

Full Text Available Capitals gather constellations of bright and creative people, attracting them from the peripheries. Tchekhov’s sisters were anxious to get to Moscow, d’Artagnan – to Paris. Evtushenko, Shukshin and Gaidai ascended to the climax of their glory, having moved to the capital. Vampilov, Rasputin and Astafiev became internationally famous without leaving their home grounds, but having joined in the metropolitan whirl. In this regard, the architectural profession differs greatly from the literary and cinematographic ones. The destinies of the masters who fulfilled themselves far from the capital are different but equally bright and unique. The Irkutsk “Varangians”of the sixtieth – Voronezhsky, Bukh and Pavlov – built up their relations with geography in a different way:someone came from the capitals just for a few years that became the brightest, the most fruitful and the most interesting years of his creative life. But someone stayed in the non-metropolitan city for a long time and even forever. This subsection contains certain examples of self-fulfillment in the cities distant from the capitals: Khabarovsk, Irkutsk, Bratsk, Krasnoyarsk, Kemerovo and Anzhero-Sudzhensk.

Smart City, Metropolitan Areas and Competitiveness: the Case Study of Florence

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Carmela Gargiulo

2015-07-01

Full Text Available In several urban contexts, the definition of a new development process is arising and it is focused on the use and the application of new technologies in different areas of the urban system. Such new development process is aimed at increasing life quality and local communities wellness and at promoting the creation of a more efficient and more sustainable urban system, as well as at making it more competitive. The issue of the reorganization of metropolitan areas is combined with such process, following the recent approval of the Delrio Law that establishes the Metropolitan City in Italy, as government authority of the metropolitan areas. Smart City, Metropolitan Areas and Competitiveness are the three topics of this paper, which aim is the description of the most innovative politics and initiatives adopted in the Metropolitan City of Florence that is proposed as a case study where such topics are combined.

Burnout syndrome in dental surgeons from Lima Metropolitan hospitals

OpenAIRE

Robles Velásquez, Ronald; Cáceres Gutiérrez, Lita

2014-01-01

This research was carried out in a probabilistic randomized sample of 117 dental surgeons who work in hospitals from the Armed Forces, Social Security and the Ministry of Health (MINSA) from Lima and El Callao, during the months of March and April 2008. Its objective was to determine the levels of the Burnout Syndrome in this population and its association with some socio-demographic, labor and general health variables. The Maslash Burnout Inventory questionnaire, as well as a personal data s...

40 CFR 81.63 - Metropolitan Fort Smith Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Fort Smith Interstate Air... Air Quality Control Regions § 81.63 Metropolitan Fort Smith Interstate Air Quality Control Region. The Metropolitan Fort Smith Interstate Air Quality Control Region (Arkansas-Oklahoma) has been revised to consist...

Audit of appendicectomies at Frere Hospital | Rogers | South African ...

African Journals Online (AJOL)

Objective. We sought to evaluate the surgical service in the central part of the Eastern Cape Province by reviewing the practice of appendicectomy at Frere Hospital. Specifically, it was our aim to compare the service to those patients who reside in and outside the East London metropolitan area and the outcomes of patients ...

23 CFR 450.336 - Applicability of NEPA to metropolitan transportation plans and programs.

Science.gov (United States)

2010-04-01

... the Secretary concerning a metropolitan transportation plan or TIP developed through the processes... 23 Highways 1 2010-04-01 2010-04-01 false Applicability of NEPA to metropolitan transportation... TRANSPORTATION PLANNING AND RESEARCH PLANNING ASSISTANCE AND STANDARDS Metropolitan Transportation Planning and...

The food environment and adult obesity in US metropolitan areas.

Science.gov (United States)

Michimi, Akihiko; Wimberly, Michael C

2015-11-26

This research examines the larger-scale associations between obesity and food environments in metropolitan areas in the United States (US). The US Census County Business Patterns dataset for 2011 was used to construct various indices of food environments for selected metropolitan areas. The numbers of employees engaged in supermarkets, convenience stores, full service restaurants, fast food restaurants, and snack/coffee shops were standardised using the location quotients, and factor analysis was used to produce two uncorrelated factors measuring food environments. Data on obesity were obtained from the 2011 Behavioral Risk Factor Surveillance System. Individual level obesity measures were linked to the metropolitan area level food environment factors. Models were fitted using generalised estimating equations to control for metropolitan area level intra-correlation and individual level sociodemographic characteristics. It was found that adults residing in cities with a large share of supermarket and full-service restaurant workers were less likely to be obese, while adults residing in cities with a large share of convenience store and fast food restaurant workers were more likely to be obese. Supermarkets and full-service restaurant workers are concentrated in the Northeast and West of the US, where obesity prevalence is relatively lower, while convenience stores and fast-food restaurant workers are concentrated in the South and Midwest, where obesity prevalence is relatively higher. The food environment landscapes measured at the metropolitan area level explain the continental-scale patterns of obesity prevalence. The types of food that are readily available and widely served may translate into obesity disparities across metropolitan areas.

Labor Force Activity of Women in Metropolitan and Nonmetropolitan America. Rural Development Research Report No. 15.

Science.gov (United States)

Brown, David L.; O'Leary, Jeanne M.

Between 1960 and 1970 economic opportunity and progress for women in American non-metropolitan areas was mixed. While women in metropolitan areas were more likely to be labor force members than were non-metropolitan women, the difference in metropolitan and non-metropolitan labor force participation rates narrowed during the period. For women…

Metropolitan vision making - using backcasting as a strategic learning process to shape metropolitan futures

NARCIS (Netherlands)

Neuvonen, A.; Ache, P.M.

2014-01-01

Abstract: The need for new forward looking tools in urban planning is immense: The new functional relations and structures are stretching beyond our capacity to 'rationally' capture modern metropolitan spaces Neuman & Hull 2009). At the same time cities struggle to find tools to help manage a

[Prenatal patient cards and quality of prenatal care in public health services in Greater Metropolitan Vitória, Espírito Santo State, Brazil].

Science.gov (United States)

Santos Neto, Edson Theodoro dos; Oliveira, Adauto Emmerich; Zandonade, Eliana; Gama, Silvana Granado Nogueira da; Leal, Maria do Carmo

2012-09-01

This study aimed to assess the completeness of prenatal care information on the patients' prenatal care cards, according to coverage by various public health services: Family Health Strategy (FHS), Community-Based Health Workers' Program (CBHWP), and traditional Primary Care Units (PCU) in Greater Metropolitan Vitória, Espírito Santo State, Brazil. In a cross-sectional study, 1,006 prenatal cards were randomly selected from postpartum women at maternity hospitals in the metropolitan area. Completeness of the cards was assessed according to the criteria proposed by Romero & Cunha, which measure the quality on a scale from excellent ( 50% incomplete cards). In general, completion of information on the cards was bad (> 20% incomplete), but cards were filled out better in the FHS than in the CBHWP and PCU, especially for tetanus vaccination (p = 0.016) and gestational weight (p = 0.039). In conclusion, the quality of prenatal care in the public health system in Greater Metropolitan Vitória fails to meet the Brazilian national guidelines for maternal and child health.

Exarh of the Bulgarian Church metropolitan Stephen and the Moscow Patriarchy

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Kostriukov Andrei

2013-02-01

Full Text Available The article covers the last period of church-administrative activity of the Sofia’s metropolitan Stephаn (Shokov. The author describes the testimonies of contemporaries about the character and personal qualities of this ambiguous hierarch. In 1945–1948 metropolitan Stephan was the exarch of the Bulgarian Orthodox Church and participated in the Meeting of heads and representatives of Autocephalous Orthodox Churches in 1948. The author considers the circumstances of the dismissal of metropolitan Stephаn and his exile as especially important and interesting ones. The meeting of 1948 became the critical event in the exarch’s destiny. Being the supporter of ecumenism, metropolitan Stephen tried unsuccessfully to convince Patriarch Alexis of his rightness in order not to allow the condemnation of ecumenical contacts by the Moscow meeting. However Moscow looked on ecumenism differently in those days. In Moscow the Soviet management aspired to establishment of the centre of World Orthodoxy and tried to cite the Moscow Patriarchy against Constantinople that was under the influence of the USA and the Great Britain. As the Constantinople Patriarchy approved the ecumenical movement, the Moscow Patriarchy has been forced to take of an opposite position. Therefore, the participation of the Russian Church and Churches of the socialist countries in the ecumenical movement was impossible. Metropolitan Stephan, supporting the superiority of the Moscow Patriarchy in the World Orthodoxy, supported the active participation of all Local Churches in the ecumenical movement. The communistic management applied the maximum force to the exarch in order he has not made undesirable statements at the meeting. The fate of metropolitan Stephan has been decided after this meeting. In 1948 he was fired and exiled. The Moscow Patriarchy did not exclude the possibility of moving of metropolitan Stephаn to Russia and his location in any monastery. However metropolitan

Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study.

Science.gov (United States)

Robinson, Emily J; Smith, Gary B; Power, Geraldine S; Harrison, David A; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

2016-11-01

Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. To describe IHCA demographics during three day/time periods-weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)-and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during weekday daytimes. Organisational or care differences at

78 FR 53270 - Revision of Air Quality Implementation Plan; California; Sacramento Metropolitan Air Quality...

Science.gov (United States)

2013-08-29

... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... to the Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the..., Sacramento Metropolitan Air Quality Management District, Rule 214 (Federal New Source Review), Rule 203...

Small-town migration to metropolitan centres: a case in Peninsular Malaysia.

Science.gov (United States)

Lee Boon Thong

1979-12-01

In Malaysia small towns are an important source of population gowth in metropolitan areas. To provide empirical evidence of the magnitude and roles of small urban centers as complementary sources of population growth in metropolitan areas, a small survey was conducted in 10 small towns in the State of Selangor. Criteria for the selection of these towns include a fair geographical spread over the State, and each area must characteristically possess a dominant urban center. The questionnaires were directed to the heads of 300 households with the intention of investigating the socioeconomic background of the households and the magnitude and characteristics of those members of the households who have migrated elsewhere. The total number of outmigrants from each area varied from 27-57, giving an overall average figure of 1.53 outmigrants/household. About 77% of the outmigrants had moved to the metropolitan centers. As the majority of the metropolitan migrants were more attracted to Kuala Lumpur, Klang, and Petaling Jaya, it may be assumed that the total outmigrants from small towns as derived would have consitituted about 39% of the population in the Klang Valley region. Based on this estimate, the role of small towns in metropolitan population growth is important. In the survey conducted, 2 broad categories of movements were involved: "economic movers," i.e., those who migrated to work or to establish businesses in the metropolitan areas; and "noneconomic movers," i.e., those who moved to continue their studies or to follow their spouses, and so forth. The economic mover stream made up 71% of the total metropolitan migrants. 2 variables--marital status and sex--were significantly related to the economic or noneconomic nature of the metropolitan migrants. The movement of males tended to be associated with economic motives whereas noneconomic reasons for movement tended to be the case among females migrants. The most important occupational group of the economically

Human milk use in Australian hospitals, 1949-1985.

Science.gov (United States)

Thorley, Virginia

2012-07-01

This paper will draw mainly on the experiences of fourteen women to explore the use of expressed human milk by hospitals in Australia from the postwar period through to 1985. The purpose is to provide a snapshot of common practices before the decline of human milk banking and other uses of expressed breastmilk in Australian hospitals, thus providing a source for future comparison against the more rigorous, uniform practices being instituted in the new milk banks of the early-21st century. The ten mothers included were a convenience sample drawn from the author's networks, with recruitment continuing till a range of hospital types and a majority of states were included. Three of the mothers also had experience as trainee midwives and midwives, and four midwives contributed their experiences as staff members, only. The hospitals ranged from large teaching hospitals to small private hospitals and were in metropolitan, regional and country locations. The practices included routine expression and expression for specific purposes, whether for the mother's own baby or to donate. Some hospitals pooled the donor milk for premature or sick babies.

Air pollution holiday effect in metropolitan Kaohsiung

Science.gov (United States)

Tan, P.; Chen, P. Y.

2014-12-01

Different from Taipei, the metropolitan Kaohsiung which is a coastal and industrial city has the major pollution sources from stationary sources such as coal-fired power plants, petrochemical facilities and steel plants, rather than mobile sources. This study was an attempt to conduct a comprehensive and systematical examination of the holiday effect, defined as the difference in air pollutant concentrations between holiday and non-holiday periods, over the Kaohsiung metropolitan area. We documented evidence of a "holiday effect", where concentrations of NOx, CO, NMHC, SO2 and PM10 were significantly different between holidays and non-holidays, in the Kaohsiung metropolitan area from daily surface measurements of seven air quality monitoring stations of the Taiwan Environmental Protection Administration during the Chinese New Year (CNY) and non-Chinese New Year (NCNY) periods of 1994-2010. Concentrations of the five pollutants were lower in the CNY than in the NCNY period, however, that of O3 was higher in the CNY than in the NCNY period and had no holiday effect. The exclusion of the bad air quality day (PSI > 100) and the Lantern Festival Day showed no significant effects on the holiday effects of air pollutants. Ship transportation data of Kaohsiung Harbor Bureau showed a statistically significant difference in the CNY and NCNY period. This difference was consistent with those found in air pollutant concentrations of some industrial and general stations in coastal areas, implying the possible impact of traffic activity on the air quality of coastal areas. Holiday effects of air pollutants over the Taipei metropolitan area by Tan et al. (2009) are also compared.

Printing activity of the Metropolitan Gavriil Banulescu Bodoni

Directory of Open Access Journals (Sweden)

Nicolae Fustei

2013-07-01

Full Text Available The present study is dedicated to the printing activity of the Metropolitan Gavriil Bănulescu-Bodoni’s activity. The religious and secular prints made from Chisinau’s Diocesan typography by Metropolitan Gavriil promote the idea of national unity of people from Moldavia, Wallachia and Transylvania. Due to the new documents from archives, more evidences and „more light” are being spread over the activity of famous hierarch, whose life is linked with the history of culture of three nations – Romanians, Ukrainians and Russians.

Polycentric Structures in Latin American Metropolitan Areas : Identifying Employment Sub-centres

NARCIS (Netherlands)

Fernández-Maldonado, Ana María; Romein, Arie; Verkoren, Otto|info:eu-repo/dai/nl/073181773; Parente Paula Pessoa, Renata

2014-01-01

Fernández-Maldonado A. M., Romein A., Verkoren O. and Parente Paula Pessoa R. Polycentric structures in Latin American metropolitan areas: identifying employment sub-centres, Regional Studies. The significant spatial transformations that have occurred within Latin American metropolitan areas since

Assessment of flood risk in Tokyo metropolitan area

Science.gov (United States)

Hirano, J.; Dairaku, K.

2013-12-01

Flood is one of the most significant natural hazards in Japan. The Tokyo metropolitan area has been affected by several large flood disasters. Therefore, investigating potential flood risk in Tokyo metropolitan area is important for development of adaptation strategy for future climate change. We aim to develop a method for evaluating flood risk in Tokyo Metropolitan area by considering effect of historical land use and land cover change, socio-economic change, and climatic change. Ministry of land, infrastructure, transport and tourism in Japan published 'Statistics of flood', which contains data for flood causes, number of damaged houses, area of wetted surface, and total amount of damage for each flood at small municipal level. By using these flood data, we estimated damage by inundation inside a levee for each prefecture based on a statistical method. On the basis of estimated damage, we developed flood risk curves in the Tokyo metropolitan area, representing relationship between damage and exceedance probability of flood for the period 1976-2008 for each prefecture. Based on the flood risk curve, we attempted evaluate potential flood risk in the Tokyo metropolitan area and clarify the cause for regional difference of flood risk. By analyzing flood risk curves, we found out regional differences of flood risk. We identified high flood risk in Tokyo and Saitama prefecture. On the other hand, flood risk was relatively low in Ibaraki and Chiba prefecture. We found that these regional differences of flood risk can be attributed to spatial distribution of entire property value and ratio of damaged housing units in each prefecture.We also attempted to evaluate influence of climate change on potential flood risk by considering variation of precipitation amount and precipitation intensity in the Tokyo metropolitan area. Results shows that we can evaluate potential impact of precipitation change on flood risk with high accuracy by using our methodology. Acknowledgments

Metropolization Process for enhancing local and regional planning : an experience of cirebon metropolitan, West Java

Science.gov (United States)

Supriyadi Rustidja, E.

2018-03-01

Metropolitan develops in line with resource utilization, investment, and transactions of regional activities. Metropolization of an area gives emerge urban economy that changes the situation, form, and pattern of urban space interactions. On the other hand, metropolism concerns the strategy of changing variation of urban space, so that metropolitan invasion not only form of urban space but also the process of interaction among stakeholders in developing metropolitan area. Based on participatory research, this article explores metropolitan invasion process for enhancing local and regional planning, both indigenous and intrusive cataclysmic. The study find that the primeval, rural, and urban as elemental environment must be considered in developing metropolitan, not merely form the structure and pattern of urban space. The metropolization process also requires the strategic of rural urban linkage, context setting and local assessment, strategic community investment, and interculturalist approach. The other findings of the study show that metropolization in Cirebon Metropolitan, West Java emphasizing on promotion of competitiveness strategy, value chain urban activities, and networking of urban areas. Cirebon Metropolitan must promote the realization of growth centers and connect the interregional activities of metropolitan area for providing sustainable economic growth.

40 CFR 81.43 - Metropolitan Toledo Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.43 Section 81.43 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.43 Metropolitan Toledo Interstate Air Quality Control Region. The Metropolitan Toledo Interstate Air Quality Control Region (Ohio-Michigan) consists of the territorial area...

40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.31 Section 81.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

40 CFR 81.78 - Metropolitan Portland Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.78 Section 81.78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.78 Metropolitan Portland Intrastate Air Quality Control Region. The Metropolitan Portland Intrastate Air Quality Control Region (Maine) consists of the territorial area...

40 CFR 81.16 - Metropolitan Denver Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.16 Section 81.16 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.16 Metropolitan Denver Intrastate Air Quality Control Region. The Metropolitan Denver Intrastate Air Quality Control Region (Colorado) consists of the territorial area...

40 CFR 81.29 - Metropolitan Indianapolis Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Air Quality Control Region. 81.29 Section 81.29 Protection of Environment ENVIRONMENTAL PROTECTION... Designation of Air Quality Control Regions § 81.29 Metropolitan Indianapolis Intrastate Air Quality Control Region. The Metropolitan Indianapolis Intrastate Air Quality Control Region consists of the territorial...

40 CFR 81.101 - Metropolitan Dubuque Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.101 Section 81.101 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.101 Metropolitan Dubuque Interstate Air Quality Control Region. The Metropolitan Dubuque Interstate Air Quality Control Region (Illinois-Iowa-Wisconsin) consists of the...

40 CFR 81.44 - Metropolitan Memphis Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.44 Section 81.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.44 Metropolitan Memphis Interstate Air Quality Control Region. The Metropolitan Memphis Interstate Air Quality Control Region (Arkansas-Mississippi-Tennessee) consists of the...

40 CFR 81.19 - Metropolitan Boston Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.19 Section 81.19 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.19 Metropolitan Boston Intrastate Air Quality Control Region. The Metropolitan Boston Intrastate Air Quality Control Region (Massachusetts) consists of the territorial area...

40 CFR 81.28 - Metropolitan Baltimore Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.28 Section 81.28 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.28 Metropolitan Baltimore Intrastate Air Quality Control Region. The Metropolitan Baltimore Intrastate Air Quality Control Region (Maryland) consists of the territorial area...

40 CFR 81.89 - Metropolitan Cheyenne Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.89 Section 81.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.89 Metropolitan Cheyenne Intrastate Air Quality Control Region. The Metropolitan Cheyenne Intrastate Air Quality Control Region (Wyoming) consists of the territorial area...

40 CFR 81.87 - Metropolitan Boise Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.87 Section 81.87 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.87 Metropolitan Boise Intrastate Air Quality Control Region. The Metropolitan Boise Intrastate Air Quality Control Region (Idaho) consists of the territorial area encompassed...

40 CFR 81.75 - Metropolitan Charlotte Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.75 Section 81.75 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.75 Metropolitan Charlotte Interstate Air Quality Control Region. The Metropolitan Charlotte Interstate Air Quality Control Region (North Carolina-South Carolina) has been revised...

40 CFR 81.45 - Metropolitan Atlanta Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.45 Section 81.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.45 Metropolitan Atlanta Intrastate Air Quality Control Region. The Metropolitan Atlanta Intrastate Air Quality Control Region (Georgia) has been revised to consist of the...

40 CFR 81.20 - Metropolitan Cincinnati Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.20 Section 81.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.20 Metropolitan Cincinnati Interstate Air Quality Control Region. The Metropolitan Cincinnati Interstate Air Quality Control Region (Ohio-Kentucky-Indiana) is revised to consist of...

40 CFR 81.34 - Metropolitan Dayton Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.34 Section 81.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.34 Metropolitan Dayton Intrastate Air Quality Control Region. The Metropolitan Dayton Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.41 Section 81.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

40 CFR 81.14 - Metropolitan Chicago Interstate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.14 Section 81.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.14 Metropolitan Chicago Interstate Air Quality Control Region. The Metropolitan Chicago Interstate Air Quality Control Region (Illinois-Indiana) is revised to consist of the...

Telehealth-based model of care redesign to facilitate local fitting and management of patients with a spinal fracture requiring a thoracic lumbar sacral orthosis in rural hospitals in New South Wales.

Science.gov (United States)

Gallagher, Ryan; Giles, Michelle; Morison, Jane; Henderson, Judith

2018-03-23

To develop and implement a telehealth-based model of care for spinal fractures requiring management with thoracic lumbar sacral orthoses that eliminates the need for transfer to a metropolitan tertiary referral hospital. Pre-post design observational study evaluating model of care implementation. Rural referral hospitals in a large NSW region covering metropolitan, rural and remote hospitals. Patients presenting with a thoracic or lumbar spine fracture requiring thoracic lumbar sacral orthoses management and rural clinicians caring for them. Number of patients managed in rural hospitals without transfer to a metropolitan tertiary referral hospital; length of stay and related cost efficiencies; clinicians' perceived skills, knowledge and confidence levels. Model of care was implemented with clinical and system governance processes; and educational workshops across eight rural hospitals. A total of 81 patients managed in rural hospitals under this model between July 2013 and June 2016 without transfer were included in this study. Mean length of stay reduced from nine to four days. Hospital transfers were eliminated from the patient journey, totalling 24 324 km. Workshops were attended by 71 clinicians from nine rural hospitals and survey findings indicated a significant increase in staff knowledge, skill and confidence post education. Cost efficiencies were gained by eliminating 162 inter-hospital transfers and 405 patient bed days. This model has streamlined patient journeys and reduced transfers and travel, enabling rural clinicians to provide specialised services in local communities and facilitating timely evidence-based care in local communities without any adverse events. © 2018 National Rural Health Alliance Ltd.

Spatial clustering of knowledge-based industries in the Helsinki Metropolitan Area

Directory of Open Access Journals (Sweden)

Juan Eduardo Chica

2016-01-01

Full Text Available The central locations of metropolitan areas have some specific attributes, leading to an accumulation of large knowledge exchanges and extensive knowledge externalities, which encourage the concentration of various economic activities, especially knowledge-based industries (KBI. Other agglomeration economies found in metropolitan areas – such as telecommunications and transport infrastructures connected to global productive circuits and complementary labour markets – are key factors for KBI employment growth. This paper explores the Helsinki Metropolitan Area’s (HMA spatial clustering of KBI at the sub-district level, and the role played by agglomeration economies (both specialization and diversity economies in fostering this process. The results reveal that KBI employment shows patterns of concentration in the core and adjacent areas. The specialization and diversity economies found in the metropolitan core and the specialization economies found in others areas lead to KBI spatial clustering in the HMA. Public policies regarding the promotion of science parks have also played a decisive role.

URBANIZATION AND SPATIAL CHANGES IN DEMOGRAPHIC CHARACTERISTICS IN MONTERREY METROPOLITAN REGION

Directory of Open Access Journals (Sweden)

Arun Kumar Acharya

2011-10-01

Full Text Available This paper tries to explore the process of urbanization and spatial changes in demographic features in the Monterrey Metropolitan Region (MMR, Mexico. This city is the third largest urban sector in Mexico which has around 4 million population. It is also the industrial and economic capital of the country. The present study found that rapid urbanization in the metropolitan region has a close association with process of industrialization. In population distribution and composition, study found that the metropolitan region had its “demographic transition” during the years seventies and currently the region is taking advantages of demographic bonus cohort, i.e. a higher concentration of population in economic active groups compare to children and old age population. However, this paper indentified a higher imbalance in metropolitan demographic scenario. On the one hand, there is di-populization in the city center region and in other there is a steady increment of population in peri-urban region.

Acute adverse effects of radiation therapy on HIV-positive patients in Japan. Study of 31 cases at Tokyo Metropolitan Komagome Hospital

International Nuclear Information System (INIS)

Kaminuma, Takuya; Karasawa, Katsuyuki; Hanyu, Nahoko

2010-01-01

Recently, the number of human immunodeficiency virus (HIV)-positive patients has increased in Japan. HIV-positive patients are at a higher risk of cancer than the general population. This paper retrospectively reports the acute adverse effects of radiation therapy on HIV-positive patients who were treated at Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital (TMCICK). Thirty-one cases involving 24 HIV-positive cancer patients who were treated at TMCICK from January 1997 to March 2009 were included in this study. All acute adverse effects of radiation therapy were examined during, and one month after, the last radiation therapy session. Acute adverse effects were classified according to the site of radiation therapy treatment and analyzed using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. Grade 3 acute adverse effects were seen in 17% of cases, and Grade 2 toxicities were found in 23% of patients. Damage to the skin and mucosa, including stomatitis or diarrhea, tended to occur after low-dose radiation therapy; however, no severe acute adverse effects were seen in other organs, such as the brain, lung, and bone. Acute adverse effects tended to occur earlier in HIV-positive patients and became severe more frequently than in the general population. In particular, disorders of the mucosa, such as those of the oral cavity, pharynx, and intestine, tended to occur rapidly. It was shown that radiation therapy is safe when treatment is performed carefully and that it is a very useful treatment for cancer in HIV-positive patients. (author)

Implications of urban structure on carbon consumption in metropolitan areas

International Nuclear Information System (INIS)

Heinonen, Jukka; Junnila, Seppo

2011-01-01

Urban structure influences directly or indirectly the majority of all green house gas (GHG) emissions in cities. The prevailing belief is that dense metropolitan areas produce less carbon emissions on a per capita basis than less dense surrounding rural areas. Consequently, density targets have a major role in low-carbon urban developments. However, based on the results of this study, the connection seems unclear or even nonexistent when comprehensive evaluation is made. In this letter, we propose a hybrid life cycle assessment (LCA) method for calculating the consumption-based carbon footprints in metropolitan areas, i.e. carbon consumption, with the emphasis on urban structures. The method is input-output-based hybrid LCA, which operates with the existing data from the region. The study is conducted by performing an analysis of the carbon consumption in two metropolitan areas in Finland, including 11 cities. Both areas consist of a dense city core and a less dense surrounding suburban area. The paper will illustrate that the influence of urban density on carbon emissions is insignificant in the selected metropolitan areas. In addition, the utilized consumption-based method links the climate effects of city-level development to the global production of emissions.

Towards a Metropolitan Fundamental Diagram Using Travel Survey Data

Science.gov (United States)

2016-01-01

Using travel diary data from 2000–2001 and 2010–2012 this research examines fundamental traffic relationships at the metropolitan level. The results of this paper can help to explain the causes of some traffic phenomena. Network average speed by time of day can be explained by trip length and cumulative number of vehicles on the road. A clockwise hysteresis loop is found in the Metropolitan Fundamental Diagram in the morning period and a reverse process happens in the afternoon. PMID:26866913

Outpatient admissions and hospital costs of Syrian refugees in a Turkish university hospital.

Science.gov (United States)

Tahirbegolli, Bernard; Çavdar, Sabanur; Çetinkaya Sümer, Esin; Akdeniz, Sıdıka I; Vehid, Suphi

2016-07-01

To examine the most frequent admitted polyclinics, diagnoses, and the costs of Syrian refugee patient in a Turkish university hospital in the metropolitan city of Istanbul, Western part of Turkey.  Research methodology consist of analyzing outpatient admissions to the Hospital Polyclinics of Faculty of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey from January-June 2014. We carried out diagnosis groups as classified in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, and analyzed the hospital cost of first admission through records based in the hospital information system.  Median age of 251 Syrian refugee patients is 19 years, inter quartile rate 7-34 years. Patients aged 65 and older compared with those until 18 years and 19 to 64 years aged groups have made statistically significant (p less than 0.001) less hospital admissions. The Most frequented clinic was the emergency clinic. On June there have been significantly (p less than 0.001) more admissions compared with other months. The most common diagnoses were diseases of the respiratory system. The costs of per admission was estimated nearly 48 US Dollar/per patient and the total amount of hospital admissions was 12,031.93 US Dollar.  On the specified dates, the clinics were mostly frequented from Syrian refugees until 18 years group. The most common presenting symptoms are respiratory diseases and most frequented clinic is emergency.

Metropolitan Quantum Key Distribution with Silicon Photonics

Science.gov (United States)

Bunandar, Darius; Lentine, Anthony; Lee, Catherine; Cai, Hong; Long, Christopher M.; Boynton, Nicholas; Martinez, Nicholas; DeRose, Christopher; Chen, Changchen; Grein, Matthew; Trotter, Douglas; Starbuck, Andrew; Pomerene, Andrew; Hamilton, Scott; Wong, Franco N. C.; Camacho, Ryan; Davids, Paul; Urayama, Junji; Englund, Dirk

2018-04-01

Photonic integrated circuits provide a compact and stable platform for quantum photonics. Here we demonstrate a silicon photonics quantum key distribution (QKD) encoder in the first high-speed polarization-based QKD field tests. The systems reach composable secret key rates of 1.039 Mbps in a local test (on a 103.6-m fiber with a total emulated loss of 9.2 dB) and 157 kbps in an intercity metropolitan test (on a 43-km fiber with 16.4 dB loss). Our results represent the highest secret key generation rate for polarization-based QKD experiments at a standard telecom wavelength and demonstrate photonic integrated circuits as a promising, scalable resource for future formation of metropolitan quantum-secure communications networks.

Metropolitan siting: a historical perspective

International Nuclear Information System (INIS)

Bunch, D.F.

1978-09-01

The paper discusses the development and implementation of the Reactor Site Criteria and particularly the evolving posture of the agency on the subject of metropolitan siting. The review actions on nine sites are described to illustrate the various issues and positions and to clarify at least some of the bases for current practices of the NRC staff

Disparities experienced by Aboriginal compared to non-Aboriginal metropolitan Western Australians in receiving coronary angiography following acute ischaemic heart disease: the impact of age and comorbidities.

Science.gov (United States)

Lopez, Derrick; Katzenellenbogen, Judith M; Sanfilippo, Frank M; Woods, John A; Hobbs, Michael S T; Knuiman, Matthew W; Briffa, Tom G; Thompson, Peter L; Thompson, Sandra C

2014-10-21

Aboriginal Australians have a substantially higher frequency of ischaemic heart disease (IHD) events than their non-Aboriginal counterparts, together with a higher prevalence of comorbidities. The pattern of health service provision for IHD suggests inequitable delivery of important diagnostic procedures. Published data on disparities in IHD management among Aboriginal Australians are conflicting, and the role of comorbidities has not been adequately delineated. We compared the profiles of Aboriginal and non-Aboriginal patients in the metropolitan area undergoing emergency IHD admissions at Western Australian metropolitan hospitals, and investigated the determinants of receiving coronary angiography. Person-linked administrative hospital and mortality records were used to identify 28-day survivors of IHD emergency admission events (n =20,816) commencing at metropolitan hospitals in 2005-09. The outcome measure was receipt of angiography. The Aboriginal to non-Aboriginal risk ratio (RR) was estimated from a multivariable Poisson log-linear regression model with allowance for multiple IHD events in individuals. The subgroup of myocardial infarction (MI) events was modelled separately. Compared with their non-Aboriginal counterparts, Aboriginal IHD patients were younger and more likely to have comorbidities. In the age- and sex-adjusted model, Aboriginal patients were less likely than others to receive angiography (RRIHD 0.77, 95% CI 0.72-0.83; RRMI 0.81, 95% CI 0.75-0.87) but in the full multivariable model this disparity was accounted for by comorbidities as well as IHD category and MI subtype, and private health insurance (RRIHD 0.95, 95% CI 0.89-1.01; RRMI 0.94, 95% CI 0.88-1.01). When stratified by age groups, this disparity was not significant in the 25-54 year age group (RRMI 0.95, 95% CI 0.88-1.02) but was significant in the 55-84 year age group (RRMI 0.88, 95% CI 0.77-0.99). The disproportionate under-management of older Aboriginal IHD patients is of

Non-metropolitan residential gated developments in the Western Cape Province, South Africa

CSIR Research Space (South Africa)

Spocter, M

2011-07-01

Full Text Available -metropolitan locale and the topic is also unexplored in the South African context. This research attempts to address this research gap by investigating the locations of gated developments in non-metropolitan towns of varying sizes in the Western Cape...

Political apathy amongst students: A case study of Nelson Mandela Metropolitan University

Directory of Open Access Journals (Sweden)

Ntsikelelo B. Breakfast

2017-09-01

Full Text Available The primary motivation for this research, in which a qualitative method was employed, was to examine political apathy amongst students at Nelson Mandela Metropolitan University. The secondary motivation was to question whether youth political apathy threatens the consolidation of democracy. The researchers arranged four focus groups at Nelson Mandela Metropolitan University. A purposive sampling technique was utilised. All 50 participants in the study were Nelson Mandela Metropolitan University undergraduate and postgraduate black students, with ages ranging from 21 to 35 years. The researchers encouraged participants to have maximum participation in the focus group deliberations. The researchers also made use of elite interviews in the study. The findings of this study suggest that political apathy does exist amongst students at Nelson Mandela Metropolitan University. Most of the participants in the focus groups indicated that young people in post-apartheid South Africa have no interest in politics.

The diffusion of Magnet hospital recognition.

Science.gov (United States)

Abraham, Jean; Jerome-D'Emilia, Bonnie; Begun, James W

2011-01-01

Magnet recognition is promoted by many in the practice community as the gold standard of nursing care quality. The Magnet hospital population has exploded in recent years, with about 8% of U.S. general hospitals now recognized. The purpose of this study was to identify the characteristics that distinguish Magnet-recognized hospitals from other hospitals within the framework of diffusion theory. We conceptualize Magnet recognition as an organizational innovation and Magnet-recognized hospitals as adopters of the innovation. We hypothesize that adoption is associated with selected characteristics of hospitals and their markets. The study population consists of the 3,657 general hospitals in the United States in 2008 located in metropolitan or micropolitan areas. We used logistic regression analysis to estimate the association of Magnet recognition with organizational and market characteristics. Empirical results support hypotheses that adoption is positively associated with hospital complexity and specialization, as measured by teaching affiliation, and with hospital size, slack resources, and not-for-profit or public ownership (vs. for-profit). Adopters also are more likely to be located in markets that are experiencing population growth and are more likely to have competitor hospitals within the market that also have adopted Magnet status. A positive association of adoption with baccalaureate nursing school supply is contrary to the hypothesized relationship. Because of its rapid recent growth, consideration of Magnet program recognition should be on the strategic planning agenda of hospitals and hospital systems. Hospital administrators, particularly in smaller, for-profit hospitals, may expect more of their larger not-for-profit competitors, particularly teaching hospitals, to adopt Magnet recognition, increasing competition for baccalaureate-prepared registered nurses in the labor market.

Comparison of daytime and night-time populations adjacent to interstate highways in metropolitan areas

International Nuclear Information System (INIS)

Mills, G.S.; Neuhauser, K.S.

1999-01-01

Daytime and night-time population densities bordering Interstate highway routes in metropolitan areas are compared at the traffic analysis zone level. In three of the metropolitan areas studied, histograms of daytime to night-time population density ratios are peaked at 1.0. In a smaller metropolitan area, the peak of the histogram moves to values greater than 1.0 but less than 2.0. In view of the typical uncertainties in calculating radiological transport effects (∼2), this study indicates that a distinction between daytime and night-time transport is not warranted, especially since a typical route includes extensive transport outside metropolitan areas. (author)

Green Infrastructure Concept for JABODETABEKJUR Metropolitan Area

Science.gov (United States)

Tanuwidjaja, Gunawan; Gates Chang, Bill

2017-07-01

Sixty “Mega Cities” would emerge by 2015 catering of 600 million populations, and were threatened by the climate change, because of cyclones, flooding, etc. Jakarta became a metro region covering Jakarta, Bogor, Tangerang, Bekasi, Depok and Cianjur. Jakarta metropolitan faced the very high population growth, urban sprawling, traffic jams, flooding, green open space reduction, environmental degradation, urban slums and illegal street hawkers. Flooding and traffic congestions were the two most important issues to solve. SWOT analysis and urban design solutions were produced to create a sustainable solution. Related to transportation issues, Singapore Mass Rapid Transport (MRT) concept was evaluated. Meanwhile the Netherlands’ polder concept as well as Singapore’s Integrated Water Management were also analyzed. The development of above ground MRT as well as Busway could be developed to connect Jakarta Metropolitan Region. The networks were developed on the main toll road networks. The MRT and Busway would eventually replace the need of automobile use in the future. The Transit - Oriented - Development (TOD) with high density can be suggested to be concentrated nearby the MRT and Busway interchange stations. The Netherlands’ polder and were adopted for urban’ low-lying lands in Jakarta Metropolitan Region, A polder system was defined as the Integrated Man-made Drainage System consisting Dikes, Drains, Retention Ponds, Outfall Structures or Pumping Stations. The polder system was proposed to be extended to Tangerang and Bekasi area.

Factors Influencing Patronage Of Medical Tourism In Metropolitan Lagos Nigeria

Directory of Open Access Journals (Sweden)

Omisore

2015-08-01

Full Text Available Since medical tourism attract patient from various origin to seek medical services at different destinations it is paramount to consider the factors that motivate patrons decision on medical tourism. Hence this study assesses the factors influencing patronage of medical tourism in Lagos metropolis Nigeria. Lagos State is situated in the southwestern corner of Nigeria it lies within Latitudes 62N to 64N of the Equator and Longitudes 245E to 420E of the Greenwich meridian. Metropolitan Lagos is a statistical division and not an administrative unit it extends over 16 of the 20 LGAs of Lagos State it contains 88 of the population of Lagos State and includes semi-rural areas. Data were collected from primary source. Primary data collection was carried out through the use of structured questionnaire. Systematic sampling technique was employed to select 15 specialized private hospitals and 14 Public hospitals in the study area resulting to a sample size of 29 hospitals. Ten 10 patrons were contacted in each of the selected hospitals consequently 290 patrons were sampled. The study revealed three factors influencing patronage of medical tourism in the study area to be service related economic and facilities. These were further established by factor analysis result which combine service related economic factor as factor one with 29.5 variance explained and Eigen value of 5.605 Facility factor as factor two with 28.6 variance explained and Eigen value of 5.435 Service related factor as factor three with 14.7 variance explained and Eigen value of 2.788 and Economic factor as factor four with 9.2 variance explained and Eigen value of 1.754. The relevant authority in charge of health facilities in the study area would have to employ adequate manpower in-terms of doctors and other healthcare personnel across the public hospital while also regulating the scale of charges of the registered private hospitals in the study area. There is need to improve upon the

The metropolitan VoD system based on ethernet/SCM PON

Science.gov (United States)

Ji, Wei; Yang, Hongliang; Feng, Dejun; Liu, Yang; Sun, Jande

2008-11-01

VoD is a very attractive service which used for entertainment, education and other purposes. In this paper, we present an evolution method that integrates the EPON and SCM-PON by WDM technology to provide high dedicated bandwidth for the metropolitan VoD services. Using DVB, IPTV protocol, unicasting and broadcasting method to maximize the system throughput and by numerical analysis, the hybrid PON system can implement the metropolitan VoD services.

Polycentric Metropolitan Form: Application of a ‘Northern’ Concept in Latin America

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Arie Romein

2014-07-01

Full Text Available Since the mid 20th century, large urban areas in advanced economies have experienced a fundamental transformation from relatively compact monocentric cities towards more extended polycentric metropolitan areas. By now, it is being commented repeatedly, but not investigated systematically that the concept of polycentricity is also adequate to characterise recent metropolitan dynamics in Latin-America.This paper aims to present a few key-issues for a future research agenda into polycentricity in Latin-American metropolitan areas. These elements are identified from a review of existing literature. Since no clear-cut definition and operationalisation of polycentricity exist yet, we distinguish some key-elements of this phenomenon in North America as a frame of reference for this review. It reveals that ‘polycentricity U.S. style’ is at best dawning in Latin-America. In order to achieve a more appropriate picture of polycentricity of Latin American metropolitan areas, our ideas for a research agenda take into account these areas typical economic, social and spatial conditions.

Metropolitan Quantum Key Distribution with Silicon Photonics

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Darius Bunandar

2018-04-01

Full Text Available Photonic integrated circuits provide a compact and stable platform for quantum photonics. Here we demonstrate a silicon photonics quantum key distribution (QKD encoder in the first high-speed polarization-based QKD field tests. The systems reach composable secret key rates of 1.039 Mbps in a local test (on a 103.6-m fiber with a total emulated loss of 9.2 dB and 157 kbps in an intercity metropolitan test (on a 43-km fiber with 16.4 dB loss. Our results represent the highest secret key generation rate for polarization-based QKD experiments at a standard telecom wavelength and demonstrate photonic integrated circuits as a promising, scalable resource for future formation of metropolitan quantum-secure communications networks.

Rural hospital ownership: medical service provision, market mix, and spillover effects.

Science.gov (United States)

Horwitz, Jill R; Nichols, Austin

2011-10-01

To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. © Health Research and Educational Trust.

Hospital emergency on-call coverage: is there a doctor in the house?

Science.gov (United States)

O'Malley, Ann S; Draper, Debra A; Felland, Laurie E

2007-11-01

The nation's community hospitals face increasing problems obtaining emergency on-call coverage from specialist physicians, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. The diminished willingness of specialist physicians to provide on-call coverage is occurring as hospital emergency departments confront an ever-increasing demand for services. Factors influencing physician reluctance to provide on-call coverage include decreased dependence on hospital admitting privileges as more services shift to non-hospital settings; payment for emergency care, especially for uninsured patients; and medical liability concerns. Hospital strategies to secure on-call coverage include enforcing hospital medical staff bylaws that require physicians to take call, contracting with physicians to provide coverage, paying physicians stipends, and employing physicians. Nonetheless, many hospitals continue to struggle with inadequate on-call coverage, which threatens patients' timely access to high-quality emergency care and may raise health care costs.

Sources of funding for adult and paediatric CT procedures at a metropolitan tertiary hospital: How much do Medicare statistics really cover?

Science.gov (United States)

Hayton, Anna; Wallace, Anthony; Johnston, Peter

2015-12-01

The radiation dose to the Australian paediatric population as a result of medical imaging is of growing concern, in particular the dose from CT. Estimates of the Australian population dose have largely relied on Medicare Australia statistics, which capture only a fraction of those imaging procedures actually performed. The fraction not captured has been estimated using a value obtained for a survey of the adult population in the mid-1990s. To better quantify the fraction of procedures that are not captured by Medicare Australia, procedure frequency and funding data for adult and paediatric patients were obtained from a metropolitan tertiary teaching and research hospital. Five calendar years of data were obtained with a financial class specified for each individual procedure. The financial classes were grouped to give the percentage of Medicare Australia billable procedures for both adult and paediatric patients. The data were also grouped to align with the Medicare Australia age cohorts. The percentage of CT procedures billable to Medicare Australia increased from 16% to 28% between 2008 and 2012. In 2012, the percentage billable for adult and paediatric patients was 28% and 33%, respectively; however, many adult CT procedures are performed at stand-alone clinics, which bulk bill. Using Medicare Australia statistics alone, the frequency of paediatric CT procedures performed on the Australian paediatric population will be grossly under estimated. A correction factor of 4.5 is suggested for paediatric procedures and 1.5 for adult procedures. The fraction of actual procedures performed that are captured by Medicare Australia will vary with time. © 2015 The Royal Australian and New Zealand College of Radiologists.

Hospital emergency preparedness and response during Superstorm Sandy.

Science.gov (United States)

2015-01-01

This article presents the findings of a report by the HHS Office of Inspector General (OIG) on the performance of 172 Medicare-certified hospitals in the New York Metropolitan Area before, during, and after Sandy. It makes recommendations on how to close gaps that were found in emergency planning and execution for a disaster of this magnitude. To download the complete 40-page report and a Podcast based on it, go to http://oig.hhs.gov/oei/ reports/oei-06-13-00260. asp.

Area Median Income and Metropolitan Versus Nonmetropolitan Location of Care for Acute Coronary Syndromes: A Complex Interaction of Social Determinants.

Science.gov (United States)

Fabreau, Gabriel E; Leung, Alexander A; Southern, Danielle A; James, Matthew T; Knudtson, Merrill L; Ghali, William A; Ayanian, John Z

2016-02-23

Metropolitan versus nonmetropolitan status and area median income may independently affect care for and outcomes of acute coronary syndromes. We sought to determine whether location of care modifies the association among area income, receipt of cardiac catheterization, and mortality following an acute coronary syndrome in a universal health care system. We studied a cohort of 14 012 acute coronary syndrome patients admitted to cardiology services between April 18, 2004, and December 31, 2011, in southern Alberta, Canada. We used multivariable logistic regression to determine the odds of cardiac catheterization within 1 day and 7 days of admission and the odds of 30-day and 1-year mortality according to area median household income quintile for patients presenting at metropolitan and nonmetropolitan hospitals. In models adjusting for area income, patients who presented at nonmetropolitan facilities had lower adjusted odds of receiving cardiac catheterization within 1 day of admission (odds ratio 0.22, 95% CI 0.11-0.46, Pcommunities. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Regional differences in commuting activities of inhabitants in the Tokyo metropolitan suburb

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Masaki Kawase

2004-12-01

Full Text Available The purpose of this study is to elucidate gender differences and regional differences of co-mmuting activities by inhabitants in Japanese metropolitan suburbs. I found the different parts by districts in the metropolitan suburb. Regional factors cause gender differences in commuting activities and result in regional differences: In residential areas, inhabitants who work in metropolitan centers occupy much of the population. In older built-up areas, there are many “local” persons. In rural areas, motorization is progressing because access to rail-roads has been inconvenient. These regional factors influence the behavioral characteristics of commuting by married men, married women, never married men and never married women.

An indoor radon survey of the X-ray rooms of Mexico City hospitals

Energy Technology Data Exchange (ETDEWEB)

Juarez, Faustino [Facultad de Ciencias, Universidad Autonoma del Estado de Mexico, Instituto Literario No. 100. Estado de Mexico, 50000, Mexico. Instituto de Geofisica, Universidad Nacional Autonoma de Mexico, Circuito (Mexico); Reyes, Pedro G. [Facultad de Ciencias, Universidad Autonoma del Estado de Mexico, Instituto Literario No. 100. Estado de Mexico, 50000 (Mexico); Espinosa, Guillermo [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, Circuito Exterior Ciudad Universitaria, Mexico D.F. Cp.04510 (Mexico)

2013-07-03

This paper presents the results of measurements of indoor radon concentrations in the X-ray rooms of a selection of hospitals in the metropolitan area of Mexico City. The metropolitan area of Mexico City is Mexico's largest metropolitan area by population; the number of patients requiring the use of X-rays is also the highest. An understanding of indoor radon concentrations in X-ray rooms is necessary for the estimation of the radiological risk to which patients, radiologists and medical technicians are exposed. The indoor radon concentrations were monitored for a period of six months using nuclear track detectors (NTD) consisting of a closed-end cup system with CR-39 (Lantrack Registered-Sign ) polycarbonate as detector material. The indoor radon concentrations were found to be between 75 and 170 Bq m{sup -3}, below the USEPA-recommended indoor radon action level for working places of 400 Bq m{sup -3}. It is hoped that the results of this study will contribute to the establishment of recommended action levels by the Mexican regulatory authorities responsible for nuclear safety.

Emergency response planning in hospitals, United States: 2003-2004.

Science.gov (United States)

Niska, Richard W; Burt, Catharine W

2007-08-20

This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

Changing Housing Patterns in Metropolitan Washington

Science.gov (United States)

Grier, George; Grier, Eunice

1975-01-01

This testimony, before a public hearing of the New York City Commission on Human Rights in May 1974, summarizes extensive studies of changing minority residential patterns in metropolitan Washington and less extensive studies of other groups; the prospects for future desegregation and for using the growing economic potential of minority families…

Tokyo Metropolitan Earthquake Preparedness Project - A Progress Report

Science.gov (United States)

Hayashi, H.

2010-12-01

Munich Re once ranked that Tokyo metropolitan region, the capital of Japan, is the most vulnerable area for earthquake disasters, followed by San Francisco Bay Area, US and Osaka, Japan. Seismologists also predict that Tokyo metropolitan region may have at least one near-field earthquake with a probability of 70% for the next 30 years. Given this prediction, Japanese Government took it seriously to conduct damage estimations and revealed that, as the worst case scenario, if a7.3 magnitude earthquake under heavy winds as shown in the fig. 1, it would kill a total of 11,000 people and a total of direct and indirect losses would amount to 112,000,000,000,000 yen(1,300,000,000,000, 1=85yen) . In addition to mortality and financial losses, a total of 25 million people would be severely impacted by this earthquake in four prefectures. If this earthquake occurs, 300,000 elevators will be stopped suddenly, and 12,500 persons would be confined in them for a long time. Seven million people will come to use over 20,000 public shelters spread over the impacted area. Over one millions temporary housing units should be built to accommodate 4.6 million people who lost their dwellings. 2.5 million people will relocate to outside of the damaged area. In short, an unprecedented scale of earthquake disaster is expected and we must prepare for it. Even though disaster mitigation is undoubtedly the best solution, it is more realistic that the expected earthquake would hit before we complete this business. In other words, we must take into account another solution to make the people and the assets in this region more resilient for the Tokyo metropolitan earthquake. This is the question we have been tackling with for the last four years. To increase societal resilience for Tokyo metropolitan earthquake, we adopted a holistic approach to integrate both emergency response and long-term recovery. There are three goals for long-term recovery, which consists of Physical recovery, Economic

Earthquake Risk Mitigation in the Tokyo Metropolitan area

Science.gov (United States)

Hirata, N.; Sakai, S.; Kasahara, K.; Nakagawa, S.; Nanjo, K.; Panayotopoulos, Y.; Tsuruoka, H.

2010-12-01

Seismic disaster risk mitigation in urban areas constitutes a challenge through collaboration of scientific, engineering, and social-science fields. Examples of collaborative efforts include research on detailed plate structure with identification of all significant faults, developing dense seismic networks; strong ground motion prediction, which uses information on near-surface seismic site effects and fault models; earthquake resistant and proof structures; and cross-discipline infrastructure for effective risk mitigation just after catastrophic events. Risk mitigation strategy for the next greater earthquake caused by the Philippine Sea plate (PSP) subducting beneath the Tokyo metropolitan area is of major concern because it caused past mega-thrust earthquakes, such as the 1703 Genroku earthquake (magnitude M8.0) and the 1923 Kanto earthquake (M7.9) which had 105,000 fatalities. A M7 or greater (M7+) earthquake in this area at present has high potential to produce devastating loss of life and property with even greater global economic repercussions. The Central Disaster Management Council of Japan estimates that the M7+ earthquake will cause 11,000 fatalities and 112 trillion yen (about 1 trillion US$) economic loss. This earthquake is evaluated to occur with a probability of 70% in 30 years by the Earthquake Research Committee of Japan. In order to mitigate disaster for greater Tokyo, the Special Project for Earthquake Disaster Mitigation in the Tokyo Metropolitan Area (2007-2011) was launched in collaboration with scientists, engineers, and social-scientists in nationwide institutions. The results that are obtained in the respective fields will be integrated until project termination to improve information on the strategy assessment for seismic risk mitigation in the Tokyo metropolitan area. In this talk, we give an outline of our project as an example of collaborative research on earthquake risk mitigation. Discussion is extended to our effort in progress and

Spatio-temporal aspects of gated residential security estates in non-metropolitan Western Cape

CSIR Research Space (South Africa)

Spocter, M

2011-04-01

Full Text Available . This research attempts to address this research gap by focusing on the spatio-temporal aspects of non-metropolitan gated residential security estates in the Western Cape Province. It was found that most non-metropolitan gated residential security estates were...

Daily Mobility and Residential Migrations in the Montréal Metropolitan Region

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Gilles Sénécal

2013-06-01

Full Text Available The purpose of this article is to simultaneously examine two types of mobility by developing a model of metropolitan organization that emphasizes the axis structure of mobility. The model is based on the realities of daily mobility and long-term residential mobility. Origin−Destination study results validated the axis representation of the metropolitan structure. Furthermore, building on data from a telephone survey, we considered the interactions between the two types of mobility along the Center-North axis of Montréal’s Census Metropolitan Area (CMA. The ensuing discussion on various models of metropolitan structure and their relevance today is framed in terms of the axes of mobility defined as territorial practices that are established within the patterns of daily life and are a significant factor in residential location decisions. The study raises broader issues concerning the relevance of drawing on standard models such as Burgess’s concentric zone model, Hoyt’s sector theory, Adam’s directional bias, or recent findings from the literature to understand urban form dynamics in the CMA.

Movement Technologies, Scale Structure and Metropolitan Life – an Empirical Research on the Effects of the Transportation System on the Metropolitan Process in Beijing

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Qiang Sheng

2014-07-01

Full Text Available This paper is a morphological study on Beijing’s metropolitanisation process based on the development of its transportation networks. By extracting the ‘scale structure’ embedded in them, we construct a movement network model for Beijing and use it to analyse changing metropolitan centralities as shopping areas and market places in 1924, 1987 and 2006. Following Taylor’s proposal of Central Flow as a complementary model to Central Place, our study focuses on how the spatial distribution of metropolitan centralities has been affected by the rapid modernisation of transportation networks.

Helsinki Metropolitan Area Climate Change Adaptation Strategy

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-07-01

The Helsinki Metropolitan Area Climate Change Adaptation Strategy has been prepared in close cooperation with the four cities of the metropolitan area (Helsinki, Espoo, Vantaa and Kauniainen), the Helsinki Region Environmental Services Authority HSY and other municipal, regional and state level organisations. In the strategy, strategic starting points and policies with which the metropolitan area prepares for the consequences of climate change, are compiled. The Helsinki Metropolitan Area adaptation strategy concentrates on the adaptation of the built and urban environment to the changing climate. The vision of the strategy is climate proof city - the future is built now. The strategy aims to (1) assess the impacts of climate change in the area, (2) prepare for the impacts of climate change and to extreme weather events and (3) to reduce the vulnerabilities of the area to climate variability and change. The target is to secure the well-being of the citizens and the functioning of the cities also in the changing climate conditions. The preparation of the adaptation strategy started in 2009 by producing the background studies. They include the regional climate and sea level scenarios, modelling of river floods in climate change conditions and a survey of climate change impacts in the region. Also, existing programmes, legislation, research and studies concerning adaptation were collected. The background studies are published in a report titled 'The Helsinki metropolitan area climate is changing - Adaptation strategy background studies' (in Finnish) (HSY 2010). HSY coordinated the strategy preparation. The work was carried out is close cooperation with the experts of the metropolitan area cities, regional emergency services, Ministry of the Environment, Helsinki Region Transport Authority and other regional organisations. The strategy work has had a steering group that consists of representatives of the cities and other central cooperation partners. The

Giving birth, going home: influences on when low-income women leave hospital.

Science.gov (United States)

Lichtenstein, Bronwen; Brumfield, Cynthia; Cliver, Suzanne; Chapman, Victoria; Lenze, Deanna; Davis, Valisia

2004-01-01

The US Newborns' and Mothers' Health Protection Act of 1996 ('The Two-Day Law') mandates insurance coverage for women who have just given birth to remain in hospital for two days post-partum. However, many women are being discharged from hospital after 24 hours. To assess why early discharge is still occurring, a study of 406 new mothers was conducted at an urban metropolitan hospital in the USA. The women were aware of the new law (95%) but decision making was often relinquished to hospital authorities. Patients who stayed longer tended to be more assertive in decision making, and used the Two-Day Law as leverage in discussions about going home. The study concluded that the nurses were authoritative and often influential agents in the decision-making process, and that patients were likely to interpret specific interactions with hospital staff as a signal to leave.

The Hydro-Economic Interdependency of Cities: Virtual Water Connections of the Phoenix, Arizona Metropolitan Area

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Richard R. Rushforth

2015-06-01

Full Text Available Water footprinting has revealed hydro-economic interdependencies between distant global geographies via trade, especially of agricultural and manufactured goods. However, for metropolitan areas, trade not only entails commodity flows at many scales from intra-municipal to global, but also substantial intra-metropolitan flows of the skilled labor that is essential to a city’s high-value economy. Virtual water flows between municipalities are directly relevant for municipal water supply policy and infrastructure investment because they quantify the hydro-economic dependency between neighboring municipalities. These municipalities share a physical water supply and also place demands on their neighbors’ water supplies by outsourcing labor and commodity production outside the municipal and water supply system boundary to the metropolitan area. Metropolitan area communities span dense urban cores to fringe agricultural towns, spanning a wide range of the US hydro-economy. This study quantifies water footprints and virtual water flows of the complete economy of the Phoenix Metropolitan Area’s municipalities. A novel approach utilized journey to work data to estimate virtual water flows embedded in labor. Commodities dominate virtual water flows at all scales of analysis, however labor is shown to be important for intra-metropolitan virtual water flows. This is the first detailed water footprint analysis of Phoenix, an important city in a water-scarce region. This study establishes a hydro-economic typology for communities to define several niche roles and decision making points of view. This study’s findings can be used to classify communities with respect to their relative roles, and to benchmark future improvements in water sustainability for all types of communities. More importantly, these findings motivate cooperative approaches to intra-metropolitan water supply policy that recognize the hydro-economic interdependence of these

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

Science.gov (United States)

Baltazar, J C; Tiglao, T V; Tempongko, S B

1993-01-01

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.

Urban food security at the crossroads between metropolitan food planning and global trade

NARCIS (Netherlands)

Wascher, Dirk Michael; Jeurissen, Leonne

2017-01-01

Making use of Life Cycle Thinking, the Metropolitan Foodscape Planner (MFP) tool provides ecological footprint maps and supply/demand data showing a large potential for metropolitan food supplies. In the discussion, we examine these results in the light of recent research on the impacts of the

[Urban and population development of the city of Puebla and its metropolitan area].

Science.gov (United States)

Barbosa Prieto, A

1991-12-01

Metropolitanization has been considered an important problem of regional development in developing countries. Attitudes toward the metropolis have been ambivalent in Latin America. On the 1 hand the metropolis is viewed as an obstacle to development that absorbs resources from the zone of influence and incurs high social costs of urbanization, but on the hand it is also viewed as a form of achieving levels of economic efficiency comparable to those of developed countries. Metropolitan areas should not be viewed as isolated, but rather as important points of demographic and manpower attraction, poles of economic growth and technological and cultural innovation. "Urban areas" and "metropolitan zones" are distinct ways of defining and delimiting urban phenomena. Although there is no consensus as to the exact definitions of these 2 urban units, it is generally accepted that the urban area is the city itself as well as the contiguous built up area reaching in all directions to the onset of nonurban land uses such as forests territorial extension that includes the politico-administrative units with urban characteristics such as work places and residences for nonagricultural workers, and that maintain constant and intense socioeconomic interrelations with the central city. The process of urban planning in the metropolitan zone of Puebla, Mexico, began in institutional form in 1980 with master plans for the population centers of Puebla, Amozoc, San Andres and San Pedro Cholula, and Zacatelco in the state of Tlaxcala. In 1987., an attempt was made by the governments of the states of Puebla and Tlaxcala to develop a plan for the metropolitan zone as a single unit. Population growth was greater within the city of Puebla than in the metropolitan zone from 1960-80, but after 1980 growth in the outlying areas exceeded that in the center city. The population density of the city of Puebla declined from 160/hectare in 1950 to 76/hectare in 1990, the result of progressive dispersion

Uber and Metropolitan Traffic Fatalities in the United States.

Science.gov (United States)

Brazil, Noli; Kirk, David S

2016-08-01

Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Twelve metropolitan carbon footprints. A preliminary comparative global assessment

International Nuclear Information System (INIS)

Sovacool, Benjamin K.; Brown, Marilyn A.

2010-01-01

A dearth of available data on carbon emissions and comparative analysis between metropolitan areas make it difficult to confirm or refute best practices and policies. To help provide benchmarks and expand our understanding of urban centers and climate change, this article offers a preliminary comparison of the carbon footprints of 12 metropolitan areas. It does this by examining emissions related to vehicles, energy used in buildings, industry, agriculture, and waste. The carbon emissions from these sources - discussed here as the metro area's partial carbon footprint - provide a foundation for identifying the pricing, land use, help metropolitan areas throughout the world respond to climate change. The article begins by exploring a sample of the existing literature on urban morphology and climate change and explaining the methodology used to calculate each area's carbon footprint. The article then depicts the specific carbon footprints for Beijing, Jakarta, London, Los Angeles, Manila, Mexico City, New Delhi, New York, Sao Paulo, Seoul, Singapore, and Tokyo and compares these to respective national averages. It concludes by offering suggestions for how city planners and policymakers can reduce the carbon footprint of these and possibly other large urban areas. (author)

Assessing the Impact of Chlorinated-Solvent Sites on Metropolitan Groundwater Resources

OpenAIRE

Brusseau, Mark L.; Narter, Matthew

2013-01-01

Chlorinated-solvent compounds are among the most common groundwater contaminants in the U.S.A. The majority of the many sites contaminated by chlorinated-solvent compounds are located in metropolitan areas, and most such areas have one or more chlorinated-solvent contaminated sites. Thus, contamination of groundwater by chlorinated-solvent compounds may pose a potential risk to the sustainability of potable water supplies for many metropolitan areas. The impact of chlorinated-solvent sites on...

Tracking the deployment of the integrated metropolitan ITS infrastructure in Orlando : FY99 results

Science.gov (United States)

2000-01-01

In January 1996, Secretary Pea set a goal of deploying the integrated metropolitan Intelligent Transportation System (ITS) infrastructure in 75 of the nations largest metropolitan areas by 2006. In 1997, the U.S. Department of Transportation ini...

New Metropolitan Spaces and Metropolitan Strategies in the Face of Modernisation

Directory of Open Access Journals (Sweden)

Willem Salet

2007-10-01

Full Text Available Au début du xxie siècle, les espaces urbains traversent une période de croissance et de transformation radicale. Les villes s’étendent de plus en plus. Leur configuration spatiale devient de plus en plus décentralisée et fragmentée. La dichotomie traditionnelle entre hiérarchie urbaine et périphérie est en train de disparaître. Les nouveaux espaces métropolitains sont caractérisés par des processus de segmentation et de spécialisation à distance ainsi que par des polarisations sociales qui structurent l’espace. Les tentatives de planification des villes-régions essaient de rééquilibrer ces processus qui font éclater la ville. Cet article explore brièvement les transformations métropolitaines actuelles en utilisant une approche générique. Il se focalise également sur les stratégies des métropoles pour affronter ces défis dans le cadre de situations institutionnelles variées, un peu partout en Europe. En troisième lieu, cet article interroge les effets potentiels des projets urbains sur un rééquilibrage des transformations urbaines. Comment les grands projets urbains sont-ils conceptuellement élaborés ? Comment les alliances d’acteurs qui les soutiennent se forgent-elles ? Comment les citoyens et les groupes sociaux sont-ils impliqués de manière à produire de nouveaux espaces plus intégrés ?At the beginning of the 21st century, urban spaces can be said to be in a stage of growth and radical transformation. Cities are highly expansive, both in scale and scope. The spatial configuration of urban spaces is, however, becoming more and more decentralised and fragmentary. The traditional dichotomy between urban hierarchy and periphery is disappearing. New metropolitan spaces are characterised by distance related processes of social and economic specialisation and segmentation, and often also by splitting social polarisation. The planning agendas in city regions are trying to make add more balance to the

The effect of chain membership on hospital costs.

Science.gov (United States)

Menke, T J

1997-06-01

To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. Data from all sources were merged at the hospital level to form the study sample. Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals.

75 FR 40726 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Science.gov (United States)

2010-07-14

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Metropolitan Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD...

Usage of Social Media in City Marketing: A Research on 30 Metropolitan Municipalities in Turkey

Directory of Open Access Journals (Sweden)

Niyazi Gümüş

2017-01-01

Full Text Available Rapid changes in information and communication technologies cause serious developments in marketing field similar to every sector. In parallel with these developments, the social media channels which appear as Web 2.0 applications have a number of advantages in comparison with traditional media channels. Social media gained a place in marketing activities because of its advantages. Social media is added on instruments in line with these developments that countries benefit in marketing activities for attracting more tourists, investment and becoming prominent against the other cities. Cities intensively benefit from social media because of social media’s properties like reaching the large masses, low marketing cost, interaction, receiving feedbacks rapidly, etc. Within this context, the purpose of this research is to determine the use statuses of social media by metropolitan municipalities as part of city marketing. In accordance with this purpose, official social media accounts of 30 metropolitan municipalities are investigated between the dates of 01/09/2016 and 30/09/2016, then their shares in social media channels are investigated in the context of city marketing.It is observed that two metropolitan municipalities do not have official Facebook accounts, four metropolitan municipalities do not have an official Twitter account as well. Again, it is found that 19 metropolitan municipalities do not have an official Instagram account and 17 metropolitan municipalities do not have official YouTube account. In consequence, it is observed that, our metropolitan municipalities do not benefit from social media effectively for city marketing activities.

Temporal Patterns of In-Hospital Falls of Elderly Patients.

Science.gov (United States)

López-Soto, Pablo J; Smolensky, Michael H; Sackett-Lundeen, Linda L; De Giorgi, Alfredo; Rodríguez-Borrego, María A; Manfredini, Roberto; Pelati, Cristiano; Fabbian, Fabio

A potentially important factor yet to receive adequate study is the time when hospital falls occur. A prior study conducted before the system-wide introduction of preventive measures revealed a biphasic 24-hour pattern of hospital falls with major peak in the morning. The purpose was to identify the temporal patterning of falls among elderly patients in hospitals with comprehensive fall prevention programs in place. A 4-year observational study was conducted by the local health authority in the five nonteaching public hospitals located in the province of Ferrara, Italy. Fall records involving patients of ages ≥65 years hospitalized in the general medical departments were used. Single- and multiple-component cosinor (time series) analyses were used to explore 24-hour, weekly, and annual patterns of falls. A total of 763 falls were experienced by 709 different elderly hospitalized patients. Falls typically took place in the patient's hospital room (72%) and bathroom (23%). Major causes were patient instability (32%) and accident (13%), and most occurred when not wearing footwear (45%) or wearing inappropriate sling-back open-toe shoes (39%). Falls happened while standing (39%), while seated (21%), and while getting into, out of, or laying in bed (32%)-either with the bed rails raised or lowered. Fall outcome usually involved no injury (58%) or slight injury (35%), but some (7%) were disabling. Fall occurrence was higher during the night (46%) compared to either the morning (30%) or afternoon (24%) shift. Patterns across 24 hours were characterized by a single major and one or more minor peaks that seemed to be associated with a variety of scheduled patient, hospital, and nursing activities. Multiple-component cosinor analysis identified significant (p footwear. Falls were more frequent, but not significantly so, on Fridays, Sundays, and Mondays compared with Tuesdays, and were more frequent in winter and spring (p = .003). Documentation by cause and circumstance of

75 FR 40762 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

Science.gov (United States)

2010-07-14

... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Sacramento Metropolitan Air Quality...

ELECTRICITY DEMAND IN A NORTHERN MEXICO METROPOLITAN ECONOMY

Directory of Open Access Journals (Sweden)

Thomas M. Fullerton

2014-10-01

Full Text Available Using an error correction framework, this study analyzes the long- and short-run dynamics of electricity demand in Ciudad Juarez, a large metropolitan economy on Mexico’s northern border. Demand is decomposed into the total number of electricity accounts and electricity usage per customer, each of which is modeled separately. A two-stage least squares approach is used to estimate the per customer electricity demand equations due to the endogeneity of the average price variable. The results indicate sustained growth in population, employment, and income can be expected to exert substantial upward pressure on regional electric power demand. Furthermore, demand is found to be price-inelastic in this metropolitan area, suggesting that rate increases can help raise the revenues necessary to fund expansion of the electrical grid.

Addressing hospital-acquired pressure ulcers: patient care managers enhancing outcomes at the point of service.

Science.gov (United States)

Frumenti, Jeanine M; Kurtz, Abby

2014-01-01

An innovative leadership training program for patient care managers (PCMs) aimed at improving the management of operational failures was conducted at a large metropolitan hospital center. The program focused on developing and enhancing the transformational leadership skills of PCMs by improving their ability to manage operational failures in general and, in this case, hospital-acquired pressure ulcers. The PCMs received 8 weeks of intense training using the Toyota Production System process improvement approach, along with executive coaching. Compared with the control group, the gains made by the intervention group were statistically significant.

78 FR 10589 - Revision of Air Quality Implementation Plan; California; Sacramento Metropolitan Air Quality...

Science.gov (United States)

2013-02-14

... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... sources within the areas covered by the plan as necessary to assure that the National Ambient Air Quality...

Recognition of management structure and spatial planning in Tehran metropolitan area

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Manijeh Lalehpour

2016-06-01

Full Text Available Metropolitan areas are concentrated and dense areas filled settlements and include a central urban region with its surrounding residences. Severity and complexity of issues in metropolitan areas along with intricacy and quantity of influential factors in these areas necessitate novel approaches and innovative solutions for comprehensive strategies and management coordination of land use in these regions. The present study has taken this approach to investigate management structure and spatial planning in Tehran metropolitan area. The study takes parameters like political and management decentralization, elements affecting urban management based on the sources of power and province and finally spatial domain of urban management into account. Findings revealed that decentralization in national management and political structure has limited tasks and authority of urban management. In this regard, a closer look at management structure and spatial planning of Tehran metropolitan are demonstrates that the government and its element dominate policy making, planning and spatial management of the city and inherent position of municipality and city council suffer weaknesses in their role as urban management. Results from investigating official tasks in urban management elements and their spatial domain reveals lack of coordination and Fragmentation in management structure and spatial planning in the region. The paper attempts to discuss these Fragmentation in the fields of management, function, politics and domains.

[Avoidable perinatal deaths and the environment outside the health care system: a case study in a city in Greater Metropolitan Rio de Janeiro].

Science.gov (United States)

Rosa, Maria L G; Hortale, Virginia Alonso

2002-01-01

This paper focuses on the role of environmental factors external to the health care system in the occurrence of perinatal deaths in maternity hospitals belonging to the local health system in a city in Greater Metropolitan Rio de Janeiro in 1994. Elements from the political and administrative context that contribute to an understanding of the relationship between failures in health care and structural deficiencies in these maternity hospitals were divided into four groups of variables: distribution of resources, spatial and temporal factors, organizational and managerial features, and action by interest groups. Semi-structured interviews were conducted. The study concluded that poor performance in four groups of variables may have contributed to perinatal mortality: distribution of resources was insufficient to provide quality in health care, especially in private maternity hospitals; there was no formal or informal regional or hierarchical organization of obstetric care in the city; Ministry of Health guidelines were ignored in all four maternity hospitals, while in three of the hospitals there were no admissions procedures and delivery and fetal follow-up listed in their own rules; and the level of actual participation was low.

Revenues for Education in Metropolitan Areas. Chapter VI, Metropolitanism: Its Challenge to Education, 1968. Sixty-seventh Yearbook, Part I.

Science.gov (United States)

Alkin, Marvin C.

For local school districts to provide equal educational opportunities throughout a metropolitan area, a school organization plan should distribute populations among districts in such a manner as to maximize the aggregate expressed demand for educational services and to provide relatively equal financial support. Consolidation of contiguous…

Evaluation of the external costs of energy production in the Helsinki metropolitan area

International Nuclear Information System (INIS)

Otterstroem, T.

1995-01-01

The aim of the research is to evaluate the external costs of energy production at Helsinki metropolitan area (Helsinki, Espoo, Vantaa). The previously developed valorization method for effects on population centres is adjusted. All the main health, material and environmental effects will be taken into account in the research. The effects of emissions of the energy production of the Helsinki metropolitan area on concentrations of the impurities in the air and through them on human and environment will be evaluated. The estimates will be based on the relativistic fuels consumption and the emission data of Helsinki metropolitan area. Life-cycle reasoning will be applied so that the emissions of the main components of the fuels used in the metropolitan area will be included in the estimation. The cost-effectiveness of the investments will be estimated by comparing the environmental investments of energy boards with the external costs. The methods of this work can be applied to estimation of the profitability of energy production plants from the point of view of national economy also elsewhere in the country

A REGIONAL APPROACH TO THE METROPOLITAN ECONOMIC GROWTH: EVIDENCE FROM THE EUROPEAN UNION

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Florin Teodor Boldeanu

2016-09-01

Full Text Available The main goal of this study is to contribute to metropolitan economic growth literature by carrying out an analysis for 271 areas located in the EU between 2000 and 2013. For this objective the study uses several panel data estimation techniques, namely the GMM, System GMM and the QML estimation. To check the robustness of the results, the time period is divided in two (post and ante economic crisis and by splitting the sample of metropolitan regions in two components, the Western more developed regions and the Central and South-Eastern (the formal communist states, except for Cyprus areas. The results indicate that the industrial, construction and wholesale and retail trade sectors are positively linked with metropolitan growth. The agricultural, fishery and forestry sector is negatively influencing growth. The manufacturing and ITC sectors and migration are not statistically significant. Furthermore population density and size is more important than population growth and European enlargement did not have a substantial positive impact on metropolitan growth for the Central and South-Eastern regions.

Kansas City Metropolitan Community Colleges. Audit Report.

Science.gov (United States)

Missouri Office of the State Auditor, Jefferson City.

This audit report reviews the employment contracts, related compensation, and other benefits provided for the chancellor and other officers of the Kansas City Metropolitan Community Colleges (KCMCC) in Missouri. The chancellor is allowed to either solicit bids or negotiate for contracted services such as architects, construction managers,…

Radiological protection study at the 'Hospital Edgardo Rebagliati Martins'/Peru

International Nuclear Information System (INIS)

Luna Q, R.

1996-01-01

Edgardo Rebagliati Martins Hospital of the Peruvian Institute of Social Security started its activities in 1957, as the largest metropolitan general hospital for the insured workers of the I.P.S.S. At present, it has 1350 hospital beds, attends 36,600 external consults per month, about 10,700 x-rays examinations, as well as 16,800 radiotherapy treatments monthly. 200 brachytherapies with Cesium or Radium are performed annually, besides many other (examinations) imaging exams that use ionizing radiation are carried out by our radiology staff with diagnosis or therapeutic purposes. This is the reason why the hospital directory sent some staff physicians abroad to learn all about radiation protection in a hospital setting, so that they will be able to organize a Radiation Protection Committee to advise and to set up rules and regulations to protect exposed personnel, as well as public in general, improving quality and, consequently, saving costs to the institution. The Constitution of the Radiation Protection Committee, its importance in a medical institution, is informed, and finally its experiences of the every day work and how to act in hospital accidents where ionizing radiation is involved, are transmitted. (author). 1 fig

23 CFR 420.109 - What are the requirements for distribution of metropolitan planning funds?

Science.gov (United States)

2010-04-01

... and Research Funds § 420.109 What are the requirements for distribution of metropolitan planning funds... 23 Highways 1 2010-04-01 2010-04-01 false What are the requirements for distribution of metropolitan planning funds? 420.109 Section 420.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF...

Heterogeneous Structure and Seismicity beneath the Tokyo Metropolitan Area

Science.gov (United States)

Nakagawa, S.; Kato, A.; Sakai, S.; Nanjo, K.; Panayotopoulos, Y.; Kurashimo, E.; Obara, K.; Kasahara, K.; Aketagawa, T.; Kimura, H.; Hirata, N.

2010-12-01

Beneath the Tokyo metropolitan area, the Philippine Sea Plate (PSP) subducts and causes damaged mega-thrust earthquakes. Sato et al. (2005) revealed the geometry of upper surface of PSP, and Hagiwara et al. (2006) estimated the velocity structure beneath Boso peninsula. However, these results are not sufficient for the assessment of the entire picture of the seismic hazards beneath the Tokyo metropolitan area including those due to an intra-slab M7+ earthquake. So, we launched the Special Project for Earthquake Disaster Mitigation in the Tokyo Metropolitan area (Hirata et al., 2009). Proving the more detailed geometry and physical properties (e.g. velocities, densities, attenuation) and stress field within PSP is very important to attain this issue. The core item of this project is a dense seismic array called Metropolitan Seismic Observation network (MeSO-net) for making observations in the metropolitan area (Sakai and Hirata, 2009; Kasahara et al., 2009). We deployed the 249 seismic stations with a spacing of 5 km. Some parts of stations construct 5 linear arrays at interval of 2 km such as Tsukuba-Fujisawa (TF) array, etc. The TF array runs from northeast to southwest through the center of Tokyo. In this study, we applied the tomography method to image the heterogeneous structure under the Tokyo metropolitan area. We selected events from the Japan Meteorological Agency (JMA) unified earthquake list. All data of MeSO-net were edited into event data by the selected JMA unified earthquake list. We picked the P and S wave arrival times. The total number of stations and events are 421 and 1,256, respectively. Then, we applied the double-difference tomography method (Zhang and Thurber, 2003) to this dataset and estimated the fine-scale velocity structure. The grid nodes locate 10 km interval in parallel with the array, 20 km interval in perpendicular to the array; and on depth direction, 5 km interval to a depth of less than 50 km and 10 km interval at a depth of more

Information Systems Evaluation: A Study in Hospital Organizations

Directory of Open Access Journals (Sweden)

Laís Coelho Ayala

2012-06-01

Full Text Available Given increasing demand for timely and accurate information to support decision making, hospitals, a particularly complex type of service organization, have increasingly resorted to a wide range of tools such as the Clinical Information Systems (CIS. However, research has shown that such systems do not always meet hospital managers’ needs, and assessment processes are necessary both before and after CIS implementation. Aiming to identify whether the CIS do meet hospital managers’ information needs and do fit in the specificities of such organizations, this paper reports on the assessment of four CIS based on the perspective of their users in four hospitals in the Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil. The data was collected by means of semi-structured interviews and non-obtrusive observation. On the one hand, the result shows that the four organizations have difficulties in using their systems, such as accessibility problems, inadequate training and system underutilization. On the other hand, they also benefit from such systems, as they make processes faster and enable information control. One can say that the results from this research contribute to a better understanding of evaluating information systems in hospitals. Managers of such organizations can benefit from these results when seeking to evaluate and improve their information systens.

Engaging with sustainability issues in metropolitan Chennai

NARCIS (Netherlands)

Kennedy, L.; Varrel, A.; Denis, E.; Dupont, V.; Dhanalakshmi, R.; Roumeau, S.; Baud, I.; Pfeffer, K.; Sridharan, N.; Vijayabaskar, M.; Suresh Babu, M.; Seifelislam, A.; Rouanet, H.; Saharan, T.

2014-01-01

Chennai is the largest metropolitan city in South India (8.7 million in 2011) and the provincial capital of the large state of Tamil Nadu (population 72 million in 2011). Before that, under British rule, the city was the capital of the Madras Presidency, and was known as Madras until 1996, when the

Explaining turnover intention in Korean public community hospitals: occupational differences.

Science.gov (United States)

Hwang, Jee-In; Chang, Hyejung

2008-01-01

Personnel in public hospitals had relatively low job satisfaction despite of tenure employment. High turnover rates degrade hospital image and incur additional costs related to recruitment and training. The purposes of this study were to describe the occupational differences and to identify factors affecting turnover intention among public hospital personnel. A questionnaire survey was conducted as part of Administrative Services Quality Evaluation Program by Seoul metropolitan municipality from 1 November to 1 December in 2003. The subjects were 1251 entire hospital personnel in four hospitals. The questionnaire was designed to measure job satisfaction, organizational commitment, turnover intention, and demographic characteristics. Logistic regression analysis was performed to determine factors influencing turnover intention. There were significant differences in job satisfaction, organizational commitment, and turnover intention according to the occupations. The turnover intention rates were highest among physicians, followed by paramedicals and nursing staffs and then administrators. The significant factors affecting turnover intention were involvement and loyalty among physicians, hospital type, satisfaction with systems and loyalty among nursing staffs, satisfaction with relationship and loyalty among administrators, and loyalty among paramedicals. There were different moderators that influence turnover intentions of hospital personnel. Loyalty had the most important effect upon turnover intention in all occupations. 2007 John Wiley & Sons, Ltd

Atmospheric pollution biomonitoring of the Sao Paulo metropolitan region using epiphytic lichens

International Nuclear Information System (INIS)

Fuga, Alessandra

2006-01-01

Due to the increasing problems of atmospheric pollution in the Sao Paulo metropolitan region that affect the environment and human health the application of biomonitoring methodologies using cosmopolite organisms has now become relevant. Biomonitoring is a method to evaluate the response of live organisms to pollution. This method offers advantages such as reduced costs, efficient monitoring of large geographic areas and accumulated pollutants over a large period in which low concentrations of chemicals elements in the environment can be evaluated. In the present study, neutron activation analysis method was applied to determine elements accumulated in Canoparmelia texana lichenized fungi. Samples were collected in two distinct areas: Carlos Botelho (PECB) and Intervales (PEI) State Parks that are considered as non-polluted areas and that belong to the Atlantic Forest - SP ecosystem; and Sao Paulo city metropolitan region in sites near automatic monitoring stations of the Environmental Protection Agency of the State of Sao Paulo (CETESB). The lichens collected from the bark of the trees were properly treated, and irradiated with neutrons from IEA-R1 nuclear reactor along with synthetic standards of elements. The precision and the accuracy of the results were evaluated by the analyses of IAEA-336 LICHEN and Mixed Polish Herbs (INCT -MPH-2) certified reference materials. The results obtained for these materials were in accordance with the certified values and presented good precision with variation coefficients ranging from 0.9 to 14.6%. Results obtained for lichens showed that elements As, Co, Cr, Cs, La, Mo, Sb, Sc, Se and U are present at ng g -1 levels, Ba, Br, Cl, Fe, K, Mn, Na, Rb and Zn at μg g -1 and Ca at mg g -1 . By applying cluster and discriminant analyses to the results for the lichen samples from areas with different levels of pollution, the sampling sites were grouped according to their chemical similarities and their elemental composition. It was

Diarrheal diseases and hospitalization of children under five years of age according to population-based surveys in the State of Pernambuco, Brazil, in the years 1997 and 2006.

Science.gov (United States)

Vasconcelos, Maria Josemere Oliveira Borba; Rissin, Anete; Figueiroa, José Natal; Lira, Pedro Israel Cabral de; Batista Filho, Malaquias

2018-03-01

The scope of this paper was to assess the temporal and geographical trends of diarrhea and its implications on the demands of hospitalizations of children under five years of age in the state of Pernambuco in 1997 and 2006. Databases of two population-based surveys were assessed with probabilistic samples of 2078 children (1997) and 1650 children (2006) evaluated in 18 municipalities of Pernambuco, including the Metropolitan Region of Recife, Urban Interior and Rural Interior. Prevalence was considered to involve the occurrence of cases on the day or in the two weeks prior to the interview and as admissions, service cases with minimal hospital stay of 24 hours in the period, covering up to one year before the interview. The prevalence of diarrhea in Pernambuco had a statistically non-significant decline (19.8% to 18.1%; p = 0.192). However, a statistically-significant reduction was observed (16.9% to 10.5%; p = 0.003) in the Metropolitan Region of Recife. The number of admissions increased by more than double (2.7% to 5.5% in the State and from 1.6% to 3.8% within the Metropolitan Region of Recife), in contrast with national trends. Therefore, diarrhea in the State appears as the main component of the demands of pediatric hospitalizations during the period under scrutiny.

Effect of National Football League games on small animal emergency room caseload.

Science.gov (United States)

Rozanski, Elizabeth A; Rondeau, Mark P; Shaw, Scott P; Rush, John E

2009-07-01

To evaluate whether games of popular professional football teams have an effect on small animal emergency room caseload and percentage of dogs and cats that subsequently are hospitalized, are euthanatized, or die following admission to veterinary emergency rooms located within a dedicated fan base. Prospective study. 818 dogs and cats admitted to the emergency room. During the 2007 New England Patriots (NEP) football season, small animal emergency room caseload was recorded for Sunday (4-hour blocks, 8:00 AM until 12:00 midnight) and Monday night (7:00 PM to 11:00 PM). Number of dogs and cats that subsequently were hospitalized, died, or were euthanatized was recorded. Mean game importance rating (GIR) was determined for NEP games (scale, 1 [mild] to 3 [great]). Percentage of dogs and cats admitted from 12:00 noon to 4:00 PM on Sundays during NEP games (mean GIR, 1.7) versus non-NEP games was not different. Mean +/- SD percentage of dogs and cats admitted from 4:00 PM to 8:00 PM on Sundays during NEP games (mean GIR, 2.4) versus non-NEP games was significantly different (18 +/- 5% and 25 +/- 7% of daily caseload, respectively). Percentage of dogs and cats admitted from 8:00 PM to 12:00 midnight on Sundays during NEP games (mean GIR, 2.1) versus non-NEP games was not different. Game type (NEP vs non-NEP) during emergency room admission did not influence whether dogs and cats subsequently were hospitalized, died, or were euthanatized. Professional sporting events may influence veterinary emergency room caseloads.

The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

Science.gov (United States)

Linnen, Daniel T; Kornak, John; Stephens, Caroline

2018-03-28

Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p centers may contribute to these results, a potential factor that future research should examine.

Governing metropolitan green infrastructure in the United States

Science.gov (United States)

Robert F. Young; E. Gregory McPherson

2013-01-01

In this paper we explore whether the enhancement of urban ecosystem services through largescale metropolitan treeplanting initiatives is being planned and executed as a component of traditional municipal government or represents new transdisciplinary strategies in environmental governance Drawing on qualitative interviews with...

Spatial analysis of the Rio de Janeiro metropolitan area and social and environmental management issues

DEFF Research Database (Denmark)

Ribeiro, Gustavo

2005-01-01

and infrastructural data. Through these three levels of spatial analysis it is possible to develop and to support a more comprehensible study of urban development of the Rio de Janeiro Metropolitan Area. The aim of this study is (a) to develop an alternative spatial analysis leading to a more comprehensive...... understanding of the urban development process and its correlation not just with political-administrative borders but also to ecological systems: (b) to identify the correlations between infrastructure and socio-economical data in the Rio de Janeiro Metropolitan Area (c) to evaluate urban development dynamics...... in the period between 1990 and 2000, based on the application of the above-mentioned data to the three spatial levels in question. This paper highlights the role of the hydrographical systems of the Rio de Janeiro Metropolitan Area as an important spatial unit of analysis to understand the metropolitan urban...

Green Urbanism for the Greener Future of Metropolitan Areas

Science.gov (United States)

Zaręba, Anna; Krzemińska, Alicja; Widawski, Krzysztof

2016-10-01

Intensive urbanization is swallowing municipal green areas which causes intensification of erosion, decrease in biodiversity and permanent fragmentation of habitats. In the face of these changes, a risk of irreversible damages to urban ecosystems is growing. That is why planning of solutions within the framework of Green Urbanism in metropolitan areas inhabited by over 55% of the global population is of extraordinary importance. The task of the paper is to present patterns of the Green Urbanism using selected examples of metropolitan areas as case studies. The main goal of the research is to make comparison between GU practices in different countries, in various spatial settings. The principles of triple zero framework: zero fossil-fuel energy use, zero waste, zero emissions (from low-to-no-carbon emissions) introduce not only the contemporary trends in theoretical urban planning but are dictated by practical considerations to create a healthy environment for a healthy society with a minimized environmental footprint. The research results help to identify Green Urbanism techniques used for multiple functions, including ecological, recreational, cultural, aesthetic and other uses and present opportunities for implementation of Green Urbanism solutions in metropolitan areas. To achieve healthier society and environment, highly congested and polluted cities have to be recreated through working with the existing landscape, topography and natural resources particular to the site.

‘Riegl and “objective aesthetics”’: Alois Riegl, ‘Objective aesthetics’ [‘Objective Ästhetik,’ Neue Freie Presse, No. 13608, Morning Edition, Sunday, July 13, 1902, ‘Literatur-Blatt,’ 34-35

Directory of Open Access Journals (Sweden)

Karl Johns

2014-12-01

Full Text Available Riegl published this short review of a popular book from France in a very widely read Sunday newspaper not long after the Spätrömische Kunstindustrie and Das hollāndische Gruppenporträt appeared. It touches on many of his favorite subjects in what is probably a more palatable presentation than his voluminous publications with more complex analysis.

Iron, Oil, and Emeryville: Resource Industrialization and Metropolitan Expansion in the San Francisco Bay Area, 1850-1900

OpenAIRE

Lunine, Seth

2013-01-01

Scholars have largely overlooked the formative role of industry in both California's economic development and the San Francisco Bay Area's metropolitan expansion during the late nineteenth century. Beginning in the early 1880s, leading firms in San Francisco's specialized industries, such as the iron and chemicals sectors, dispersed to the metropolitan periphery. This process of industrial suburbanization created an integrative metropolitan economy, as well as individual suburbs. In this di...

Design and Scale Isses in the New Metropolitan City: a study of the south-east homogeneous zone

Directory of Open Access Journals (Sweden)

Elena Mussinelli

2015-11-01

Full Text Available The establishment of the new Metropolitan City and recent anti-sprawl legislations form part of a new urban regeneration initiative. In this context, the goal of the current research is to provide spatial forecasts, guidelines for governance, and economic feasibility scenarios for revitalisation work. The research is centred on the Milan Metropolitan area. In addition to exploring certain theories of regeneration and resilience, this paper reinstates the practice of spatial analysis of abandoned industrial areas at a metropolitan scale and identifies boundaries, environments, and issues for meta-design testing based on public initiatives aimed at increasing socio-economic resilience for the south-east sector of the Milanese metropolitan area. 

Business profile of metropolitan Las Vegas

International Nuclear Information System (INIS)

Boyle, M.R.

1988-06-01

This first report describes the present makeup of the Las Vegas metropolitan statistical area (MSA) economy and analyzes the climate for business expansion. The second report contains an assessment of the competitiveness of the area as a location for new or expanded facilities investment by companies in approximately 600 business groups. The third report projects Las Vegas' competitiveness at the start of the next century in the absence of a nuclear waste storage facility and then evaluates the potential impacts of siting that facility near Las Vegas on its ability to attract and retain business investment. The primary purpose of these reports is to contribute to the overall assessment of the environmental impact of the US Department of Energy's proposed action to build and operate an underground nuclear waste storage facility at Yucca Mountain. The first two reports also serve a second purpose -- they can be used by economic development organizations in the Las Vegas metropolitan area in their ongoing efforts to attract new business investment. Information contained in the business climate analysis found in this first report can be incorporated into marketing materials. The competitiveness assessment contained in the second report can be used by these organizations in identifying targets they wish to pursue

Use of renewable energy in the greater metropolitan area

International Nuclear Information System (INIS)

Arias Garcia, Rocio; Castro Gomez, Gustavo; Fallas Cordero, Kenneth; Grant Chaves, Samuel; Mendez Parrales, Tony; Parajeles Fernandez, Ivan

2012-01-01

A study is conducted on different renewable energy within the larger metropolitan area, selecting the most suitable for the area and the implementation for distributed generation. A research methodology is practiced type pretending gather the necessary information to make proposals selected of different type of energy. The geography of the greater metropolitan area is studied along with the different existing renewable energy: distributed generation, remote measurement of energy which is one of the elements of the concept of intelligent networks (Smart Grid) in the electricity sector, legislation of Costa Rica regarding the generation of renewable energy and environmental impact. An analysis of economic feasibility is covered for each of the proposals estimating current rates for leading distributors of a future value, concluding with the viability of projects for possible execution of the same. (author) [es

The Metropolitan Area of the Municipality of Bucharest. Present-Day Features Relating to Some Environmental Issues in an International Context

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INES GRIGORESCU

2005-01-01

Full Text Available The development of metropolitan areas represents the main characteristic of today’s urban evolution trends. The first initiatives to delimitate and define metropolitan areas have been in the United States since 1910. In Europe, this concept was adopted at the beginning of the1990s when the United States had already had 250 metropolitan areas. Romania adopted the concept of metropolitan area in the late 1990s, namely in 1997 when a study on the Directions, Ways, and Intensities of Development in the Municipality of Bucharest and its Metropolitan Zone. Environmental protection politics appeared. This made public a point of view about the Bucharest metropolitan area, which was legally defined by Law no. 351 of July 6th 2001 regarding the National Territory Management Plan, Section IV – Settlements. But many other limits of this area were also taken into account. The uncontrolled evolution of the Bucharest Metropolitan Area as well as of many other European capital cities can be stopped or stabilized by developing green belts or green areas.

Inpatient satisfaction at different public sector hospitals of a metropolitan city in Pakistan: a comparative cross-sectional study.

Science.gov (United States)

Hussain, Mehwish; Rehman, Rehana; Ikramuddin, Zia; Asad, Nava; Farooq, Ayesha

2018-04-01

To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance. Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four hospitals (P public sector hospitals showed satisfaction with healthcare personnel and related administration. However, treatment dimension needs to be improved to get more satisfaction.

Intestinal Parasites among Waste-Handlers in Jos Metropolitan Area ...

African Journals Online (AJOL)

Intestinal Parasites among Waste-Handlers in Jos Metropolitan Area of Plateau State, Nigeria. ... Solid waste management is associated with health hazards. ... Waste disposal workers are at high risk of infection with different species of ...

[Characterization of assistance among philanthropic hospitals in Brazil].

Science.gov (United States)

Portela, Margareth C; Lima, Sheyla M L; Barbosa, Pedro R; Vasconcellos, Miguel M; Ugá, Maria Alícia D; Gerschman, Silvia

2004-12-01

To characterize the Brazilian philanthropic hospital network and its relation to the public and private sectors of the Sistema Unico de Saude (SUS) [Brazilian Unified Health System]. This is a descriptive study that took into consideration the geographic distribution, number of beds, available biomedical equipment, health care complexity as well as the productive and consumer profiles of philanthropic hospitals. It is based on a sample of 175 hospitals, within a universe of 1,917, involving 102 distinct institutions. Among these, there were 66 Brazilian Unified Health System (SUS) inpatient care providers with less than 599 beds randomly included in this study. Twenty-six of the twenty-seven SUS inpatient care providers with at least 599 beds, as well as ten institutions which do not provide their services to SUS, were also included. This is a cross-sectional study and the data was obtained in 2001. Data collection was conducted by trained researchers, who applied a questionnaire in interviews with the hospital's managers. Within the random sample, 81.2% of the hospitals are located in cities outside of metropolitan areas, and 53.6% of these are the only hospitals within their municipalities. Basic clinical hospitals, without ICUs, predominate within the random sample (44.9%). Among the individual hospitals of the large philanthropic institutions and the special hospitals, the majority -- 53% and 60% respectively -- are level II general hospitals, a category of greater complexity. It was verified that complexity of care was associated to hospital size, being that hospitals with the greatest complexity are situated predominantly in the capitals. Given the importance of the philanthropic hospital sector within the SUS [Unified Health System] in Brazil, this paper identifies some ways of formulating appropriate health policies adjusted to the specificities of its different segments.

Agricultural land cover changes in metropolitan areas of Poland for the period 1990–2012

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Nalej Marta

2016-06-01

Full Text Available Agricultural land covers more than half the area of metropolitan areas in Poland, and is therefore particularly prone to the influences of the processes associated with their development. The aim of the study was to analyse changes in agricultural land cover within the metropolitan areas of Poland for the years 1990–2012; and to capture their dynamics, types and directions. The percentage share of the total study area, for each of the forms of agricultural land cover and their changes were traced, with the spatial distribution of the changes also being determined. The results of the study show that in metropolitan areas, agricultural land cover is undergoing transformations that do not result in the loss of agricultural lands, or that involve a decrease in surface area due to their change into anthropogenic forms of land cover. The greatest transitions occurred between 2000 and 2006 and were observed in the outer zones of metropolitan areas.

Transfer of residents to hospital prior to cardiac death: the influence of nursing home quality and ownership type.

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Anic, Gabriella M; Pathak, Elizabeth Barnett; Tanner, Jean Paul; Casper, Michele L; Branch, Laurence G

2014-01-01

We hypothesised that among nursing home decedents, nursing home for-profit status and poor quality-of-care ratings, as well as patient characteristics, would lower the likelihood of transfer to hospital prior to heart disease death. Using death certificates from a large metropolitan area (Tampa Florida Metropolitan Statistical Area) for 1998-2002, we geocoded residential street addresses of heart disease decedents to identify 2172 persons who resided in nursing homes (n=131) at the time of death. We analysed decedent place of death as an indicator of transfer prior to death. Multilevel logistic regression modelling was used for analysis. Cause of death and decedent characteristics were obtained from death certificates. Nursing home characteristics, including state inspector ratings for multiple time points, were obtained from Florida's Agency for Healthcare Administration. Nursing home for-profit status, level of nursing care and quality-of-care ratings were not associated with the likelihood of transfer to hospital prior to heart disease death. Nursing homes >5 miles from a hospital were more likely to transfer decedents, compared with facilities located close to a hospital. Significant predictors of no transfer for nursing home residents were being white, female, older, less educated and widowed/unmarried. In this study population, contrary to our hypotheses, sociodemographic characteristics of nursing home decedents were more important predictors of no transfer prior to cardiac death than quality rankings or for-profit status of nursing homes.

The Tshwane metropolitan municipality and strategic partnerships in ...

African Journals Online (AJOL)

... Tshwane Metropolitan Municipality commissioned research to investigate the potential of strategic partnerships for the optimal facilitation and co-operative governance of sport and recreation. The aim of this project was to identify the possible structure and nature of partnerships in order to facilitate effective management, ...

Effect of photochemical smog associated with synoptic weather patterns on cardiovascular and respiratory hospital admissions in metropolitan Taipei.

Science.gov (United States)

Lai, Li-Wei

2012-01-01

This study focuses on the relationship between photochemical smog (PS) (hourly ozone conc. >100 ppb), PS-related diseases, and the synoptic weather patterns during 2005-2009 in metropolitan Taipei. The results show that compared to respiratory ailments (ICD code 460-519) and asthma (ICD code 493), cardiovascular ailments (ICD code 390-459) were more clearly influenced by PS events. On the PS event day, the number of admissions of babies, children, and adults increased by 0.04 [95% CI 0.01-0.06], 0.03 [95% CI 0.00-0.07], and 1.12 [95% CI 0.36-1.89] (P < 0.05), respectively. The investigation showed that more than 70% of the PS events were associated primarily with the peripheral circulation of typhoons, Pacific pressure, and discrete Pacific pressure. PS events are a threat to public health. To avoid the ill effects of air pollution, residents should be informed about the daily weather patterns and air quality.

Study on waste waters of metal finishing industries around Lahore metropolitan area

International Nuclear Information System (INIS)

Khan, Izhar-ul-Haq; Mahmood, F.; Tufail, S.; Naeem, M.

2002-01-01

Study was undertaken on the waste water samples from metal finishing industries of Lahore metropolitan area for the evaluation of metallic impurities. The metal finishing industry was classified into three categories i. e. medium scale, small scale and cottage scale industry. About 93 wastewater samples were collected from various metal finishing industries around Lahore metropolitan area. In addition to toxic elements like cadmium, nickel and zinc the other parameters such as hydrogen ion concentration (pH), Electrical conductivity (EC) and Total Dissolved Salts (TDS) were also determined. (author)

Shifting balances in U.S. metropolitan and nonmetropolitan area growth.

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Garnick, D H

1984-12-01

"This paper assesses some of the recent attempts to explain the perceived growth reversal between metropolitan and nonmetropolitan areas in the United States during the 1970s. The paper argues that the reversal in population trends was not a one-time, radical shift in settlement trends, but rather the result of more continuous underlying industrial trends. Indeed, since 1979, population growth has again become faster in metropolitan than nonmetropolitan areas." The paper includes three sections. Regional and area population and industrial earnings growth patterns are first summarized for the 1960s, 1970s, and 1980s. Theories of polarization and polar reversal are then evaluated and found to be inadequate. Finally, a reconstruction of the neoclassical model is proposed. excerpt

The Role of Great Cities in Romania for the Metropolitan Development

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Ruxandra Irina POPESCU

2008-02-01

Full Text Available According to the legislation in force, in Romania there are 11 first rank cities that given their size, their importance, the level of services and the economic activity, represent attractions and are subjected to the development pressures. Still, according to the European tendencies, the urban agglomerations tend to approach this type of cooperation regardless the number of the inhabitants. Currently in Romania there are 11 great cities that have developed processes of organizing the metropolitan areas corresponding to them. Among them, two have already created metropolitan areas: Oradea (2001 and Iaşi (2004, both with the assistance of programs financed by USAID.

Intra-metropolitan inequalities in Rio de Janeiro and the Guanabara Bay cleaning programme

DEFF Research Database (Denmark)

Ribeiro, Gustavo; Silva, Victor

2005-01-01

This paper investigates the impacts of the Guanabara Bay Cleaning Programme (GBCP) on the Rio de Janeiro urban development process. Based on the magnitude of the budget of the programme (HOW MUCH?) and its relevance to the improvement of the life quality of urban dwellers, the main discussion...... of this paper focuses on the role of GBCP in the context of the Rio de Janeiro urban trends and intra-metropolitan inequality dynamics. In studying the impact of the GBCP, we present: (a) a description of the GBCP intervention process and its goals, (b) a spatial analysis of the Rio de Janeiro Metropolitan Area...... the role of the GBCP implementation in the spatial distribution of these patterns throughout these 10 years. The conclusion builds on an analysis of the GBCP role in the current urban development process of the Rio de Janeiro Metropolitan Area, identifying its influences on the dynamics of intra...

Self-reported oral health of a metropolitan homeless population in Australia: comparisons with population-level data.

Science.gov (United States)

Parker, E J; Jamieson, L M; Steffens, M A; Cathro, P; Logan, R M

2011-09-01

There is limited information on self-perceived oral health of homeless populations. This study quantified self-reported oral health among a metropolitan homeless adult population and compared against a representative sample of the metropolitan adult population obtained from the National Survey of Adult Oral Health. A total of 248 homeless participants (age range 17-78 years, 79% male) completed a self-report questionnaire. Data for an age-matched, representative sample of metropolitan-dwelling adults were obtained from Australia's second National Survey of Adult Oral Health. Percentage responses and 95% confidence intervals were calculated, with non-overlapping 95% confidence intervals used to identify statistically significant differences between the two groups. Homeless adults reported poorer oral health than their age-matched general population counterparts. Twice as many homeless adults reported visiting a dentist more than a year ago and that their usual reason for dental attendance was for a dental problem. The proportion of homeless adults with a perceived need for fillings or extractions was also twice that of their age-matched general population counterparts. Three times as many homeless adults rated their oral health as 'fair' or 'poor'. A significantly greater proportion of homeless adults in an Australian metropolitan location reported poorer oral health compared with the general metropolitan adult population. © 2011 Australian Dental Association.

Occupational Therapy and Physiotherapy in Acute Stroke: Do Rural Patients Receive Less Therapy?

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Josie Merchant

2016-01-01

Full Text Available Objective. To assess whether acute stroke patients in rural hospitals receive less occupational therapy and physiotherapy than those in metropolitan hospitals. Design. Retrospective case-control study of health data in patients ≤10 days after stroke. Setting. Occupational therapy and physiotherapy services in four rural hospitals and one metropolitan hospital. Participants. Acute stroke patients admitted in one health district. Main Outcome Measures. Frequency and duration of face-to-face and indirect therapy sessions. Results. Rural hospitals admitted 363 patients and metropolitan hospital admitted 378 patients. Mean age was 73 years. Those in rural hospitals received more face-to-face (p>0.0014 and indirect (p=0.001 occupational therapy when compared to those in the metropolitan hospital. Face-to-face sessions lasted longer (p=0.001. Patients admitted to the metropolitan hospital received more face-to-face (p>0.000 and indirect (p>0.000 physiotherapy when compared to those admitted to rural hospitals. Face-to-face sessions were shorter (p>0.000. Almost all were seen within 24 hours of referral. Conclusions. Acute stroke patients in Australian rural hospital may receive more occupational therapy and less physiotherapy than those in metropolitan hospitals. The dose of therapy was lower than recommended, and the referral process may unnecessarily delay the time from admission to a patient’s first therapy session.

Epitaphios of Jovan, the Metropolitan of Skopje, in the treasury of the Hilandar monastery

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Radovanović Janko

2006-01-01

Full Text Available The epitaphios of Jovan, the Metropolitan of Skopje, was created between 1346 and 1348. It is unique for its beauty and iconographic program and, at the same time, it is the oldest of the epitaphia preserved in our country. The epitaphios was worn in the course of Holy Liturgy, during the Great Entrance in the cathedral churches and the major monasteries. Metropolitan Jovan presented the epitaphios as a gift to Christ 'my life-giver.' Depicted on its central field is the Epitaphios Threnos (Lamentation at the Tomb. Added around it, at a later time it seems, are bands representing the fourteen scenes of Great Feasts and the officiating Church Fathers, in embroidery. Holy Liturgy is served by the greatest fathers and teachers of the Church and Metropolitan Jovan.

Statewide and Metropolitan Transportation Planning Processes : a TPCB Peer Exchange

Science.gov (United States)

2016-04-20

This report highlights key recommendations and noteworthy practices identified at Statewide and Metropolitan Transportation Planning Processes Peer Exchange held on September 9-10, 2015 in Shepherdstown, West Virginia. This event was sponsored ...

Clinical profile of hypertension at a University Teaching Hospital in Nigeria

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Arthur C Onwuchekwa

2010-07-01

Full Text Available Arthur C Onwuchekwa, Sunday ChinenyeDepartment of Internal Medicine, University of Port Harcourt Teaching Hospital, NigeriaBackground: Hypertension in Nigeria is a widespread problem of immense social and economic importance because of its high prevalence and the severity of its complications.Aim: To define the morbidity and mortality pattern of hypertension at the University of Port Harcourt Teaching Hospital (UPTH.Method: Records of all patients admitted to the medical wards of the UPTH over a 5-year period with essential hypertension or any of its complications were retrieved from the ward and medical records and reviewed.Result: A total of 780 hypertensive patients were reviewed, constituting 28.2% of all ­medical admissions. Only 424 (15.2% had complete records and were analyzed. Record keeping was poor. There were 173 (41% males and 251 (59% females with a male to female ratio of 1:1.5. The ages ranged from 18 years to 100 years with a mean of 56.5 ± 16.2. Stroke was responsible for 169 (39.9% hypertensive complications. Heart failure occurred in 97 (22% cases while renal failure and encephalopathy accounted for 40 (9.4% and 7 (1.7% hypertensive complications respectively. There were 99 deaths out of which 51 (51.5% were due to stroke, 14 (14.12% were due to heart failure, and 12 (12.1% were due to renal failure.Conclusion: The contribution of systemic hypertension to the morbidity and mortality of adults at UPTH is quite significant.Keywords: clinical profile, hypertension, University of Port Harcourt Teaching Hospital

Is There a Global Role for Metropolitan City Libraries?

Science.gov (United States)

Mason, Marilyn Gell

1994-01-01

Discusses the potential for linking large metropolitan public libraries to international interlibrary loan networks. Issues involved in international networking, including funding, standards, network connectivity, and protectionism, are discussed. Examples of libraries capable of participating and brief descriptions of their collections are given.…

Moving Upstream in U.S. Hospital Care Toward Investments in Population Health.

Science.gov (United States)

Begun, James W; Potthoff, Sandra

The root causes for most health outcomes are often collectively referred to as the social determinants of health. Hospitals and health systems now must decide how much to "move upstream," or invest in programs that directly affect the social determinants of health. Moving upstream in healthcare delivery requires an acceptance of responsibility for the health of populations. We examine responses of 950 nonfederal, general hospitals in the United States to the 2015 American Hospital Association Population Health Survey to identify characteristics that distinguish those hospitals that are most aligned with population health and most engaged in addressing social determinants of health. Those "upstream" hospitals are significantly more likely to be large, not-for-profit, metropolitan, teaching-affiliated, and members of systems. Internally, the more upstream hospitals are more likely to organize their population health activities with strong executive-level involvement, full-time-equivalent support, and coordination at the system level.The characteristics differentiating hospitals strongly involved in population health and upstream activity are not unlike those characteristics associated with diffusion of many innovations in hospitals. These hospitals may be the early adopters in a diffusion process that will eventually include most hospitals or, at least, most not-for-profit hospitals. Alternatively, the population health and social determinants movements could be transient or could be limited to a small portion of hospitals such as those identified here, with distinctive patient populations, missions, and resources.

Comparative Analysis of User-Generated Online Yelp Reviews for Periodontal Practices in Multiple Metropolitan Markets.

Science.gov (United States)

Holtzclaw, Dan J

2017-02-01

Previously published research for a single metropolitan market (Austin, Texas) found that periodontists fare poorly on the Yelp website for nearly all measured metrics, including average star ratings, number of reviews, review removal rate, and evaluations by "elite" Yelp users. The purpose of the current study is to confirm or refute these findings by expanding datasets to additional metropolitan markets of various sizes and geographic locations. A total of 6,559 Yelp reviews were examined for general dentists, endodontists, pediatric dentists, oral surgeons, orthodontists, and periodontists in small (Austin, Texas), medium (Seattle, Washington), and large (New York City, New York) metropolitan markets. Numerous review characteristics were evaluated, including: 1) total number of reviews; 2) average star rating; 3) review filtering rate; and 4) number of reviews by Yelp members with elite status. Results were compared in multiple ways to determine whether statistically significant differences existed. In all metropolitan markets, periodontists were outperformed by all other dental specialties for all measured Yelp metrics in this study. Intermetropolitan comparisons of periodontal practices showed no statistically significant differences. Periodontists were outperformed consistently by all other dental specialties in every measured metric on the Yelp website. These results were consistent and repeated in all three metropolitan markets evaluated in this study. Poor performance of periodontists on Yelp may be related to the age profile of patients in the typical periodontal practice. This may result in inadvertently biased filtering of periodontal reviews and subsequently poor performance in multiple other categories.

Knowledge Worker Perceptions of Telework Policy in the New York Metropolitan Area: A Qualitative Descriptive Study

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Slaughter, Sandra Lorraine Hawks

2013-01-01

This qualitative descriptive case study, "Knowledge Worker Perceptions of Telework in the New York Metropolitan Area," was conducted to explore the perceptions of knowledge workers who commute to a physical workplace in the New York Metropolitan area (NYMA). In-depth interviews were conducted with fourteen NYMA commuters who are…

Outsourcing and "dismantling" of steady jobs at hospitals

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Helton Saragor de Souza

2016-04-01

Full Text Available Abstract OBJECTIVE To relate hospitals' organizational structure as the core of a web of outsourced services and flexible employment bonds among healthcare professionals in the context of finance capitalism, analyzing work arrangements based mainly on the type of employment bond. METHOD Qualitative research through ethnography, interviews, data analysis, and case studies. The case studies were concentrated in 3 hospitals located in the São Paulo metropolitan region under different management types: public administration; outsourced administration via a healthcare social organization (HSO; and private administration. RESULTS This study highlights a trend in outsourcing, dismantling of steady jobs, and shaping working relations asymmetrically in terms of healthcare professions. CONCLUSION These aspects are characteristic of contemporary capitalism and post-Fordist work organization. In this context, the state under sponsorship cripples the very existence of an effective human resources policy, creating a favorable environment for outsourcing and flexibility of employment bonds among healthcare workers.

The metropolitan area as a knee-jerk response to the multilevel governance and its derived national public decisions

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Cătălin Daniel DUMITRICĂ

2013-06-01

Full Text Available The paper objectifies the first part of a larger projects aiming at establishing a public decision-making map pertaining to the negative externalities in the framework of the economic approach of subsidiarity in the multilevel governance (the case of Romania. The first part of the larger research project refers to testing whether the economic theory of the European Union multilevel governance, with its core consisting in the subsidiarity principle, puts more pressure on the national public decisions (more specifically those related to specific market failures, though it interferes with all state’s functions and their specific decisions.Our research thesis begins by establishing whether the relationship between the local political elites and public governance at the level of towns and communes is considered a very straight forward, even obvious relationship. The political parties, by means of the publicly and democratically-elected officials (mayors and local council-members, make the most important decisions concerning public affairs (i.e. pertaining to a market failure examined by a second stage of the project.In an attempt to modernize the Romanian administrative system, to make public administration more dynamic, flexible and pro-active, the local political leaders decided the development of a new type of structure, the metropolitan area. The metropolitan areas, due to the constraints of the law, were established as associative organizations, composed of several administrative-territorial units.The paper at hand presents the establishment of the metropolitan areas in Romania as a political decision to associate towns and communes, in view of gaining access to better-performance instruments for local economic development. The emergence of the metropolitan areas in our country is strongly connected with the local political elites, the local political actors representing, in fact, the engine of the metropolitan structures and regional

CT scanning in stroke patients: meeting the challenge in the remote and rural district general hospital.

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Todd, A W; Anderson, E M

2009-05-01

National audit data allow crude comparison between centres and indicate that most Scottish hospitals fail to meet current guidelines for CT scanning of the brain in stroke patients. This study identifies some of the reasons for delay in performing CT scans in a largely rural population. This audit study assesses the delays from onset of symptoms, time of admission and request received to CT scan in stroke patients for three different in-patient groups as well as those managed in the community. The reasons for delay in CT scanning varied between different patient groups but for one group of in-patients, changes in booking procedure and introduction of a second CT scanner increased the proportion scanned within 48 hours of request from 65% to 96%. Further developments including the introduction of Saturday and Sunday routine CT scanning, radiologist reporting from home and additional CT scanners placed in remote hospitals may be expected to improve these figures further. Target times of three hours from onset of symptoms to scan to allow thrombolysis may however be impossible to meet for all stroke patients in rural areas.

Health Impacts and Economic Costs of Air Pollution in the Metropolitan Area of Skopje.

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Martinez, Gerardo Sanchez; Spadaro, Joseph V; Chapizanis, Dimitris; Kendrovski, Vladimir; Kochubovski, Mihail; Mudu, Pierpaolo

2018-03-29

Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. In 2012, long-term exposure to PM 2.5 (49.2 μg/m³) caused an estimated 1199 premature deaths (CI95% 821-1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM 2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104-977) from cardiovascular diseases, and 937 admissions (CI95% 937-1869) for respiratory disease that year. Reducing PM 2.5 levels to the EU limit (25 μg/m³) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m³) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM 2.5 concentrations could provide substantial health and economic gains to the city.

Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas - United States.

Science.gov (United States)

Mack, Karin A; Jones, Christopher M; Ballesteros, Michael F

2017-10-20

Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015. The National Survey of Drug Use and Health (NSDUH) collects information through face-to-face household interviews about the use of illicit drugs, alcohol, and tobacco among the U.S. noninstitutionalized civilian population aged ≥12 years. Respondents include residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories, migratory workers' camps, and halfway houses) and civilians living on military bases. NSDUH variables include sex, age, race/ethnicity, residence (metropolitan/nonmetropolitan), annual household income, self-reported drug use, and drug use disorders. National Vital Statistics System Mortality (NVSS-M) data for U.S. residents include information from death certificates filed in the 50 states and the District of Columbia. Cases were selected with an underlying cause of death based on the ICD-10 codes for drug overdoses (X40-X44, X60-X64, X85, and Y10-Y14). NVSS-M variables include decedent characteristics (sex, age, and race/ethnicity) and information on intent (unintentional, suicide, homicide, or undetermined), location of death (medical facility, in a home, or other [including nursing homes, hospices, unknown, and other locations]) and county of residence (metropolitan/nonmetropolitan). Metropolitan/nonmetropolitan status is assigned independently in each data system. NSDUH uses a three-category system: Core Based Statistical Area (CBSA) of ≥1 million persons; CBSA of illicit drugs, the prevalence was highest for the large metropolitan areas compared with

Is Urban Planning in Australia Hindered by Poor Metropolitan Governance?

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Paul Burton

2017-11-01

Full Text Available There are many calls for urban planning in Australia to be reformed, although often in contradictory ways. For example, some argue it should be capable of delivering greater certainty to developers while others call for more flexibility in processes of urban development regulation; some would like to roll back its regulatory impact while others argue for a renewal of planning’s commitment to promoting social and spatial justice. The Australian planning system is also held to be hindered by a comparative lack of planning at and for the metropolitan scale. This is connected to the absence of well-developed structures of metropolitan governance in what is a three-tier federal system, with most power over planning concentrated at the State and Territory government scale. The paper explores this putative hindrance by considering three important issues in Australian urban policy debates about the efficacy of contemporary multi-level governance arrangements: spatial scale; identity and legitimacy; and efficiency and effectiveness. It includes some analysis of the case made for a more explicit and rigorous national urban policy and how this might relate to lower level planning regimes. The paper focuses on recent urban policy and planning initiatives in South East Queensland, one of Australia’s fastest growing metropolitan regions, and concludes that while incremental but nonetheless significant improvements in planning policy and practice are possible, these are unlikely to satisfy those calling for more radical changes to improve the Australian planning system.

Estimating the health and economic benefits associated with reducing air pollution in the Barcelona metropolitan area (Spain).

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Pérez, Laura; Sunyer, Jordi; Künzli, Nino

2009-01-01

To estimate the health and economic benefits that would result from two scenarios of improved air quality in 57 municipalities of the metropolitan area of Barcelona. We used attributable fractions and life tables to quantify the benefits for selected health outcomes, based on published concentration-response functions and economic unit values. The mean weighted concentration of PM(10) for the study population was estimated through concentration surface maps developed by the local government. The annual mean health benefits of reducing the mean PM(10) exposure estimated for the population in the study area (50microg/m(3)) to the annual mean value recommended by the World Health Organization (20microg/m(3)) were estimated to be 3,500 fewer deaths (representing an average increase in life expectancy of 14 months), 1,800 fewer hospitalizations for cardio-respiratory diseases, 5,100 fewer cases of chronic bronchitis among adults, 31,100 fewer cases of acute bronchitis among children, and 54,000 fewer asthma attacks among children and adults. The mean total monetary benefits were estimated to be 6,400 million euros per year. Reducing PM(10) to comply with the current European Union regulatory annual mean level (40microg/m(3)) would yield approximately one third of these benefits. This study shows that reducing air pollution in the metropolitan area of Barcelona would result in substantial health and economic benefits. The benefits are probably underestimated due to the assumptions made in this study. Assessment of the health impact of local air pollution is a useful tool in public health.

The polycentric structure of local labour markets in Mexico City's Metropolitan Area

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José María Casado Izquierdo

2012-11-01

Full Text Available Commuting data at a district level and an algorithm designed to delineate self–contained areas show that Mexico City Metropolitan Area (MCMA was organized in 2007 in twelve local labour market areas. Although six exployment subcenters were identified, the MCMA is still clearly dominated by its Central Business District (CBD, being located the remaining five subcenters close to the CBD. Assessment of this spatial structure is not a positive one: diminishing co–location, decrease in speed and increase in commuting time and distance. Nevertheless, the rising percentage of intra–district commuting is a positive sign, even if this trend is not uniform throughout the metropolitan area.

Relative Food Prices and Obesity in U.S. Metropolitan Areas: 1976-2001

Science.gov (United States)

Xu, Xin; Variyam, Jayachandran N.; Zhao, Zhenxiang; Chaloupka, Frank J.

2014-01-01

This study investigates the impact of food price on obesity, by exploring the co-occurrence of obesity growth with relative food price reduction between 1976 and 2001. Analyses control for female labor participation and metropolitan outlet densities that might affect body weight. Both the first-difference and fixed effects approaches provide consistent evidence suggesting that relative food prices have substantial impacts on obesity and such impacts were more pronounced among the low-educated. These findings imply that relative food price reductions during the time period could plausibly explain about 18% of the increase in obesity among the U.S. adults in metropolitan areas. PMID:25502888

Assessment of the Impact of Metropolitan-Scale Urban Planning Scenarios on the Moist Thermal Environment under Global Warming: A Study of the Tokyo Metropolitan Area Using Regional Climate Modeling

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Asuka Suzuki-Parker

2015-01-01

Full Text Available Using a high-resolution regional climate model coupled with urban canopy model, the present study provides the first attempt in quantifying the impact of metropolitan-scale urban planning scenarios on moist thermal environment under global warming. Tokyo metropolitan area is selected as a test case. Three urban planning scenarios are considered: status quo, dispersed city, and compact city. Their impact on the moist thermal environment is assessed using wet-bulb globe temperature (WBGT. Future projections for the 2070s show a 2–4°C increase in daytime mean WBGT relative to the current climate. The urban scenario impacts are shown to be small, with a −0.4 to +0.4°C range. Relative changes in temperature and humidity as the result of a given urban scenario are shown to be critical in determining the sign of the WBGT changes; however, such changes are not necessarily determined by local changes in urban land surface parameters. These findings indicate that urban land surface changes may improve or worsen the local moist thermal environment and that metropolitan-scale urban planning is inefficient in mitigating heat-related health risks for mature cities like Tokyo.

The New England Drought Study: Water Resources Planning Metropolitan Boston, Massachusetts

National Research Council Canada - National Science Library

Joyce, Charles

1994-01-01

.... The drought of the 1960s precipitated a debate between the operators of the metropolitan Boston water system and interested citizens and citizens' groups, who were opposed to a structural solution...

Disparities in Salaries: Metropolitan versus Nonmetropolitan Community College Faculty

Science.gov (United States)

Glover, Louis C.; Simpson, Lynn A.; Waller, Lee Rusty

2009-01-01

This article explores disparities in faculty salaries between metropolitan and nonmetropolitan Texas community colleges. The analysis reveals a significant difference in faculty salaries for the 2000 and 2005 academic years respectively. The study found no significant difference in the rate of change in faculty salaries from 2000 to 2005.…

[Compatibility of Work and Family Life: Survey of Physicians in the Munich Metropolitan Area].

Science.gov (United States)

Lauchart, Meike; Ascher, Philipp; Kesel, Karin; Weber, Sabine; Grabein, Beatrice; Schneeweiss, Bertram; Fischer-Truestedt, Cordula; Schoenberg, Michael; Rogler, Gudrun; Borelli, Claudia

2017-05-15

Aim Investigation of the compatibility of work and family life for physicians in the Munich metropolitan area. Methods Survey of a representative sample of 1,800 physicians using a questionnaire. Results Men were less satisfied (7% very satisfied vs. 21%) with compatibility between work and family life than women. The group least satisfied overall was hospital-based physicians (p=0.000, chi-square=122.75). Women rather than men cut back their career due to children, perceived their professional advancement as impaired, desisted from establishing private practice or quit hospital employment altogether. Respondents strove for flexible childcare and makeshift solution if the established service failed. Most did not have that at their disposal. Hospital-based physicians wished for predictable working hours, and would like to have a say in the structure of their schedule. For the majority this was not the case. While for 80% it would be important to participate in the definition of their working hours, this was only possible in 17%. 86% found the opportunity to work part-time important, but many doctors (more than 30%) did not have that option. The biggest help for office-based physicians would be an expedited procedure by the Bavarian Association of Statutory Health Insurance Physicians (KVB) when applying for a proxy. The second most important would be the ability to hand over on-call duties. 36% of respondents felt that compatibility of work and family life was best achieved outside of patient care, during residency 42% believed this to be the case. Only 6% of physicians felt the best compatibility to be achieved in a hospital. Among the physician owners of practices, 34% considered their model to be the best way to reconcile both aspects of life. Conclusion More flexible options for childcare and more influence on the definition of working hours are necessary in order to better reconcile work and family life. For office-based physicians it must be made easier to

Leaching Functions from the Outer Metropolitan Zones (Trade, Services - Increasing Peripherality of Small Towns and Rural Areas

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Krystian Heffner

2015-01-01

Full Text Available Intensive spatial processes taking place around metropolitan areas leads to many economic, structural and social changes in their surroundings. The small towns and rural areas located in the outer zone of metropolitan areas are most affected by this functional changes. In the outer zone of a big urban canters appears a lot of new competing possibilities on the labor market and a comprehensive commercial, service and cultural offer to smaller centres. One of the most competitive advantage of the metropolitan zones becomes modern shopping centres being established in the most accessible places, providing a comprehensive shopping-services and even cultural-recreational offer.

Characterizing Spatial and Temporal Patterns of Thermal Environment and Air Quality in Taipei Metropolitan Area

Science.gov (United States)

Juang, J. Y.; Sun, C. H.; Jiang, J. A.; Wen, T. H.

2017-12-01

The urban heat island effect (UHI) caused by the regional-to-global environmental changes, dramatic urbanization, and shifting in land-use compositions has becoming an important environmental issue in recent years. In the past century, the coverage of urban area in Taipei Basin has dramatically increasing by ten folds. The strengthen of UHI effect significantly enhances the frequency of warm-night effect, and strongly influences the thermal environment of the residents in the Greater Taipei Metropolitan. In addition, the urban expansions due to dramatic increasing in urban populations and traffic loading significantly impacts the air quality and causes health issue in Taipei. In this study, the main objective is to quantify and characterize the temporal and spatial distributions of thermal environmental and air quality in the Greater Taipei Metropolitan Area by using monitoring data from Central Weather Bureau, Environmental Protection Administration. In addition, in this study, we conduct the analysis on the distribution of physiological equivalent temperature in the micro scale in the metropolitan area by using the observation data and quantitative simulation to investigate how the thermal environment is influenced under different conditions. Furthermore, we establish a real-time mobile monitoring system by using wireless sensor network to investigate the correlation between the thermal environment, air quality and other environmental factors, and propose to develop the early warning system for heat stress and air quality in the metropolitan area. The results from this study can be integrated into the management and planning system, and provide sufficient and important background information for the development of smart city in the metropolitan area in the future.

Metropolitan Blueprints of Colonial Taxation? Lessons from Fiscal Capacity Building in British and French Africa, c. 1880-1940

NARCIS (Netherlands)

Frankema, E.H.P.; Waijenburg, van M.F.M.

2014-01-01

The historical and social science literature is divided about the importance of metropolitan blueprints of colonial rule for the development of colonial states. We exploit historical records of colonial state finances to explore the importance of metropolitan identity on the comparative development

Australian Hospital-Based Nurse Educators' Perceptions of Their Role.

Science.gov (United States)

Thornton, Karleen

2018-06-01

This article presents the findings from a phenomenological study that explored the understandings of Australian hospital-based nurse educators' experiences of their role. Purposive sampling resulted in 11 nurse educators from four large metropolitan hospitals within an Australian jurisdiction. The participants were asked how they understand their role and translate that understanding into practice. Thematic analysis identified four themes representative of nurse educators' understanding of their role: Becoming an Educator, Capability Building, Panacea, and Tension. A coherent picture emerged from subthemes highlighting that nurse educators were undervalued and value is added. Being undervalued and value adding are translated into nurse educator practice as resilience, being educationally literate, investing, and having a presence. This article identifies a gap in knowledge related to understanding the nurse educator role and informs recruitment and subsequent retention of nurses into nurse educator roles at a time when the nursing workforce in Australia and internationally is about to experience a major shortfall. Findings are specific to the Australian context and are not necessarily generalizable to other hospital jurisdictions. J Contin Educ Nurs. 2018;49(6):274-281. Copyright 2018, SLACK Incorporated.

Analysing contemporary metropolitan spatial plans in Europe through their institutional context, instrumental content and planning process

DEFF Research Database (Denmark)

Elinbaum, Pablo; Galland, Daniel

2016-01-01

This article sets out to propose and apply a qualitative framework for thinking about how to analyze and compare metropolitan spatial plans in a milieu of divergent spatial planning traditions and discretionary planning practices. In doing so, the article reviews and develops an understanding...... concerning the institutional context, instrumental content and planning processes associated with four contemporary metropolitan spatial plans in Europe, namely London, Copenhagen, Paris and Barcelona. Through the results of a multiple case study and a subsequent cross comparative analysis, the article...... stresses that contemporary metropolitan spatial plans tend to merge characteristics associated with project-based and strategy-based spatial plans, thus contrasting with the typical land-use character of municipal plans and the often strategic, growth-oriented pursuit of regional plans in Europe...

Urban heat island effect on cicada densities in metropolitan Seoul

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Hoa Q. Nguyen

2018-01-01

Full Text Available Background Urban heat island (UHI effect, the ubiquitous consequence of urbanization, is considered to play a major role in population expansion of numerous insects. Cryptotympana atrata and Hyalessa fuscata are the most abundant cicada species in the Korean Peninsula, where their population densities are higher in urban than in rural areas. We predicted a positive relationship between the UHI intensities and population densities of these two cicada species in metropolitan Seoul. Methods To test this prediction, enumeration surveys of cicada exuviae densities were conducted in 36 localities located within and in the vicinity of metropolitan Seoul. Samples were collected in two consecutive periods from July to August 2015. The abundance of each species was estimated by two resource-weighted densities, one based on the total geographic area, and the other on the total number of trees. Multiple linear regression analyses were performed to identify factors critical for the prevalence of cicada species in the urban habitat. Results C. atrata and H. fuscata were major constituents of cicada species composition collected across all localities. Minimum temperature and sampling period were significant factors contributing to the variation in densities of both species, whereas other environmental factors related to urbanization were not significant. More cicada exuviae were collected in the second rather than in the first samplings, which matched the phenological pattern of cicadas in metropolitan Seoul. Cicada population densities increased measurably with the increase in temperature. Age of residential complex also exhibited a significantly positive correlation to H. fuscata densities, but not to C. atrata densities. Discussion Effects of temperature on cicada densities have been discerned from other environmental factors, as cicada densities increased measurably in tandem with elevated temperature. Several mechanisms may contribute to the abundance of

The New England Drought Study: Water Resources Planning Metropolitan Boston, Massachusetts

National Research Council Canada - National Science Library

Joyce, Charles

1994-01-01

The study has traced the water resources planning experience for the metropolitan Boston area from the 17th century to the present in order to investigate how current planning has evolved from seeking...

Health Impacts and Economic Costs of Air Pollution in the Metropolitan Area of Skopje

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Gerardo Sanchez Martinez

2018-03-01

Full Text Available Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. Methods: we obtained, cleaned, and validated Particulate Matter (PM concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. Results: In 2012, long-term exposure to PM2.5 (49.2 μg/m3 caused an estimated 1199 premature deaths (CI95% 821–1519. The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104–977 from cardiovascular diseases, and 937 admissions (CI95% 937–1869 for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m3 could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m3 could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Conclusions: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city.

Designing metropolitan landscapes for biodiversity: deriving guidelines from metapopulation ecology

NARCIS (Netherlands)

Opdam, P.F.M.; Steingröver, E.G.

2008-01-01

The decentralization of planning is giving local planning groups more power in decision making on the spatial development of metropolitan landscapes. However, because scientific knowledge is rarely used in these decision-making processes, there is a risk of discrepancies between the conservation

A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

Science.gov (United States)

Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

2017-12-13

Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

Broadband availability in metropolitan and non-metropolitan Pennsylvania

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Lawrence E. Wood

2016-09-01

Full Text Available Over the past few years having a broadband connection has become essential for many Internet activities. As broadband increases in importance, it becomes imperative to assess how its use and availability may vary, especially in relation to issues such as geographic location. For rural areas in particular, the availability of broadband service is especially important. This research assesses broadband service availability in rural areas of Pennsylvania, USA. In particular, it examines the extent to which Digital Subscriber Line (DSL and broadband cable modem services are being deployed throughout rural Pennsylvania. It compares this deployment with the availability of such services in the state’s urban and metropolitan areas. The results of this research suggest that there is a “digital divide” in terms of broadband availability between rural and urban areas of Pennsylvania. However, this “divide” is perhaps not as wide as might be expected. Thus, as broadband is becoming increasingly available in rural areas of the U.S. and throughout much of the rest of the world, this research concludes that while research must remain vigilant in terms of assessing advanced telecommunications availability in rural areas, future research should also be sure to focus on how such technologies can be used to promote economic and social concerns, including in relation to building online networks and diminishing social and professional isolation in rural areas.

Analysis of Solid Waste Management and Strategies for Bangkok Metropolitan

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Palika Wannawilai

2017-04-01

Full Text Available This study aimed to examine and analyze strategic gaps and the environment of waste management of Bangkok Metropolitan Administration (BMA in order to suggest suitable waste management strategies for Bangkok Metropolitan. The study was conducted by interviewing BMA and districts’ administrators and officers, local leaders and people, and private sectors, conducting a focus group, as well as reviewing relevant documents. The data was analyzed by applying Gap analysis and SWOT analysis. The proposed five strategies are: 1 enhancement of efficiency in solid waste and hazardous waste management; 2 discipline, participation and responsibility of citizens and all sectors related to waste management; 3 appropriate and integrated waste management; 4 capacity building for BMA’s staff and improvement of solid waste management system; and 5 research and development of knowledge and technology in waste management. The study also suggested driving approaches for effective implementation of the strategies.

Urbanisation, urban growth and planning in the Copenhagen Metropolitan Region

DEFF Research Database (Denmark)

Fertner, Christian

pressure. Growth management strategies are necessary to secure future balanced and sustainable development throughout the whole urban region. The analysis of urbanisation and urban growth in peri-urban areas is at the core of this study, including socio-demographic and functional dynamics, land use impacts...... and options for spatial planning. The main case was the metropolitan region of Copenhagen, Denmark. Other cases from Europe and the USA were used as reference studies. The methods included quantitative analyses of register and land use data as well as general case study work to investigate options for spatial...... planning. The study shows that, while the most visible impacts of land use changes can be found at the close urban fringe, many other dynamics have a much longer reach into the rural-urban region. In the Copenhagen metropolitan region, we can observe migration to peri-urban areas and to the urban core...

ORAL HEALTH ATTENTION IN HOSPITAL LEVEL: REPORT OF EXPERIENCES OF EDUCATION/SERVICE INTEGRATION IN DENTISTRY

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Andréa Silvia Walter de Aguiar

2010-07-01

Full Text Available A healthy mouth is closely linked to general health and quality of life. Oral Health Education actions are extremely important in encouraging the practice of oral hygiene by the population. It is essential that actions related to oral health issues in hospitalized patients be developed by means of educational and preventive methods. In this context, students from the Extension Project of the Dentistry Course of the Federal University of Ceará saw the needs of patients of Dr. José Frota Institute for the collective actions in oral hygiene. The activities began in November 2007, being held on Sundays by 15 students divided into groups with regard to implementing the feelings of teamwork and the exchange of fun activities for the practice of solidarity. Guidelines on oral hygiene were made through the use of macro models, folders, mirrors, fluoridated toothpastes and brushes of teeth. All observations were recorded on a specific form - since the sociodemographic data to the oral health conditions in order to know the reality under an epidemiology look and make it possible to propose oral health policy in the Instituition. A total of 385 patients were assisted in two years of operation. It was founded that the prolonged hospitalization and/or obstruction of the self implementation means that oral hygiene is not prioritized, requiring the implementation of educational activities in a work environment even uncommon to the surgeon-dentist, but very promising for the designs of Dentistry, the hospital environment.

Creation of inpatient capacity during a major hospital relocation: lessons for disaster planning.

Science.gov (United States)

Jen, Howard C; Shew, Stephen B; Atkinson, James B; Rosenthal, J Thomas; Hiatt, Jonathan R

2009-09-01

To identify tools to aid the creation of disaster surge capacity using a model of planned inpatient census reduction prior to relocation of a university hospital. Prospective analysis of hospital operations for 1-week periods beginning 2 weeks (baseline) and 1 week (transition) prior to move day; analysis of regional hospital and emergency department capacity. Large metropolitan university teaching hospital. Hospital census figures and patient outcomes. Census was reduced by 36% from 537 at baseline to 345 on move day, a rate of 18 patients/d (P emergency operations was unchanged. Hospital admissions were decreased by 42%, and the adjusted discharges per occupied bed were increased by 8% (both P capacity to absorb new patients was limited. During a period in which southern California population grew by 8.5%, acute care beds fell by 3.3%, while Los Angeles County emergency departments experienced a 13% diversion rate due to overcrowding. Local or regional disasters of any size can overwhelm the system's ability to respond. Our strategy produced a surge capacity of 36% without interruption of emergency department and trauma services but required 3 to 4 days for implementation, making it applicable to disasters and mass casualty events with longer lead times. These principles may aid in disaster preparedness and planning.

Derivation of Nationally Consistent Indices Representing Urban Intensity Within and Across Nine Metropolitan Areas of the Conterminous United States

Science.gov (United States)

Cuffney, Thomas F.; Falcone, James A.

2009-01-01

Two nationally consistent multimetric indices of urban intensity were developed to support studies of the effects of urbanization on streams in nine metropolitan areas of the conterminous United States: Atlanta, Georgia; Birmingham, Alabama; Boston, Massachusetts; Dallas-Fort Worth, Texas; Denver, Colorado; Milwaukee-Green Bay, Wisconsin; Portland, Oregon; Raleigh, North Carolina; and Salt Lake City, Utah. These studies were conducted as a part of the U.S. Geological Survey's National Water-Quality Assessment Program. These urban intensity indices were used to define gradients of urbanization and to interpret biological, physical, and chemical changes along these gradients. Ninety census, land-cover, and infrastructure variables obtained from nationally available databases were evaluated. Only variables that exhibited a strong and consistent linear relation with 2000 population density were considered for use in the indices. Housing-unit density (HUDEN), percentage of basin area in developed land (P_NLCD1_2), and road density (ROADDEN) were selected as the best representatives of census, land-cover, and infrastructure variables. The metropolitan area national urban intensity index (MA-NUII) was scaled to represent urban intensity within each metropolitan area and ranged from 0 (little or no urban) to 100 (maximum urban) for sites within each metropolitan area. The national urban intensity index (NUII) was scaled to represent urban intensity across all nine metropolitan areas and ranged from 0 to 100 for all sites. The rates at which HUDEN, P_NLCD1_2, and ROADDEN changed with changes in population density varied among metropolitan areas. Therefore, these variables were adjusted to obtain a more uniform rate of response across metropolitan areas in the derivation of the NUII. The NUII indicated that maximum levels of urban intensity occurred in the West and Midwest rather than in the East primarily because small inner-city streams in eastern metropolitan areas are

OXYGEN TRANSFER STUDIES AT THE MADISON METROPOLITAN SEWERAGE DISTRICT FACILITIES

Science.gov (United States)

Field studies at the Madison Metropolitan Sewerage District facilities were conducted over a 3-year period to obtain long-term data on the performance of fine pore aeration equipment in municipal wastewater. The studies were conducted on several basins in the East Plant containi...

Uranium in underground water public supply of the metropolitan region of Recife

International Nuclear Information System (INIS)

Silva, C.M.; Sousa, G.H.; Vasconcelos, W.E.; Hazin, C.A.; Amaral, R.S.

2001-01-01

The geologic formation of the metropolitan region of Recife is of sedimentary origin. In the coast area, where the phosphate deposits are located, it is sufficiently rich in underground hydric features. In the superposed layers of the sedimentary basin exists three underground aquifers and 80% of the underground hydric features of public supplying of the metropolitan region of Recife are located in the phosphate deposits, which are rich in uranium. Physiologically the uranian are in the steady state (6+) with bivalent cations U 2+ 2 . The ingestion of uranium by man occurs through foods and water ingestion. The places of the human body where it has greater clamping of this radionuclides are the bones. The uranium is deposited slowly from surface of the bone, redistributing itself in route to the marrow. An important competition between Ca 2+ 2 and the UO 2+ 2 exists in the kidneys, where the Ca 2+ 2 efficiently is absorbed. This work was carried through aiming to determine the concentrations of uranium in waters of the wells of public supplying of the metropolitan region of Recife, collating them with the limits established for the Health Department, that establishes the level of 0.1 Bq/L referring to the total alpha radioactivity in drinking waters

Potential for air quality improvement in the Tokyo metropolitan area from use of hydrogen fuel

International Nuclear Information System (INIS)

Kruger, Paul; Murdock, Mork

1998-01-01

A revised estimation has been made of the local air quality improvement that can be achieved in Tokyo as a byproduct of a word-wide hydrogen energy economy based on global reduction of CO2 emission from fossil fuels. The study for the WE-NET Project in Japan examined the potential for reduction in nitrogen oxide emission with hydrogen fuel in the Tokyo metropolitan area where sufficient data exist on trends in population, vehicle registrations, traffic activity, and exhaust emissions. A dynamic model was developed to extrapolate the trends in these data to estimate future NOx emission rates in comparison to regulatory scenarios based on policy and technical decisions of the Tokyo Metropolitan Government for improvement of air quality in the metropolitan area. The results of the model show significant potential for reduction of NOx emission by the year 2020 with a concomitant reduction in mean roadside NOx concentration. (author)

Infection after open heart surgery in Golestan teaching hospital of Ahvaz, Iran.

Science.gov (United States)

Nashibi, Roohangiz; Mohammadi, Mohammad Javad; Alavi, Seyed Mohammad; Yousefi, Farid; Salmanzadeh, Shokrolah; Ahmadi, Fatemeh; Varnaseri, Mehran; Ramazani, Asghar; Moogahi, Sasan

2018-02-01

The present study surveyed demographic and infection data which were obtained after open heart surgery (OHS) through patient's admission in Golestan teaching hospital, Ahvaz metropolitan city of Iran, taking into account the confirmed location of the infection, microorganism and antibiotic susceptibility. The occurrence of infection among patients during 48 to 72 h after surgery and hospital admission is the definition of Nosocomial infections (NIs) (Salmanzadeh et al., 2015) [1]. All of them after OHS were chosen for this study. In this paper, type of catheter, fever, type of microorganism, antibiotic susceptibility, location of the infection and outcome (live or death) were studied (Juhl et al., 2017; Salsano et al., 2017) [2], [3]. After the completion of the observations and recording patients' medical records, the coded data were fed into EXCELL. Data analysis was performed using SPSS 16.

The 'unnecessary' use of emergency departments by older people: findings from hospital data, hospital staff and older people.

Science.gov (United States)

Faulkner, Debbie; Law, Julia

2015-11-01

Increasing demands are being placed on emergency departments in Australia and there is a view that older Australians are more likely than other age groups to attend for non-urgent conditions. The objective of this paper is to compare and contrast administrative data with the views of hospital staff and older people with regard to their presentation at two emergency departments in metropolitan Adelaide and how this aligns with the Australian Institute of Health and Welfare definition of 'potentially avoidable general practitioner-type presentations'. The study used three sources of data from two emergency departments: hospital data for the financial year 2010-11 for patients aged 65 years and over and identified as triage category four or five; three focus groups with medical, nursing and allied staff from these two hospitals; and interviews with 58 older people who presented at the two emergency departments over a two-week period. The hospital administrative data provided a very limited insight into why older people attended the emergency department, other than the medical diagnosis. Professional staff identified individual determinants, societal determinants and the health services system as explanations. Older people attended the emergency department for a range of reasons that may not necessarily reflect the opinions of health professionals. For many older people the emergency department was an appropriate place to attend considering their condition, though some presentations could be circumvented with appropriate and increased services in the community. However, as many older people suffer comorbidities, careful consideration needs to be given as to the best possible practices to achieve this.

Risk factors for recurrent hospital-acquired Clostridium difficile infection in a Japanese university hospital

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Hikone M

2015-07-01

Full Text Available Mayu Hikone,1 Yusuke Ainoda,1,2 Sayaka Tago,2 Takahiro Fujita,2 Yuji Hirai,2 Kaori Takeuchi,2 Kyoichi Totsuka31Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, 2Department of Infectious Diseases, Tokyo Women's Medical University, 3Department of Internal Medicine, Kitatama Hospital, Tokyo, JapanBackground: Clostridium difficile infection (CDI is a highly prevalent hospital-associated infection. Although most patients respond well to discontinuation of antibiotics, 20%–30% of patients relapse. To initiate early therapeutic measures, the risk factors for recurrent CDI must be identified, although very few Japanese studies have used standard surveillance definitions to identify these risk factors.Methods: We retrospectively reviewed the medical records of patients with health care facility-onset CDI between August 2011 and September 2013. Patients with diarrhea who were positive for Clostridium difficile (via an enzyme immunoassay were defined as having CDI. Clinical data (eg, demographics, comorbidities, medication, laboratory results, and clinical outcomes were evaluated, and multivariate analysis was used to identify risk factors that were associated with recurrent CDI.Results: Seventy-six health care facility-onset CDI cases were identified, with an incidence rate of 0.8 cases per 10,000 patient-days. Fourteen cases (18.4% were recurrent, with 13 patients having experienced a single recurrent episode and one patient having experienced three recurrent episodes. The 30-day and 90-day mortality rates were 7.9% and 14.5%, respectively. Multivariate analysis revealed that recurrent patients were more likely to have underlying malignant disease (odds ratio: 7.98; 95% confidence interval: 1.22–52.2; P=0.03 and a history of intensive care unit hospitalization (odds ratio: 49.9; 95% confidence interval: 1.01–2,470; P=0.049.Conclusion: Intensive care unit hospitalization and malignancy are risk factors for recurrent

Comparative Analysis of Health Care Needs among Children with Special Health Care Needs in Ohio's Metropolitan and Appalachian Counties.

Science.gov (United States)

Earley, Elizabeth; Asti, Lindsey; Chisolm, Deena

2015-08-01

The study assessed whether children with special health care needs (CSHCN) living in Appalachian Ohio have differential health care utilization, unmet needs, and health outcomes compared with CSHCN in Ohio's metropolitan counties using a statewide Ohio survey. Based on this survey, an estimated 28% of children in Appalachian Ohio counties have special health care needs compared with 25% of children in metropolitan counties. In Appalachia, CSHCN are poorer and more likely to have Medicaid than their metropolitan counterparts, but had no reported significant differences in health outcomes or unmet needs. Data suggested a trend toward higher use of emergency department care and inpatient services and lower use of well-child visits but these differences did not reach significance. We conclude that CSHCN in Appalachian and metropolitan areas face similar levels of health status and unmet needs but results suggest a need for additional research on access to primary care services.

The Challenge of Forecasting Metropolitan Growth: Urban Characteristics Based Models versus Regional Dummy Based Models

OpenAIRE

NA

2005-01-01

This paper presents a study of errors in forecasting the population of Metropolitan Statistical Areas and the Primary MSAs of Consolidated Metropolitan Statistical Areas and New England MAs. The forecasts are for the year 2000 and are based on a semi-structural model estimated by Mills and Lubelle using 1970 to 1990 census data on population, employment and relative real wages. This model allows the testing of regional effects on population and employment growth. The year 2000 forecasts are f...

Organizational and market factors associated with leadership development programs in hospitals: a national study.

Science.gov (United States)

Kim, Tae Hyun; Thompson, Jon M

2012-01-01

Effective leadership in hospitals is widely recognized as the key to organizational performance. Clinical, financial, and operational performance is increasingly being linked to the leadership practices of hospital managers. Moreover, effective leadership has been described as a means to achieve competitive advantage. Recent environmental forces, including reimbursement changes and increased competition, have prompted many hospitals to focus on building leadership competencies to successfully address these challenges. Using the resource dependence theory as our conceptual framework, we present results from a national study of hospitals examining the association of organizational and market factors with the provision of leadership development program activities, including the presence of a leadership development program, a diversity plan, a program for succession planning, and career development resources. The data are taken from the American Hospital Association's (AHA) 2008 Survey of Hospitals, the Area Resource File, and the Centers for Medicare & Medicaid Services. The results of multilevel logistic regressions of each leadership development program activity on organizational and market factors indicate that hospital size, system and network affiliation, and accreditation are significantly and positively associated with all leadership development program activities. The market factors significantly associated with all leadership development activities include a positive odds ratio for metropolitan statistical area location and a negative odds ratio for the percentage of the hospital's service area population that is female and minority. For-profit hospitals are less likely to provide leadership development program activities. Additional findings are presented, and the implications for hospital management are discussed.

Youthification in the Metropolitan Area of Cluj

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Vlad Cocheci

2018-06-01

Full Text Available This research exercise aims to identify all areas affected by what is now known as ‘youthification’ in the Metropolitan Area of Cluj. Broadly speaking, an area touched by youthification witnesses a massive arrival of young adults, who invest in housing, but only remain there until they age. Youthification is usually the second phase within an encompassing process of gentrification. To gain a clearer picture of this phenomenon, we employed a snapshot of the situation recorded by the Population and Housing Census of 2011. Using this image as a starting point, we then applied statistical thresholds aimed at measuring the presence and intensity of youthification within different areas. Thereafter, we looked at areas exhibiting the same level of youthification, in order to find those common traits of their young adult inhabitants that might prove relevant for their choices in matters of housing. Once completed, our efforts resulted in the first map showing the areas affected by youthification within the Metropolitan Area of Cluj. In addition, we reached the following conclusion: Young adults who live in the city are more likely to still be enrolled in a form of education and less likely to be married or to have children than those who live in the suburbs or in rural areas. This observation implies that there might be some hidden dependency relations, which are at work in shaping the choice of housing.

The one million volt X-ray therapy equipment at St Bartholomew's Hospital, 1936-1960

International Nuclear Information System (INIS)

Innes, G.S.

1988-01-01

St Bartholomew's Hospital in 1934 placed a contract with Messrs Metropolitan Vickers, of Manchester, for an X-ray therapy equipment to operate at 600 kV, 2mA d.c., but with the proviso that every effort would be made to attain an operating condition of 1000 kV, 4mA. The X-ray tube and rectifiers were to be continuously evacuated and demountable. This meant that components such as filaments, anodes and the target could be easily replaced, so providing cheap maintenance and continuous availability of the plant. No specification exists today, but one was assembled from the minutes of the Cancer Committee of the hospital and the contract pricing. A brief outline historical review is also presented, particularly of the personalities involved, and the War years 1939-1945. (author)

Top Soils Geochemical and Radioactivity Survey of Naples (Italy) Metropolitan.

Science.gov (United States)

Somma, R.; De Vivo, B.; Cicchella, D.

2001-05-01

The metropolitan area of Naples due to intense human activities is an emblematic area affected by various environmental pollution of soils and waters in addition to hydrogeological volcanic, seismic and bradyseismic hazards. The geology of the area is prevailing represented by volcanics erupted, from the Upper Pleistocene to Recent by Mt. Somma-Vesuvius on the east and the Campi Flegrei fields on the west. The morphology of the metropolitan area of Naples city can be subdivided in flat areas, constituted by reworked pyroclastic terrains, and by hills originated by the overlapping of different welded pyroclastic flows (i.e.: Campanian Ignimbrite and Neapoletan Yellow Tuff) intercalated with pyroclastic deposits of different origins (i.e.: Campi Flegrei, Mt. Somma-Vesuvius, Ischia) and ages. In order to compile a multi-element baseline geochemical and radioactivity mapping of the metropolitan area of the Napoli we have sampled for this study, in situ top soil and imported filling material (mainly soil, volcanic ash, pumice and scoriae). The sampling and radioactivity survey has been carried out on about 200 sampling sites covering an area of about 150 Km2, with a grid of 0.5 x 0.5 km in the urbanised downtown and 1 km x 1 km in the sub urban areas. In each site has been determined a radioactivity by a Scintrex GRS-500 at different emission spectra as total radioactivity (> 0.08 MeV and > 0.40 MeV), 238U (at 1.76 MeV mostly from 214Bi), 232Th (at 2.6 MeV mostly from 208Tl) and 40K (at 1.46 MeV mostly for 40K). The range of values of in situ soils are as follow for the in situ soils (Total radioactivity: 1327- 360 and 114- 47; 238U: 2.6- 1.3; 40K: 8.1- 3.1; 232U: 0.5- 0.1). Analyses of major, metallic elements and pH of each soil sample are in progress, while Pb isotopes compositions, for a selected number of samples, will be determined to discriminate the natural (geogenic) from the anthropogenic components in the soils by versus the anthropogenetic origin. The data

The perception of corporate services directorate in a metropolitan municipality on King III good governance compliance in business and projects

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Sly Newton Mutiro

2015-03-01

Full Text Available Good governance has been and is a growing phenomenon for many business organisations regardless of size, profit margins and purpose for existence. The South African Metropolitan municipality Metropolitan Municipality is one such organisation that has adopted good governance models to business practices. The challenge was how to effectively and efficiently implement governance issues around projects and business organisations. A number of people, committees and institutions have developed different governance frameworks that can be adopted by organisations as a guide to good governance. This research is based on King III guide to good governance. The objective was to establish the perceptions of the corporate services directorate in the South African Metropolitan municipality municipality on King III good governance compliance by interviewing some employees orally and through a questionnaire. The responses were captured and analysed using IMB SPSS software. Problems were identified in governance training and understanding in general. Another major finding was poor communication internally and externally. To overcome these shortfall recommendations were made. Communication models, communication plan, governance models and training were recommended. The major challenges facing the South African Metropolitan municipality Metropolitan Municipality are poor effective governance communication and lack of governance training.

Model LPA Terpadu untuk Wilayah Surabaya Metropolitan

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Mimien Bt. M. Al Muhdhar a Henie Irawati

2009-02-01

Full Text Available The purpose of this research is to establish the integrated LPA model for Surabaya Metropolitan Area. The methods used are literature overviews, comparative studies to well-established areas, and expert assistantships through national seminars. The result shows that the integrated LPA has opportunity to combine some activities such as sorting and classifying, producing, wrapping and containing, selling the compost and decayed materials, and filling residual waste by landfill system. In 25 Ha land area, 14.10 Ha is allocated for waste management, and 10.90 Ha for sanitary landfill.

Association of Admission to Veterans Affairs Hospitals vs Non-Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia.

Science.gov (United States)

Nuti, Sudhakar V; Qin, Li; Rumsfeld, John S; Ross, Joseph S; Masoudi, Frederick A; Normand, Sharon-Lise T; Murugiah, Karthik; Bernheim, Susannah M; Suter, Lisa G; Krumholz, Harlan M

2016-02-09

Little contemporary information is available about comparative performance between Veterans Affairs (VA) and non-VA hospitals, particularly related to mortality and readmission rates, 2 important outcomes of care. To assess and compare mortality and readmission rates among men in VA and non-VA hospitals. Cross-sectional analysis involving male Medicare fee-for-service beneficiaries aged 65 years or older hospitalized between 2010 and 2013 in VA and non-VA acute care hospitals for acute myocardial infarction (AMI), heart failure (HF), or pneumonia using the Medicare Standard Analytic Files and Enrollment Database together with VA administrative claims data. To avoid confounding geographic effects with health care system effects, we studied VA and non-VA hospitals within the same metropolitan statistical area (MSA). Hospitalization in a VA or non-VA hospital in MSAs that contained at least 1 VA and non-VA hospital. For each condition, 30-day risk-standardized mortality rates and risk-standardized readmission rates for VA and non-VA hospitals. Mean aggregated within-MSA differences in mortality and readmission rates were also assessed. We studied 104 VA and 1513 non-VA hospitals, with each condition-outcome analysis cohort for VA and non-VA hospitals containing at least 7900 patients (men; ≥65 years), in 92 MSAs. Mortality rates were lower in VA hospitals than non-VA hospitals for AMI (13.5% vs 13.7%, P = .02; -0.2 percentage-point difference) and HF (11.4% vs 11.9%, P = .008; -0.5 percentage-point difference), but higher for pneumonia (12.6% vs 12.2%, P = .045; 0.4 percentage-point difference). In contrast, readmission rates were higher in VA hospitals for all 3 conditions (AMI, 17.8% vs 17.2%, 0.6 percentage-point difference; HF, 24.7% vs 23.5%, 1.2 percentage-point difference; pneumonia, 19.4% vs 18.7%, 0.7 percentage-point difference, all P percentage-point difference, -0.22; 95% CI, -0.40 to -0.04) and HF (-0.63; 95% CI, -0.95 to -0.31), and

Subsurface information for risk-sensitive urban spatial planning in Dhaka Metropolitan City, Bangladesh

Science.gov (United States)

Günther, Andreas; Aziz Patwary, Mohammad Abdul; Bahls, Rebecca; Asaduzzaman, Atm; Ludwig, Rüdiger; Ashraful Kamal, Mohammad; Nahar Faruqa, Nurun; Jabeen, Sarwat

2016-04-01

Dhaka Metropolitan City (including Dhaka and five adjacent municipal areas) is one of the fastest developing urban regions in the world. Densely build-up areas in the developed metropolitan area of Dhaka City are subject to extensive restructuring as common six- or lower storied buildings are replaced by higher and heavier constructions. Additional stories are built on existing houses, frequently exceeding the allowable bearing pressure on the subsoil as supported by the foundations. In turn, newly developing city areas are projected in marshy terrains modified by extensive, largely unengineered landfills. In most areas, these terrains bear unfavorable building ground conditions within 30 meters. Within a collaborative technical cooperation project between Bangladesh and Germany, BGR supports GSB in the provision of geo-information for the Capital Development Authority (RAJUK). For general urban planning, RAJUK successively develops a detailed area plan (DAP) at scale 1 : 50000 for the whole Dhaka Metropolitan City area (approx. 1700 km2). Geo-information have not been considered in the present DAP. Within the project, geospatial information in form of a geomorphic map, a digital terrain model and a 3-D subsurface model covering the whole city area have been generated at a scale of 1 : 50000. An extensive engineering geological data base consisting of more than 2200 borehole data with associated Standard Penetration Testing (SPT) and lab data has been compiled. With the field testing (SPT) and engineering geological lab data, the 3-D subsurface model can be parameterized to derive important spatial subsurface information for urban planning like bearing capacity evaluations for different foundation designs or soil liquefaction potential assessments for specific earthquake scenarios. In conjunction with inundation potential evaluations for different flooding scenarios, comprehensive building ground suitability information can be derived to support risk

Regional Disparities and Social Cohesion Policies. The Case of the Metropolitan Area of Bari (Italy

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ROSALINA GRUMO

2015-06-01

Full Text Available The role of Regions appears reconfigured by the "reshaping" of national States. Besides, under a sub-regional scale, forms of governance have been launched, redefining a new territoriality. In Italy, the role of the Regions and Cities is more and more important in the decision-making processes of the territories and it is also characterized by the recent establishment of the metropolitan cities, but still not geo-politically defined. There is, in fact, a constitutional reform process through the region's reorganization legislative autonomy and strengthening of local governments. In this context, some areas are characterized by social unrest that includes new forms of poverty, urban malaise and marginalization, due also to the financial and economic crisis whose signs of recovery are still very weak. In the European Union, the programming decisions considered the policy of development and cohesion also at the local scale. The 2014-2020 EU programming cycle, in fact, has defined the main role of metropolitan cities, but also of cities and internal areas. The contribution will analyze Puglia, region of southern Italy, and the metropolitan area of Bari, the regional capital, in order to verify policies concerning the social field, both through "strategic planning" and launching the so-called "smart city" experience. In the metropolitan city, indeed, there is already an orientation towards the "social innovation" to address the issues of social cohesion and inclusion, consistent to sustainable development.

Los Angeles County Metropolitan Transportation Authority climate change adaptation pilot project report.

Science.gov (United States)

2013-08-01

This Climate Change Adaptation Pilot Project Report details the project background of the recently-completed Los Angeles County : Metropolitan Transportation Authority (Metro) Transit Climate Change Adaptation Pilot Project as well as the various wor...

The design of gated communities in São Paulo metropolitan area

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João Rett Lemos

2007-06-01

Full Text Available This paper has as study object the formation of a kind of residential urban landscape spread in a large number of Brazilian cities, in special those around the Sao Paulo metropolitan area: the gated communities destined to a population with average and high income. The premise that it deals with a type of appropriation of urban ground related since the middle of the 1970‘s when internal adjustments in real estate market were implemented, and to the standards of growth of the São Paulo metropolitan area, specifically its process of dispersion, excites the necessity of identify the characteristics and specially the effects to the rest of the urban space that are been spread in terms never seen. Twenty eight enterprises launched between 1994 and 2005 in the metropolitan area are analyzed. The set of case studies involves from communities settled in the rural zones to the urban areas; in common is the fact that are enterprises created by a private entrepreneur to subdivide an only one private property, and the management of the internal space by proper codes. The analysis was developed in two scales: at a first moment, it was restricted in the internal spaces, appointing the planning methods and the distribution standards of the open areas, the volumetric occupations, and the leisure equipments; in the following one, were analyzed the neighbor landscape, identifying the main characteristics of the fabric urban and the not constructed natural environment.

Can Maine metropolitan planning organizations (MPOs) finance transportation projects through bond financing?

Science.gov (United States)

2008-12-01

In January 2008 the Maine metropolitan planning organizations (MPOs) requested the Transportation : Research Division of the Maine Department of Transportation to conduct research to determine if it is : possible for MPOs to finance projects through ...

Demographic Transformation in a Policy Vacuum: The Changing Face of U.S. Metropolitan Society and Challenges for Public Schools

Science.gov (United States)

Mordechay, Kfir; Orfield, Gary

2017-01-01

Educators and policy makers must confront the race and class disparities in learning opportunities across American society. Nowhere are these disparities more acute than in the country's great metropolitan areas. As the demographic landscape continues to shift, metropolitan areas are fueling the transition to a majority-minority country. This…

Prevalence and risk factors of childhood allergic diseases in eight metropolitan cities in China: A multicenter study

OpenAIRE

Jin Xingming; Jiang Fan; Zhou Yingchun; Li Shenghui; Li Fei; Yan Chonghuai; Tian Ying; Zhang Yiwen; Tong Shilu; Shen Xiaoming

2011-01-01

Abstract Background Several studies conducted during the past two decades suggested increasing trend of childhood allergic diseases in China. However, few studies have provided detailed description of geographic variation and explored risk factors of these diseases. This study investigated the pattern and risk factors of asthma, allergic rhinitis and eczema in eight metropolitan cities in China. Methods We conducted a cross-sectional survey during November-December 2005 in eight metropolitan ...

A Political-Ecological Analysis of Income Inequality in the Metropolitan Area.

Science.gov (United States)

Bollens, Scott A.

1986-01-01

Metropolitan development is not simply a result of ecological factors. Governmental organization affects the incentives of localities and helps determine patterns of growth. This study updates previous studies on factors influencing residential area income inequality. Modification of the variables in the ecological explanation will increase…

The Spatial Changes of Land Use in the Bucharest Metropolitan Area 1970s – 2000s

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Gabriel Simion

2010-11-01

Full Text Available The article explore the dimension of spatial changes of land use in the Bucharest Metropolitan Area (BMA over the past forty years. Using GIS-based land use data sets of the years 1970, 1990 and 2000, combining with statistical data, we attempted to quantify the spatial pattern of land use changes in the BMA. Our findings indicate that most significantly changes occurred with arable lands that have been reduced from 77% of total metropolitan area in 1970 to 71.3% in 2000 and in same time the built up area increase from 6.2% in 1970 to 10.4% in 2000. Vineyards and orchards suffered a reduced of their spread. In the case of vineyards the percentage of total area decrease from 2.7% in 1970 to 0.8% and regarding orchards from 1.1% in 1970 to 0.6% in 2000. The growth of built up indicate the urban influence of Bucharest city on it the large metropolitan area. The decrease of vineyards and orchards can be correlated with agrarian reform passed after the fall of socialist economic system that generated many problems for the farmers that cannot continue to cultivate the land with these kinds of cultures. These findings have implication with the futures strategies on urban and metropolitan planning in this area.

Addressing the Clinical Burden of Child Physical Abuse and Neglect in a Large Metropolitan Region: Improving the Evidence-Base

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Shanti Raman

2014-10-01

Full Text Available Children at risk of abuse are more likely to be hospitalized and utilize health services according to international research. In a large metropolitan health region in New South Wales, Australia, there was little known of the clinical burden of child physical abuse and/or neglect (PAN, or of systems for clinical assessment of children presenting with abuse/neglect. We aimed to identify the number of children presenting with suspected PAN to emergency departments (EDs and paediatric services in this region, to determine enablers and barriers to assessment for children with PAN presenting to frontline services, and to identify best practices to address gaps. We collated available data on children presenting to EDs and paediatric services with suspected PAN in 2007. We interviewed 36 health professionals from nine hospitals and 12 statutory child protection professionals, across the region before undertaking relevant document analysis. Of 64,700 paediatric ED presentations, a quarter were due to injury; 2%–5% of these were due to maltreatment. Clinician estimates and assessments of PAN varied widely; health and welfare workers identified major practice gaps, as well as good local practice. We identified feasible minimum standards for improving clinical assessment and follow-up for children presenting with PAN, given the right organizational support.

Impact and management of dual relationships in metropolitan, regional and rural mental health practice.

Science.gov (United States)

Endacott, Ruth; Wood, Anita; Judd, Fiona; Hulbert, Carol; Thomas, Ben; Grigg, Margaret

2006-01-01

To explore the extent and impact of professional boundary crossings in metropolitan, regional and rural mental health practice in Victoria and identify strategies mental health clinicians use to manage dual relationships. Nine geographically located focus groups consisting of mental health clinicians: four focus groups in rural settings; three in a regional city and two in a metropolitan mental health service. A total of 52 participants were interviewed. Data revealed that professional boundaries were frequently breached in regional and rural settings and on occasions these breaches had a significantly negative impact. Factors influencing the impact were: longevity of the clinician's relationship with the community, expectations of the community, exposure to community 'gossip' and size of the community. Participants reported greater stress when the boundary crossing affected their partner and/or children. Clinicians used a range of proactive and reactive strategies, such as private telephone number, avoidance of social community activities, when faced with a potential boundary crossing. The feasibility of reactive strategies depended on the service configuration: availability of an alternative case manager, requirement for either patient or clinician to travel. The greater challenges faced by rural and regional clinicians were validated by metropolitan participants with rural experience and rural participants with metropolitan experience. No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.

Exploitation of geospatial techniques for monitoring metropolitan population growth and classification of landcover features

International Nuclear Information System (INIS)

Almas, A.S.; Rahim, C.A.

2006-01-01

The present research relates to the exploitation of Remote Sensing and GIS techniques for studying the metropolitan expansion and land use/ landcover classification of Lahore, the second largest city of Pakistan where urbanization is taking place at a striking rate with inadequate development of the requisite infrastructure. Such sprawl gives rise to the congestion, pollution and commuting time issues. The metropolitan expansion, based on growth direction and distance from the city centre, was observed for a period of about thirty years. The classification of the complex spatial assemblage of urban environment and its expanding precincts was done using the temporally spaced satellite images geo-referenced to a common coordinate system and census data. Spatial categorization of urban landscape involving densely populated residential areas, sparsely inhibited regions, bare soil patches, water bodies, vegetation, Parks, and mixed features was done with the help of satellite images. Resultantly, remote sensing and GIS techniques were found very efficient and effective for studying the metropolitan growth patterns along with the classification of urban features into prominent categories. In addition, census data augments the usefulness of spatial techniques for carrying out such studies. (author)

The Age of Environmental Impasse? Globalization and Environmental Transformation of Metropolitan Cities

NARCIS (Netherlands)

Melchert Saguas Presas, L.

2005-01-01

Metropolitan cities are undergoing a major spatial and environmental transformation. The proliferation of business districts, corporate headquarters and international hotels is prompting a massive verticalization and densification of land use, which is affecting the urban environment and

Coronary heart disease prevalence and occupational structure in U.S. metropolitan areas: a multilevel analysis.

Science.gov (United States)

Michimi, Akihiko; Ellis-Griffith, Gregory; Nagy, Christine; Peterson, Tina

2013-05-01

This research explored the link between coronary heart disease (CHD) prevalence and metropolitan-area level occupational structure among 137 metropolitan/micropolitan statistical areas (MMSA) in the United States. Using data from the 2006-2008 Behavioral Risk Factor Surveillance System and 2007 County Business Patterns, logistic mixed models were developed to estimate CHD prevalence between MMSAs controlling for individual-level socioeconomic characteristics and various types of occupational structure. Results showed that CHD prevalence was lower in MMSAs where their economy was dominated by 'tourism and resort' and 'the quaternary sector' and higher in MMSAs dominated by 'manufacturing', 'transportation and warehousing', and 'mining'. MMSA-level effects on CHD were found in 'tourism and resort' and 'the quaternary sector' having lower risk and 'mining' having higher risk of CHD. Although these effects prevailed in many MMSAs, some MMSAs did not fit into these effects. Additional analysis indicated a possible link between metropolitan population loss and higher CHD prevalence especially in the coal mining region of the Appalachian Mountains. Copyright © 2013 Elsevier Ltd. All rights reserved.

CITTÀ METROPOLITANE E PROVINCE IN ITALIA: ORGANI, FUNZIONI FONDAMENTALI ED ESIGENZE DI RIDUZIONE DELLA SPESA

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Giovanni Cocozza

2014-04-01

Full Text Available This paper analyses the problems derived from the metropolitan cities entities in Italy and the simultaneous reform of the provinces. These two issues are part of a broader and current Italian political debate related to targets for reduction of public spending and have to do with the achievement of a new order of local government different from that established in the Title V of the Italian Constitution after its 2001 reform. After an examination of previous attempts to regulate metropolitan cities entities, the article examines the aspects contained in decree law on spending review (d.l. n. 95/2012. In this way, the article aims to highlight both the difficulties and incoherencies of the identification of administrative functions and of the general structure to be assigned to the new level of government (the metropolitan city, provided in the Italian Constitution in 2001 but not yet established. Consequently, the article considers the effects that this new model has upon the other and already existing levels of government (such as municipalities, as provinces and as regions.

Uudised : Õhtu Metropolitan Operas. Järvi Michigani ülikooli audoktoriks / Priit Kuusk

Index Scriptorium Estoniae

Kuusk, Priit, 1938-

1999-01-01

"Klassikaraadio" vahendab 25. dets. otseülekande New Yorgist Metropolitan Operast, kus tuleb ettekandele W.A. Mozarti ooper "Figaro pulm". 19. dets. nimetati N. Järvi Michigani ülikooli audoktoriks

Suicide among young rural Australians 1964-1993: a comparison with metropolitan trends.

Science.gov (United States)

Dudley, M; Kelk, N; Florio, T; Howard, J; Waters, B; Haski, C; Alcock, M

1997-07-01

The study tested hypotheses that from 1964 to 1993: (1) suicide rates among Australian 15- to 24-year-old males rose more sharply in rural than metropolitan areas; (2) firearm suicide rates among 15- to 24-year-old males, declining throughout Australia recently, rose continuously in rural areas; (3) suicide rates among 15- to 24-year-old females did not change significantly in either metropolitan or rural areas. Suicides of those aged 10-24 years recorded by the Australian Bureau of Statistics (ABS) were classified according to the subject's residential grouping. Rates were calculated using ABS population data corresponding to these groupings. Results were analysed using log-linear analysis and chi-square statistics. The results supported the first two hypotheses, but not the third. Suicide rates for 15- to 24-year-old males rose by a factor of 2.2 in metropolitan areas, by 4-fold in towns with populations between 4,000 and 25,000, and by 12-fold in towns with populations less than 4,000. Male firearm suicide rates continued to rise in rural areas, and the greatest proportion of deaths in those locations were by firearms, though male hanging rates increased most in recent years in all locations. Female youth suicide rates did not change overall, but in towns with populations less than 4,000, they increased 4.5-fold. Possible explanations for this epidemic, which are mostly speculative and require confirmation, are discussed.

Partners In Motion And Customer Satisfaction In The Washington Dc Metropolitan Area

Science.gov (United States)

1999-06-01

PARTNERS IN MOTION IS A PROGRAM AIMED AT IMPROVING THE QUALITY, QUANTITY, AND AVAILABILITY OF TRAVEL INFORMATION TO TRANSPORTATION AGENCIES, THE MEDIA, AND, ULTIMATELY, TO THE TRAVELER IN THE WASHINGTON, D.C. METROPOLITAN AREA. THE PROGRAM WAS INITIA...

Access to destinations : annual accessibility measure for the Twin Cities Metropolitan Region.

Science.gov (United States)

2012-11-01

This report summarizes previous phases of the Access to Destinations project and applies the techniques developed : over the course of the project to conduct an evaluation of accessibility in the Twin Cities metropolitan region for : 2010. It describ...

Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study.

Science.gov (United States)

Balikuddembe, Joseph Kimuli; Ardalan, Ali; Khorasani-Zavareh, Davoud; Nejati, Amir; Raza, Owais

2017-10-03

Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims' pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions respectively. Data was descriptively analyzed, and after the principal component analysis was employed to identify the most influential weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTI in the GKMA. From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 2016, 4 and 5 key weaknesses and capacities respectively were identified to affect the pre-hospital emergency care for RTI victims in the GKMA. Although some strengths exist like ambulance facilitation, EMS structuring, coordination and others), the key weaknesses affecting the pre-hospital care for victims were noted to relate to absence of predefined EMS systems particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment; insufficient skills/training of the first responders; inadequate EMS resources; and avoidable delays to respond and transport RTI victims to medical facilities. Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.

Morte neonatal precoce segundo complexidade hospitalar e rede SUS e não-SUS na Região Metropolitana de São Paulo, Brasil Early neonatal mortality according to level of hospital complexity in Greater Metropolitan São Paulo, Brazil

Directory of Open Access Journals (Sweden)

Zilda Pereira da Silva

2010-01-01

Full Text Available O objetivo foi analisar o perfil dos recém-nascidos, mães e mortalidade neonatal precoce, segundo complexidade do hospital e vínculo com o Sistema Único de Saúde (SUS, na Região Metropolitana de São Paulo, Brasil. Estudo baseado em dados de nascidos vivos, óbitos e cadastro de hospitais. Para obter a tipologia de complexidade e o perfil da clientela, empregaram-se análise fatorial e de clusters. O SUS atende mais recém-nascidos de risco e mães com baixa escolaridade, pré-natal insuficiente e adolescentes. A probabilidade de morte neonatal precoce foi 5,6‰ nascidos vivos (65% maior no SUS, sem diferenças por nível de complexidade do hospital, exceto nos de altíssima (SUS e média (não-SUS complexidade. O diferencial de mortalidade neonatal precoce entre as duas redes é menor no grupo de recém-nascidos 2.500g. Há uma concentração de nascimentos de alto risco na rede SUS, contudo a diferença de mortalidade neonatal precoce entre a rede SUS e não-SUS é menor nesse grupo de recém-nascidos. Novos estudos são necessários para compreender melhor a elevada mortalidade de recém-nascidos > 2.500g no SUS.The aim of this study was to analyze the profile of newborns, mothers, and early neonatal mortality according to the hospital's complexity and affiliation (or lack thereof with the Unified National Health System (SUS in Greater Metropolitan São Paulo, Brazil. The study was based on data for live births, deaths, and hospital registries. Factor and cluster analysis were used to obtain the typology of hospital complexity and user profile. The SUS treats more high-risk newborns and mothers with low schooling, insufficient prenatal care, and teenage mothers. The probability of early neonatal death was 5.6‰ live births (65% higher in the SUS, with no significant differences by level of hospital complexity, except those with extremely high (SUS and medium (non-SUS complexity. The difference in early neonatal mortality between the

FINE PORE DIFFUSER SYSTEM EVALUATION FOR THE GREEN BAY METROPOLITAN SEWERAGE DISTRICT

Science.gov (United States)

The Green Bay Metropolitan Sewerage District retrofitted two quadrants of their activated sludge aeration system with ceramic and membrane fine pore diffusers to provide savings in energy usage compared to the sparged turbine aerators originally installed. Because significant di...

The Spatial Changes of Land Use in the Bucharest Metropolitan Area 1970s – 2000s

OpenAIRE

Gabriel Simion

2010-01-01

The article explore the dimension of spatial changes of land use in the Bucharest Metropolitan Area (BMA) over the past forty years. Using GIS-based land use data sets of the years 1970, 1990 and 2000, combining with statistical data, we attempted to quantify the spatial pattern of land use changes in the BMA. Our findings indicate that most significantly changes occurred with arable lands that have been reduced from 77% of total metropolitan area in 1970 to 71.3% in 2000 and in same time th...

When rendering hospitality becomes collateral damage: Psycho-organisational variables and job burnout amongst hotel workers in metropolitan Nigeria

Directory of Open Access Journals (Sweden)

Oluyinka Ojedokun

2013-10-01

Research purpose: The study investigated the influence of psycho-organisational variables (i.e. perceived organisational support, self-efficacy and age on job burnout amongst hotel workers. Motivation for the study: Investigating the independent and joint influence of psychoorganisational variables on burnout will assist in pulling together psycho-organisational factors influencing burnout and its dimensions cohesively in systematic theory building and intervention plans. Research design, approach and method: This is a cross-sectional survey designed to investigate perceived organisational support, self-efficacy and age as predictors of job burnout amongst 268 hotel workers from 10 registered hotels in some metropolitan cities in Ondo State, south-western Nigeria. Structural equation modelling techniques were conducted to test the proposed hypotheses. Main findings: Structural equation modelling revealed that perceived organisational support and self-efficacy have inverse relationships with burnout syndrome and its dimensions. Practical/managerial implications: These findings imply that it is possible for different stakeholders in the hotel industry in Nigeria to reduce the incidence of high burnout amongst hotel workers by providing adequate organisational support to cope with difficult job demands and organising self-efficacy training to improve individuals’ confidence in their abilities to deal with job burnout. Such intervention can be individual-oriented, organisation-oriented or a combination. Contribution/value-add: This study contributes to literature by confirming that organisational support and self-efficacy are relevant in coping with burnout.

The impact of heat on mortality and morbidity in the Greater Metropolitan Sydney Region: a case crossover analysis.

Science.gov (United States)

Wilson, Leigh Ann; Morgan, Geoffrey Gerard; Hanigan, Ivan Charles; Johnston, Fay H; Abu-Rayya, Hisham; Broome, Richard; Gaskin, Clive; Jalaludin, Bin

2013-11-15

This study examined the association between unusually high temperature and daily mortality (1997-2007) and hospital admissions (1997-2010) in the Sydney Greater Metropolitan Region (GMR) to assist in the development of targeted health programs designed to minimise the public health impact of extreme heat. Sydney GMR was categorized into five climate zones. Heat-events were defined as severe or extreme. Using a time-stratified case-crossover design with a conditional logistic regression model we adjusted for influenza epidemics, public holidays, and climate zone. Odds ratios (OR) and 95% confidence intervals were estimated for associations between daily mortality and hospital admissions with heat-event days compared to non-heat event days for single and three day heat-events. All-cause mortality overall had similar magnitude associations with single day and three day extreme and severe events as did all cardiovascular mortality. Respiratory mortality was associated with single day and three day severe events (95th percentile, lag0: OR = 1.14; 95%CI: 1.04 to 1.24). Diabetes mortality had similar magnitude associations with single day and three day severe events (95th percentile, lag0: OR = 1.22; 95%CI: 1.03 to 1.46) but was not associated with extreme events. Hospital admissions for heat related injuries, dehydration, and other fluid disorders were associated with single day and three day extreme and severe events. Contrary to our findings for mortality, we found inconsistent and sometimes inverse associations for extreme and severe events with cardiovascular disease and respiratory disease hospital admissions. Controlling for air pollutants did not influence the mortality associations but reduced the magnitude of the associations with hospital admissions particularly for ozone and respiratory disease. Single and three day events of unusually high temperatures in Sydney are associated with similar magnitude increases in mortality and hospital admissions. The trend

Survey of intestinal parasitism in dogs in the Phoenix metropolitan area.

Science.gov (United States)

Cornell, Heather N; O'Neal, Peter R; Wong, Valerie M; Noah, Donald L

2017-09-01

OBJECTIVE To determine the prevalence of selected intestinal parasites in pet dogs and recently apprehended free-roaming (AFR) shelter dogs in the Phoenix metropolitan area and compare those prevalences between the 2 groups. DESIGN Cross-sectional study. SAMPLE Convenience samples of fecal specimens from owned pet dogs from the Phoenix metropolitan area (n = 175) and free-roaming dogs apprehended and admitted to Maricopa County Animal Care and Control and Arizona Humane Society facilities from November 2014 through March 2015 (188). PROCEDURES Fresh fecal specimens were collected from all dogs; for AFR shelter dogs, specimens were collected within 72 hours after facility admission. Standard centrifugal flotation tests and an ELISA were performed to detect 5 common intestinal parasites (roundworms, hookworms, whipworms, Giardia spp, and Cystoisospora spp). Group comparisons were performed by means of the χ 2 test and Rogan-Gladen prevalence estimate. RESULTS At least 1 of the 5 evaluated parasites was detected in 85 (45.2%) fecal specimens from AFR shelter dogs and 24 (13.7%) specimens from owned pet dogs. This prevalence differed significantly between the groups. Notably, the prevalence of Giardia spp in AFR shelter dogs (n = 76 [40.4%]) was higher than previously reported in the United States. CONCLUSIONS AND CLINICAL RELEVANCE The prevalence of the evaluated intestinal parasites, particularly of Giardia spp, in AFR shelter dogs was higher than expected. This information is important for veterinarians, animal shelter personnel, pet owners, human health-care providers, and public health officials to consider when devising effective interventions and risk communication efforts against potential zoonotic threats, particularly those relevant to the Phoenix metropolitan area.

Unsettling Theology: Sunday school children reading the text of the Bible in the age of recolonisation

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Nico Botha

2016-12-01

Full Text Available During Women’s month in South Africa (August, a group of Sunday school children from the rural congregation of the Uniting Reformed Church in Southern Africa (URCSA, Middelburg- Nasaret, got together to read the narratives of the resurrection of the daughter of Jairus and the healing of the woman suffering from a blood disease. The exercise which appears to be quite innocent is in a sense subversive in its hidden script. In the Reformed tradition, the pulpit as a centre of reading and preaching the Word has become the ‘holy of holiest’ which nobody, leave alone children, except the ordained minister could occupy. This is of course contrary to the intention of the Reformation to return the Bible to the people and have the people return to the Bible. The reading exercise of this article goes beyond all exegetical and theological presuppositions, unsettling conventional interpretations of Scripture. The children allow their real life experiences in the township of having witnessed, among others, child and women abuse to inform their reading of Mark 5:21–43. In the process they avoid a linear reading of the Bible which is based on the explication-application scheme of matters. Put differently, instead of doing a deductive reading of the portion, i.e. trying to explain or exegete the text clinically and then applying it to their context, they read it inductively, resulting in a hope sharing and hope giving understanding of the rising from the dead of the 12-year-old girl and the healing of the woman with a blood disease. A major spin-off of such reading of the Bible by children is the unlocking of refreshingly new avenues of reading the Bible and interpreting the text.

Satisfaction among early and mid-career dentists in a metropolitan dental hospital in China

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Cui X

2017-06-01

Full Text Available Xiaoxi Cui,1 David G Dunning,2 Na An3 1College of Dentistry, University of Nebraska Medical Center, Lincoln, NE, USA; 2Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE, USA; 3School of Stomatology, Department of General Dentistry II, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China Abstract: A growing body of research has examined career satisfaction among dentists using a standardized instrument, dentist satisfaction survey (DSS. This project examined career satisfaction of early to mid-career dentists in China, a population whose career satisfaction, heretofore, has not been studied. This is an especially critical time to examine career satisfaction because of health care reform measures being implemented in China. A culturally sensitive Chinese-language version of the DSS (CDSS was developed and electronically administered to 367 early and mid-career dentists in a tertiary dental hospital in Beijing, China. One hundred and seventy respondents completed the survey. The average total career score was 123, with a range of 82–157. Data analysis showed some significant differences in total career score and several subscales based on gender, working hours per week, and years in practice. A stepwise regression model revealed that two variables predicted total career score: working hours per week and gender. Stepwise regression also demonstrated that four subscales significantly predicted the overall professional satisfaction subscale score: respect, delivery of care, income and patient relations. Implications of these results are discussed in light of the health care delivery system and dentist career paths in China. Keywords: job satisfaction, career satisfaction, early and mid-career dentists, Chinese health care reform

The freight landscape : using secondary data sources to describe metropolitan freight flows.

Science.gov (United States)

2015-12-01

Metropolitan areas around the world are seeking to better manage freight flows and reduce negative impacts on local populations. A major challenge to better urban freight management is the lack of data; little is known about freight movements at the ...

Actual Condition of Quality Control of X-ray Imaging System in Primary Care Institution: focused on Gwangju Metropolitan City

International Nuclear Information System (INIS)

Dong, Kyung Rae; Lee, Seun Joo; Lee, Kyu Su; Kweon, Dae Cheol; Goo, Eun Hoe; Jung, Jae Eun; Lee, Kyu Su

2010-01-01

With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within 1.5 . deg. . Of all fifty hospitals 30.0% were beyond 3 . deg. . The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible

Metropolitan governance and infrastructure in São Paulo: the challenge of mediating regional interests and local impact

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Marcelo Sacenco Asquino

2010-12-01

Full Text Available The formation of the São Paulo metropolis is related to the historical process of building regional infrastructure as of the late 19th century, in connection with economic motivation and territorial influences. Since that time, São Paulo has played a key role in the network of cities that has been fundamental to its economic development and to its recognition as the most important city in Brazil. This article examines the importance of understanding the regional scale in relation to São Paulo's plans and projects, from Plano de Avenidas (Avenue Plan in the 1930s to the Rodoanel (ring road in the 1990s; the experience of planning and management of the metropolitan system in the 1970s and, in contrast, the environmental licensing process of these large projects after the 1990s. Discussing São Paulo's plans and projects is a complex task, because a project's local impact as well as regional interests must be considered. From different perspectives, the author reviewed the results of environmental licensing of Ampliação da Calha do Rio Tietê (deepening the bed of the Tietê river and Rodoanel Trecho Sul (south section of the ring road projects, and their actual role in the future arrangement and development of the São Paulo metropolis. Based on (a the results of the metropolitan planning experience in the 1970s, (b the updating of the metropolitan discussion in the 1990s from an economic globalization perspective, and (c the current experience of metropolitan systems in the state of São Paulo, it seems necessary to re-establish an effective metropolitan planning and management system in order to guarantee its legitimacy, commitment and governance.

Washington DC Metropolitan Area Drug Study Homeless and Transient Population (DC-MADST-1991)

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U.S. Department of Health & Human Services — The DC Metropolitan Area Drug Study (DCMADS) was conducted in 1991, and included special analyses of homeless and transient populations and of women delivering live...

Residential fencing in a metropolitan area and three small towns.

Science.gov (United States)

Edwin Kallio; Jerry A. Sesco

1967-01-01

Many types of fences were found on residential lots in the metropolitan-suburban area of St. Louis County, Missouri, and three small towns in southern Illinois. Wire fences predominated. More wooden fences were found on village lots than on city lots. In general, the more expensive homes had the most wooden fencing. Homes over 5 years old had more fencing of all...

On scaling of scientific knowledge production in U.S. metropolitan areas

NARCIS (Netherlands)

Nomaler, Önder; Frenken, Koen; Heimeriks, Gaston

2014-01-01

Using data on all scientific publications from the Scopus database, we find a superlinear scaling effect for U.S. metropolitan areas as indicated by the increase of per capita publication output with city size. We also find that the variance of residuals is much higher for mid-sized cities (100,000

Radon survey in Metropolitan Toronto schools

International Nuclear Information System (INIS)

Becker, E.; Moridi, R.

1992-01-01

The radon testing survey in Metropolitan Toronto public schools was the most intensive project of its kind ever undertaken in Canadian schools. It also included an extensive public education program on radiation and radon-in-schools. The radon levels at 632 schools were measured using the CAIRS Radon Monitors. Ninety percent of the locations measured were found to have a radon level equal to or less than 2 mWL. Two locations in two different schools were found to have a radon level at or above the Action Level (20 mWL). The remaining results were between the two extremes. Follow-up testing in those schools where more than 10 mWL of radon was found is in progress. (author)

Diabetes diagnosis and management among insured adults across metropolitan areas in the U.S.

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Wenya Yang

2018-06-01

Full Text Available This study provides diabetes-related metrics for the 50 largest metropolitan areas in the U.S. in 2012—including prevalence of diagnosed and undiagnosed diabetes, insurance status of the population with diabetes, diabetes medication use, and prevalence of poorly controlled diabetes.Diabetes prevalence estimates were calculated using cross-sectional data combining the Behavioral Risk Factor Surveillance System, American Community Survey, National Nursing Home Survey, Census population files, and National Health and Nutrition Examination Survey. Analysis of medical claims files (2012 de-identified Normative Health Information database, 2011 Medicare Standard Analytical Files, and 2008 Medicaid Analytic eXtract produced information on treatment and poorly controlled diabetes by geographic location, insurance type, sex, and age group.Among insured adults with diagnosed type 2 diabetes in 2012, the proportion receiving diabetes medications ranged from 83% in Oklahoma City, Oklahoma, to 65% in West Palm Beach, Florida. The proportion of treated patients with medical claims indicating poorly controlled diabetes was lowest in Minneapolis, Minnesota (36% and highest in Texas metropolitan areas of Austin (51%, San Antonio (51%, and Houston (50%.Estimates of diabetes detection and management across metropolitan areas often differ from state and national estimates. Local metrics of diabetes management can be helpful for tracking improvements in communities over time. Keywords: Diabetes, Management

Going Up? Canada's metropolitan areas and their role as escalators or elevators

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Bruce Newbold

2015-10-01

Full Text Available Canada’s major metropolitan areas offer multiple opportunities for economic and social advancement for in-migrants. As such, young adults may be attracted to these locations. In-migrants to Toronto have been observed to receive a substantial income benefit associated with migration into Toronto that is consistent with a productivity effect. This income effect is greater than the income benefit received by migrants elsewhere in the system or those who did not migrate. However, migration into Toronto did not lead to an acceleration in income gains consistent with the more rapid career progression expected to result from the migration into an escalator region.Consequently, this paper explores the income benefits for young adult migrants by considering the role of other major metropolitan areas within Canada, and whether they function similar to Toronto as escalators, or serve other roles that are unique to employment sector and type.

The 13-year experience of performing pancreaticoduodenectomy in a mid-volume municipal hospital.

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Kim, Hongbeom; Chung, Jung Kee; Ahn, Young Joon; Lee, Hae Won; Jung, In Mok

2017-02-01

Pancreaticoduodenectomy (PD) is a complex surgery associated with high morbidity, mortality, and cost. Municipal hospitals have their important role in the public health and welfare system. The purpose of this study was to identify the feasibility as well as the cost-effectiveness of performing PD in a mid-volume municipal hospital based on 13 years of experience with PD. From March 2003 to November 2015, 183 patients underwent PD at Seoul Metropolitan Government - Seoul National University Boramae Medical Center.. Retrospectively collected data were analyzed, with a particular focus on complications. Hospital costs were analyzed and compared with a national database, with patients divided into 2 groups on the basis of medical insurance status. The percentage of medical aid was significantly higher than the average in Korean hospitals. (19.1% vs. 5.8%, P = 0.002). Complications occurred in 88 patients (44.3%). Postoperative pancreatic fistula (POPF) occurred in 113 cases (61.7%), but the clinically relevant POPF was 24.6% (grade B: 23.5% and grade C: 1.1%). The median hospital stay after surgery was 20 days (range, 6-137 days). In-hospital mortality was 3.8% (n = 7), with pulmonary complications being the leading cause. During the study period, improvements were observed in POPF rate, operation time, and hospital stay. The mean total hospital cost was 13,819 United States dollar (USD) per patient, and the mean reimbursement from the National Health Insurance Service (NHIS) to health care providers was 10,341 USD (74.8%). The patient copayment portion of the NHIS payment was 5%. Performing PD in a mid-volume municipal hospital is feasible, with comparable results and cost-effectiveness.

Metropolitan natural area protection to maximize public access and species representation

Science.gov (United States)

Jane A. Ruliffson; Robert G. Haight; Paul H. Gobster; Frances R. Homans

2003-01-01

In response to widespread urban development, local governments in metropolitan areas in the United States acquire and protect privately-owned open space. We addressed the planner's problem of allocating a fixed budget for open space protection among eligible natural areas with the twin objectives of maximizing public access and species representation. Both...

Internal audit disclosures in annual reports of metropolitan municipalities in South Africa

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Christo Ackermann

2016-03-01

Full Text Available The role of internal audit in governance contributes significantly to accountability. However, its work is limited to internal use, and as such, it does not provide external stakeholders with information about the accountability contributions made by the internal audit function (IAF. The assurance provided by internal audit is equally important as the assurance provided by external auditors. Arguments exist that the inclusion of internal audit disclosure in public annual reports could contribute significantly to transparency and accountability in respect of municipalities. Literature suggest that the advantages of internal audit disclosure outweigh its disadvantages. This paper reports on the extent of internal audit disclosure in the eight metropolitan municipalities in South Africa for the 2012/2013 financial year. To achieve the objective set out in this paper, a mixed method approach was followed. A qualitative content analysis (deductive and inductive was performed. Qualitative text was displayed showing evidence of the disclosure item (visual presentation of quotes. To complement the qualitative text, Atlas.Ti was further utilised to quantify the codes which showed the differences in the disclosure practices of IAFs across metropolitan municipalities in South Africa. The results of this study show evidence of internal audit disclosure in annual reports despite the fact that no legislative requirements exist for internal audit to report in annual reports of municipalities. The extent and the nature of disclosure varied across metropolitan municipalities in South Africa. The results of this paper could be used to assist with establishing policy guidelines for internal audit disclosure.

Spatial mismatch, wages and unemployment in metropolitan areas in Brazil

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Ana Maria Bonomi Barufi

2017-12-01

Full Text Available The spatial mismatch hypothesis states that a lack of connection to job opportunities may affect an individual’s prospects in the labour market, especially for low-skilled workers. This phenomenon is especially observed in large urban areas, in which low-skilled minorities tend to live far away from jobs and face geographical barriers to finding and keeping jobs. This paper aims to investigate whether this negative relationship between spatial mismatch and labour market outcomes is valid in Brazil after controlling for individual characteristics. Our conclusions indicate that there is no clear relation between different measures of accessibility to jobs and the probability of being unemployed. However, for wages there is a clear correlation, which is stronger in larger metropolitan areas in the country. Given the exploratory nature of this work, our results still rely on strong identification hypotheses to avoid potential bias related to simultaneous location decisions of workers and firms within the city. Even if these conditions do not hold, the results are still meaningful as they provide a better understanding of the conditional distribution of wages and the unemployment rate in the biggest metropolitan areas of Brazil.

Violence against metropolitan bus drivers and fare collectors in Brazil

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Ada Ávila Assunção

2015-01-01

Full Text Available OBJECTIVE To analyze the correlation between sociodemographic factors and working conditions of bus workers in a metropolitan area and violence against them. METHODS This cross-sectional study used a nonprobabilistic sample estimated according to the number of workers employed in bus companies located in three cities in the Belo Horizonte metropolitan region in 2012 (N = 17,470. Face-to-face interviews were conducted using a digital questionnaire. The factors associated with violence were analyzed in two stages using Poisson regression, according to each level. The magnitude of the association was evaluated using prevalence ratios with robust variance and a statistical significance of 5%, and 95% confidence intervals were obtained. RESULTS The study sample comprised 782 drivers and 691 fare collectors; 45.0% participants reported at least one act of violence in the workplace in the last 12 months, with passengers being predominantly responsible. The age of the bus workers was inversely associated with violence. Chronic diseases, sickness absenteeism, and working conditions were also associated with violence. CONCLUSIONS The findings on the correlation between violence and working conditions are essential for implementing prevention strategies by transportation service managers.

The role of a bus network in access to primary health care in Metropolitan Auckland, New Zealand.

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Rocha, C M; McGuire, S; Whyman, R; Kruger, E; Tennant, M

2015-09-01

Background: This study examined the spatial accessibility of the population of metropolitan Auckland, New Zealand to the bus network, to connect them to primary health providers, in this case doctors (GP) and dentists. Analysis of accessibility by ethnic identity and socio-economic status were also carried out, because of existing health inequalities along these dimensions. The underlying hypothesis was that most people would live within easy reach of primary health providers, or easy bus transport to such providers. An integrated geographic model of bus transport routes and stops, with population and primary health providers (medical. and dental practices) was developed and analysed. Although the network of buses in metropolitan Auckland is substantial and robust it was evident that many people live more than 150 metres from a stop. Improving the access to bus stops, particularly in areas of high primary health care need (doctors and dentists), would certainly be an opportunity to enhance spatial access in a growing metropolitan area.

Implementing the Green City Policy in Municipal Spatial Planning: The Case of Buffalo City Metropolitan Municipality

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Abongile Dlani

2015-06-01

Full Text Available The term “eco-city,” and similar concepts such as “green” and “sustainable” cities, has evolved overtime concurrent to the development of the understanding of social change and mankind’s impact on environmental and economic health. With the advent of climate change impacts, modern economies developed the green city policy to create sustainable urban development, low emission, and environmentally friendly cities. In South Africa municipalities, including Buffalo City Metropolitan Municipality (BCMM have been tasked to and implement the green city policy. However, BCMM is yet to develop the green city policy that clearly articulate how the municipality will combat climate change and reduce its Green House Gases (GHG emissions in its spatial planning designs. Against this background, this article reviews and analyses green policy landscape in Metropolitan Municipalities. It is envisaged that the research will provide the basis for the development of a comprehensive green policy strategies and programmes for the local transition to action in Buffalo City Metropolitan Municipality, in the Eastern Cape Province.

The provision and utilisation of casemix and demographic data by nursing managers in seven hospitals.

Science.gov (United States)

Blay, Nicole; Donoghue, Judith

2003-01-01

The role of the nursing manager has evolved from clinician and bed manager to one with greater accountability for evidence based practice, benchmarking and more recently, budget liability. Casemix data are widely believed to be a means of providing essential information for effective decision making and financial management but have not been widely utilised by nursing managers (Diers & Bozzo, 1999). This paper will report the results of a survey of nursing managers in seven hospitals within a metropolitan area health service. The hospitals include tertiary referral hospitals, specialist public hospitals and an affiliated public hospital for aged care and rehabilitation services. The survey sought to establish what casemix and related data were provided to nurse managers, who provided these data and how supplied data were utilised by the nurse managers. Results demonstrated that the majority of nursing managers surveyed received minimal (if any) casemix and/or demographic data on a routine basis. Some were provided with data in response to specific requests. The information that was provided varied both within and across hospitals, and no consistent methods of data distribution were available. Few nursing managers believed that the information provided aided their decision-making processes partly due to the minimalist nature of provided data while some nursing managers demonstrated a lack of understanding of the potential benefit of casemix data as a resource to support management decision making.

FINANCING FARMLAND PRESERVATION: THE TWIN CITIES METROPOLITAN AREA EXPERIENCE

OpenAIRE

Greden, Leah R.; Taff, Steven J.

1994-01-01

Two farmland protection programs in the Twin Cities (Minnesota) Metropolitan Area--Green Acres and Agricultural Preserves-- together enrolled 608,331 acres in 1992. The principal financing tool was a provision common to both programs under which participating landowners paid reduced property taxes in exchange for certain non- development assurances. The resulting shift in property tax obligations to other taxpayers amounted to $7.6 million for the 1993 tax year, an average shift of $12.50 per...

The determinants of part-time work in Metropolitan Lima

OpenAIRE

Manuel Enrique Saavedra Martinez

2011-01-01

The following paper examines the part-time work in Metropolitan Lima in 2008. The overall objective is to identify the determinants of the incidence of part-time work in Lima. We worked with one Probit econometric model, measured by the National Survey of Households (NSH), which explores the job characteristics of people. This will determine the presence of part-time workers in the areas of trade, health, education and communication; also realized that this group has completed university stud...

The determinants of part-time work in Metropolitan Lima

OpenAIRE

Saavedra Martinez, Manuel Enrique

2012-01-01

The following paper examines the part-time work in Metropolitan Lima in 2008. The overall objective is to identify the determinants of the incidence of part-time work in Lima. We worked with one Probit econometric model, measured by the National Survey of Households (NSH), which explores the job characteristics of people. This will determine the presence of part-time workers in the areas of trade, health, education and communication; also realized that this group has completed university stud...

The 1987 Whittier Narrows, California, earthquake: A Metropolitan shock

OpenAIRE

Hauksson, Egill; Stein, Ross S.

1989-01-01

Just 3 hours after the Whittier Narrows earthquake struck, it became clear that a heretofore unseen geological structure was seismically active beneath metropolitan Los Angeles. Contrary to initial expectations of strike-slip or oblique-slip motion on the Whittier fault, whose north end abuts the aftershock zone, the focal mechanism of the mainshock showed pure thrust faulting on a deep gently inclined surface [Hauksson et al., 1988]. This collection of nine research reports spans the spectru...

Forecasting drug utilization and expenditure in a metropolitan health region

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Korkmaz Seher

2010-05-01

Full Text Available Abstract Background New pharmacological therapies are challenging the healthcare systems, and there is an increasing need to assess their therapeutic value in relation to existing alternatives as well as their potential budget impact. Consequently, new models to introduce drugs in healthcare are urgently needed. In the metropolitan health region of Stockholm, Sweden, a model has been developed including early warning (horizon scanning, forecasting of drug utilization and expenditure, critical drug evaluation as well as structured programs for the introduction and follow-up of new drugs. The aim of this paper is to present the forecasting model and the predicted growth in all therapeutic areas in 2010 and 2011. Methods Linear regression analysis was applied to aggregate sales data on hospital sales and dispensed drugs in ambulatory care, including both reimbursed expenditure and patient co-payment. The linear regression was applied on each pharmacological group based on four observations 2006-2009, and the crude predictions estimated for the coming two years 2010-2011. The crude predictions were then adjusted for factors likely to increase or decrease future utilization and expenditure, such as patent expiries, new drugs to be launched or new guidelines from national bodies or the regional Drug and Therapeutics Committee. The assessment included a close collaboration with clinical, clinical pharmacological and pharmaceutical experts from the regional Drug and Therapeutics Committee. Results The annual increase in total expenditure for prescription and hospital drugs was predicted to be 2.0% in 2010 and 4.0% in 2011. Expenditures will increase in most therapeutic areas, but most predominantly for antineoplastic and immune modulating agents as well as drugs for the nervous system, infectious diseases, and blood and blood-forming organs. Conclusions The utilisation and expenditure of drugs is difficult to forecast due to uncertainties about the rate

Chieti-Pescara Metropolitan Area: International Migrations, Residential Choices and Economic Deconcentration

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Armando Montanari

2006-06-01

Full Text Available The subject of human mobility – with reference to the migratory component – has taken on specific significance during the last decade, particularly with regard to the concept of place. This paper considers the subject in relation to residential and economic deconcentration. The specific point of reference is the metropolitan area of Chieti-Pescara, in the central part of Italy’s Adriatic coast. The research was carried out through quantitative analysis of official data from population censuses and register offices. The results highlight the links between movements of residents and those of firms, in which foreign residents show distinctive behaviour. The residential choices made by foreigners in the area are based on economic reasons and are primarily linked to housing and transport costs. Their communities tend to be concentrated in specific zones of the metropolitan area and in specific districts of the cities, as a consequence of a feeling of belonging and solidarity. Although there are no clear signs of segregation phenomena, the native population tends to avoid mingling with foreigners from marginal countries.

Provider-related barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs) and hospitals.

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Bogart, Laura M; Howerton, Devery; Lange, James; Setodji, Claude Messan; Becker, Kirsten; Klein, David J; Asch, Steven M

2010-06-01

We examined provider-reported barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs), and hospitals. 12 primary metropolitan statistical areas (PMSAs; three per region) were sampled randomly, with sampling weights proportional to AIDS case reports. Across PMSAs, all 671 hospitals and a random sample of 738 clinics/CBOs were telephoned for a survey on rapid HIV test availability. Of the 671 hospitals, 172 hospitals were randomly selected for barriers questions, for which 158 laboratory and 136 department staff were eligible and interviewed in 2005. Of the 738 clinics/CBOs, 276 were randomly selected for barriers questions, 206 were reached, and 118 were eligible and interviewed in 2005-2006. In multivariate models, barriers regarding translation of administrative/quality assurance policies into practice were significantly associated with rapid HIV testing availability. For greater rapid testing diffusion, policies are needed to reduce administrative barriers and provide quality assurance training to non-laboratory staff.

The MeSO-net (Metropolitan Seismic Observation network) confronts the Pacific Coast of Tohoku Earthquake, Japan (Mw 9.0)

Science.gov (United States)

Kasahara, K.; Nakagawa, S.; Sakai, S.; Nanjo, K.; Panayotopoulos, Y.; Morita, Y.; Tsuruoka, H.; Kurashimo, E.; Obara, K.; Hirata, N.; Aketagawa, T.; Kimura, H.

2011-12-01

On April 2007, we have launched the special project for earthquake disaster mitigation in the Tokyo Metropolitan area (Fiscal 2007-2011). As a part of this project, construction of the MeSO-net (Metropolitan Seismic Observation network) has been completed, with about 300 stations deployed at mainly elementary and junior-high schools with an interval of about 5 km in space. This results in a highly dense network that covers the metropolitan area. To achieve stable seismic observation with lower surface ground noise, relative to a measurement on the surface, sensors of all stations were installed in boreholes at a depth of about 20m. The sensors have a wide dynamic range (135dB) and a wide frequency band (DC to 80Hz). Data are digitized with 200Hz sampling and telemetered to the Earthquake Research Institute, University of Tokyo. The MeSO-net that can detect and locate most earthquakes with magnitudes above 2.5 provides a unique baseline in scientific and engineering researches on the Tokyo metropolitan area, as follows. One of the main contributions is to greatly improve the image of the Philippine Sea plate (PSP) (Nakagawa et al., 2010) and provides an accurate estimation of the plate boundaries between the PSP and the Pacific plate, allowing us to possibly discuss clear understanding of the relation between the PSP deformation and M7+ intra-slab earthquake generation. Also, the latest version of the plate model in the metropolitan area, proposed by our project, attracts various researchers, comparing with highly-accurate solutions of fault mechanism, repeating earthquakes, etc. Moreover, long-periods ground motions generated by the 2011 earthquake off the Pacific coast of Tohoku earthquake (Mw 9.0) were observed by the MeSO-net and analyzed to obtain the Array Back-Projection Imaging of this event (Honda et al., 2011). As a result, the overall pattern of the imaged asperities coincides well with the slip distribution determined based on other waveform inversion

A metropolitan optical network with support for multicasting in the optical domain

NARCIS (Netherlands)

Dey, D.; Koonen, A.M.J.; Bochove, van A.C.; Geuzebroek, D.; Salvador, M.R.; Berghmans, F.; Thienpont, H.; Danckaert, J.; Desmet, L.

2001-01-01

We present the FLAMINGO1 network architecture, an all-optical wavelength-and-timeslotted Metropolitan Optical Network based on a multiple-ring topology. A couple of important aspects of this architecture include all-optical packet switching at intermediate nodes on a ring and the ability to put IP

A Metropolitan Optical Network with support for multicasting in the optical domain

NARCIS (Netherlands)

Dey, D.; Koonen, A.M.J.; van Bochove, A.C.; Geuzebroek, D.H.; Salvador, M.R.; Thienpont, H.; Berghmans, F.; Danckaert, J.; Desmet, L.

2001-01-01

We present the FLAMINGO1 network architecture, an all-optical wavelength-and-timeslotted Metropolitan Optical Network based on a multiple-ring topology. A couple of important aspects of this architecture include all-optical packet switching at intermediate nodes on a ring and the ability to put IP

Seroprevalence of Toxoplasma gondii in domestic pets from metropolitan regions of Panama

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Rengifo-Herrera Claudia

2017-01-01

Full Text Available Toxoplasmosis is a worldwide zoonotic disease but information regarding domestic animals in Central America is scarce and fragmented. The aim of this study was to determine the seroprevalence of Toxoplasma gondii in domestic cats and dogs in different metropolitan regions of Panama. A total of 576 samples were collected; sera from 120 cats and 456 dogs were tested using a commercial indirect enzyme-linked immunosorbent assay (ELISA. The overall seroprevalence of IgG antibodies was 30.73%. There is high seroprevalence of T. gondii in cats and dogs in the metropolitan regions around the Panama Canal; however, differences between these species were not significant. Statistical analysis indicated that there are relevant variables, such as the age of animals, with a direct positive relationship with seroprevalence. None of the variables related to animal welfare (veterinary attention provided, type of dwelling, and access to green areas and drinking water were associated with seropositivity.

Vaccine-preventable, hospitalizations among American Indian/Alaska Native children using the 2012 Kid's Inpatient Database.

Science.gov (United States)

Nickel, Amanda J; Puumala, Susan E; Kharbanda, Anupam B

2018-02-08

Our aim was to assess the odds of hospitalization for a vaccine-preventable, infectious disease (VP-ID) in American Indian/Alaska Native (AI/AN) children compared to other racial and ethnic groups using the 2012 Kid's Inpatient Database (KID) The KID is a nationally representative sample, which allows for evaluation of VP-ID in a non-federal, non-Indian Health Service setting. In a cross-sectional analysis, we evaluated the association of race/ethnicity and a composite outcome of hospitalization due to vaccine-preventable infection using multivariate logistic regression. AI/AN children were more likely (OR=1.81, 95% CI=1.34, 2.45) to be admitted to the hospital in 2012 for a VP-ID compared to Non-Hispanic white children after adjusting for age, sex, chronic disease status, metropolitan location, and median household income. This disparity highlights the necessity for a more comprehensive understanding of immunization and infectious disease exposure among American Indian children, especially those not covered or evaluated by Indian Health Service. Copyright © 2017 Elsevier Ltd. All rights reserved.

Suburbanization and sustainability in metropolitan Moscow.

Science.gov (United States)

Mason, Robert J; Nigmatullina, Liliya

2011-01-01

Although Soviet-era urban-growth controls produced relatively sustainable metropolitan development patterns, low-density suburban sprawl has accelerated markedly in modern Russia. Distinctive features of Moscow's development history are its greenbelt, which dates from 1935 and is becoming increasingly fragmented, proliferation of satellite cities at the urban fringe, conversion of seasonal dachas into full-time residences, the very exclusive Rublevo Uspenskoe Highway development, and today's crippling traffic congestion. The recent economic crisis has slowed development and actually increased the supply of “economy-class” single-family homes, for which there is much pent-up desire but insufficient credit availability to meet the demand. A renewed commitment to sustainability's triple bottom line—environmental quality, equity, and economic prosperity—will require greater government transparency and fairness, stronger planning controls, and an expanded public transportation system.

Racial/Ethnic Pay Disparities among Registered Nurses (RNs) in U.S. Hospitals: An Econometric Regression Decomposition.

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Moore, Jean; Continelli, Tracey

2016-04-01

To detect the presence of racial and ethnic pay disparities between minority and white hospital RNs using a national sample. The National Sample Survey of Registered Nurses, 2008, which is representative at both the state and national level. Cross-sectional data were analyzed using multivariate regression and regression decomposition. Differences between groups were decomposed into differences in the possession of characteristics and differences in the value of the same characteristic between different groups, the latter being a commonly used measure of wage discrimination. As the majority of minority hospital RNs are employed within the most densely populated (central) counties of metropolitan statistical areas (MSAs), only hospital RNs employed in the central counties of MSAs were selected. Regression decomposition found that black and Hispanic RNs earned less than whites and Asians, while Asian RNs earned more than white RNs. The majority of pay variation between white RNs, versus Asian, black, or Hispanic RNs was due to unexplained differences in the value of the same characteristic between groups. Differences in earnings between underrepresented and overrepresented hospital RNs is suggestive of discrimination. © Health Research and Educational Trust.

SPATIAL SEGMENTATION WITHIN METROPOLITAN LABOUR MARKET: MAPPING THE GENDER DIMENSION

OpenAIRE

DEBNATH, TANIA

2017-01-01

Spatial segmentation of the labour market of informal workers within the metropolitan is observed globally. InIndia it is not only compartmentalised on gender, caste, ethnic lines but also geographically segmented by thecreation of spatially disjoined markets. The differential impact of this limited mobility on female and malelabour remains largely unexplored. The present paper argues that the labour market for informal workers issegmented into smaller labour markets separated by commuting (h...

Budaya Konsumsi Remaja-Pelajar di Tiga Kota Metropolitan Pantai Indonesia

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Andi Mappiare

2016-02-01

Full Text Available This research aimed to obtain a narrative description of students' thought patterns on their consumptive behaviors and the work ethos in self-management relating to their consumptive motives. The research was conducted using  focused ethnography on senior high school students in three Indonesian coastal metropolitan cities. Following, this research, a self-help book was constructed  increase students awareness of their"budgeting intelligence and their local wisdom.

CHANGES IN BACTERIAL COMPOSITION OF BIOFILM IN A METROPOLITAN DRINKING WATER DISTRIBUTION SYSTEM

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This study examined the development of bacterial biofilms within a metropolitan distribution system. The distribution system is fed with different source water (i.e., groundwater, GW and surface water, SW) and undergoes different treatment processes in separate facilities. The b...

Spirometry and impulse oscillometry (IOS) for detection of respiratory abnormalities in metropolitan firefighters.

NARCIS (Netherlands)

Schermer, T.R.J.; Malbon, W.; Newbury, W.; Holton, C.; Smith, M.; Morgan, M.; Crockett, A.

2010-01-01

BACKGROUND AND OBJECTIVE: As firefighters are at increased risk of adverse health effects, periodic examination of their respiratory health is important. The objective of this study was to establish whether the use of impulse oscillometry (IOS) reveals respiratory abnormalities in metropolitan

78 FR 40146 - Patient Safety Organizations: Voluntary Relinquishment From Northern Metropolitan Patient Safety...

Science.gov (United States)

2013-07-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Northern Metropolitan Patient Safety Institute AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of Delisting. SUMMARY: The Patient Safety and...

Regeneration as an approach for the development of informal settlements in Cairo metropolitan

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Ghada Farouk Hassan

2012-09-01

Finally the paper ends by discussing the capability of the application of this approach in dealing with the informal settlements in Cairo metropolitan as proper approach to cope with the need of dealing effectively with those shadows in the urban context.

Geographically varying associations between personality and life satisfaction in the London metropolitan area

NARCIS (Netherlands)

Jokela, M.; Bleidorn, W.; Lamb, M.E.; Gosling, S.D.; Rentfrow, P.J.

2015-01-01

Residential location is thought to influence people’s well-being, but different individuals may value residential areas differently. We examined how life satisfaction and personality traits are geographically distributed within the UK London metropolitan area, and how the strength of associations

Using database reports to reduce workplace violence: Perceptions of hospital stakeholders.

Science.gov (United States)

Arnetz, Judith E; Hamblin, Lydia; Ager, Joel; Aranyos, Deanna; Essenmacher, Lynnette; Upfal, Mark J; Luborsky, Mark

2015-01-01

Documented incidents of violence provide the foundation for any workplace violence prevention program. However, no published research to date has examined stakeholders' preferences for workplace violence data reports in healthcare settings. If relevant data are not readily available and effectively summarized and presented, the likelihood is low that they will be utilized by stakeholders in targeted efforts to reduce violence. To discover and describe hospital system stakeholders' perceptions of database-generated workplace violence data reports. Eight hospital system stakeholders representing Human Resources, Security, Occupational Health Services, Quality and Safety, and Labor in a large, metropolitan hospital system. The hospital system utilizes a central database for reporting adverse workplace events, including incidents of violence. A focus group was conducted to identify stakeholders' preferences and specifications for standardized, computerized reports of workplace violence data to be generated by the central database. The discussion was audio-taped, transcribed verbatim, processed as text, and analyzed using stepwise content analysis. Five distinct themes emerged from participant responses: Concerns, Etiology, Customization, Use, and Outcomes. In general, stakeholders wanted data reports to provide ``the big picture,'' i.e., rates of occurrence; reasons for and details regarding incident occurrence; consequences for the individual employee and/or the workplace; and organizational efforts that were employed to deal with the incident. Exploring stakeholder views regarding workplace violence summary reports provided concrete information on the preferred content, format, and use of workplace violence data. Participants desired both epidemiological and incident-specific data in order to better understand and work to prevent the workplace violence occurring in their hospital system.

Local macroeconomic trends and hospital admissions for child abuse, 2000-2009.

Science.gov (United States)

Wood, Joanne N; Medina, Sheyla P; Feudtner, Chris; Luan, Xianqun; Localio, Russell; Fieldston, Evan S; Rubin, David M

2012-08-01

To examine the relationship between local macroeconomic indicators and physical abuse admission rates to pediatric hospitals over time. Retrospective study of children admitted to 38 hospitals in the Pediatric Hospital Information System database. Hospital data were linked to unemployment, mortgage delinquency, and foreclosure data for the associated metropolitan statistical areas. Primary outcomes were admission rates for (1) physical abuse in children <6 years old, (2) non-birth, non-motor vehicle crash-related traumatic brain injury (TBI) in infants <1 year old (which carry high risk for abuse), and (3) all-cause injuries. Poisson fixed-effects regression estimated trends in admission rates and associations between those rates and trends in unemployment, mortgage delinquency, and foreclosure. Between 2000 and 2009, rates of physical abuse and high-risk TBI admissions increased by 0.79% and 3.1% per year, respectively (P ≤ .02), whereas all-cause injury rates declined by 0.80% per year (P < .001). Abuse and high-risk TBI admission rates were associated with the current mortgage delinquency rate and with the change in delinquency and foreclosure rates from the previous year (P ≤ .03). Neither abuse nor high-risk TBI rates were associated with the current unemployment rate. The all-cause injury rate was negatively associated with unemployment, delinquency, and foreclosure rates (P ≤ .007). Multicenter hospital data show an increase in pediatric admissions for physical abuse and high-risk TBI during a time of declining all-cause injury rate. Abuse and high-risk TBI admission rates increased in relationship to local mortgage delinquency and foreclosure trends.

Land suitability for waste disposal in metropolitan areas.

Science.gov (United States)

Baiocchi, Valerio; Lelo, Keti; Polettini, Alessandra; Pomi, Raffaella

2014-08-01

Site selection for waste disposal is a complex task that should meet the requirements of communities and stakeholders. In this article, three decision support methods (Boolean logic, index overlay and fuzzy gamma) are used to perform land suitability analysis for landfill siting. The study was carried out in one of the biggest metropolitan regions of Italy, with the objective of locating suitable areas for waste disposal. Physical and socio-economic information criteria for site selection were decided by a multidisciplinary group of experts, according to state-of-the-art guidelines, national legislation and local normative on waste management. The geographic information systems (GIS) based models used in this study are easy to apply but require adequate selection of criteria and weights and a careful evaluation of the results. The methodology is arranged in three steps, reflecting the criteria defined by national legislation on waste management: definition of factors that exclude location of landfills or waste treatment plants; classification of the remaining areas in terms of suitability for landfilling; and evaluation of suitable sites in relation to preferential siting factors (such as the presence of quarries or dismissed plants). The results showed that more than 80% of the provincial territory falls within constraint areas and the remaining territory is suitable for waste disposal for 0.72% or 1.93%, according to the model. The larger and most suitable sites are located in peripheral areas of the metropolitan system. The proposed approach represents a low-cost and expeditious alternative to support the spatial decision-making process. © The Author(s) 2014.

South Platte Watershed from the Headwaters to the Denver Metropolitan Area (Colorado) Systems Thinking

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South Platte Watershed from the Headwaters to the Denver Metropolitan Area (Colorado) of the Urban Waters Federal Partnership (UWFP) reconnects urban communities with their waterways by improving coordination among federal agencies and collaborating

Washington DC Metropolitan Area Drug Study Household and Non-Household Populations (DC-MADSH-1991)

Data.gov (United States)

U.S. Department of Health & Human Services — The DC Metropolitan Area Drug Study (DCMADS) was conducted in 1991, and included special analyses of homeless and transient populations and of women delivering live...

Uudised : ERSO menu Rootsis. Õhtu Metropolitan Operas. NYYD Ensemble'i kontserdid / Madis Kolk

Index Scriptorium Estoniae

Kolk, Madis, 1953-

2001-01-01

ERSO kontserdireisist Rootsis. "Klassikaraadio" teeb 17. veebr. otseülekande New Yorgi Metropolitan Operast, kus tuleb ettekandele Rossini ooepr "Itaallanna Alzhiiris". NYYD Ensemble'i kontsertidest Pärnus ja Tallinnas kontserdisarjas "I Got Rhythm"

A Partial Proportional Odds Model for Pedestrian Crashes at Mid-Blocks in Melbourne Metropolitan Area

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Toran Pour Alireza

2016-01-01

Full Text Available Pedestrian crashes account for 11% of all reported traffic crashes in Melbourne metropolitan area between 2004 and 2013. There are very limited studies on pedestrian accidents at mid-blocks. Mid-block crashes account for about 46% of the total pedestrian crashes in Melbourne metropolitan area. Meanwhile, about 50% of all pedestrian fatalities occur at mid-blocks. In this research, Partial Proportional Odds (PPO model is applied to examine vehicle-pedestrian crash severity at mid-blocks in Melbourne metropolitan area. The PPO model is a logistic regression model that allows the covariates that meet the proportional odds assumption to affect different crash severity levels with the same magnitude; whereas the covariates that do not meet the proportional odds assumption can have different effects on different severity levels. In this research vehicle-pedestrian crashes at mid-blocks are analysed for first time. In addition, some factors such as distance of crashes to public transport stops, average road slope and some social characteristics are considered to develop the model in this research for first time. Results of PPO model show that speed limit, light condition, pedestrian age and gender, and vehicle type are the most significant factors that influence vehicle-pedestrian crash severity at mid-blocks.

Appropriate Urban Livability Indicators for Metropolitan Johor, Malaysia via Expert-Stakeholder Approach: a Delphi technique

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Dario Gallares Pampanga

2015-11-01

Full Text Available Metro Johor is one of the fast emerging metropolitan urban centers where its current progress and spatial transformation have made it a key player in the economic growth of Malaysia. The recent creation of the Iskandar Malaysia, an economic strategy which aims to be a global player as potential destination for high-value investments, has certainly added social, environmental and economic stress to its urban citizens. This paper intends to develop urban livability indicators for Metropolitan Johor anchored on the changing urban complexion in the face of climate change, economic, governance, social and cultural dynamics, among others. The urban livability conundrum of Metro Johor illustrates that indicators are imperative, especially policy-based indicators, which would aid to scale-up the desired progress according to urban livability metrics. The study involves iterative 3-rounds of Delphi blind survey with Likert scale’s degree of agreement, and finally assigning weightings to each sub-indicator. Thus, with the expert-stakeholders involvement, constituting broad-sectoral community representation, a robust and appropriate urban livability index for Metro Johor was generated - a comprehensive framework yet prospective benchmark in appropriating timely policy decisions that would redound to the benefit of urban citizens ensuring a livable Metropolitan Johor.

Strauss, R.: Symphony in F minor, Op. 12... Tokyo Metropolitan Symphony Orchestra / David Nice

Index Scriptorium Estoniae

Nice, David

1994-01-01

Uuest heliplaadist "Strauss, R.: Symphony in F minor, Op. 12... Tokyo Metropolitan Symphony Orchestra / Hiroshi Wakasugi. Denon CD CO-75 860 (54 minutes); Symphony - comparative version: SNO, Järvi" (8/93)(CHAN) CHAN 9166

Dynamics of Metropolitan Landscapes and Daily Mobility Flows in the Italian Context. An Analysis Based on the Theory of Graphs

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Amedeo Ganciu

2018-02-01

Full Text Available The distribution of services across a territory generates daily commuting flows, which have a significant influence on the development of the territory and often causes congestion in large areas. This negatively affects the environmental, economic and social components of the metropolitan landscape. Using the graph theory, we constructed and analyzed various (in typologies of transportation and moving time flow networks in the two main Italian metropolitan areas: Rome (MCR and Milan (MCM. The analysis of these networks provided us with strategic information on the dynamics of the two urban macro-systems. In particular, the aim of our study was to: (i identify the characteristics, distribution and direction of the main attractive forces within the regional systems under study; (ii identify the main differences in size and structure of commuter networks between the two metropolitan areas and between the two regional systems that include the two mother cities; and, (iii identify the main differences in the size and structure of the two commuting networks by transport modes (private, public, non-motorized mobility and the travel time. The results highlighted significant differences between the two case studies regarding volume flows, complexity and structure networks, and the spatial extension of the territories that are governed by the two metropolitan areas. MCR is a strongly monocentric urban system with a regional influence centred on the mother city of Rome, while MCM is a diffused polycentric regional metropolitan system centred on multiple mother cities. The findings many have a role in urban planning choices and in the evaluation of policies aimed to favor sustainable mobility.

PAD TECHNIQUE ON DEFORESTATION SITUATION ON PETROPOLIS’ METROPOLITAN AREA - RJ

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Amanda Santos de Alencar

2015-12-01

Full Text Available With the rising and intensification of production’s activities, as industries, the deforestation taxes show to be on an alarming level. It is wide spread known the consequences that deforestation might cause in metropolitan areas. In order to evalue the consequences of this growing phenomenon, is possible to use a role of ambiental impacts evaluations techniques. One of them is the Preliminary Analysis of Danger (PAD, which is based on qualitative and statistics analysis and might be used in association with other ambiental impacts evaluations techniques. It’s goal is to analyze dangers in potential, it’s causes and consequences, in which is also done an associated risk analysis, which the last is the association between the classifications of frequency and severity, and, in the end, it gives suggestions of measures to avoid these dangers (undesired events. In this study, six dangers have been identified, in which none of them present despicable or low risk (0%, 16% present medium or high risk and 66% present critic risk. These datas point out that the deforestation situation might cause dangers with great consequences to Petropolis’ metropolitan area, just as floodings and earth slidings, which higthlights the urgency of management of the area. DOI: http://dx.doi.org/10.12957/sustinere.2015.20003

Working paper : national costs of the metropolitan ITS infrastructure : updated with 2004 deployment data

Science.gov (United States)

The purpose of this report, "Working Paper National Costs of the Metropolitan ITS infrastructure: Updated with 2004 Deployment Data," is to update the estimates of the costs remaining to deploy Intelligent Transportation Systems (ITS) infrastructure ...

First epidemiological report of feline heartworm infection in the Barcelona metropolitan area (Spain).

Science.gov (United States)

Montoya-Alonso, José Alberto; Carretón, Elena; García-Guasch, Laín; Expósito, Jordi; Armario, Belén; Morchón, Rodrigo; Simón, Fernando

2014-11-12

The metropolitan area of Barcelona is the most densely populated metropolitan area on the Mediterranean coast. Several studies have reported the presence of canine heartworm disease in this region; however, there are no published epidemiological data regarding feline heartworm in this region and the prevalence in this species remains unknown. Serum samples from 758 cats living in the metropolitan area of Barcelona (Spain) were collected between 2012 and 2013. To establish the seroprevalence of heartworm infection in cats, serological techniques for anti-D.immitis and anti-Wolbachia antibody detection were used while a commercial ELISA test kit was used to detect circulating D.immitis antigens. Of these samples, 11.47% were positive to D.immitis and Wolbachia surface protein antibodies and 0.26% were positive to D.immitis antigens. The higher antibody seroprevalences were found in the areas that follow the courses of the rivers Llobregat and Anoia (Baix Llobregat 11.5%, Vallés Occidental 13.2%; Barcelonés 11.7%) where humidity and vegetation favour the development of the mosquito vectors. High antibody seroprevalences were also found in the urban areas (Barcelona city 13.1%; Sabadell 15.5%), which demonstrates that city cats are also at risk from D.immitis infection. Generally, in Spain cats do not receive prophylactic treatment and therefore the risk of infection is higher in this species than in dogs. Adequate prophylactic plans should be implemented in the feline population. This is the first epidemiologic study on feline heartworm infection to be carried out in continental Spain.

[External workplace violence against doctors in hospital services in Lima Metropolitana, Peru 2014].

Science.gov (United States)

Tuya-Figueroa, Ximena; Mezones-Holguin, Edward; Monge, Eduardo; Arones, Ricardo; Mier, Milagros; Saravia, Mercedes; Torres, Jose; Mayta-Tristán, Percy

2016-01-01

. To calculate the frequency and factors associated with external workplace violence (EWV) against doctors in health inpatient services in the metropolitan area of Lima (Spanish: Lima Metropolitana), Peru. . A cross-sectional analytic study, which included doctors from the Ministry of Health (MINSA), Social Security (EsSalud), and the private subsector, was carried out. The frequency of EWV was measured throughout the entire professional practice during the previous 12 months and during the last month. Variables related to the doctor, assailant, and health service were measured. Raw and adjusted prevalence ratios (PR) were calculated by means of a Poisson-family generalized linear model with non-parametric bootstrapping. . A total of 406 doctors participated; 31.5% were victims of EWV at least once during their professional practice, with 19.9% over the past 12 months and 7.6% during the last month. The chances of being threatened in the last 12 months increased if the doctor was male (adjusted PR [aPR]: 1.7; 95% confidence interval [CI] = 1.1- 2.8), had graduated from a Peruvian university outside of the metropolitan area of Lima (aPR: 1.5; 95% CI = 1.1-2.4), worked at MINSA (aPR: 7.9; 95% CI = 2.24-50.73) or EsSalud (RR: 8.68; 95% CI = 2.26-56.17), and worked in the emergency (aPR: 1.9; 95% CI = 1.2-3.6) or operating room (aPR: 1.6; 95% CI = 1.1-2.3). Age, years of professional practice, or being a medical resident were not associated with EWV. . In the hospitals studied, a large number of doctors have been victims of EWV. Working in public services increases the possibility of violence. Implementation of support, identification, and primary prevention strategies in hospitals is recommended.

The Audiometric Findings among Curitiba and Metropolitan Area Students

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Klas, Regina

2014-02-01

Full Text Available Introduction Hearing loss can compromise the language, learning process, and socialization of students. Objective Study the audiometric findings among Curitiba and Metropolitan Area students. Methods Analysis of data collected at the hearing health service of Paraná State special education and inclusion department. Results The sample consisted of 646 students, children and teenagers of both genders (38.2% female and 61.8% male, with average age of 8.12 years (range 2 to 15; all were students of public or private schools of Curitiba and Metropolitan Area. The justifications to refer the students to audiometric evaluation were: otolaryngologists diagnosis (73.1%, school difficulties (39.6%, and midlevel hearing problems (32%. Audiometric results showed that 29.5% of the students had hearing loss. Conductive hearing losses showed the greatest occurrence among preschool students (right ear 38.6%, left ear 39.8%. The predominant hearing loss degree was mild (RE 20.5%, LE 19.3% to slight (RE 17%, LE 19.3%, as was the horizontal configuration (RE 81.5%, LE 78.4%. A significant relationship (p = 0.0000 between hearing loss and poor school performance was noted. Conclusion Considering the available data, especially the high number of findings of conductive losses, it is necessary to highlight prevention and diagnosis of early hearing alteration. Nevertheless, Brazil, as an emerging country, has been pursuing improvement in health and life quality of all citizens.

Municipal Revenue Generation and Development in the Calgary and Edmonton Metropolitan Regions

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Brian W. Conger

2016-12-01

Full Text Available Municipal reliance on property taxes and the competing priorities of municipalities—in terms of where they plan and approve land development within their boundaries—in order to capture new property taxes, has led to political conflict between adjacent municipalities.1 Nowhere in Alberta is this more evident than in the Edmonton and Calgary metropolitan regions, where sustained high-levels of growth has led to the expansion of the core-cities, rapid residential development rates in peripheral urban centres and the rise urban-scale development in the rural municipal districts – spurring intrametropolitan competition, harsh words and hurt feelings amongst municipalities.2 In response to this ongoing conflict, the province and at times the municipalities themselves have developed successive regional planning frameworks over the past 60 years3 to guide development and encourage—and at times enforce—intermunicipal collaboration. In an exploration of the contemporary relationship between municipal finance and development patterns in the Calgary and Edmonton metropolitan regions, we use municipal property tax and building-permit data for new residential, commercial and industrial development to track the incidence of development since 1983 and the property tax rates for municipalities in both regions from 2001 to 2015. In looking at the tax data there is evidence of increasing competition among municipalities, in particular for non-residential development; however, the trends could also be consistent with collusion. In looking at the building permit data, although there has been a lot of development in the peripheral urban and rural municipalities, proportionately, growth and development has occurred overwhelmingly in the core-cities. Our findings point to a system where local development considerations in both metropolitan regions, and the municipal prerogative to set municipal tax rates to attract development, take precedence over the

Special Report - USNS Comfort Underway

Science.gov (United States)

region. The Navy hospital ship will provide medical, dental, veterinary and engineering assistance in medical clinic set up during Continuing Promise 2009. Story» Air Force Band Member Enjoys Audience Alexis arrived at a medical clinic set up by the crew of USNS Comfort wearing her Sunday best in

Dietary intake, nutritional status and rehabilitation outcomes of stroke patients in hospital.

Science.gov (United States)

Nip, W F R; Perry, L; McLaren, S; Mackenzie, A

2011-10-01

Nutrition affects rehabilitation through its influence on physical and mental functioning, although little attention has been paid to effects on rehabilitation outcomes. The present study aimed to describe nutritional status and food consumption in stroke patients within 2 weeks of hospital admission and before discharge, as well as to investigate the effects of nutritional and dietary factors on rehabilitation outcomes. One hundred patients from a consecutive cohort admitted to a metropolitan hospital with acute stroke were recruited and assessed by a single researcher, with 38 reassessed at discharge. Nutritional status was assessed using Mini-Nutritional Assessment and anthropometric indices and dietary intake was assessed by 1-day weighed dietary records. Rehabilitation outcomes were changes in Barthel index scores and the rehabilitation efficiency index. Few (n = 9; 10%) consumed ≥100% of the estimated average requirement (EAR) for energy within 2 weeks of admission and 13 (33%) had energy intakes stroke patients to improve rehabilitation outcomes. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Population deconcentration in metropolitan Manila in the twentieth century.

Science.gov (United States)

Stinner, W F; Bacol-montilla, M

1981-10-01

"The present analysis is intended to delineate the extent of population deconcentration through an examination of changes in core-periphery growth and density patterns within the Metropolitan Manila complex. Specifically, [the authors] examine changes in absolute and relative population growth and density levels in the central city of Manila, the inner suburban ring, and the outer suburban ring from 1903 to 1975. [The authors] also present a preliminary assessment of the demographic processes underlying the post-World War II trends." Data are from the 1975 Philippine census. excerpt

Spatiotemporal Analysis of Human Mobility in Manila Metropolitan Area with Person-Trip Data

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Kai Liu

2018-01-01

Full Text Available The metropolitan area can be regarded as a multi-functional structure consisting of plural coordinated urban nucleuses. This study aims to clarify the characteristics of urban nucleuses and a spatiotemporal pattern of human mobility in the Manila metropolitan area. Hourly density of human mobility from 00:00 to 24:00 in the whole study area is quantitatively studied. Urban nucleuses with six types: central city, business city, commuter town, south suburb, north suburb, and subcenter city, are identified. Differences of human mobility owing to different human behaviors or properties are also analyzed in 10 typical areas with different urban functions. Results prove that pattern of human mobility in each area depends on its human social division, population composition, infrastructure condition, and functional structure. This study provides an effective thinking on handling geo-tagged big data supported by MATLAB programming and GIS technology. Moreover, spatiotemporal analysis of human mobility also possesses a meaningful academic value for transport geography.

Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) County Prevalence Data (2010 and prior)

Data.gov (United States)

U.S. Department of Health & Human Services — 2002-2010. BRFSS SMART County Prevalence land line only data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral Risk Factor Surveillance...

Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) MMSA Prevalence Data (2010 and Prior)

Data.gov (United States)

U.S. Department of Health & Human Services — 2002-2010. BRFSS SMART MMSA Prevalence land line only data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral Risk Factor Surveillance...

Clinical audit on documentation of anticipatory "Not for Resuscitation" orders in a tertiary australian teaching hospital

Directory of Open Access Journals (Sweden)

Naveen Sulakshan Salins

2011-01-01

Full Text Available Aim: The purpose of this clinical audit was to determine how accurately documentation of anticipatory Not for Resuscitation (NFR orders takes place in a major metropolitan teaching hospital of Australia. Materials and Methods: Retrospective hospital-based study. Independent case reviewers using a questionnaire designed to study NFR documentation reviewed documentation of NFR in 88 case records. Results: Prognosis was documented in only 40% of cases and palliative care was offered to two-third of patients with documented NFR. There was no documentation of the cardiopulmonary resuscitation (CPR process or outcomes of CPR in most of the cases. Only in less than 50% of cases studied there was documented evidence to suggest that the reason for NFR documentation was consistent with patient′s choices. Conclusion: Good discussion, unambiguous documentation and clinical supervision of NFR order ensure dignified and quality care to the dying.

Trends in hospital cost and revenue, 1994-2005: how are they related to HMO penetration, concentration, and for-profit ownership?

Science.gov (United States)

Shen, Yu-Chu; Wu, Vivian Y; Melnick, Glenn

2010-02-01

Analyze trends in hospital cost and revenue, as well as price and quantity (1994-2005) as a function of health maintenance organization (HMO) penetration, HMO concentration, and for-profit (FP) HMO market share. Medicare hospital cost reports, AHA Annual Surveys, HMO data from Interstudy, and other supplemental data. A retrospective study of all short-term, general, nonfederal hospitals in metropolitan statistical areas (MSAs) in the United States from 1994 to 2005, using hospital/MSA fixed-effects translog regression models. A 10 percentage point increase in HMO enrollment is associated with 4.1-4.2 percent reduction in costs and revenues in the pre-2000 period but only a 2.1-2.5 percent reduction in the post-2000 period. Hospital revenue in HMO-dominant markets (highly concentrated HMO market and competitive hospital market) is 19-27 percent lower than other types of markets, and the difference is most likely due mainly to lower prices and to a lesser extent lower utilization. The historical difference of lower spending in high HMO penetration markets compared with low HMO markets narrowed after 2000 and the relative concentration between HMO and hospital markets can substantially influence hospital spending. Additional research is needed to understand how different aspects of these two markets have changed and interacted and how they are causally linked to spending trends.

Legislation and water management of water source areas of São Paulo Metropolitan Region, Brazil

Directory of Open Access Journals (Sweden)

Luis Eduardo Gregolin Grisotto

2010-12-01

Full Text Available This paper presents the history of occupation in the water source areas in São Paulo Metropolitan Region (hereinafter SPMR and the evolution of the legislation related to this issue, from the point of view of the environmental and water management. A descriptive methodology was used, with searches into bibliographical and documental materials, in order to present the main laws for the protection of the water supply areas of SPMR and environmental and water management. It was possible to observe some progress in the premises of the both legislation and the format proposed for the management of the water source areas. However, such progress is limited due to the lack of a more effective mechanism for metropolitan management. The construction of the metropolitan management in SPMR would enlarge the capacity of integration between municipalities and sectors. The integration between the management of water and the land use management showed to be fundamental for the protection of the water sources. The new law for protection of the water sources, State Law nº 9.866/97, is decentralized and participative, focusing on non-structural actions and integrated management. However, the effective implementation of the law still depends on the harmonization of sectoral public policies, extensive coordination and cooperation among municipalities and the progress in the degree of the commitment of the governments.

Pediatric Neglected Tropical Diseases in a Major Metropolitan Children's Hospital in the United States, 2004-2013.

Science.gov (United States)

Sweet, Leigh R; Palazzi, Debra L

2016-12-01

We conducted a retrospective study of neglected tropical diseases (NTDs) diagnosed at Texas Children's Hospital between 2004 and 2013. Forty-three patients with an NTD were identified; 47% had never traveled outside of the United States. The results of this study highlight the importance of physician awareness of NTDs in children in the United States. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) County Prevalence Data (2011 to 2012)

Data.gov (United States)

U.S. Department of Health & Human Services — 2011 to 2012. BRFSS SMART County Prevalence combined land line and cell phone data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral...

Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) MMSA Prevalence Data (2011 to Present)

Data.gov (United States)

U.S. Department of Health & Human Services — 2011 to present. BRFSS SMART MMSA Prevalence combined land line and cell phone data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral...

The freight landscape : using secondary data sources to describe metropolitan freight flows : final report.

Science.gov (United States)

2015-12-01

Metropolitan areas around the world are seeking to better manage freight flows and reduce negative impacts on local populations. A major challenge to better urban freight management is the lack of data; little is known about freight movements at the ...

Staff Recall Travel Time for ST Elevation Myocardial Infarction Impacted by Traffic Congestion and Distance: A Digitally Integrated Map Software Study.

Science.gov (United States)

Cole, Justin; Beare, Richard; Phan, Thanh G; Srikanth, Velandai; MacIsaac, Andrew; Tan, Christianne; Tong, David; Yee, Susan; Ho, Jesslyn; Layland, Jamie

2017-01-01

Recent evidence suggests hospitals fail to meet guideline specified time to percutaneous coronary intervention (PCI) for a proportion of ST elevation myocardial infarction (STEMI) presentations. Implicit in achieving this time is the rapid assembly of crucial catheter laboratory staff. As a proof-of-concept, we set out to create regional maps that graphically show the impact of traffic congestion and distance to destination on staff recall travel times for STEMI, thereby producing a resource that could be used by staff to improve reperfusion time for STEMI. Travel times for staff recalled to one inner and one outer metropolitan hospital at midnight, 6 p.m., and 7 a.m. were estimated using Google Maps Application Programming Interface. Computer modeling predictions were overlaid on metropolitan maps showing color coded staff recall travel times for STEMI, occurring within non-peak and peak hour traffic congestion times. Inner metropolitan hospital staff recall travel times were more affected by traffic congestion compared with outer metropolitan times, and the latter was more affected by distance. The estimated mean travel times to hospital during peak hour were greater than midnight travel times by 13.4 min to the inner and 6.0 min to the outer metropolitan hospital at 6 p.m. ( p  travel time can predict optimal residence of staff when on-call for PCI.

The Changing Influence of Educational Policy and Race on Metropolitan Inequality, 1970-2010

Science.gov (United States)

Johnson, Odis, Jr.

2017-01-01

Schools do not receive much recognition within urban sociological research for the role they perform in shaping the demographic, structural, and social features of neighborhoods, cities, and metropolitan areas. In contrast, this article links schools, and the racial avoidance that operates through educational policy, to the extreme economic…

Pent-up demand for surgery in the Manaus metropolitan region: A population-based cross-sectional study.

Science.gov (United States)

Ferreira, Priscila Gusmão da Silva; Galvao, Tais Freire; Silva, Marcus Tolentino

2017-08-01

Waiting lines in healthcare reflect an imbalance between the availability and the demand for medical services. This study aimed to analyze the prevalence and factors associated with the pent-up demand for surgical procedures in the Manaus metropolitan region.We performed a population-based cross-sectional study in 2015. Pent-up demand was based on self-report by the participants; those who reported waiting were contacted by phone to clarify the nature and reasons for the experienced delay.We interviewed 4001 adults in their households. The pent-up demand for surgical procedures in the Manaus metropolitan region was 14% (95% confidence interval: 13-15%). The surgical specialties with the highest demand included orthopedics (18.1%), gynecology (17.0%), ophthalmology (12.4%), neurosurgery (10.8%), and general surgery (10.2%). The main reason for not accessing services was their lack of availability in the public health system, leading some patients to pay for procedures in private facilities. The populations most affected by pent-up demand included elderly individuals, women, and housewives.Pent-up demand for surgical procedures is a common problem in the Manaus metropolitan region and thus requires coordinated actions to optimize access to and capacity of the healthcare system.

Hurricane & Tropical Storm Impacts over the South Florida Metropolitan Area: Mortality & Government

Science.gov (United States)

Colon Pagan, I. C.

2007-12-01

Since 1985, the South Florida Metropolitan area (SFMA), which covers the counties of Miami-Dade, Broward, and Palm Beach, has been directly affected by 9 tropical cyclones: four tropical storms and 5 hurricanes. This continuous hurricane and tropical storm activity has awakened the conscience of the communities, government, and private sector, about the social vulnerability, in terms of age, gender, ethnicity, and others. Several factors have also been significant enough to affect the vulnerability of the South Florida Metropolitan area, like its geographic location which is at the western part of the Atlantic hurricane track, with a surface area of 6,137 square miles, and elevation of 15 feet. And second, from the 2006 Census estimate, this metropolitan area is the 7th most populous area in the United States supporting almost 1,571 individuals per square mile. Mortality levels due to hurricanes and tropical storms have fluctuated over the last 21 years without any signal of a complete reduction, a phenomenon that can be related to both physical characteristics of the storms and government actions. The average annual death count remains almost the same from 4.10 between 1985 and 1995 to 4 from 1996 to 2006. However, the probability of occurrence of a direct impact of an atmospheric disturbance has increase from 0.3 to 0.6, with an average of three hurricane or tropical storm direct impacts for every five. This analysis suggests an increasing problem with regard to atmospheric disturbances-related deaths in the South Florida Metropolitan area. In other words, despite substantial increases in population during the last 21 years, the number of tropical cyclone-related deaths is not declining; it's just being segregated among more storms. Gaps between each impact can be related to mortality levels. When that time increases in five years or more, such as Bob and Andrew or Irene and Katrina, or decreases in weeks or months, such as Harvey and Irene or Katrina and Wilma

Radiation protection in an interventional laboratory: a comparative study of Australian and Saudi Arabian hospitals

International Nuclear Information System (INIS)

Alahmari, Mohammed Ali S.; Sun, Zhonghua; Bartlett, Andrew

2016-01-01

This study aimed to investigate whether the use of protection devices and attitudes of interventional professionals (including radiologists, cardiologists, vascular surgeons, medical imaging technicians and nurses) towards radiation protection will differ between Saudi Arabian and Australian hospitals. Hard copies of an anonymous survey were distributed to 10 and 6 clinical departments in the Eastern province of Saudi Arabia and metropolitan hospitals in Western Australia, respectively. The overall response rate was 43 % comprising 110 Australian participants and 63 % comprising 147 Saudi participants. Analysis showed that Australian respondents differed significantly from Saudi respondents with respect to their usages of leaded glasses (p < 0.001), ceiling-suspended lead screen (p < 0.001) and lead drape suspended from the table (p < 0.001). This study indicates that the trained interventional professionals in Australia tend to adhere to benefit from having an array of tools for personal radiation protection than the corresponding group in Saudi Arabia. (authors)

Task Manager: an innovative approach to improving hospital communication after hours.

Science.gov (United States)

Seddon, Mary E; Hay, David

2010-10-15

To improve communication between doctors and nurses after hours, by developing a tool to display ward tasks, allowing staff to prioritise their work, without constant interruption from pagers (beepers). Middlemore Hospital, a large metropolitan 800-bed hospital in Auckland, New Zealand. Introduction of computerised system (Task Manager) to identify, allocate and complete after-hours tasks. In the first 6 months 21,000 tasks have been completed in Task Manager. Paging of junior doctors has decreased by over 30% and there is broad acceptance of the tool by both nursing and medical staff. Task Manager has collected real-time data on the type of after hours tasks (nearly 50% are phlebotomy-related tasks), busy times of the day (1600 hours to 2400 hours) and who is performing most of the tasks. Task Manager is a simple yet powerful tool for prioritising routine tasks after hours. It allows staff to quickly create tasks, and communicate effectively with other members of the team. It has reduced the frequency of junior doctors paging so that they can continue their work with fewer interruptions. Whilst it was introduced to improve effective communication after hours, it has become apparent that there are multiple 'tasks' that are ordered in a multitude of ways in our hospital and many could be served by Task Manager.

Treatment of out-of-hospital supraventricular tachycardia: adenosine vs verapamil.

Science.gov (United States)

Brady, W J; DeBehnke, D J; Wickman, L L; Lindbeck, G

1996-06-01

To compare the use of adenosine and the use of verapamil as out-of-hospital therapy for supraventricular tachycardia (SVT). A period of prospective adenosine use (March 1993 to February 1994) was compared with a historical control period of verapamil use (March 1990 to February 1991) for SVT. Data were obtained for SVT patients treated in a metropolitan, fire-department-based paramedic system serving a population of approximately 1 million persons. Standard drug protocols were used and patient outcomes (i.e., conversion rates, complications, and recurrences) were monitored. During the adenosine treatment period, 105 patients had SVT; 87 (83%) received adenosine, of whom 60 (69%) converted to a sinus rhythm (SR). Vagal maneuvers (VM) resulted in restoration of SR in 8 patients (7.6%). Some patients received adenosine for non-SVT rhythms: 7 sinus tachycardia, 18 atrial fibrilation, 7 wide-complex tachycardia (WCT), and 2 ventricular tachycardia; no non-SVT rhythm converted to SR and none of these patients experienced an adverse effect. Twenty-five patients were hemodynamically unstable (systolic blood pressure fibrillation). Recurrence of SVT was noted in 2 adenosine patients and 2 verapamil patients in the out-of-hospital setting and in 23 adenosine patients and 15 verapamil patients after ED arrival, necessitating additional therapy (p = 0.48 and 0.88, for recurrence rates and types of additional therapies, respectively). Hospital diagnoses, outcomes, and ED dispositions were similar for the 2 groups. Adenosine and verapamil were equally successful in converting out-of-hospital SVT in patients with similar etiologies responsible for the SVT. Recurrence of SVT occurred at similar rates for the 2 medications. Rhythm misidentification remains a common issue in out-of-hospital cardiac care in this emergency medical services system.

Internet of Things (IoT) Applicability in a Metropolitan City

OpenAIRE

Dr. D Mohammed

2015-01-01

Internet of Things (IoT)is defined here as a network of interconnected objects. These objects can include several technological systems. This paper examines the wireless communication systems and IoT sensors. IoT is technically feasible today, allowing people and things to be connected anytime, anyplace, with anything and anyone. IoT privacy is a concern but security solutions exist today to solve these issues. A proposal is made to use secure IoT solutions in supporting the metropolitan need...

Factors Influencing Patronage Of Medical Tourism In Metropolitan Lagos Nigeria

OpenAIRE

Omisore; E.O.; Agbabiaka; H. I.

2015-01-01

Since medical tourism attract patient from various origin to seek medical services at different destinations it is paramount to consider the factors that motivate patrons decision on medical tourism. Hence this study assesses the factors influencing patronage of medical tourism in Lagos metropolis Nigeria. Lagos State is situated in the southwestern corner of Nigeria it lies within Latitudes 62N to 64N of the Equator and Longitudes 245E to 420E of the Greenwich meridian. Metropolitan Lagos is...

Place matters: variation in the black/white very preterm birth rate across U.S. metropolitan areas, 2002-2004.

Science.gov (United States)

Kramer, Michael R; Hogue, Carol R

2008-01-01

We reported on the distribution of very preterm (VPT) birth rates by race across metropolitan statistical areas (MSAs). Rates of singleton VPT birth for non-Hispanic white, non-Hispanic black, and Hispanic women were calculated with National Center for Health Statistics 2002-2004 natality files for infants in 168 MSAs. Subanalysis included stratification by parity, age, smoking, maternal education, metropolitan size, region, proportion of MSA that was black, proportion of black population living below the poverty line, and indices of residential segregation. The mean metropolitan-level VPT birth rate was 12.3, 34.8, and 15.7 per 1,000 live births for white, black, and Hispanic women, respectively. There was virtually no overlap in the white and black distributions. The variation in mean risk across cities was three times greater for black women compared with white women. The threefold disparity in mean rate, and two- to threefold increased variation as indicated by standard deviation, was maintained in all subanalyses. Compared with white women, black women have three times the mean VPT birth risk, as well as three times the variance in city-level rates. The racial disparity in VPT birth rates was composed of characteristics that were constant across MSAs, as well as factors that varied by MSA. The increased sensitivity to place for black women was unexplained by measured maternal and metropolitan factors. Understanding determinants of differences in both the mean risk and the variation of risk among black and white women may contribute to reducing the disparity in risk between races.

The Neighborhood Unit: Schools, Segregation, and the Shaping of the Modern Metropolitan Landscape

Science.gov (United States)

Erickson, Ansley T.; Highsmith, Andrew R.

2018-01-01

Background/Context: In the first half of the 20th century, American policy makers at all levels of government, alongside housing and real estate industry figures, crafted mechanisms of racial exclusion that helped to segregate metropolitan residential landscapes. Although educators and historians have recognized the long-term consequences of these…

Measures of social segregation in the context of Warsaw, Berlin and Paris metropolitan areas

Directory of Open Access Journals (Sweden)

Grzegorczyk Anna

2015-09-01

Full Text Available Social segregation is a subject common in contemporary studies of metropolitan areas. Until recently, studies of segregation focused on the distribution of ethnic groups, immigrants, and the poor. Today, they also cover additional indicators such as demographic properties, education, and affiliation with social and professional categories, which can also serve to determine the causes of the segregation (including the self-segregation of the rich. This article aims to point out the measures of segregation that present the segregation levels in the most complete manner, along with their application in the context of three European metropolitan areas: Warsaw, Berlin, and Paris. The first part of the article is a review of the existing approaches to segregation measures, followed by the selection of research method, presentation of the analysis’ results, and evaluation of the applied methods; presenting the opportunities and limitations in research of the social segregation phenomenon.

Regional transportation and land use decision making in metropolitan regions : findings from four case studies.

Science.gov (United States)

2012-02-01

"Throughout the United States, metropolitan regions face increasingly complex issues related to transportation and : land use. The diffuse nature of decision making creates a need to better coordinate land use and transportation to : address issues s...

Shortening and Thickening of Metropolitan Los Angeles Measured and Inferred Using Geodesy

Science.gov (United States)

Argus, D.; Heflin, M.; Donnellan, A.; Webb, F.; Dong, D.; Hurst, K.; Jefferson, D.; Lyzenga, G.; Watkins, M.; Zumberge, J.

1999-01-01

Geodetic measurements using the Global Positioning System and other techniques show north-south shortening near Los Angeles to be fastest across the northern part of the metropolitan area, where an ESE-striking, 5- to 40-km-wide belt lying to the south of San Gabriel Mountains and to the north of downtown and West Los Angeles is shortening at 5 mm/yr.

Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care.

Science.gov (United States)

Daws, Karen; Punch, Amanda; Winters, Michelle; Posenelli, Sonia; Willis, John; MacIsaac, Andrew; Rahman, Muhammad Aziz; Worrall-Carter, Linda

2014-11-01

Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne. A quality improvement framework using a retrospective case notes audit evaluated Aboriginal patients' admissions to hospital and identified low attendance rates at cardiac rehabilitation services. A working together model of care coordination by an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse was implemented to improve cardiac rehabilitation attendance in Aboriginal patients admitted with ACS to the cardiac wards of the hospital. A retrospective medical records audit showed that there were 68 Aboriginal patients admitted to the cardiac wards with ACS from 1 July 2008 to 30 June 2011. A referral to cardiac rehabilitation was recorded for 42% of these. During the implementation of the model of care, 13 of 15 patients (86%) received a referral to cardiac rehabilitation and eight of the 13 (62%) attended. Implementation of the working together model demonstrated improved referral to and attendance at cardiac rehabilitation services, thereby, has potential to prevent complications and mortality. WHAT IS KNOWN ABOUT THE TOPIC?: Aboriginal Australians experience disparities in access to recommended care for acute coronary syndrome. This may contribute to the life expectancy gap between Aboriginal and non-Aboriginal Australians. WHAT DOES THIS PAPER ADD?: This paper describes a model of care involving an Aboriginal Hospital Liaisons Officer and a specialist cardiac nurse working

Seismic Microzonation of Islamabad-Rawalpindi Metropolitan Area, Pakistan

Science.gov (United States)

Khan, Sarfraz; Khan, M. Asif

2018-01-01

Microzonation deals with classifying seismic hazards in terms of ground motions resulting from amplification of seismic waves by nature of soil profiles underlying a site, town or city. This paper presents the results of microzonation study for Islamabad metropolitan, the capital of Pakistan. Cumulative SPT- N values from geophysical borehole and microtremor (Tromino Engy Plus) data were used to classify the soils into classes C (very dense soil profile and soft rock) and D (stiff soil profile) as devised by the National Earthquake Hazard Reduction Program (NEHRP). Soil response analyses were carried out based on scaled time histories of Kashmir earthquake (2005, 0.02 g), Mangla earthquake (2006, 0.031 g) and Haripur earthquake (2010, 0.13 g) corresponding to return periods of 150, 475, 975 and 2475 years. Spectral accelerations on the ground surface are calculated by two different approaches (1) soil response analysis performed using one dimensional shear wave propagation method (equivalent linear approach); and (2) NEHRP and Borcherdt amplification factors. Microzonation maps are produced with respect to ground shaking intensity for the return periods of 150, 475, 975 and 2475 years taking into account the variation of the spectral accelerations calculated based on these two procedures. The results show that the accelerations at the ground surface in the Islamabad-Rawalpindi metropolitan are in the range of 0.40-0.48 g (for 150 years), 0.59-0.65 g (for 475 years), 0.71-0.77 g (for 975 years), and 0.92-0.94 g (for 2475 years). The amplification factors for these four hazard levels range from 0.96 to 1.38 (150 years), 0.90-1.14 (475 years), 0.85-1.04 (975 years) and 0.84-1.00 (2475 years).

Metropolitan Foodsheds as Spatial References for a Landscape-Based Assessment of Regional Food Supply

NARCIS (Netherlands)

Wascher, D.M.; Eupen, van M.; Corsi, S.; Sali, G.; Zasada, I.

2016-01-01

The Food Planning and Innovation for Sustainable Metropolitan Regions (FOODMETRES) project strives to assess the environmental and socioeconomic impacts of food chains, with regard to the spatial, logistical, and resource dimensions of growing food as well as the questions of food safety and quality

Hybrid Wavelength Routed and Optical Packet Switched Ring Networks for the Metropolitan Area Network

DEFF Research Database (Denmark)

Nord, Martin

2005-01-01

Increased data traffic in the metropolitan area network calls for new network architectures. This paper evaluates optical ring architectures based on optical packet switching, wavelength routing, and hybrid combinations of the two concepts. The evaluation includes overall throughput and fairness...... attractive when traffic is unbalanced....

Quality of runoff from small watersheds in the Twin Cities Metropolitan Area, Minnesota - A project plan

Science.gov (United States)

Ayers, M.A.; Payne, G.A.; Oberts, Gary L.

1980-01-01

A program of water-quality sampling to define the relationships between land use, watershed characteristics, and the quantity, quality, and timing of runoff has been started for the Twin Cities metropolitan area of Minnesota. Ten major watersheds were chosen as representative of conditions in the metropolitan area. Each will be sampled at one location near the outlet. Six of the watersheds are agricultural and range in size from 14.3 to 82.9 square miles. The four remaining watersheds are urbanized and range in size from 1.22 to 31.7 square miles. In addition, seven urban subwatersheds, which range in size from 0.12 to 0.47 square miles and reflect a dominant land-use type, will be sampled.

A computerized model for integrating the physical environmental factors into metropolitan landscape planning

Science.gov (United States)

Julius Gy Fabos; Kimball H. Ferris

1977-01-01

This paper justifies and illustrates (in simplified form) a landscape planning approach to the environmental management of the metropolitan landscape. The model utilizes a computerized assessment and mapping system, which exhibits a recent advancement in computer technology that allows for greater accuracy and the weighting of different values when mapping at the...

Peer Mentoring Experiences of Psychology Students at the London Metropolitan University Writing Centre

Science.gov (United States)

Bakhshi, Savita; Harrington, Kathy; O'Neill, Peter

2008-01-01

"It really helps knowing that you are going to have someone around to help you..." This short article reports on research taking place into peer writing tutorials at London Metropolitan University and examines in particular, the experiences of psychology students who have taken part in the scheme. Some of the implications of this…

The determinants of part-time work in Metropolitan Lima

Directory of Open Access Journals (Sweden)

Manuel Enrique Saavedra Martinez

2011-12-01

Full Text Available The following paper examines the part-time work in Metropolitan Lima in 2008. The overall objective is to identify the determinants of the incidence of part-time work in Lima. We worked with one Probit econometric model, measured by the National Survey of Households (NSH, which explores the job characteristics of people. This will determine the presence of part-time workers in the areas of trade, health, education and communication; also realized that this group has completed university studies and incomplete, and the woman has a probability of 83,11397% more than men of working part time.

Intergroup communication between hospital doctors: implications for quality of patient care.

Science.gov (United States)

Hewett, David G; Watson, Bernadette M; Gallois, Cindy; Ward, Michael; Leggett, Barbara A

2009-12-01

Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

The improbable metropolis: decentralization, local democracy and metropolitan areas in the western world A metrópole improvável: Descentralização, democracia local e áreas metropolitanas no mundo ocidental

OpenAIRE

Christian Lefèvre

2010-01-01

Metropolitan areas have become the new spatial fix of globalised capitalism. However, their economic strength is not matched by their political strength because metropolitan areas remain politically weak. This article reflects upon the process of building metropolitan areas as political spaces. Considering this process as a conflicting one because it challenges the power of existing players, it seeks to expose the general failure of metropolitan institution building - including most of the so...

Did the Great Recession affect mortality rates in the metropolitan United States? Effects on mortality by age, gender and cause of death.

Science.gov (United States)

Strumpf, Erin C; Charters, Thomas J; Harper, Sam; Nandi, Arijit

2017-09-01

Mortality rates generally decline during economic recessions in high-income countries, however gaps remain in our understanding of the underlying mechanisms. This study estimates the impacts of increases in unemployment rates on both all-cause and cause-specific mortality across U.S. metropolitan regions during the Great Recession. We estimate the effects of economic conditions during the recent and severe recessionary period on mortality, including differences by age and gender subgroups, using fixed effects regression models. We identify a plausibly causal effect by isolating the impacts of within-metropolitan area changes in unemployment rates and controlling for common temporal trends. We aggregated vital statistics, population, and unemployment data at the area-month-year-age-gender-race level, yielding 527,040 observations across 366 metropolitan areas, 2005-2010. We estimate that a one percentage point increase in the metropolitan area unemployment rate was associated with a decrease in all-cause mortality of 3.95 deaths per 100,000 person years (95%CI -6.80 to -1.10), or 0.5%. Estimated reductions in cardiovascular disease mortality contributed 60% of the overall effect and were more pronounced among women. Motor vehicle accident mortality declined with unemployment increases, especially for men and those under age 65, as did legal intervention and homicide mortality, particularly for men and adults ages 25-64. We find suggestive evidence that increases in metropolitan area unemployment increased accidental drug poisoning deaths for both men and women ages 25-64. Our finding that all-cause mortality decreased during the Great Recession is consistent with previous studies. Some categories of cause-specific mortality, notably cardiovascular disease, also follow this pattern, and are more pronounced for certain gender and age groups. Our study also suggests that the recent recession contributed to the growth in deaths from overdoses of prescription drugs in

[Estimation on value of water and soil conservation of agricultural ecosystems in Xi' an metropolitan, Northwest China].

Science.gov (United States)

Yang, Wen-yan; Zhou, Zhong-xue

2014-12-01

With the urban eco-environment increasingly deteriorating, the ecosystem services provided by modern urban agriculture are exceedingly significant to maintain and build more suitable environment in a city. Taking Xi' an metropolitan as the study area, based on remote sensing data, DEM data and the economic and social statistics data, the water and soil conservation service of the agricultural ecosystems was valued employing the remote sensing and geographic information system method, covering the reduction values on land waste, soil fertility loss and sediment loss from 2000 to 2011, and analyzed its changes in time and space. The results showed that during the study period, the total value of water and soil conservation service provided by agricultural systems in Xi' an metropolitan was increased by 46,086 and 33.008 billion yuan respectively from period of 2000 to 2005 and from 2005 to 2011. The cultivated land (including grains, vegetables and other farming land), forest (including orchard) and grassland provided higher value on the water and soil conservation service than waters and other land use. Ecosystem service value of water and soil conserva- tion provided by agriculture was gradually decreasing from the southern to the northern in Xi' an metropolitan. There were significantly positive relationship between the ecosystem service value and the vegetation coverage. Forest, orchard and grassland distributed intensively in the southern which had higher vegetation coverage than in northern where covered by more cultivated land, sparse forest and scattered orchard. There were significantly negative correlation between the urbanization level and the value of water and soil conservation. The higher level of urbanization, the lower value there was from built-up area to suburban and to countryside within Xi' an metropolitan.

Polycentric Development for Sustainable Cities: An Evaluation for the Ankara Metropolitan Area

Directory of Open Access Journals (Sweden)

N Aydan Sat

2017-06-01

Full Text Available Urban population growth and the accompanying urban growth and expansion are seen as the main problems of metropolitan cities; this keeps the issues of how to consider the social, economic, spatial and environmental dimensions of cities within the framework of a concept of sustainability, and how to shape cities within this context, on the agenda. In today’s world, cities are accepted as the main hubs of energy consumption and environmental pollution, as centers of capital, culture and innovation, and as the places of residence of millions of people. Expanding and sprawling urban forms are seen as unsustainable in terms of land use, energy and the consumption of environmental resources. Thus, the question ‘How should the urban development model be applied to create sustainable cities?’ is on the agenda of theorists, politicians and practitioners alike. Taking these discussions into consideration, this study searches for an answer to the question of whether the polycentric urban development model can be used as a tool for sustainable cities by taking into account the current literature and practices, and evaluating the case of the Ankara metropolitan area.

Metropolitan garbage dumps: possible winter migratory raptor monitoring stations in peninsular India

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S. Pande

2010-09-01

Full Text Available Winter raptor migration and movement is poorly documented for peninsular India, mainly due to the lack of geographical bottlenecks. We describe, for the first time, the use of a garbage dump in a metropolitan city as an alternative visual winter raptor monitoring station. The daily count, adult to juvenile ratios and species composition of three migratory raptor species, Steppe Eagle Aquila nipalensis, Black-eared Kite Milvus migrans lineatus and Tawny Eagle Aquila rapax are presented. Ground temperatures at the garbage dump site and surrounding area, and the wing beat rate of migratory raptors before and after arrival in the early morning were measured. A total of 355 raptors migrating over a period of six observation days with 250 adults and 105 juveniles were recorded. The temperature of the garbage dump was significantly higher than the surrounding area, while the wing flapping rate was significantly lower over the garbage dump area. It is possible that migrating raptors use garbage dump thermals in the early morning to save energy with soaring and gliding flight (versus flapping flight. We propose that such sites may be used as visual winter migration monitoring stations in metropolitan cities in peninsular India.

Theory of planned behavior applied to fish consumption in modern Metropolitan Lima

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Angie HIGUCHI

Full Text Available Abstract Despite being an important source of protein, fish consumption in Peru is low compared with other coastal countries. Thus, the objective of this study is to identify the core determinants of such consumption. We based our analysis on the framework provided by the Theory of Planned Behavior (TPB where attitudes, subjective norms, past experience and health involvement determine the intention and frequency of fish consumption. Primary data were gathered through 159 consumers of fish in modern Metropolitan Lima between August and October 2015. From a set of likert scale indicators a structural model was specified to evaluate the relationships given by the theoretical framework of the TPB. The results showed that the intention to eat fish is determined by personal attitudes, norms and past experience, and as expected, intention itself causes the frequency of fish consumption. Nonetheless, although consumers’ interest in healthy eating was shown to positively influence fish consumption behavior by theory, Metropolitan Lima fish consumers seem to be not concerned by positive health attributes related to fish consumption. These results may have important implications on production decisions, sales and marketing for the promotion of fish in Lima as a means of economic development.

[Food satisfaction in Mapuche persons in the Metropolitan Region of Santiago, Chile].

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Schnettler, Berta; Miranda, Horacio; Sepúlveda, José; Denegri, Marianela; Mora, Marcos; Lobos, Germán

2011-06-01

Although the study and measurement of satisfaction with life has generated great interest in the last 15 years, there are few works which address satisfaction with food-related life. In order to identify variables which have an influence on satisfaction with food-related life among Mapuche persons, a survey was applied to 400 Mapuche subjects in the Santiago Metropolitan Region, Chile. The scales evaluated in the questionnaire included: SWFL (Satisfaction with Food-related Life), lifestyles, food, and Mapuche acculturation. It was found that 41.0% were extremely satisfied, 40.5% satisfied, 17.2% somewhat satisfied and 1.2% dissatisfied with their food-related life. To identify variables which have an influence on satisfaction with food, an ordinal multinomial logit model was proposed, which was significant (p Mapuche foods, is aged 55 or more, consumes red meat in moderation, consumes foods without additives, try to balance work and private life, does not read the labels of products, and if he/she had Mapuche friends at school. Thus satisfaction with food-related life in Mapuche persons in the Metropolitan Region is related to demographic variables, expenditure on food, consumption of Mapuche foods and life-style.

Management of groundwater in urban centers: A case study; Greater Dammam Metropolitan Area

International Nuclear Information System (INIS)

Abderrahman, Walid A.; Elamin, Abdalla S.; Al-Harazin, Ibrahim M.; Eqnaibi, Badie S.

2007-01-01

Effective management of groundwater resources in urban centers of arid regions is vital for sustainable development and groundwater protection especially with rapid growth of water demands under water stress conditions. Greater Dammam Metropolitan Area is a good example of rapid growing urban center due to comprehensive development and population growth. The water demand has increased by many times during the last three decades. Groundwater from local aquifers namely Dammam and Umm Er Radhuma, supplies more than 85% of the total water demands. The aquifers have been subjected to extensive and increasing groundwater pumping especially during last three decades. Negative impacts such as significant decline in water levels have been experienced in the area. A new groundwater management scheme in terms of improving the long-term water pumping policies is required for protection of the aquifers groundwater productivity. A special numerical simulation model of the multi-aquifer system including Dammam and Umm Er Radhuma aquifers has been developed to assess the behavior of the aquifer system under long term water stresses in Dammam Metropolitan Area. The developed numerical simulation model has been utilized to predict the responses of the aquifer system in terms of decline in terms of water level under different pumping schemes from the two aquifers during the next 30 years. The model results have postulated the importance of Umm Er Radhuma (UER) aquifer as a major water supply source to Dammam Metropolitan Area, as well as potential recharge source of more than 30% of the total water pumped from Dammam aquifer. These findings have been utilized in improving present and future groundwater management and conservation for the study area. Similar techniques can be used to improve the groundwater management in other parts of the country as well as other arid regions. (author)

The Metropolitan Studies Institute at USC Upstate: Translational Research that Drives Community Decision-Making

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Brady, Kathleen

2012-01-01

The Metropolitan Studies Institute (MSI) at the University of South Carolina Upstate (USC Upstate) demonstrates a robust and unique record of community impact through community indicators research and other translational research. The MSI's work drives programmatic priorities and funding decisions, generates revenue, and increases the community's…

Biogenic volatile organic compounds from the urban forest of the Metropolitan Region, Chile

International Nuclear Information System (INIS)

Préndez, Margarita; Carvajal, Virginia; Corada, Karina; Morales, Johanna; Alarcón, Francis; Peralta, Hugo

2013-01-01

Tropospheric ozone is a secondary pollutant whose primary sources are volatile organic compounds and nitrogen oxides. The national standard is exceeded on a third of summer days in some areas of the Chilean Metropolitan Region (MR). This study reports normalized springtime experimental emissions factors (EF) for biogenic volatile organic compounds from tree species corresponding to approximately 31% of urban trees in the MR. A Photochemical Ozone Creation Index (POCI) was calculated using Photochemical Ozone Creation Potential of quantified terpenes. Ten species, natives and exotics, were analysed using static enclosure technique. Terpene quantification was performed using GC-FID, thermal desorption, cryogenic concentration and automatic injection. Observed EF and POCI values for terpenes from exotic species were 78 times greater than native values; within the same family, exotic EF and POCI values were 28 and 26 times greater than natives. These results support reforestation with native species for improved urban pollution management. -- First experimental determination of the emission factors of biogenic volatile organic compounds in the urban forest of the Metropolitan Region, Chile

Association of Financial Integration Between Physicians and Hospitals With Commercial Health Care Prices.

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Neprash, Hannah T; Chernew, Michael E; Hicks, Andrew L; Gibson, Teresa; McWilliams, J Michael

2015-12-01

Financial integration between physicians and hospitals may help health care provider organizations meet the challenges of new payment models but also may enhance the bargaining power of provider organizations, leading to higher prices and spending in commercial health care markets. To assess the association between recent increases in physician-hospital integration and changes in spending and prices for outpatient and inpatient services. Using regression analysis, we estimated the relationship between changes in physician-hospital integration from January 1, 2008, through December 31, 2012, in 240 metropolitan statistical areas (MSAs) and concurrent changes in spending. Adjustments were made for patient, plan, and market characteristics, including physician, hospital, and insurer market concentration. The study population included a cohort of 7,391,335 nonelderly enrollees in preferred-provider organizations or point-of-service plans included in the Truven Health MarketScan Commercial Database during the study period. Data were analyzed from December 1, 2013, through July 13, 2015. Physician-hospital integration, measured using Medicare claims data as the share of physicians in an MSA who bill for outpatient services with a place-of-service code indicating employment or practice ownership by a hospital. Annual inpatient and outpatient spending per enrollee and associated use of health care services, with utilization measured by price-standardized spending (the sum of annual service counts multiplied by the national mean of allowed charges for the service). Among the 240 MSAs, physician-hospital integration increased from 2008 to 2012 by a mean of 3.3 percentage points, with considerable variation in increases across MSAs (interquartile range, 0.8-5.2 percentage points). For our study sample of 7,391,335 nonelderly enrollees, an increase in physician-hospital integration equivalent to the 75th percentile of changes experienced by MSAs was associated with a mean

Evaluation of treated sewage reuse potential and membrane-based water reuse technology for the Bangkok Metropolitan area.

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Chiemchaisri, Chart; Chiemchaisri, Wilai; Prasertkulsak, Sirilak; Hamjinda, Nutta Sangnarin; Kootatep, Thammarat; Itonaga, Takanori; Yamamoto, Kazuo

2015-01-01

Only 3.4% of total water use in the Bangkok Metropolitan area is reused treated sewage. This study anticipates that further treated-sewage reuse in industrial sectors, commercial buildings and public parks, in addition to present in-plant and street cleaning purposes, would increase total water reuse to about 10%. New water reuse technologies using membrane bioreactor (MBR) and microfiltration (MF) as tertiary treatment were implemented to assess their potential for their application in the Bangkok Metropolitan area. The MBR was applied to the treatment of raw sewage in a central treatment plant of the Bangkok Metropolitan area. The MF membrane was used for polishing the effluent of the treatment plant. The results show the quality of treated water from MBR and tertiary MF treatment could meet stringent water reuse quality standard in terms of biochemical oxygen demand, suspended solids and biological parameters. Constant permeate flux of the membrane was achieved over long-term operation, during which inorganic fouling was observed. This is due to the fact that incoming sewage contains a considerable amount of inorganic constituents contributed from storm water and street inlet in the combined sewerage systems. The total cost of the MBR for sewage treatment and production of reuse water is estimated to be about USD1.10/m3.

Urban vegetation and income segregation in drylands: a synthesis of seven metropolitan regions in the southwestern United States

International Nuclear Information System (INIS)

Jenerette, G Darrel; Buyantuev, Alexander; Miller, Greg; Pataki, Diane E; Gillespie, Thomas W; Pincetl, Stephanie

2013-01-01

To better understand how urbanization affects the amount and timing of urban vegetation in drylands we investigated remotely sensed vegetation patterns across seven large metropolitan regions in the southwestern United States. We asked (1) how low density urban land cover differed from adjacent wildland grass, herb, and shrub land covers in both the amount of vegetation and the length of the growing season, (2) how neighborhood income affected patterns of vegetation within low density urban cover, and (3) how cities differed from one another in their vegetation patterns. We found that urbanization generally has a strong influence on vegetation compared to adjacent wildlands. In four of the metropolitan regions the cumulative enhanced vegetation index (EVI) and growing season length in low density developments were higher than grass, herb, and shrub land covers. Within all metropolitan regions, there was a significant socioeconomic effect where higher income areas had a higher cumulative EVI than lower income areas. The large differences in urban vegetation among cities were related to precipitation and total domestic water use. These findings help to identify how urbanization influences vegetation, with implications for the availability of ecosystem services and requirements for irrigation in hot dryland cities. (letter)

A Comprehensive Survey on Student Perceptions of Cyberbullying at a Major Metropolitan University

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Lawler, James P.; Molluzzo, John C.

2015-01-01

Cyberbullying is a concern for any college or university. Digital harassment incidents are featured daily in the news. The authors of this study examine the perceptions of students on cyberbullying at a major metropolitan university. From the findings of a student survey, the authors learn of high levels of perceptions on incidents as an issue but…

The Evolution of a Multi-Instructional Teaching Center (MITC) in a Metropolitan University System.

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Bell, David P.; Hayes, Edward J.; Hugetz, Edward T.; Ivancevich, John M.; Smith, Don N.; Woods, Molly R.

1998-01-01

The University of Houston (Texas) and its four campuses have adopted a "co-opetition" approach to create a multi-instructional teaching center to deliver educational programs and courses in the Houston metropolitan area. It has been found that citizens, legislators, administrators, faculty, and students all benefit, without sacrificing…

Cancer incidence in Bucaramanga Metropolitan Area, 2000-2004. First five years report from population based cancer registry of Metropolitan Area of Bucaramanga.

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Erika Eliana Meza Durán

2007-11-01

Full Text Available Cancer is one of the most common chronic diseases that cause high morbidity and mortality. In the evaluation of all illnessand its impact on the community, a surveillance system becomes necessary to allows us to know its incidence. Cancersurveillance is achieved by the population-based cancer registry. Methodology: The Population Based Cancer Registry ofMetropolitan Area of Bucaramanga (RPC-AMB collected information from the years 2000 to 2004, in patients with anymalignant cancer the which include both invasive and in situ behavior in addition to reside within this geographical area . TheCancer Registry also collects data on brain and nervous system tumors classified as benign or those that have uncertainbehavior. Basal cell cancers of the skin were included during the two first years as well as all the intraepithelial neoplasm ofthe cervix. Active collections of information at all sources by registry staff were made (Hospitals, Health care institutions,especially oncology centers and Pathology and Hematology Laboratories and some specialist in oncology attention. Theinclusion approaches are verified and collects data on specific sociodemographic information (age, gender, residence, placeof birth, etc. and on the anatomic site of the tumor, the cell type of the cancer, behavior and extension on each individualdiagnosed with cancer. Each case was coded using the International Classification of Diseases Oncology Third Edition (ICDO-3, for topographical and morphological code. The data was entered into a computer with CanReg-4 software that is aconfigurable computer program designed for cancer registration in population-based registries and was provided as aservice by the Descriptive Epidemiology Unit to members of the International Association of Cancer Registries. This softwareprovides the number of cancer cases (frequency and the incidence rates. The quality control included exhaustiveness of thecases and information, verification of the

Rural migration: what attracts new residents to non-metropolitan areas.

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Maynard, L J; Kelsey, T W; Thee, R J; Fousekis, P

1997-01-01

"This study uses the experience of three non-metropolitan counties in Pennsylvania to explore which community characteristics have the greatest influence on people's decisions to move to rural areas. Personal characteristics affected how in-migrants evaluated prospective rural residential locations. Higher income in-migrants placed a high priority on job opportunities, housing quality, a short commute to work, quality of schools, and low local taxes. Lower income in-migrants were more likely to value a location near family and friends. Ability to own a home, housing costs, and local taxes were also important." excerpt

Readability levels of health pamphlets distributed in hospitals and health centres in Athens, Greece.

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Kondilis, B K; Akrivos, P D; Sardi, T A; Soteriades, E S; Falagas, M E

2010-10-01

Health literacy is important in the medical and social sciences due to its impact on behavioural and health outcomes. Nevertheless, little is known about it in Greece, including patients' level of understanding health brochures and pamphlets distributed in Greek hospitals and clinics. Observational study in the greater metropolitan area of Athens, Greece. Pamphlets and brochures written in the Greek language were collected from 17 hospitals and healthcare centres between the spring and autumn of 2006. Readability of pamphlets using the Flesch-Kincaid, Simple Measure of Gobbledygook (SMOG) and Fog methods was calculated based on a Greek readability software. Out of 70 pamphlets collected from 17 hospitals, 37 pamphlets met the criteria for the study. The average readability level of all scanned pamphlets was ninth to 10th grade, corresponding to a readability level of 'average'. A highly significant difference (PPamphlets from private hospitals were one grade more difficult than those from public hospitals. Approximately 43.7% of the Greek population aged ≥20 years would not be able to comprehend the available pamphlets, which were found to have an average readability level of ninth to 10th grade. Further research examining readability levels in the context of health literacy in Greece is warranted. This effort paves the way for additional research in the field of readability levels of health pamphlets in the Greek language, the sources of health information, and the level of understanding of key health messages by the population. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Optimization is required when using linked hospital and laboratory data to investigate respiratory infections.

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Lim, Faye J; Blyth, Christopher C; de Klerk, Nicholas; Valenti, Beverly; Rouhiainen, Oliver J; Wu, Dominic Yu-An; Jansz, Christopher S; Moore, Hannah C

2016-01-01

Despite a recommendation for microbiological testing, only 45% of children hospitalized for respiratory infections in our previous data linkage study linked to a microbiological record. We conducted a chart review to validate linked microbiological data. The chart review consisted of children aged data linkage study. Poisson regression was used to identify factors predicting the likelihood of microbiological tests in the chart review cohort. From the chart review, 77% of 746 records had a microbiological test performed compared with 46% of 18,687 records from our previous data linkage study. Of those undergoing testing, 66% of the chart review and 64% of data linkage records had ≥1 respiratory pathogen(s) detected. In the chart review cohort, frequency of testing was highest in children admitted to metropolitan hospitals. Validation studies are essential to ensure the quality of linked data. Our previous data linkage study failed to capture all relevant microbiological records. Findings will be used to optimize extraction protocols for future linkage studies. Copyright © 2016 Elsevier Inc. All rights reserved.

The metropolitan park: searching for a new typology for intermediate green areas in urban fields

NARCIS (Netherlands)

Brinkhuijsen, M.; Velde, van der R.; Graaf, de E.; Kruit, E.; Lodder, A.

2011-01-01

Ongoing urbanization in metropolitan regions creates a wish for large green areas in the urban peripheries for recreational purposes. Agricultural landscapes are being replaced with woods, nature and water to provide citizens with space for outdoor recreation and other activities. Park-like settings

Climate change impacts on extreme temperature mortality in select metropolitan areas of the United States

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Projected mortality from climate change-driven impacts on extremely hot and cold days increases significantly over the 21st century in a large group of United States Metropolitan Statistical Areas. Increases in projected mortality from more hot days are greater than decreases in ...

MeTriS : Metropolitan Transportation Information System : applying space based technologies for freight congestion mitigation.

Science.gov (United States)

2010-06-01

Port operations are at the heart of some of the most dynamic metropolitan centers in the : world: London, New York, Los Angeles, Singapore and Hong Kong, to name a few. Ports are : critical cogs in national and local economies, but their operations a...

Teaching Language Minority Students in Los Angeles and Oslo--A Metropolitan Perspective nr 1

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Kerchner, Charles Taylor; Özerk, Kamil

2014-01-01

Receiving, accommodation and education of children with immigrant background is one of the challenging issues in almost all the metropolitan areas in many countries. In our study we are exploring the impact of demographic changes on political agendas, legal frames, educational approaches, research findings and student achievement in the field of…

Diversity and Educational Challenges in Oslo and Los Angeles--A Metropolitan Perspective nr 2

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Özerk, Kamil; Kerchner, Charles Taylor

2014-01-01

Receiving, accommodation and education of children with immigrant background is one of the challenging issues in almost all the metropolitan areas in many countries. In our study we are exploring the impact of demographic changes on political agendas, legal frames, educational approaches, research findings and student achievement in the field of…

Trends in Hospital Cost and Revenue, 1994–2005: How Are They Related to HMO Penetration, Concentration, and For-Profit Ownership?

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Shen, Yu-Chu; Wu, Vivian Y; Melnick, Glenn

2010-01-01

Objective Analyze trends in hospital cost and revenue, as well as price and quantity (1994–2005) as a function of health maintenance organization (HMO) penetration, HMO concentration, and for-profit (FP) HMO market share. Data Medicare hospital cost reports, AHA Annual Surveys, HMO data from Interstudy, and other supplemental data. Study Design A retrospective study of all short-term, general, nonfederal hospitals in metropolitan statistical areas (MSAs) in the United States from 1994 to 2005, using hospital/MSA fixed-effects translog regression models. Principal Findings A 10 percentage point increase in HMO enrollment is associated with 4.1–4.2 percent reduction in costs and revenues in the pre-2000 period but only a 2.1–2.5 percent reduction in the post-2000 period. Hospital revenue in HMO-dominant markets (highly concentrated HMO market and competitive hospital market) is 19–27 percent lower than other types of markets, and the difference is most likely due mainly to lower prices and to a lesser extent lower utilization. Conclusions The historical difference of lower spending in high HMO penetration markets compared with low HMO markets narrowed after 2000 and the relative concentration between HMO and hospital markets can substantially influence hospital spending. Additional research is needed to understand how different aspects of these two markets have changed and interacted and how they are causally linked to spending trends. PMID:19840134

Water levels and groundwater and surface-water exchanges in lakes of the northeast Twin Cities Metropolitan Area, Minnesota, 2002 through 2015

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Jones, Perry M.; Trost, Jared J.; Erickson, Melinda L.

2016-10-19

OverviewThis study assessed lake-water levels and regional and local groundwater and surface-water exchanges near northeast Twin Cities Metropolitan Area lakes applying three approaches: statistical analysis, field study, and groundwater-flow modeling.  Statistical analyses of lake levels were completed to assess the effect of physical setting and climate on lake-level fluctuations of selected lakes. A field study of groundwater and surface-water interactions in selected lakes was completed to (1) estimate potential percentages of surface-water contributions to well water across the northeast Twin Cities Metropolitan Area, (2) estimate general ages for waters extracted from the wells, and (3) assess groundwater inflow to lakes and lake-water outflow to aquifers downgradient from White Bear Lake.  Groundwater flow was simulated using a steady-state, groundwater-flow model to assess regional groundwater and surface-water exchanges and the effects of groundwater withdrawals, climate, and other factors on water levels of northeast Twin Cities Metropolitan Area lakes.

Analysis of Acculturative Stress and Sociocultural Adaptation among International Students at a Non-Metropolitan University

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Mahmood, Hajara; Burke, Monica Galloway

2018-01-01

This quantitative descriptive study analyzed levels of acculturative stress and sociocultural adaptation among international students at a non-metropolitan university in the United States related to certain demographic characteristics. Surveys were used to measure international students' levels of acculturative stress and sociocultural adaptation,…

Metropolitan City Finances in India: Options for A New Fiscal Architecture

OpenAIRE

Roy Bahl

2012-01-01

India will face great problems in finding a way to finance public services in its large cities in the next two decades. Backlogs in service levels and infrastructure are already great, and migration to urban areas will put even more pressure on state and local government budgets. Metropolitan cities have an economic base of significant size, but have not been empowered to tap this revenue potential. State governments have more ability to reach a buoyant tax base, and to borrow, but must also ...

Media exposure and parental mediation on fast-food consumption among children in metropolitan and suburban Indonesian.

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Lwin, May O; Malik, Shelly; Ridwan, Hardinsyah; Au, Cyndy Sook Sum

2017-01-01

Fast-food companies have been reproached for rising obesity levels due to aggressive marketing tactics targeted at children. They have countered that parents should be held responsible considering their critical role as nutritional gatekeepers. This study examined the comparative effects of media exposure and parental mediation on Indonesian children's fast food consumption and how the effects compare in the metropolitan versus suburban areas. The sample consisted of 394 child-mother pairs comprising grade three and four children and their mothers from two schools each in Jakarta and Bogor representing 40.9% metropolitan sample and 59.1% suburban sample, respectively. The children completed a guided inclass survey, while the mothers completed a paper-and-pen survey at home. Measures comprised children's weekly media exposure to broadcast media, computer and mobile games, print media, and online and social media, active and restrictive parental mediation strategies, children's fast food consumption and nutrition knowledge. The relationship of media exposure and parental mediation with children's fast food consumption was analyzed using Structural Equation Modelling. Fast food consumption was positively influenced by exposure to broadcast media among metropolitan children, and by exposure to online and social media among suburban children. Active parental mediation was related to lower fast food consumption, but only for suburban children. Active parental mediation is critical in preventing fast food consumption. The media play a key role in influencing fast food consumption, and hence, literacy education is important to alleviate the adverse effects of exposure to junk food marketing.

Causes and consequences of rural-urban migration: The case of Juba Metropolitan, Republic of South Sudan

Science.gov (United States)

Babi Moses, Lomoro Alfred; Guogping, Xiong; Celestino Ladu John, Leju

2017-08-01

Migration is the movement of people from one ecological region to another; it may be on temporary or permanent basis. This research studies focused on the causes and consequences of rural-urban migration in Juba Metropolitan, Republic of South Sudan as a case study. The stratified random sampling method on the basis of existing payam (districts) was used to divide the study area into three zones of Juba, Kator and Munuku. Data were generated through primary and secondary sources. The data generated were analyzed using SPSS. The findings of the study show that Munuki payam covers most of the migrants. The study also reveals that males migrate more than the females in Juba and migration is high within the age cohorts of 30-39 years and 40-49 years old. Furthermore, the study revealed that the propensity to migrate is directly related to educational attainment. It can be inferred from the findings of the study that the majority of migrants in Juba Metropolitan migrated in search of employment while others migrated to continue their education while others migrated in search for basic amenities, to join relatives and get married. This means, until the imbalance or disparity in socio-economic development between the rural and urban areas are removed, no amount of persuasion or force can put a stop to rural-urban migration and its’ multiplying effects in Juba Metropolitan, Republic of South Sudan.

Monitoring of patients in the Oncology department of the Clinical Hospital

International Nuclear Information System (INIS)

De Quiroz, J.

2010-01-01

An important number of patients that visit the Oncology department o the Clinicas Hospital lost sight at some stage of their evolution. Our objective was to quantify the proportion of patients who are lost and describe the time spent in the service and its relationship with variables such as age, sex, origin of the patient and progress of the disease, for which we performed a descriptive observational study with an analytical component of 435 stories clinics patients with confirmed diagnosis of cancer, treated from January 2001 to December 2004, in order to have a minimum of 5 years of follow-up potential. Data were processed with Excel 2003. Patients had between 15-85 years old with a mean and median of 52 ± 14 years DS. Two hundred Seventy women and 165 were men, 232 were from the metropolitan area. The time of length of service was 0-114 months with a median of 8 and an average DS 21 months ± 27 months. As of December 2009 31 117 patients had died 36 remained in control and 282 were lost from sight. We found no relationship between age (p = 0.1) nor the state of progress of the disease at diagnosis (p = 0.21) If there were significant differences with greater probability of loss tracking men (p = 0.009) and from sites outside the metropolitan area (p = 0.04). The number of patients who are lost is very large and we must develop strategies more effective monitoring

AC Transmission Emulation Control Strategies for the BTB VSC HVDC System in the Metropolitan Area of Seoul

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Sungyoon Song

2017-08-01

Full Text Available In the Korean power system, growing power loads have recently created the problems of voltage instability and fault current in the Seoul Capital Area (SCA. Accordingly, the back-to-back (BTB voltage source converter (VSC high-voltage direct-current (HVDC system is emerging to resolve such problems with grid segmentation. However, non-convergence problems occur in this metropolitan area, due to the large change of power flow in some contingencies. Therefore, this paper proposes two kinds of AC transmission emulation control (ATEC strategies to improve the metropolitan transient stability, and to resolve the non-convergence problem. The proposed ATEC strategies are able to mitigate possible overloading of adjacent AC transmission, and maintain power balance between metropolitan regions. The first ATEC strategy uses a monitoring system that permits the reverse power flow of AC transmission, and thus effectively improves the grid stability based on the power transfer equation. The second ATEC strategy emulates AC transmission with DC link capacitors in a permissible DC-link voltage range according to angle difference, and securely improves the gird stability, without requiring grid operator schedule decisions. This paper compares two kinds of ATEC schemes: it demonstrates the first ATEC strategy with specific fault scenario with PSS/E (Power Transmission System Planning Software, and evaluates the second ATEC strategy with internal controller performance with PSCAD/EMTDC (Power System Electromagnetic Transients Simulation Software.

Occupational therapy in Australian acute hospitals: A modified practice.

Science.gov (United States)

Britton, Lauren; Rosenwax, Lorna; McNamara, Beverley

2016-08-01

Ongoing changes to health-care funding Australia wide continue to influence how occupational therapists practise in acute hospitals. This study describes the practice challenges experienced by Western Australian acute care occupational therapists. Then, it explores if and how acute care occupational therapists are modifying their practice in response to these practice changes. This study used a qualitative grounded theory approach. Semi-structured interviews were completed with 13 purposively selected acute care occupational therapists from four Western Australian metropolitan hospitals. Data were analysed using a constant comparative method to provide detailed descriptions of acute care occupational therapy practice and to generate theory. Five conceptual categories were developed. The first two addressed practice challenges: pragmatic organisational influences on client care and establishing a professional identity within the multidisciplinary team. Three categories related to therapist responses are as follows: becoming the client advocate, being the facilitator and applying clinical reasoning. Finally, modified practice was identified as the core category which explains the process whereby acute care occupational therapists are ensuring they remain relevant and authentic in the acute care context. Western Australian acute care occupational therapists are practising in a highly complex health context that presents many challenges. They are responding by using a modified form of practice that ensures occupational therapy skills remain relevant within the narrow confines of this health setting. © 2016 Occupational Therapy Australia.

Metropolitan Transportation Commission, San Francisco Bay area : developing regional objectives and performance measures to improve system operations

Science.gov (United States)

2009-04-01

The Metropolitan Transportation Commission (MTC) uses an objectives-driven, performance-based approach in its transportation planning for the San Francisco Bay Area. This approach focuses attention on transportation investments of highest priority. T...

Envisioning a metropolitan foodshed: potential environmental consequences of increasing food-crop production around Chicago

Science.gov (United States)

Bowen, E. E.; Martin, P. A.; Schuble, T. J.

2009-12-01

Nationwide, cities are increasingly developing policies aimed at greater sustainability, particularly focusing on reducing environmental impact. Such policies commonly emphasize more efficiently using energy to decrease the greenhouse gas (GHG) footprint of the city. However, most plans ignore the food system as a factor in regional energy use and GHG emissions. Yet, the food system in the United States accounts for ~20% of per capita greenhouse gas emissions. Local, sustainable food production is cited as one strategy for mitigating GHG emissions of large metropolitan areas. “Sustainable” for regional agriculture is often identified as small-scale, diversified food crop production using best practices management. Localized food production (termed “foodshed”) using sustainable agriculture could mitigate climate change in multiple ways: (1) energy and therefore CO2-intensive portions of the conventional food system might be replaced by local, lower-input food production resulting in carbon offsets; (2) increased regional carbon storage might result from well-managed food crop production vs. commodity crop production; and (3) averted N2O emissions might result from closing nutrient cycles on agricultural lands following changes in management practices. The broader implications for environmental impact of widespread conversion to sustainable food crop agriculture, however, remain largely unknown. We examine the Chicago metropolitan region to quantify the impact of increased local food production on regional energy efficiency and GHG emissions. Geospatial analysis is used to quantify the resource potential for establishing a Chicago metropolitan foodshed. A regional foodshed is defined by minimizing cost through transportation mode (road, rail, or water) and maximizing the production potential of different soil types. Simple biogeochemical modeling is used to predict changes in N2O emissions and nutrient flows following changes in land management practices

Urban mobility, socioeconomic and urban transport variables in metropolitan areas in three continents

Energy Technology Data Exchange (ETDEWEB)

Carvalho da Costa, F.B. de; Nassi, C.D.

2016-07-01

Transportation is the soul of urban cities. Find sustainable ways to keep people moving in our cities is more important than ever. Historically, cities have developed in different ways. Each has its own personality and complexity. But in all cases, transport and mobility have played a key role in city life. Due to the relevance of mobility this article tries to establish the relationship between some variables. The method was developed by collecting, analyzing and comparing data on metropolitan regions in North America, South America, Europe and Oceania through a mathematical model. From each selected location the following data were gathered: population, area (km²), demographic density (inhab/km²), socio-economic aspects (annual GDP per capita), transport system (subway extension), number of trips per person per day and modal split (% non-motorized, % public transport and % private transport). In this study we analyze some variables that influence the number of trips per person per day. Understanding the associations between all the variables that influence the number of trips per person per day contributes the planners to determine whether changes are needed to improve in the transport system in the metropolitan region. (Author)

Radon and lung cancer in Bangalore Metropolitan, India

International Nuclear Information System (INIS)

Sathish, L.A.; Nethravathi, K.S.; Ramachandran, T.V.

2012-01-01

Radon is a radioactive gas released from the normal decay of 238 U in rocks and soil. It is an invisible, odorless, tasteless gas that seeps up through the ground and diffuses into the air. In a few areas, depending on local geology, radon dissolves into ground water and can be released into the air when the water is used. Radon gas usually exists at very low levels outdoors. However, in areas without adequate ventilation, such as underground mines, radon can accumulate to levels that substantially increase the risk of lung cancer. Radon decays quickly, giving off tiny radioactive particles. When inhaled, these radioactive particles can damage the cells that line the lung. Long-term exposure to radon can lead to lung cancer, the only cancer proven to be associated with inhaling radon. Public interest in radon has been occasionally piqued by articles in the general press. Considerable attention has been given to the high radon levels that were uncovered in the Reading Prong region of Pennsylvania, following the discovery in late 1984 of extremely high levels in one home. Several epidemiological study programmes in different countries are in progress to estimate the population exposures due to natural radiation with a view to obtain the radiation risk coefficients at low dose rate levels. In this regard, radiation surveys in high background areas (HBRAs) can provide excellent settings for epidemiological studies relating to the effects of low doses of radiation. In view of these, a comprehensive estimate of the natural inhalation dose requires both 222 Rn and 220 Rn levels in the indoor atmosphere. In this outlook an attempt is made to investigate the 222 Rn and 220 Rn levels in dwellings of Bangalore Metropolitan, India. Three year results shows that the activity concentrations of 226 Ra, 232 Th, radon in ground water, the concentrations 222 Rn and 220 Rn and the dose rate (mSvy -1 ) are at alarming levels for the environment of Bangalore Metropolitan, India. The

Decomposition of Net CO2 Emission in the Wuhan Metropolitan Area of Central China

Directory of Open Access Journals (Sweden)

Xin Yang

2016-08-01

Full Text Available Policy-makers have been sharing growing concerns that climate change has significant impacts on human society and economic activates. Knowledge of the influencing factors of CO2 emission is the crucial step to reduce it. In this paper, both CO2 emission and CO2 sink on a city-level of the nine cities in Wuhan Metropolitan Area are calculated using the Intergovernmental Panel on Climate Change approach. Moreover, the logarithmic mean Divisia index (LMDI model was employed to decompose the net CO2 emission from 2001 to 2009. Results showed that (1 the largest amount of CO2 emission comes from energy while the largest amount CO2 sink comes from cropland; (2 economic level (S was the largest positive driving factor for net CO2 emission growth in the Wuhan Metropolitan Area, population (P also played a positive driving role, but with very weak contribution; and as negative inhibiting factors, energy structure (E and energy efficiency (C significantly reduced the net CO2 emission.

Environmental impact assessment of bus rapid transit (BRT in the Metropolitan City of Tehran

Directory of Open Access Journals (Sweden)

F. Salehi

2016-01-01

Full Text Available Bus rapid transit is an innovative, high capacity, lower cost public transit solution in metropolitan cities. Idea is to dedicate lanes for quick and efficient transport of passengers to their destinations. In the present investigation the environmental impact assessment of bus rapid transit  in Tehran metropolitan city is brought out. For this purpose bus rapid transit Lane No. 10 is investigated. The bus rapid transit Lane No.10 is about 10 km in distance that moves up and down between Azadi and Simon Bolivar Squares. About 77500 passengers using 50 buses are transited per day in lane No. 10. These 50 buses cover a distance of 9600 km/day. The results of present study showed that about 6.5 million liters of fuel is saved annually. It should be pointed out that environmental costs are also reduced for about US$ 1.7 million/yr. The overall score of environmental impact assessment stands at +10 that is indicative of Lane No. 10 compatibility with the environmental considerations.

Bacterial Composition of Biofilms Collected From Two Service Areas in a Metropolitan Drinking Water Distribution System

Science.gov (United States)

The development and succession of bacteria were examined by 16S rRNA gene clone libraries generated from various biofilms within a metropolitan water distribution system. Biofilms were obtained from off-line devices using polycarbonate coupons from annular reactors incubated for ...

Convergence of metropolitan house prices in South Africa: a re-examination using efficient unit root tests

CSIR Research Space (South Africa)

Das, Sonali

2010-01-01

Full Text Available This paper analyzes whether the Law of One Price (LOOP) holds in the housing market of five metropolitan areas of South Africa, namely Cape Town, Durban, Greater Johannesburg, Port Elizabeth/Uitenhage and Pretoria. The authors test the existence...

76 FR 16654 - Austin Western Railroad, L.L.C.-Lease and Operation Exemption-Capital Metropolitan Transportation...

Science.gov (United States)

2011-03-24

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35456] Austin Western Railroad, L.L.C.--Lease and Operation Exemption-- Capital Metropolitan Transportation Authority Austin... be leased since 2007, pursuant to an operating agreement. See Austin W. R.R.--Operation Exemption...

Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) MMSA Age-adjusted Prevalence Data (2011 to Present)

Data.gov (United States)

U.S. Department of Health & Human Services — 2011 to present. BRFSS SMART MMSA age-adjusted prevalence combined land line and cell phone data. The Selected Metropolitan Area Risk Trends (SMART) project uses the...

Strategic information for hospital service planning: a linked data study to inform an urban Aboriginal Health Liaison Officer program in Western Australia.

Science.gov (United States)

Katzenellenbogen, Judith M; Miller, Laura J; Somerford, Peter; McEvoy, Suzanne; Bessarab, Dawn

2015-09-01

The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006-11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital readmissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes.

Quantum metropolitan optical network based on wavelength division multiplexing.

Science.gov (United States)

Ciurana, A; Martínez-Mateo, J; Peev, M; Poppe, A; Walenta, N; Zbinden, H; Martín, V

2014-01-27

Quantum Key Distribution (QKD) is maturing quickly. However, the current approaches to its application in optical networks make it an expensive technology. QKD networks deployed to date are designed as a collection of point-to-point, dedicated QKD links where non-neighboring nodes communicate using the trusted repeater paradigm. We propose a novel optical network model in which QKD systems share the communication infrastructure by wavelength multiplexing their quantum and classical signals. The routing is done using optical components within a metropolitan area which allows for a dynamically any-to-any communication scheme. Moreover, it resembles a commercial telecom network, takes advantage of existing infrastructure and utilizes commercial components, allowing for an easy, cost-effective and reliable deployment.

From groundwater baselines to numerical groundwater flow modelling for the Milan metropolitan area

Science.gov (United States)

Crosta, Giovanni B.; Frattini, Paolo; Peretti, Lidia; Villa, Federica; Gorla, Maurizio

2015-04-01

Contamination of major aquifers in highly densely populated areas is a major concern for stakeholders involved in the use and protection of groundwater resources. Sustainable groundwater withdrawal and management, and the identification of trends in groundwater contamination require a careful hydrochemical baseline characterization. This characterization is fundamental to investigate the presence and evolutionary trend of contaminants. In fact, it allows recovering and understanding: the spatial-temporal trend of contamination; the relative age of the contamination episodes; the reasons for anomalous behavior of some compounds during migration to and in the groundwater; the associations with which some contaminants can be found; the different behaviors in phreatic and semi-confined and confined aquifers. To attain such a characterization for the Milan metropolitan area (about 2,500 km2, ca 4.000.000 inhabitants, Lombardy, Italy), we carried out three main activities. (1) Collection of complete and reliable datasets concerning the geological, hydrogeological and hydrochemical (over 60,000 chemical analysis since 2003 to 2013) characteristics of the area and of the involved aquifers. This activity was very demanding because the available data are provided by different authorities (Lombardy Region, Provinces, Lombardy Environmental Agency - ARPA Lombardia, public own companies in charge of water system managements) in raw format and with different database standard, which required a large effort of manual verification and harmonization. (2) Completion of a hydrochemical characterization of the metropolitan area aquifers by classical statistical and multivariate statistical analyses, in order to define a baseline both for some major physical chemical characteristics and for the most relevant contaminants. (3) Development of a three dimensional hydrogeological model for the metropolitan area starting from the above listed datasets and existing models. This model will

There Are No Subways in Lickingville: Metropolitan Models Don't Work for Rural People.

Science.gov (United States)

Hillman, Arnold

This book presents an overview of the problems facing rural America and offers solutions at the national, state, and local levels. The combination of public lack of awareness and metropolitan-centered authority has created a view of rural America and its people that is contrary to both the data and actual living conditions. Rural education has…

The Day Hospitals Organisation

African Journals Online (AJOL)

1974-05-25

May 25, 1974 ... costs and the long period taken in planning before con- struction (which in itself takes ... in the Peninsula and near metropolitan Cape Town, where the old 'Free ..... At the invitation of the Red Cross War Memorial. Children's ...

High-resolution 3D seismic reflection imaging across active faults and its impact on seismic hazard estimation in the Tokyo metropolitan area

Science.gov (United States)

Ishiyama, Tatsuya; Sato, Hiroshi; Abe, Susumu; Kawasaki, Shinji; Kato, Naoko

2016-10-01

We collected and interpreted high-resolution 3D seismic reflection data across a hypothesized fault scarp, along the largest active fault that could generate hazardous earthquakes in the Tokyo metropolitan area. The processed and interpreted 3D seismic cube, linked with nearby borehole stratigraphy, suggests that a monocline that deforms lower Pleistocene units is unconformably overlain by middle Pleistocene conglomerates. Judging from structural patterns and vertical separation on the lower-middle Pleistocene units and the ground surface, the hypothesized scarp was interpreted as a terrace riser rather than as a manifestation of late Pleistocene structural growth resulting from repeated fault activity. Devastating earthquake scenarios had been predicted along the fault in question based on its proximity to the metropolitan area, however our new results lead to a significant decrease in estimated fault length and consequently in the estimated magnitude of future earthquakes associated with reactivation. This suggests a greatly reduced seismic hazard in the Tokyo metropolitan area from earthquakes generated by active intraplate crustal faults.

Local materials in the regeneration of urban space of the historic centre of the Metropolitan City of Naples

Directory of Open Access Journals (Sweden)

Paola De Joanna

2015-11-01

Full Text Available The contribution is part of the studies conducted by the Urban Planning Board, Land Management, Environment Laboratory for the “metropolitan city” and the Big Project “Historic centre of Naples, enhancement of the UNESCO site”. Among the issues under discussion, very important for the 92 municipalities of the Metropolitan City, is the preservation of different urban identities which, although united administratively, are claiming their own cultural profile rooted in the urban space, in the architecture of places and in local resources. The work is based on the principle that the use of local resources affects the quality and perception of urban space and, as evidence of belonging to the place, it is necessary to deal its exploitation under sustainable auspices.

Do Metropolitan and Nonmetropolitan Chicano Youth Differ: A Study of South Texas Teen-Agers - 1973.

Science.gov (United States)

Venegas, Moises; Kuvlesky, William

Based on comparative data from two 1973 studies, this study examined whether or not the occupational and educational status projections and language usage patterns of Mexican American teenagers living in a large metropolitan area differed from those of teenagers living in isolated, relatively small nonmetropolitan places. The two separate, but…

Remembering Pearl Harbor at 75 Years.

Science.gov (United States)

Liehr, Patricia; Sopcheck, Janet; Milbrath, Gwyneth

2016-12-01

: On December 7, 1941, the Sunday-morning quiet of the U.S. naval base in Pearl Harbor, Hawaii, was shattered by dive-bombing Japanese fighter planes. The planes came in two waves-and when it was all over, more than 2,400 were killed and more than 1,100 were injured.Nurses were stationed at U.S. Naval Hospital Pearl Harbor, Tripler General Hospital (now Tripler Army Medical Center), Hickam Field Hospital, Schofield Barracks Station Hospital, and aboard the USS Solace, and witnessed the devastation. But they also did what nurses do in emergencies-they responded and provided care to those in need. Here are the stories of a few of those nurses.

Clinical characteristics of dental emergencies and prevalence of dental trauma at a university hospital emergency center in Korea.

Science.gov (United States)

Bae, Ji-Hyun; Kim, Young-Kyun; Choi, Yong-Hoon

2011-10-01

The aim of this study was to examine the clinical characteristics of dental emergency patients who visited a university hospital emergency center and to evaluate the incidence of dental trauma. A retrospective chart review of patients with dental complaints and who visited the Seoul National University Bundang Hospital (SNUBH) emergency center in Gyeonggi-do, Korea, from January 2009 to December 2009 was conducted. Information regarding age, gender, the time, day, and month of presentation, diagnosis, treatment, and follow up was collected and analyzed. One thousand four hundred twenty-five patients with dental problems visited the SNUBH emergency center. Dental patients accounted for 1.47% of the total 96,708 patients at the emergency center. The male-to-female ratio was 1.68:1, with a considerably larger number of male patients (62.7%). The age distribution peak was at 0-9 years (27.5%), followed by patients in their forties (14.1%). The number of patients visiting the dental emergency center peaked in May (14.2%), on Sundays (22.4%), and between 2100 and 2400 h (20.8%). The patients' chief complaints were as follows: dental trauma, dental infection, oral bleeding, and temporomandibular joint disorder (TMD). The prevalence of dental trauma was 66%. The reasons for dental emergency visits included the following: dental trauma, dental infection, oral bleeding, and TMD, with 66% of the patients requiring management of dental trauma. It is important that dentists make a prompt, accurate diagnosis and initiate effective treatment in case of dental emergencies, especially dental trauma. © 2011 John Wiley & Sons A/S.

Costs of day hospital and community residential chemical dependency treatment.

Science.gov (United States)

Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

2008-03-01

Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs

Agricultural and green infrastructures: The role of non-urbanised areas for eco-sustainable planning in a metropolitan region

International Nuclear Information System (INIS)

La Greca, Paolo; La Rosa, Daniele; Martinico, Francesco; Privitera, Riccardo

2011-01-01

Non-Urbanised Areas (NUAs) are part of agricultural and green infrastructures that provide ecosystem services. Their role is fundamental for the minimization of urban pollution and adaptation to climate change. Like all natural ecosystems, NUAs are endangered by urban sprawl. The regulation of sprawl is a key issue for land-use planning. We propose a land use suitability strategy model to orient Land Uses of NUAs, based on integration of Land Cover Analysis (LCA) and Fragmentation Analysis (FA). With LCA the percentage of evapotranspiring surface is defined for each land use. Dimensions and densities of NUAs patches are assessed in FA. The model has been developed with Geographical Information Systems, using an extensive set of geodatabases, including orthophotos, vectorial cartographies and field surveys. The case of the municipality of Mascalucia in Catania metropolitan area (Italy), characterized by a considerable urban sprawl, is presented. - Highlights: → Non-Urbanised Areas (NUAs) are crucial for land planning and pollution minimization. → NUAs are endangered by urban sprawl in Catania metropolitan areas (Italy). → NUAs can be characterized by Land Cover and Fragmentation analysis. → Results from analysis are used in a Land Use Suitability Strategy Model (LUSSM). → By LUSSM application seven new prospective land uses for NUAs are proposed. - Characterization of non-urbanised areas in metropolitan regions is crucial for land-use planning aimed at environmental pollution minimization.

Agricultural and green infrastructures: The role of non-urbanised areas for eco-sustainable planning in a metropolitan region

Energy Technology Data Exchange (ETDEWEB)

La Greca, Paolo; La Rosa, Daniele [Dipartimento di Architettura e Urbanistica, Universita di Catania, Viale A. Doria 6, 95125 Catania (Italy); Martinico, Francesco, E-mail: fmartinico@dau.unict.it [Dipartimento di Architettura e Urbanistica, Universita di Catania, Viale A. Doria 6, 95125 Catania (Italy); Privitera, Riccardo [Dipartimento di Architettura e Urbanistica, Universita di Catania, Viale A. Doria 6, 95125 Catania (Italy)

2011-08-15

Non-Urbanised Areas (NUAs) are part of agricultural and green infrastructures that provide ecosystem services. Their role is fundamental for the minimization of urban pollution and adaptation to climate change. Like all natural ecosystems, NUAs are endangered by urban sprawl. The regulation of sprawl is a key issue for land-use planning. We propose a land use suitability strategy model to orient Land Uses of NUAs, based on integration of Land Cover Analysis (LCA) and Fragmentation Analysis (FA). With LCA the percentage of evapotranspiring surface is defined for each land use. Dimensions and densities of NUAs patches are assessed in FA. The model has been developed with Geographical Information Systems, using an extensive set of geodatabases, including orthophotos, vectorial cartographies and field surveys. The case of the municipality of Mascalucia in Catania metropolitan area (Italy), characterized by a considerable urban sprawl, is presented. - Highlights: > Non-Urbanised Areas (NUAs) are crucial for land planning and pollution minimization. > NUAs are endangered by urban sprawl in Catania metropolitan areas (Italy). > NUAs can be characterized by Land Cover and Fragmentation analysis. > Results from analysis are used in a Land Use Suitability Strategy Model (LUSSM). > By LUSSM application seven new prospective land uses for NUAs are proposed. - Characterization of non-urbanised areas in metropolitan regions is crucial for land-use planning aimed at environmental pollution minimization.

Study on the Coupling Coordination Degree between Metropolitan Economic System and Water Environmental System - Taking Beijing as an Example

Directory of Open Access Journals (Sweden)

Chen Ming

2017-01-01

Full Text Available The generation of metropolis is the inevitable outcome of the development of urbanization to a certain stage. The economy and society of metropolis are in the rapid development, but this process brings great pressure to the ecological environment, especially the water resources environment at the same time. In this paper, the relationship between metropolitan economic system and water environmental system is deeply studied, and the concept of “coupling” is introduced. Based on the framework of “pressure-state-response” (PSR, 12 detailed indexes, such as total population and water consumption per ten thousand Yuan GDP, were selected to construct four subsystems. The coordination degree measurement model has been used to calculate the degree of coupling between the economic system and water environmental system. On this basis, the following conclusions are drawn through the example of Beijing city: (1 In the process of metropolitan development, the economic system and the water environmental system are interrelated and there exist a complex coupling mechanism. (2 With the adjustment of economic structure and the progress of technology, the coupling index between the metropolitan economic system and the water environmental system has been increasing, and this process shows an upward trend

Hospital Consolidation: FTC May be a Stick in the Spokes of Hospital Mergers.

Science.gov (United States)

Kirkner, Richard Mark

2017-12-01

For instance, in the case of Sanford Health's acquisition of Mid Dakota Clinic in North Dakota, the agency challenged the deal, claiming that the merged entity would control 75% or more of primary care and other health services in the Bismarck-Mandan metropolitan area.

Attitudes of pregnant women towards personally controlled electronic, hospital-held, and patient-held medical record systems: a survey study.

Science.gov (United States)

Quinlivan, Julie A; Lyons, Sarah; Petersen, Rodney W

2014-09-01

On July 1, 2012 the Australian Government launched the personally controlled electronic health record (PCEHR). This article surveys obstetric patients about their medical record preferences and identifies barriers to adoption of the PCEHR. A survey study was conducted of antenatal patients attending a large Australian metropolitan hospital. Consecutive patients completed questionnaires during the launch phase of the PCEHR system. Quantitative and qualitative data were collected on demographics, computer access and familiarity, preference for medical record system, and perceived benefits and concerns. Of 528 women eligible to participate, 474 completed the survey (89.8%). Respondents had high levels of home access to a computer (90.5%) and the Internet (87.1%) and were familiar with using computers in daily life (median Likert scale of 9 out of 10). Despite this, respondents preferred hospital-held paper records, and only one-third preferred a PCEHR; the remainder preferred patient-held records. Compared with hospital-held paper records, respondents felt a PCEHR would reduce the risk of lost records (padvantages and disadvantages with the PCEHR, although the majority still prefer existing record systems. To increase uptake, confidentiality, privacy, and control concerns need to be addressed.

Travel Models for Corridors of Metropolitan Areas Served by Railways

Directory of Open Access Journals (Sweden)

Brzeziński A.

2016-12-01

Full Text Available In recent years adverse processes of suburbanization have been observed in cities. It has become a serious challenge for urban and transport planners, as it influences largely the quality of space, the quality of life, and the cost of running the city. This paper is dedicated to travel models in areas serviced by a railway system, and is based on a real-life survey example of the Błonie community, a district belonging to the Warsaw metropolitan area. Research carried out in 2014 focused on combined travels behaviors recorded using GPS locators as well as quantitative research (volumes of users across various transport systems.

Study of the temporal and spatial variation of climate and solar radiation in th metropolitan Phoenix area. Final technical progress report, July 1, 1977-June 30, 1978

Energy Technology Data Exchange (ETDEWEB)

Durrenberger, R.W.

1978-09-29

The research performed was designed to identify spatial or temporal variation of any atmospheric parameters that might affect the operation of devices utilizing solar energy in the metropolitan Phoenix area. The first part of the research involved the analysis of all available solar and climatic data to determine their validity and comparability. For the standard climatic parameters, few difficulties were encountered, but the task of determining comparability of solar radiation data involved many pitfalls. It was concluded that most of the solar data acquired before January 1977 could not be used for purposes of identifying spatial variability. And, a year and a half of data does not represent a long enough period of time upon which to base sound conclusions about spatial and temporal variability of solar radiation in the metropolitan Phoenix region. The data currently available to us do not indicate any great variation of solar radiation in the metropolitan Phoenix area. However, any meaningful statements about spatial and temporal variability of solar radiation in the metropolitan Phoenix area must await the acquisition of additional data from well-calibrated equipment.

The Impact of Urbanization to Forest Degradation in Metropolitan Semarang: A Preliminary Study

Science.gov (United States)

Sejati, A. W.; Buchori, I.; Rudiarto, I.

2018-02-01

This paper aims to examine the relationship of urbanization and the consequences of environmental impacts, especially the availability of forests. The analysis used remote sensing data ie Landsat 7 ETM (1990), Landsat 7 ETM (2000), and Landsat 8 OLI (2015). Analysis of forest availability used green vegetation cover parameters with NDVI techniques, while urbanization was measured by looking at the built-up area growth with NDBI techniques. The detection result in 1990 area of urban area was 74.85 km2, in 2000 was 130.83 km2, and in 2015 was 292.74 km2. Given the overall size of the metropolitan area of Semarang (932.14 km2), the proportion of the built up area in 2015 was 31% with an average of 6% per year change in 1990-2000 and 8.2% per year in 2000-2015. Urbanization in this region is characterized by forest conversion into residential and industrial buildings. With increasing area and built-up density, NDBI is found to be proportionately increasing, while NDVI decrease is significant. The results show that NDBI-NDVI correlation is negative (-0.99). It is very important for policy makers to formulate land use control policies in Metropolitan Semarang particularly in responding to the issue of forest conversion.

A typology of female sex work in the Metropolitan Region of Santiago, Chile.

Science.gov (United States)

Belmar, Julieta; Stuardo, Valeria; Folch, Cinta; Carvajal, Bielka; Clunes, Maria José; Montoliu, Alexandra; Casabona, Jordi

2018-04-01

In Chile, sex work takes place covertly in a variety of venues and locations. Formative research using time-location sampling methods is important in order to understand the nature of this diversity. This study used qualitative methods to develop a typology of female sex work in the Metropolitan Region of Santiago, Chile, using semi-structured interviews, focus groups and ethnographic fieldwork during visits to sex work venues. The study identified seven types of venue, which reflect the context and regulatory framework of the country and the structural vulnerabilities that affect female sex workers in Chile. These venues and locations include: cafés con piernas (coffee with legs); nightclubs, topless bars and cabarets; brothels; hotels; street and highway soliciting; massage parlours; and private residences. Formative research methods were helpful in identifying and characterising the venues and locations in which sex work occurred. Barriers to accessing and mapping specific locations were also identified. Recommendations for addressing these barriers include working with non-governmental organisations to map venues and initiate contact with the populations of interest. A comprehensive typology of sex work in the Metropolitan Region of Santiago, Chile, is an essential element for future time-location sampling and bio-behavioural research in the context of second-generation surveillance for HIV and sexually transmitted infections in Chile.

[Acute myeloid leukemia versus professional occupation: the profile of workers treated at the Recife Hematology Hospital].

Science.gov (United States)

Carvalho, Queliane Gomes da Silva; Pedrosa, Wanessa de Aguiar; Sebastião, Quitéria Pereira

2011-12-01

The objective of this study was to learn the profile of workers in the economically active age group admitted from 1997 to 2007 to a hematology hospital, diagnosed with acute myeloid leukemia (AML); check which professions have the highest prevalence among the assisted workers who died; and identify the occupational risks compatible with the appearance of AML in the prevalent professions. This is a quantitative, exploratory study. Most profiles were characterized as originally from the agreste and the metropolitan region of the state of Pernambuco, male, white, and with incomplete primary education. The most common occupations were related to agriculture and domestic work, both of which involve the use of chemical substances that, according to literature, are possible factors involved in triggering the pathology.

Understanding metropolitan patterns of daily encounters.

Science.gov (United States)

Sun, Lijun; Axhausen, Kay W; Lee, Der-Horng; Huang, Xianfeng

2013-08-20

Understanding of the mechanisms driving our daily face-to-face encounters is still limited; the field lacks large-scale datasets describing both individual behaviors and their collective interactions. However, here, with the help of travel smart card data, we uncover such encounter mechanisms and structures by constructing a time-resolved in-vehicle social encounter network on public buses in a city (about 5 million residents). Using a population scale dataset, we find physical encounters display reproducible temporal patterns, indicating that repeated encounters are regular and identical. On an individual scale, we find that collective regularities dominate distinct encounters' bounded nature. An individual's encounter capability is rooted in his/her daily behavioral regularity, explaining the emergence of "familiar strangers" in daily life. Strikingly, we find individuals with repeated encounters are not grouped into small communities, but become strongly connected over time, resulting in a large, but imperceptible, small-world contact network or "structure of co-presence" across the whole metropolitan area. Revealing the encounter pattern and identifying this large-scale contact network are crucial to understanding the dynamics in patterns of social acquaintances, collective human behaviors, and--particularly--disclosing the impact of human behavior on various diffusion/spreading processes.

Prescribing Patterns in Outpatient Clinics of Township Hospitals in China: A Comparative Study before and after the 2009 Health System Reform.

Science.gov (United States)

Ding, Ding; Pan, Qingxia; Shan, Linghan; Liu, Chaojie; Gao, Lijun; Hao, Yanhua; Song, Jian; Ning, Ning; Cui, Yu; Li, Ye; Qi, Xinye; Liang, Chao; Wu, Qunhong; Liu, Guoxiang

2016-07-05

China introduced a series of health reforms in 2009, including a national essential medicines policy and a medical insurance system for primary care institutions. This study aimed to determine the changing prescribing patterns associated with those reforms in township hospitals. A multi-stage stratified random cluster sampling method was adopted to identify 29 township hospitals from six counties in three provinces. A total of 2899 prescriptions were collected from the participating township hospitals using a systematic random sampling strategy. Seven prescribing indicators were calculated and compared between 2008 and 2013, assessing use of medicines (antibiotics and adrenal corticosteroids) and polypharmacy, administration route of medicines (injections), and affordability of medicines. Significant changes in prescribing patterns were found. The average number of medicines and costs per-prescription dropped by about 50%. The percentage of prescriptions requiring antibiotics declined from 54% to 38%. The percentage of prescriptions requiring adrenal corticosteroid declined from 14% to 4%. The percentage of prescriptions requiring injections declined from 54% to 25%. Despite similar changing patterns, significant regional differences were observed. Significant changes in prescribing patterns are evident in township hospitals in China. Overprescription of antibiotics, injections and adrenal corticosteroids has been reduced. However, salient regional disparities still exist. Further studies are needed to determine potential shifts in the risk of the inappropriate use of medicines from primary care settings to metropolitan hospitals.

Forest Fires in the Metropolitan District of Quito (DMQ: Risk knowledge and public intervention

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Jairo Estacio

2013-10-01

Full Text Available Every summer, the Metropolitan District of Quito (MDQ is subject to the recurrence of forest fires with different consequences in terms of loss of protected areas of great biodiversity, affectation of public and private spaces of different use and impact on the population well-being. The management of municipal authorities of this type of risks is still limited, since there is no decisional tool that can improve the preventive planning and the response to the annual presence of these events. For this reason, the generation of a study on potential fores fires represents the first step towards the comprehension and the reduction of risks. The present article presents the result of this study, the mechanisms and the efforts of the municipal technicians that made possible the achievement of these tools in the frame of the Risk Reduction Program of the Metropolitan District of Quito. The obtained results allowed the implementation of prevention actions in areas with very valuable ecosystems services but fragile in the same time, as well as the improvement of the fire emergency plans in order to optimize resources and reinforce local capacities. 

Do daily ward interviews improve measurement of hospital quality and safety indicators? A prospective observational study.

Science.gov (United States)

Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Mitchell, Deb; O'Brien, Lisa; May, Kerry; Ghaly, Marcelle; Ho, Melissa; Haines, Terry P

2016-10-01

The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under-reporting of hospital quality and safety indicators in incident reporting systems. A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub-acute and acute medical assessment unit. An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% (n = 72), pressure injuries by 21.7% (n = 48) and rapid response medical team calls by 12.7% (n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday (P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday (P = 0.01). Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under-reported in incident reporting systems, with variability in under-reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety

Book Review of 'The Metropolitan Revolution, How Cities and Metros are fixing our Broken Policies and Fragile Economy'

OpenAIRE

Fitzpatrick, Miriam

2014-01-01

Book Reviews for Architecture Ireland of 'The Metropolitan Revolution, How Cities and Metros are fixing our Broken Policies and Fragile Economy', by Bruce Katz and Jennifer Bradley, Published by Brookings Institution Press, 288 pages.

The relationship between burnout and mobbing among hospital managers.

Science.gov (United States)

Karsavuran, Seda; Kaya, Sıdıka

2017-05-01

Mobbing and burnout can cause serious consequences, especially for health workers and managers. Level of burnout and exposure to mobbing may trigger each other. There is a need to conduct additional and specific studies on the topic to develop some strategies. The purpose of this study is to determine the relationship between level of burnout and exposure to mobbing of the managers (head physician, assistant head physician, head nurse, assistant head nurse, administrator, assistant administrator) at the Ministry of Health hospitals. The "Leymann Inventory of Psychological Terrorization" scale was used to measure the level of exposure to mobbing and the "Maslach Burnout Inventory" scale was used to measure the level of burnout of hospital managers. The relationship between level of burnout and exposure to mobbing was analyzed by Pearson's Correlation Analysis. Participants and research context: The population of this study included managers (454 managers) at the Ministry of Health hospitals in the metropolitan area of Ankara between September 2010 and May 2011. All the managers were tried to conduct, but some managers did not want to reply to the questionnaire and some managers were not found at their workplace. Consequently, using a convenience sampling, 54% of the managers replied to the questionnaire (244 managers). Ethical consideration: The approval of the study was granted by the Ministry of Health in Turkey. Furthermore, the study was evaluated and accepted by the Education, Planning and Coordination Council of one of the education and research hospitals in the study. Positive relationships were found among each subdimension of the mobbing and emotional exhaustion and depersonalization. A negative relationship was found between each subdimension of the mobbing and personal accomplishment. In hospitals, by detecting mobbing actions, burnout may be prevented. Exposure to mobbing and burnout could be a serious problem for head nurses who are responsible for both

Improving Public Health and Environment through Plastic Waste Management in Mumbai Metropolitan Region

OpenAIRE

Sanjay RODE

2015-01-01

The Mumbai Metropolitan Region is growing in terms of population, industry, educational and commercial units. The daily requirements of commodities and services by all units have increased fast. Plastic is used extensively for packing, protection and service of various commodities. The use of plastic is much higher by industry and households in region. In Brihan Mumbai Municipal Corporation, the density of population is higher. The concentration of small and large industries is more. Therefor...

Metropolitan social environments and pre-HAART/HAART era changes in mortality rates (per 10,000 adult residents among injection drug users living with AIDS.

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Samuel R Friedman

Full Text Available Among the largest US metropolitan areas, trends in mortality rates for injection drug users (IDUs with AIDS vary substantially. Ecosocial, risk environment and dialectical theories suggest many metropolitan areas characteristics that might drive this variation. We assess metropolitan area characteristics associated with decline in mortality rates among IDUs living with AIDS (per 10,000 adult MSA residents after highly active antiretroviral therapy (HAART was developed.This is an ecological cohort study of 86 large US metropolitan areas from 1993-2006. The proportional rate of decline in mortality among IDUs diagnosed with AIDS (as a proportion of adult residents from 1993-1995 to 2004-2006 was the outcome of interest. This rate of decline was modeled as a function of MSA-level variables suggested by ecosocial, risk environment and dialectical theories. In multiple regression analyses, we used 1993-1995 mortality rates to (partially control for pre-HAART epidemic history and study how other independent variables affected the outcomes.In multivariable models, pre-HAART to HAART era increases in 'hard drug' arrest rates and higher pre-HAART income inequality were associated with lower relative declines in mortality rates. Pre-HAART per capita health expenditure and drug abuse treatment rates, and pre- to HAART-era increases in HIV counseling and testing rates, were weakly associated with greater decline in AIDS mortality.Mortality among IDUs living with AIDS might be decreased by reducing metropolitan income inequality, increasing public health expenditures, and perhaps increasing drug abuse treatment and HIV testing services. Given prior evidence that drug-related arrest rates are associated with higher HIV prevalence rates among IDUs and do not seem to decrease IDU population prevalence, changes in laws and policing practices to reduce such arrests while still protecting public order should be considered.

Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area

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Ethelwynn L. Stellenberg

2014-06-01

Full Text Available Background: Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts, target setting, the shortage of nurses and expertise. Objectives: The objectives of the study were to identify ethical issues related to patient care, to describe ethical issues related to patient diversity, rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment. Method: A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5% was drawn from all nurses and caregivers (N = 2990 working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables. Results: Results included (95% of respondents provided safe and committed care to their patients, (99% loved to care for their patients and (93% believed in the Nurses’ Pledge of Service. Fifty percent (50% of the respondents indicated verbal abuse from patients and only (59% experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse. Conclusion: This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient.

Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area

Directory of Open Access Journals (Sweden)

Ethelwynn L. Stellenberg

2014-02-01

Full Text Available Background: Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts, target setting, the shortage of nurses and expertise.Objectives: The objectives of the study were to identify ethical issues related to patient care, to describe ethical issues related to patient diversity, rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment.Method: A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5% was drawn from all nurses and caregivers (N = 2990 working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables.Results: Results included (95% of respondents provided safe and committed care to their patients, (99% loved to care for their patients and (93% believed in the Nurses’ Pledge of Service. Fifty percent (50% of the respondents indicated verbal abuse from patients and only (59% experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse.Conclusion: This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient.

Dutch business opportunities in the Russian agrifood sector; Animal protein sector and Moscow Metropolitan fresh food chain

NARCIS (Netherlands)

Wijnands, J.H.M.; Valeeva, N.I.; Berkum, van S.

2012-01-01

This report studies the Russian animal protein sector and the Moscow Metropolitan Food Security. It aims at identifying the opportunities for Dutch business to do businesses through exports or via local investments. Public available government policies, papers and interviews with stakeholders are

Internet Protocol-Hybrid Opto-Electronic Ring Network (IP-HORNET): A Novel Internet Protocol-Over-Wavelength Division Multiplexing (IP-Over-WDM) Multiple-Access Metropolitan Area Network (MAN)

Science.gov (United States)

2003-04-01

IP-HORNET, Metropolitan Optical Networks 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT UNCLASSIFIED 18. SECURITY CLASSIFICATION...OF THIS PAGE UNCLASSIFIED 19. SECURITY CLASSIFICATION OF ABSTRACT UNCLASSIFIED 20. LIMITATION OF ABSTRACT UL NSN 7540-01-280-5500...Gemelos, and L. G. Kazovsky, “CSMA/CA MAC protocols for IP-HORNET: An IP over WDM metropolitan area ring netowrk ,” in Proceedings of GLOBE- COM’00

Debris flows from small catchments of the Ma Ha Tuak Range, metropolitan Phoenix, Arizona

Science.gov (United States)

Dorn, Ronald I.

2010-08-01

Debris flows debauch from tiny but steep mountain catchments throughout metropolitan Phoenix, Arizona, USA. Urban growth in the past half-decade has led to home construction directly underneath hundreds of debris-flow channels, but debris flows are not recognized as a potential hazard at present. One of the first steps in a hazard assessment is to determine occurrence rates. The north flank of the Ma Ha Tuak Range, just 10 km from downtown Phoenix, was selected to determine the feasibility of using the varnish microlaminations (VML) method to date every debris-flow levee from 127 catchment areas. Only 152 of the 780 debris-flow levees yielded VML ages in a first round of sampling; this high failure rate is due to erosion of VML by microcolonial fungi. The temporal pattern of preserved debris-flow levees indicates anomalously high production of debris flows at about 8.1 ka and about 2.8 ka, corresponding to Northern Hemisphere climatic anomalies. Because many prior debris flows are obliterated by newer events, the minimum overall occurrence rates of 1.3 debris flows per century for the last 60 ka, 2.2 flows/century for the latest Pleistocene, and 5 flows/century for the last 8.1 ka has little meaning in assessment of a contemporary hazard. This is because newer debris flows have obliterated an unknown number of past deposits. More meaningful to a hazards analysis is the estimate that 56 flows have occurred in the last 100 years on the north side of the range, an estimate that is consistent with direct observations of three small debris flows resulting events from a January 18-22, 2010 storm producing 70 mm of precipitation in the Ma Ha Tuak Range, and a 500 m long debris flow in a northern metropolitan Phoenix location that received over 150 mm of precipitation in this same storm. These findings support the need for a more extensive hazard assessment of debris flows in metropolitan Phoenix.

Appreciation of housing policies in the Metropolitan Area of Londrina-PR

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Elisa Roberta Zanon

2015-12-01

Full Text Available This paper presents the interpretation of partial search results on the "Right to Housing: applicability and effectiveness of legal instruments in the Metropolitan Area of Londrina-PR" since 2012 in the Universidade Estadual de Londrina. The context of social housing production in Londrina, from the years 1980 provides analysis allowance and reflection on the implementation of social housing policy in the city, especially in the 2000s programs, in particular with the implementation of the Residential Vista Bela by Minha Casa Minha Vida Program, one of the largest housing projects in Brazil, handed out the population in 2011 and 2012.

Urban mobility regulation in metropolitan area of Mendoza

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Lía Martínez

2016-11-01

Full Text Available Achieving the paradigm of sustainable urban mobility requires institutional capacities, appropriate policies and a regulatory framework that contains them. This work aims to contribute to the knowledge of the regulation of urban mobility in the metropolitan area of Mendoza. To this end, the current mobility regulations are assessed through indicators that are classified into three key areas: institutional and political organization, urban system and financial setup. The purpose is to account for the existence, or not, of regulatory capacities contained in the paradigm of sustainable mobility. Among the results, the absence of a policy of sustainable urban mobility is noteworthy, as well as the lack of sectorial coordination. Also of note is the absence of coordination between the urban planning system and the public transport provision. Lastly, in the financial sector, the results point to a promotion of sustainable transport modes but without such an explicit purpose.

Geographic mobility of Korean new graduate nurses from their first to subsequent jobs and metropolitan-nonmetropolitan differences in their job satisfaction.

Science.gov (United States)

Cho, Sung-Hyun; Lee, Ji Yun; Mark, Barbara A; Jones, Cheryl B

2014-01-01

Nurses are known to migrate from rural to urban areas, which may cause geographic imbalances in the workforce. The aim of this study was to compare new graduate nurse retention based on the type of geographic area (capital, metropolitan, and nonmetropolitan) of their first job and their job satisfaction by geographic location. The sample included 533 nursing graduates working full-time as registered nurses in hospitals or clinics. Survival analysis was conducted to compare nurse retention in three geographic locations. Survival curves for nurses in capital and nonmetropolitan areas were significantly different. The 1-, 2-, and 3-year survival probabilities of nurses in the capital were .923, .881, and .872, respectively, whereas those in nonmetropolitan areas were .887, .776, and .672, respectively. Nurses in nonmetropolitan areas were more dissatisfied with pay (odd ratio [OR] = 1.820, p = .009), fringe benefits (OR =1.893, p = .015), employment security (OR =2.640, p = .033), and personal growth (OR =1.626, p = .045) than those in the capital. Nurses employed in nonmetropolitan areas were more mobile and less satisfied with their jobs than those in the capital. Copyright © 2014 Elsevier Inc. All rights reserved.

Metropolitan isolation segregation and Black-White disparities in very preterm birth: a test of mediating pathways and variance explained.

Science.gov (United States)

Kramer, Michael R; Cooper, Hannah L; Drews-Botsch, Carolyn D; Waller, Lance A; Hogue, Carol R

2010-12-01

Residential isolation segregation (a measure of residential inter-racial exposure) has been associated with rates of preterm birth (births (32-36 weeks) raise questions about whether this association is similar across gestational ages, and through what pathways it might be mediated. Hierarchical Bayesian models were fit to answer three questions: is the isolation-prematurity association similar for very and moderately preterm birth; is this association mediated by maternal chronic disease, socioeconomic status, or metropolitan area crime and poverty rates; and how much of the geographic variation in Black-White very preterm birth disparities is explained by isolation segregation? Singleton births to Black and White women in 231 U.S. metropolitan statistical areas in 2000-2002 were analyzed and isolation segregation was calculated for each. We found that among Black women, isolation is associated with very preterm birth and moderately preterm birth. The association may be partially mediated by individual level socioeconomic characteristics and metropolitan level violent crime rates. There is no association between segregation and prematurity among White women. Isolation segregation explains 28% of the geographic variation in Black-White very preterm birth disparities. Our findings highlight the importance of isolation segregation for the high-burden outcome of very preterm birth, but unexplained excess risk for prematurity among Black women is substantial. Copyright © 2010 Elsevier Ltd. All rights reserved.

Development of in-vehicle noise prediction models for Mumbai Metropolitan Region, India

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Vishal Konbattulwar

2016-08-01

Full Text Available Traffic noise is one of the major sources of noise pollution in metropolitan regions causing various health hazards (e.g., long-term sleep disturbance, increase in blood pressure, physical tension, etc.. In this research, noise prediction models, which can measure the noise level experienced by the commuters while driving or traveling by motorized vehicles in the Mumbai Metropolitan Region, India, were developed. These models were developed by conducting a comprehensive study of various factors (e.g., vehicle speed, traffic volume and road characteristics, etc. affecting the levels of concentration of noise. A widespread data collection was done by conducting road trips of total length of 403.80 km via different modes of transport, such as air-conditioned (A/C car, non A/C car, bus and intermediate public transport (i.e., traditional 3-wheeler autos. Multiple regression analyses were performed to develop a functional relation between equivalent noise levels experienced by passengers while traveling (which was considered as a dependent variable and explanatory variables such as traffic characteristics, vehicle class, vehicle speed, various other location characteristics, etc. Noise levels are generally higher in the vicinity of intersections and signalized junctions. Independent data sets (for each mode of transport were used to validate the developed models. It was noted that maximum differences between observed and estimated values from the model were within the range of ±7.8% of the observed value.

Assessing Tourist Resorts Surrounding Metropolitans Applying SWOT- AHP Models Case study: Malaga Resort

OpenAIRE

A. Movahed; S. Amanpoor; R. Zarei

2013-01-01

Extended abstract1-IntroductionToday, the urban concept is not understandable without resorts in different forms and the results of urban development and environmental problems have made the development ad existence of resorts unavoidable.Ahvaz is one of the metropolitan cities. For the reason of its pollution, oil-dependent industries, hot and humid weather, having a long hot and dusty season, the citizens have been encouraged to travel to other areas with better climate. Therefore, it is ne...

Cohort profile: the Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS), a multicentre cohort for socioeconomic inequalities in health monitoring.

Science.gov (United States)

Caranci, Nicola; Di Girolamo, Chiara; Giorgi Rossi, Paolo; Spadea, Teresa; Pacelli, Barbara; Broccoli, Serena; Ballotari, Paola; Costa, Giuseppe; Zengarini, Nicolás; Agabiti, Nera; Bargagli, Anna Maria; Cacciani, Laura; Canova, Cristina; Cestari, Laura; Biggeri, Annibale; Grisotto, Laura; Terni, Gianna; Costanzo, Gianfranco; Mirisola, Concetta; Petrelli, Alessio

2018-04-20

The Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS) is a system of integrated data on health outcomes, demographic and socioeconomic information, and represents a powerful tool to study health inequalities. IN-LiMeS is a multicentre and multipurpose pool of metropolitan population cohorts enrolled in nine Italian cities: Turin, Venice, Reggio Emilia, Modena, Bologna, Florence, Leghorn, Prato and Rome. Data come from record linkage of municipal population registries, the 2001 population census, mortality registers and hospital discharge archives. Depending on the source of enrolment, cohorts can be closed or open. The census-based closed cohort design includes subjects resident in any of the nine cities at the 2001 census day; 4 466 655 individuals were enrolled in 2001 in the nine closed cohorts. The open cohort design includes subjects resident in 2001 or subsequently registered by birth or immigration until the latest available follow-up (currently 31 December 2013). The open cohort design is available for Turin, Venice, Reggio Emilia, Modena, Bologna, Prato and Rome. Detailed socioeconomic data are available for subjects enrolled in the census-based cohorts; information on demographic characteristics, education and citizenship is available from population registries. The first IN-LiMeS application was the study of differentials in mortality between immigrants and Italians. Either using a closed cohort design (nine cities) or an open one (Turin and Reggio Emilia), individuals from high migration pressure countries generally showed a lower mortality risk. However, a certain heterogeneity between the nine cities was noted, especially among men, and an excess mortality risk was reported for some macroareas of origin and specific causes of death. We are currently working on the linkage of the 2011 population census data, the expansion of geographical coverage and the implementation of the open design in all the participating cohorts. © Article author

History of ancient megathrust earthquakes beneath metropolitan Tokyo inferred from coastal lowland deposits

Science.gov (United States)

Mannen, Kazutaka; Yoong, Kim Haeng; Suzuki, Shigeru; Matsushima, Yoshiaki; Ota, Yuki; Kain, Claire L.; Goff, James

2018-02-01

Metropolitan Tokyo is located directly above a subduction zone that has generated two megathrust earthquakes in the past 300 years. However, the timing of older megathrusts on this margin is poorly understood. In this study, we aim to constrain the timings of past megathrust earthquakes, using coastal stratigraphy, paleoecology, radiocarbon dating and archaeological records from coastal lowlands. An investigation of 13 boreholes in the southern coastal area of metropolitan Tokyo found evidence for 4 m of uplift in a 6000-year period. However, we found that net vertical displacement in the last 1000 years is approximately zero. Results suggest that preservation of usually ephemeral lagoon sediments occurred on three occasions in the past 1000 years, and radiocarbon dating results show that the timings of these preservation episodes are close to that of major historical earthquakes. We thus attribute the intermittent preservation of the ephemeral lagoon deposits to coseismic uplift caused by the megathrust earthquakes. The candidates of the megathrust earthquakes are events that took place in 1703 CE, the 13th century, and 878 CE. Since these events produced no net vertical displacement due to inter-seismic subsidence, we propose that earthquakes responsible for long-term uplift of this region took place prior to the 9th century. This research also demonstrates the value of preserved intertidal sediments as paleoseismological archives where net tectonic displacement is neutral.

Assessing post apartheid settlement growth patterns using remote sensing and GIWS: A case study of Cape Town metropolitan area

CSIR Research Space (South Africa)

Pillay, DL

2008-11-01

Full Text Available The significant land-use change in South African metropolitan areas, due to urbanization, created challenges of spatial development planning, infrastructure and service provision. This paper outlines the change detection analysis method applied...

Cancer incidence and mortality in the Bucaramanga metropolitan area, 2003-2007.

Science.gov (United States)

Uribe, Claudia; Osma, Sonia; Herrera, Víctor

2012-10-01

Cancer is an important cause of morbidity and mortality worldwide. Population-based cancer registries (PBCRs) make possible to estimate the burden of this condition. To estimate cancer incidence and mortality rates in the Bucaramanga Metropolitan Area (BMA) during 2003-2007. Incident cases of invasive cancer diagnosed during 2003-2007 were identified from the Bucaramanga Metropolitan Area PBCR (BMA-PBCR). Population counts and mortality were obtained from the Colombian National Administrative Department of Statistics (NADS). We estimated total and cancer-specific crude incidence and mortality rates by age group and sex, as well as age-standardized (Segi's world population) incidence (ASIR(W)) and mortality (ASMR(W)) rates. Statistical analyses were conducted using CanReg4 and Stata/IC 10.1. We identified 8,225 new cases of cancer excluding non-melanoma skin cancer (54.3% among women). Of all cases, 6,943 (84.4%) were verified by microscopy and 669 (8.1%) were detected only by death certificate. ASIR(W) for all invasive cancers was 162.8 per 100,000 women and 177.6 per 100,000 men. Breast, cervix, colorectal, stomach and thyroid were the most common types of cancer in women. In men, the corresponding malignancies were prostate, stomach, colorectal, lung and lymphoma. ASMR(W) was 84.5 per 100,000 person-years in women and 106.2 per 100,000 person-years in men. Breast and stomach cancer ranked first as causes of death in those groups, respectively. Overall, mortality rates in our region are higher than national estimates possibly due to limited effectiveness of secondary prevention strategies. Our work emphasizes the importance of maintaining high-quality, nationwide PBCRs.

The Potential of Periurban Areas for the Resilience of Metropolitan Region.

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Angela Colucci

2015-10-01

Full Text Available The paper aims to present as an organic structure the outcomes from various pieces of research and consulting activities developed over the last few years (2011-2015. Shared topics are: urban-rural partnerships, food planning, metropolitan polices and the territorial resilience of periurban areas. In the first part (the core of the paper the paper underlines critical questions and establishes needs so as to move towards a new approach to development processes in periurban areas. The paper uses some key concepts to present the main outcomes: 1. Understanding complexity (multiscales in space and dynamics (multiscales in time; 2. Identifying all the resources and opportunities; 3. Crosscutting and multi-issues. In the second part (in the final part the paper proposes the “Ecotone” metaphor to support innovation in the approach to periurban areas. It is a “zone of transition between adjacent ecological systems, having a set of characteristics uniquely defined by space and time scales and by the strength of the interactions between adjacent ecological systems” (Hansen et al, 1992. In these terms, periurban areas may be assumed to be ecotonal zones of transition between urban and rural or natural systems. Using the concept of “ecotonal buffer of transition” to approach the periurban systems it is possible to connect main needs and critical questions underlined to a homogeneous framework and to emphasise on the strategic role that the peri-urban systems play for the future development of metropolitan regions oriented to a improvement of resilience of socio-ecosystems. In the final part the paper focuses on the governace of urban rural partnerships and research perspectives.

Risk factors and acute in-hospital costs for infected pressure ulcers among gunshot-spinal cord injury victims in southeastern Michigan.

Science.gov (United States)

Chopra, Teena; Marchaim, Dror; Awali, Reda A; Levine, Miriam; Sathyaprakash, Smitha; Chalana, Indu K; Ahmed, Farah; Martin, Emily T; Sieggreen, Mary; Sobel, Jack D; Kaye, Keith S

2016-03-01

Management of pressure ulcers (PrUs) in patients with gunshot-spinal cord injuries (SCIs) presents unique medical and economic challenges for practitioners. A retrospective chart review was conducted at 3 acute care hospitals in metropolitan Detroit for patients admitted with PrUs due to gunshot-SCIs between January 2004 and December 2008. Multivariate analysis using logistic regression was conducted to choose for the independent predictors of infected PrUs. Mean adjusted in-hospital costs per patient and per hospitalization were calculated and compared between infected and noninfected PrUs. The study cohort included 201 gunshot-SCI patients with PrUs contributing to 395 admissions, including readmissions, between 2004 and 2008. Seventy-six patients (38%) had infected PrUs at time of the index admission. Independent predictors of infected PrUs on index admission included Charlson Comorbidity Index ≥2 (odds ratio, 2.18, P = .026) and stage III/IV PrU (odds ratio, 4.82; P cost of $19,969 ± $6639 per patient. The mean adjusted cost per hospitalization for patients with infected PrUs was significantly higher than that for patients with noninfected PrUs ($16,735 ± $8310 vs $12,356 ± $7007; P costs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Spatiotemporal Simulation of Future Land Use/Cover Change Scenarios in the Tokyo Metropolitan Area

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Ruci Wang

2018-06-01

Full Text Available Simulating future land use/cover changes is of great importance for urban planners and decision-makers, especially in metropolitan areas, to maintain a sustainable environment. This study examines the changes in land use/cover in the Tokyo metropolitan area (TMA from 2007 to 2017 as a first step in using supervised classification. Second, based on the map results, we predicted the expected patterns of change in 2027 and 2037 by employing a hybrid model composed of cellular automata and the Markov model. The next step was to decide the model inputs consisting of the modeling variables affecting the distribution of land use/cover in the study area, for instance distance to central business district (CBD and distance to railways, in addition to the classified maps of 2007 and 2017. Finally, we considered three scenarios for simulating land use/cover changes: spontaneous, sub-region development, and green space improvement. Simulation results show varied patterns of change according to the different scenarios. The sub-region development scenario is the most promising because it balances between urban areas, resources, and green spaces. This study provides significant insight for planners about change trends in the TMA and future challenges that might be encountered to maintain a sustainable region.

2009 Melbourne metropolitan sewerage strategy: a portfolio of decentralised and on-site concept designs.

Science.gov (United States)

Brown, V; Jackson, D W; Khalifé, M

2010-01-01

The bulk and retail water companies of the greater Melbourne area are developing the 2009 Metropolitan Sewerage Strategy to provide sustainable sewerage services to 2060. The objective of the strategy is to establish long term principles and near term actions to produce a robust sewage management system for Melbourne. Melbourne's existing sewerage system is largely centralised and discharges to two major treatment plants. Several small satellite treatment plants service local urban areas generally more distant from the centralised system. Decentralised and on-site wastewater systems are options for future sewage management and could play a role in local recycling. A portfolio of 18 on-site and decentralised concept designs was developed, applicable to the full range of urban development types in Melbourne. The concepts can be used in evaluation of metropolitan system configurations as part of future integrated water cycle planning. The options included secondary and tertiary treatment systems incorporating re-use of water for non potable uses, urine separation, black and greywater separation and composting toilets. On-site and cluster treatment systems were analysed. Each option is described by its indicative capital and operating costs, energy use and water and nutrient balances. This paper summarises and compares the portfolio mix of decentralized and on-site options in Melbourne's context.

Zoonotic disease transmission associated with feral cats in a metropolitan area: A geospatial analysis.

Science.gov (United States)

Taetzsch, S J; Bertke, A S; Gruszynski, K R

2018-06-01

Feral cats raise public health concerns due to their large population numbers and ability to harbour pathogens that cause disease in people, pets, and wildlife. Information regarding the potential for feral cats to intersect with areas frequented by humans is lacking. This study examined the potential for feral cats and human territories to overlap in the Richmond metropolitan area of Central Virginia. Feral cats (n = 275) were trapped for monthly trap-neuter-release (TNR) clinics from July to November 2016. A geographic information system (GIS) was used to map feral cat trapping locations, elementary and preschools, public parks, and community gardens, and to evaluate the potential for cat interaction with these areas, presuming a maximum habitat radius of 0.44 miles. We found that 8.0% of feral cats in the Richmond metropolitan area had potential to range onto public elementary or preschool property, and 81.5% of feral cats trapped in Richmond City had potential to roam into one or more places of interest, including elementary and preschool grounds, public parks, and community gardens. This provides public health, veterinary, and human health professionals with important information that can be used to focus resources in an effort to reduce zoonosis associated with feral cat populations. © 2018 Blackwell Verlag GmbH.

The shelf space and strategic placement of healthy and discretionary foods in urban, urban-fringe and rural/non-metropolitan Australian supermarkets.

Science.gov (United States)

Cameron, Adrian J

2018-02-01

Supermarkets are a key influence on eating behaviours, but it is unknown if the promotion of food within stores varies on a geographic gradient from urban, to urban-fringe and non-metropolitan areas. The present study aimed to assess the shelf space and strategic placement of healthy and discretionary foods in each of urban, urban-fringe and non-metropolitan Australian supermarkets. Design/Setting In-store audits were conducted in stores from one of the two major Australian supermarket chains in urban (n 19), urban-fringe (n 20) and non-metropolitan (n 26) areas of Victoria. These audits examined selected food items (crisps/chips, chocolate, confectionery, soft drinks/sodas, fruits and vegetables) and measured the shelf space and the proportion of end-of-aisle and cash register displays containing these products. Store size was measured as the sum of aisle length. Differences in the supermarket food environment with respect to location were assessed, before and after adjustment for neighbourhood socio-economic position. The strategic placement of discretionary foods was commonly observed in all supermarkets. Adjusting for store size (larger in urban-fringe and rural areas), urban stores had greater shelf space devoted to fruits and vegetables, and less checkouts with soft drinks, than urban-fringe and rural/non-metropolitan areas. Differences remained following adjustment for neighbourhood socio-economic position. No clear pattern was observed for end-of-aisle displays, or the placement of chocolate and confectionery at checkouts. The shelf space of healthy and discretionary foods in urban-fringe and rural stores parallels the prevalence of overweight and obesity in these areas. Interventions in urban-fringe and rural stores targeting the shelf space of healthy foods and the placement of soft drinks at key displays may be useful obesity prevention initiatives.

Evaluation of the air quality in the metropolitan region of Belo Horizonte, Minas Gerais: first results

Energy Technology Data Exchange (ETDEWEB)

Moura, Igor Felipe Silva, E-mail: igorfelipedx@yahoo.com.br [Universidade Federal de Minas Gerais (DEN/UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Cruz, Ananda Borjaille; Fonseca, Raquel Luiza M.; Barreto, Alberto Avellar; Menezes, Maria Angela de B.C., E-mail: abc@cdtn.br, E-mail: menezes@cdtn.br, E-mail: aab@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte (Brazil)

2015-07-01

The Metropolitan Region of Belo Horizonte presents many industrial activities related to several industries, mainly mining activities, besides the high population concentration, which also contributes to several industrial typologies due to the existence of qualified work and to the vicinity of a future consumer market. This concentration of the population also implies in a great number of vehicles and, consequently, in big traffic jams. The particulate material is one of the pollutants which cause higher environmental risk and it is a mixture of solid and liquid particles in the air which form aerosols. These aerosols, which contain organic and inorganic substances, vary of size, form, composition and origin. In order to characterize the quality of the airborne particulate matter and identify the pollutant sources, a research is being developing in the Metropolitan Region of Belo Horizonte. This paper is focused on presenting the methodology of sampling, determination of concentration of particulates, elemental concentration analysis by k{sub 0}-Neutron Activation method and meteorological analysis, related to two sampling points, one at CDTN/CNEN and other at UFMG. (author)

Evaluation of the air quality in the metropolitan region of Belo Horizonte, Minas Gerais: first results

International Nuclear Information System (INIS)

Moura, Igor Felipe Silva

2015-01-01

The Metropolitan Region of Belo Horizonte presents many industrial activities related to several industries, mainly mining activities, besides the high population concentration, which also contributes to several industrial typologies due to the existence of qualified work and to the vicinity of a future consumer market. This concentration of the population also implies in a great number of vehicles and, consequently, in big traffic jams. The particulate material is one of the pollutants which cause higher environmental risk and it is a mixture of solid and liquid particles in the air which form aerosols. These aerosols, which contain organic and inorganic substances, vary of size, form, composition and origin. In order to characterize the quality of the airborne particulate matter and identify the pollutant sources, a research is being developing in the Metropolitan Region of Belo Horizonte. This paper is focused on presenting the methodology of sampling, determination of concentration of particulates, elemental concentration analysis by k 0 -Neutron Activation method and meteorological analysis, related to two sampling points, one at CDTN/CNEN and other at UFMG. (author)

The Prevalence of Multiple Sclerosis in the Metropolitan Area of Rome: A Capture-Recapture Analysis.

Science.gov (United States)

Farcomeni, Alessio; Cortese, Antonio; Sgarlata, Eleonora; Alunni Fegatelli, Danilo; Marfia, Gerolama Alessandra; Buttari, Fabio; Mirabella, Massimiliano; De Fino, Chiara; Prosperini, Luca; Pozzilli, Carlo; Grasso, Maria Grazia; Iasevoli, Luigi; Di Battista, Giancarlo; Millefiorini, Enrico

2018-03-02

Limited data are available on the prevalence of multiple sclerosis (MS) in central Italy. The objective of this study is to estimate MS prevalence in the metropolitan area of Rome. We used the capture-recapture method to calculate prevalence estimates in the study area. The selected prevalence day was December 31, 2015. A total of 1,007 patients, with a definite diagnosis of MS according to the revised McDonald's criteria, were considered for crude, age- and sex-specific prevalence estimation. The overall crude prevalence rate was 146.2 cases per 100,000 (95% CI 119.9-172.5). A higher prevalence rate was recorded in females (194.1, 95% CI 149.6-238.6) than in males (93.0, 95% CI 67.2-118.8) with a female to male ratio of 1.8. Age-specific prevalence peaked in the 25-34 , 35-44 and 45-54 years class; moreover, it was found to increase up to the 45-54 years age group in females and the 35-44 years age group in males, decreasing thereafter. The results confirm that the metropolitan area of Rome is a high-risk area for MS. © 2018 S. Karger AG, Basel.

Understanding heterogeneity in metropolitan India: the added value of remote sensing data for analyzing sub-standard residential areas

NARCIS (Netherlands)

Baud, I.; Kuffer, M.; Pfeffer, K.; Sliuzas, R.; Karuppannan, S.

2010-01-01

Analyzing the heterogeneity in metropolitan areas of India utilizing remote sensing data can help to identify more precise patterns of sub-standard residential areas. Earlier work analyzing inequalities in Indian cities employed a constructed index of multiple deprivations (IMDs) utilizing data from

Rainfall, runoff, and water-quality data for the urban storm-water program in the Albuquerque, New Mexico, metropolitan area, water year 2004

Science.gov (United States)

Kelly, Todd; Romero, Orlando; Jimenez, Mike

2006-01-01

Urbanization has dramatically increased precipitation runoff to the system of drainage channels and natural stream channels in the Albuquerque, New Mexico, metropolitan area. Rainfall and runoff data are important for planning and designing future storm-water conveyance channels in newly developing areas. Storm-water quality also is monitored in accordance with the National Pollutant Discharge Elimination System mandated by the U.S. Environmental Protection Agency. The Albuquerque Metropolitan Arroyo Flood Control Authority, the City of Albuquerque, and the U.S. Geological Survey began a cooperative program to collect hydrologic data to assist in assessing the quality and quantity of surface-water resources in the Albuquerque area. This report presents water-quality, streamflow, and rainfall data collected from October 1, 2003, to September 30, 2004 (water year 2004). Also provided is a station analysis for each of the 18 streamflow-gaging sites and 39 rainfall-gaging sites, which includes a description of monitoring equipment, problems associated with data collection during the year, and other information used to compute streamflow discharges or rainfall records. A hydrographic comparison shows the effects that the largest drainage channel in the metropolitan area, the North Floodway Channel, has on total flow in the Rio Grande.

Urbanisation, urban growth and planning in the Copenhagen Metropolitan Region with reference studies from Europe and the USA

DEFF Research Database (Denmark)

Fertner, Christian

pressure. Growth management strategies are necessary to secure future balanced and sustainable development throughout the whole urban region. The analysis of urbanisation and urban growth in peri-urban areas is at the core of this study, including socio-demographic and functional dynamics, land use impacts...... and options for spatial planning. The main case was the metropolitan region of Copenhagen, Denmark. Other cases from Europe and the USA were used as reference studies. The methods included quantitative analyses of register and land use data as well as general case study work to investigate options for spatial...... planning. The study shows that, while the most visible impacts of land use changes can be found at the close urban fringe, many other dynamics have a much longer reach into the rural-urban region. In the Copenhagen metropolitan region, we can observe migration to peri-urban areas and to the urban core...

Affluence and objective environmental conditions: Evidence of differences in environmental concern in metropolitan Brazil

OpenAIRE

Nawrotzki, Raphael J.; Guedes, Gilvan; do Carmo, Roberto Luiz

2014-01-01

In an age of climate change, researchers need to form a deepened understanding of the determinants of environmental concern, particularly in countries of emerging economies. This paper provides a region-specific investigation of the impact of socio-economic status (SES) and objective environmental conditions on environmental concern in urban Brazil. We make use of data that were collected from personal interviews of individuals living in the metropolitan areas of Baixada Santista and Campinas...

Incidence and predictors of 30-day readmissions in patients hospitalized with chronic pancreatitis: A nationwide analysis.

Science.gov (United States)

Shah, Rushikesh; Haydek, Christopher; Mulki, Ramzi; Qayed, Emad

2018-04-23

Patients with chronic pancreatitis are prone to frequent readmissions. The aim of this study is to evaluate the rate and predictors of 30-day readmissions in patients with chronic pancreatitis using the Nationwide Readmission Database (NRD). We performed a retrospective analysis of all adult patients with the principal discharge diagnosis of chronic pancreatitis from 2010 through 2014. We excluded patients who died during the hospitalization. Multivariate Cox proportional hazard regression was performed to identify demographic, clinical, and hospital factors that associated with 30-day unplanned readmissions. During the study period, 25,259 patients had the principal discharge diagnosis of chronic pancreatitis and survived the index hospitalization. Of these, 6477 (26.7%) were readmitted within 30 days. Younger age group, males, length of stay >5 days, admission to a large, metropolitan hospital, and several comorbidities (renal failure, rheumatic disease, chronic anemia, heart failure, depression, drug abuse, psychosis, and diabetes) were independently associated with increased risk of 30-day readmission. ERCP, pancreatic surgery, and obesity were associated with lower risk. The most common reasons for readmissions were acute pancreatitis (30%), chronic pancreatitis (17%), pseudocyst (2%), and abdominal pain (6%). One in four patients with chronic pancreatitis is readmitted within 30 days (26.7%). Pancreatic disease accounts for at least half of all readmissions. Several baseline comorbidities and characteristics are associated with 30-day readmission risk after index admission. Knowledge of these predictors can help design interventions to target high-risk patients and reduce readmissions and costs of care. Copyright © 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Water-resources-related information for the Milwaukee Metropolitan Sewerage District planning area, Wisconsin, 1970-2002

Science.gov (United States)

Schneider, Morgan A.; Lutz, Michelle A.; ,

2004-01-01

The Milwaukee Metropolitan Sewerage District (MMSD) Corridor Study is a three-phase project designed to improve the understanding of water resources in the stream corridors of the MMSD planning area by initially compiling existing data and using the compiled information to develop 3-year baseline and long-term monitoring plans. This report is one of the products of Phase I of the Corridor Study.

Setting Priorities for Urban Forest Planning. A Comprehensive Response to Ecological and Social Needs for the Metropolitan Area of Rome (Italy

Directory of Open Access Journals (Sweden)

Giulia Capotorti

2015-04-01

Full Text Available Urban forests represent key elements of green infrastructure and provide essential ecosystem services in both the ecological and social spheres. Therefore, forestation planning plays a decisive role in the sustainable development strategies of metropolitan areas and addresses the challenge of maintaining biodiversity while improving human health and well-being. The aim of this work is to present a methodological approach that can be used to identify priorities in urban forest planning and can provide comprehensive responses to ecological and social needs in any metropolitan context. The approach, which is based on interdisciplinary principles of landscape ecology, ecosystem geography and dynamic plant sociology, has been adopted in the Municipality of Rome (Italy. The first step entails defining an ecological framework for forestation plans by means of the ecological land classification and assessment of landscape conservation status. The second step entails setting forestation priorities according to both ecological and social criteria. The application of the method proved to effectively select limited areas requiring intervention within an extensive metropolitan area. Furthermore, it provided responses to sustainability issues such as long-term maintenance of restored habitats, landscape perspective of planning, greening of urban agriculture, improvement in urban resilience, and cost-effective improvement in ecosystem services provision.

Comparative Risk Analysis for Metropolitan Solid Waste Management Systems

Science.gov (United States)

Chang, Ni-Bin; Wang, S. F.

1996-01-01

Conventional solid waste management planning usually focuses on economic optimization, in which the related environmental impacts or risks are rarely considered. The purpose of this paper is to illustrate the methodology of how optimization concepts and techniques can be applied to structure and solve risk management problems such that the impacts of air pollution, leachate, traffic congestion, and noise increments can be regulated in the iong-term planning of metropolitan solid waste management systems. Management alternatives are sequentially evaluated by adding several environmental risk control constraints stepwise in an attempt to improve the management strategies and reduce the risk impacts in the long run. Statistics associated with those risk control mechanisms are presented as well. Siting, routing, and financial decision making in such solid waste management systems can also be achieved with respect to various resource limitations and disposal requirements.

A study of the characteristics and needs of people transferred from acute hospitals to nursing homes.

Science.gov (United States)

Lefroy, R B; Davey, M; Hyndman, J; Hobbs, M S

1993-09-20

To describe the categories of people being approved for admission to nursing homes; to consider whether any alternatives would have been more appropriate; and to outline the care needed for each category. Patients in acute-care facilities in metropolitan Perth for whom a request had been made for nursing home admission. Patients were interviewed (by R B L and M D) and records in the acute hospital were examined. A second interview of those patients still available was conducted after their transfer to the nursing home. Nursing care was considered necessary for 123 of the 201 people seen in the acute hospitals; domestic care in a standard hostel for 24 people; care in a special dementia unit (SDU) hostel for 26 people; and care in a psychiatric institution for 16 people. Twelve others had various specific needs. Several different categories were identified in the group needing nursing care. Applicants for nursing home admission do not form a homogeneous group; there are several categories with different needs. SDU hostels should be added to the available facilities. In addition to undertaking the assessment of nursing home applicants, personnel from geriatric services should be encouraged to become involved in their continuing care.

Causes of informal settlements in Ekurhuleni Metropolitan Municipality: An exploration

Directory of Open Access Journals (Sweden)

Noah K. Marutlulle

2017-08-01

Full Text Available This article aims to explore the causes of informal settlements in Ekurhuleni Metropolitan Municipality (EMM. The article strongly challenges the view that the cause of informal settlements in EMM and other parts of South Africa is predominantly the apartheid government and agrees with literature which provides evidence that to a larger extent, the present government, not the apartheid government, is one of the dominant causes of informal settlements. The article further establishes a common and fertile ground for the convergence of the different views and perspectives into variables which, in addition to the present government, include population growth, government economic policies, economic variables, housing shortage, unavailability of land and unaffordability as the real causes of informal settlements in EMM.

Race and the Metropolitan Origins of Postsecondary Access to Four Year Colleges: The Case of Greater Boston

Science.gov (United States)

Berger, Joseph B.; Smith, Suzanne M.; Coelen, Stephen P.

2004-01-01

The inequities of residential segregation and their impact on educational opportunity are a national problem, but greater metropolitan Boston has a particularly problematic history in terms of the extent to which racial segregation has deeply divided the city into separate and unequal systems of opportunity. Despite decades of policy efforts to…

[Health and economic benefits of reducing 10 µm particulate matter (PM₁₀) in Metropolitan Area of Concepción, Chile].

Science.gov (United States)

Mardones, Cristian; Saavedra, Andrés; Jiménez, Jorge

2015-04-01

Several international studies show the effects of PM10 pollution on health but specific analyses for many cities in Chile are lacking. To relate PM10 concentrations to effects with population health and quantify the economic benefits of its reduction in Concepción Metropolitan Area. Poisson regression and generalized additive models were used to analyze the short-term effects of PM10 on mortality and morbidity, controlling for lags, seasonal, trend and weather variables. The damage function method to determine the economic impact of pollution reduction was used. The selected concentration-response (C-R) coefficients showed that PM10 concentrations had effects on hospital admissions with a two days lag for respiratory diseases in children under 15 years of age and with a one day lag for asthma in patients over 64 years. The effects on premature mortality had a six days lag. The decrease in 1 µg/m³ of PM10 concentration would generate benefits ranging from 1,025.8 to 32,490.9 million of Chilean pesos per year, with a confidence level of 95%, according the estimation based on concentration-response coefficients and their economic cost. Reduction of PM10 would have important health and economic benefits.

Outsourcing: two case studies from the Victorian public hospital sector.

Science.gov (United States)

Young, Suzanne

2007-02-01

Outsourcing was one process of privatisation used in the Victorian public health sector in the 1990s. However it was used to varying degrees and across a variety of different services. This paper attempts to answer the questions: Why have managers outsourced? What have managers considered when they have decided to outsource? The research was carried out in a rural hospital and a metropolitan network in Victoria. The key findings highlight the factors that decision makers considered to be important and those that led to negative outcomes. Economic factors, such as frequency of exchange, length of relationships between the parties, and information availability, were often ignored. However, other factors such as outcome measurability, technology, risk, labour market characteristics and goal conflict, and political factors such as relative power of management over labour were often perceived as important in the decision-making process. Negative outcomes from outsourcing were due to the short length of relationships and accompanying difficulties with trust, commitment and loyalty; poor quality; and excessive monitoring and the measurement of outcomes.