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Sample records for unit lwrhu impact

  1. Light weight radioisotope heater unit (LWRHU): a technical description of the reference design

    International Nuclear Information System (INIS)

    Tate, R.E.

    1982-01-01

    The Light Weight Radioisotope Heater Unit (LWRHU), a new radioisotope heater unit for use in space missions, is a 238 PuO 2 -fueled unit designed to provide a thermal watt in dispersed locations on a spacecraft. The LWRHU is required to maintain the temperature of a component at a level where the component will function reliably in space. Two major constraints are placed on the unit's design; it must be as light as possible and must provide enough protection to immobilize the plutonium fuel to the maximum extent in all phases of the unit's lifetime. The four components are pelletized fuel, platinum-alloy encapsulation, pyrolytic graphite thermal insulation, and high-technology graphite ablation shell. The LWRHU is a cylinder 32 mm (1.26 in.) high and 26 mm (1.02 in.) in diameter. It weighs slightly less than 40 g

  2. Environmental safety analysis tests on the Light Weight Radioisotope Heater Unit (LWRHU)

    International Nuclear Information System (INIS)

    Tate, R.E.; Land, C.C.

    1985-05-01

    A series of safety tests has been performed on the Light Weight Radioisotope Heater Unit (LWRHU), a 238 PuO 2 -fueled device designed to provide thermal energy at selected locations in a spacecraft. The tests simulate the thermal and mechanical environments postulated for spacecraft accidents on the launch pad and on reentry abort. The tests demonstrate almost complete containment of the fuel, or fuel simulant (depleted UO 2 ), in (1) an overpressure environment of 12.76 MPa (1850 psi), (2) on impact by an 18-g aluminum fuel-tank fragment at velocities greater than 750 m/s (2460 ft/s) but less than 900 m/s (2950 ft/s), (3) during a 10.5-min burn of a 0.9 x 0.9 x 0.9 m (3 x 3 x 3 ft) block of solid rocket motor propellant, (4) after impact at 49 m/s (161 ft/s) in four different orientations on a hard surface, and (5) during immersion in seawater for 1.75 years at both sea level pressure and at a pressure equivalent to 6000 m (19,700 ft) of ocean depth

  3. Light weight radioisotope heater unit (LWRHU) production for the Cassini mission

    International Nuclear Information System (INIS)

    Rinehart, G.H.

    1997-01-01

    The Light-Weight Radioisotope Heater Unit (LWRHU) is a [sup 238]PuO[sub 2] fueled heat source designed to provide one thermal watt in each of various locations on a spacecraft. The heat sources are required to maintain the temperature of specific components within normal operating ranges. The heat source consists of a hot- pressed [sup 238]PuO[sub 2] fuel pellet, a Pt-3ORh vented capsule, a pyrolytic graphite insulator, and a woven graphite aeroshell assembly. Los Alamos National Laboratory has fabricated 180 heat sources, 157 of which will be used on the Cassini mission

  4. Light-Weight Radioisotope Heater Unit Safety Analysis Report (LWRHU-SAR). Volume II. Accident model document

    International Nuclear Information System (INIS)

    Johnson, E.W.

    1985-10-01

    Purposes of this volume (AMD), are to: Identify all malfunctions, both singular and multiple, which can occur during the complete mission profile that could lead to release outside the clad of the radioisotopic material contained therein; provide estimates of occurrence probabilities associated with these various accidents; evaluate the response of the LWRHU (or its components) to the resultant accident environments; and associate the potential event history with test data or analysis to determine the potential interaction of the released radionuclides with the biosphere

  5. Light-Weight Radioisotope Heater Unit Safety Analysis Report (LWRHU-SAR). Volume I. A. Introduction and executive summary. B. Reference Design Document (RDD)

    International Nuclear Information System (INIS)

    Johnson, E.W.

    1985-10-01

    The orbiter and probe portions of the NASA Galileo spacecraft contain components which require auxiliary heat during the mission. To meet these needs, the Department of Energy's (DOE's) Office of Special Nuclear Projects (OSNP) has sponsored the design, fabrication, and testing of a one-watt encapsulated plutonium dioxide-fueled thermal heater named the Light-Weight Radioisotope Heater Unit (LWRHU). This report addresses the radiological risks which might be encountered by people both at the launch area and worldwide should postulate mission failures or malfunctions occur, which would result in the release of the LWRHUs to the environment. Included are data from the design, mission descriptions, postulated accidents with their consequences, test data, and the derived source terms and personnel exposures for the various events

  6. Light-weight radioisotope heater impact tests

    International Nuclear Information System (INIS)

    Reimus, M.A.H.; Rinehart, G.H.; Herrera, A.

    1998-01-01

    The light-weight radioisotope heater unit (LWRHU) is a 238 PuO 2 -fueled heat source designed to provide one thermal watt in each of various locations on a spacecraft. Los Alamos National Laboratory designed, fabricated, and safety tested the LWRHU. The heat source consists of a hot-pressed 238 PuO 2 fuel pellet, a Pt-30Rh vented capsule, a pyrolytic graphite insulator, and a fineweave-pierced fabric graphite aeroshell assembly. To compare the performance of the LWRHUs fabricated for the Cassini mission with the performance of those fabricated for the Galileo mission, and to determine a failure threshold, two types of impact tests were conducted. A post-reentry impact test was performed on one of 180 flight-quality units produced for the Cassini mission and a series of sequential impact tests using simulant-fueled LWRHU capsules were conducted respectively. The results showed that deformation and fuel containment of the impacted Cassini LWRHU was similar to that of a previously tested Galileo LWRHU. Both units sustained minimal deformation of the aeroshell and fueled capsule; the fuel was entirely contained by the platinum capsule. Sequential impacting, in both end-on and side-on orientations, resulted in increased damage with each subsequent impact. Sequential impacting of the LWRHU appears to result in slightly greater damage than a single impact at the final impact velocity of 50 m/s

  7. Cryogenic explosion environment modeling and testing of space shuttle and light-weight radioisotope heater unit interactions

    International Nuclear Information System (INIS)

    Johnson, E.W.

    1985-10-01

    In order to assess the risk to the world's populace in the event of a Space Shuttle accident when radioisotope-containing heat sources are on board, testing of that system must be performed to determine release point, environments required, and the size distribution of the released fuel. To evaluate the performance of the Light-Weight Radioisotope Heater Unit (LWRHU) (101 of these 1-W items are placed on the Galileo spacecraft which will be launched from the Space Shuttle), some high-velocity impact and flyer plate testing was carried out. The results showed that a bare urania-fueled LWRHU clad (approximately 1-mm thick platinum-30 wt % rhodium alloy) will withstand 1100 m/s flyer plate (3.5-mm thick aluminum) impacts and 330 m/s impacts upon the Space Shuttle floor (approximately 12-mm thick aluminum) without rupture or fuel release. Velocities in the order of 600 m/s on a steel surface will cause clad failure with fuel release. The fuel breakup patterns were characterized as to quantity in a specific size range. These data were employed in the formal Safety Analysis Report for the LWRHU to support the planned 1986 Galileo launch. 19 figs

  8. Reentry response of the lightweight radioisotope heater unit resulting from a Cassini Venus-Venus-Earth-Jupiter gravity assist maneuver accident

    International Nuclear Information System (INIS)

    1996-12-01

    Reentry analyses consisting of ablation response, thermal response and thermal stress response have been conducted on the Lightweight Radioisotope Heater Unit (LWRHU) for Cassini/Venus-Venus-Earth-Jupiter-Gravity-Assist (VVEJGA) reentry conditions. Sequential ablation analyses of the LWRHU aeroshell, and the fuel pellet have been conducted in reentry regimes where the aeroshell has been deemed to fail. The failure criterion for ablation is generally assumed to be recession corresponding to 75% and 100% of the wall thickness. The 75% recession failure criteria allows for uncertainties that result mainly because of the high energies involved in the VVEJGA reentries compared to orbital decay reentries. Risk evaluations should consider the fact that for shallow flight paths the unit may disassemble at high-altitude as a result of ablation or may remain intact with a clad that had been molten. Within the limitations of the methodologies and assumptions of the analyses, the results indicate that: (1) For a side-on stable LWRHU reentry, aeroshell ablation failures occur for all reentry angles. (2)For a side-on spinning LWRHU reentry, aeroshell ablation failures are minimal. (3) For the tumbling LWRHU reentry, the aeroshell survives for most angles. (4) For the thermostructural analyses, using both a 1% and 5% allowable strain, all reentry angles and orientations examined resulted in small localized failures, but aeroshell breach is not predicted for any case. The analyses included in this report concentrate on VVEJGA reentry scenarios. Analyses reported previously have demonstrated that the LWRHU has adequate design margin to survive reentry from orbital decay scenarios and most injection scenarios at speeds up to escape speeds. The exception is a narrow range of flight path angles that produce multiple skip trajectories which may have excessive ablation

  9. Nuclear risk assessment for the Mars 2020 mission environmental impact statement.

    Energy Technology Data Exchange (ETDEWEB)

    Clayton, Daniel James; Bignell, John L.; Jones, Christopher Andrew; Rohe, Daniel Peter; Flores, Gregg J.; Bartel, Timothy James; Gelbard, Fred; Le, San; Morrow, Charles.; Potter, Donald L.; Young, Larry W.; Bixler, Nathan E.; Lipinski, Ronald J.

    2014-01-01

    In the summer of 2020, the National Aeronautics and Space Administration (NASA) plans to launch a spacecraft as part of the Mars 2020 mission. One option for the rover on the proposed spacecraft uses a Multi-Mission Radioisotope Thermoelectric Generator (MMRTG) to provide continuous electrical and thermal power for the mission. An alternative option being considered is a set of solar panels for electrical power with up to 80 Light-Weight Radioisotope Heater Units (LWRHUs) for local component heating. Both the MMRTG and the LWRHUs use radioactive plutonium dioxide. NASA is preparing an Environmental Impact Statement (EIS) in accordance with the National Environmental Policy Act. The EIS will include information on the risks of mission accidents to the general public and on-site workers at the launch complex. This Nuclear Risk Assessment (NRA) addresses the responses of the MMRTG or LWRHU options to potential accident and abort conditions during the launch opportunity for the Mars 2020 mission and the associated consequences. This information provides the technical basis for the radiological risks of both options for the EIS.

  10. Restarting TMI unit one: social and psychological impacts

    International Nuclear Information System (INIS)

    Sorensen, J.; Soderstrom, J.; Bolin, R.; Copenhaver, E.; Carnes, S.

    1983-12-01

    A technical background is provided for preparing an environmental assessment of the social and psychological impacts of restarting the undamaged reactor at Three Mile Island (TMI). Its purpose is to define the factors that may cause impacts, to define what those impacts might be, and to make a preliminary assessment of how impacts could be mitigated. It does not attempt to predict or project the magnitude of impacts. Four major research activities were undertaken: a literature review, focus-group discussions, community profiling, and community surveys. As much as possible, impacts of the accident at Unit 2 were differentiated from the possible impacts of restarting Unit 1. It is concluded that restart will generate social conflict in the TMI vicinity which could lead to adverse effects. Furthermore, between 30 and 50 percent of the population possess characteristics which are associated with vulnerability to experiencing negative impacts. Adverse effects, however, can be reduced with a community-based mitigation strategy

  11. Restarting TMI unit one: social and psychological impacts

    Energy Technology Data Exchange (ETDEWEB)

    Sorensen, J.; Soderstrom, J.; Bolin, R.; Copenhaver, E.; Carnes, S.

    1983-12-01

    A technical background is provided for preparing an environmental assessment of the social and psychological impacts of restarting the undamaged reactor at Three Mile Island (TMI). Its purpose is to define the factors that may cause impacts, to define what those impacts might be, and to make a preliminary assessment of how impacts could be mitigated. It does not attempt to predict or project the magnitude of impacts. Four major research activities were undertaken: a literature review, focus-group discussions, community profiling, and community surveys. As much as possible, impacts of the accident at Unit 2 were differentiated from the possible impacts of restarting Unit 1. It is concluded that restart will generate social conflict in the TMI vicinity which could lead to adverse effects. Furthermore, between 30 and 50 percent of the population possess characteristics which are associated with vulnerability to experiencing negative impacts. Adverse effects, however, can be reduced with a community-based mitigation strategy.

  12. Global climate change impacts in the United States

    Science.gov (United States)

    2009-06-01

    This report summarizes the science of climate change and the impacts of climate change on the United States, now and in the future. It is largely based on results of the U.S. Global Change Research Program (USGCRP), a and integrates those results wit...

  13. Upwind impacts of ammonia from an intensive poultry unit

    International Nuclear Information System (INIS)

    Jones, L.; Nizam, M.S.; Reynolds, B.; Bareham, S.; Oxley, E.R.B.

    2013-01-01

    This study investigated potential ammonia impacts on a sand dune nature reserve 600 m upwind of an intensive poultry unit. Ammonia concentrations and total nitrogen deposition were measured over a calendar year. A series of ammonia and nitrogen exposure experiments using dune grassland species were conducted in controlled manipulations and in the field. Ammonia emissions from the intensive poultry unit were detected up to 2.8 km upwind, contributing to exceedance of critical levels of ammonia 800 m upwind and exceedance of critical loads of nitrogen 2.8 km upwind. Emissions contributed 30% of the total N load in parts of the upwind conservation site. In the nitrogen exposure experiments, plants showed elevated tissue nitrogen contents, and responded to ammonia concentrations and nitrogen deposition loads observed in the conservation site by increasing biomass. Estimated long-term impacts suggest an increase in the soil carbon pool of 9% over a 50-year timescale. -- Highlights: •Ammonia from a poultry unit can be detected 2.8 km upwind. •Ammonia caused exceedance of critical levels 800 m and critical loads 2.8 km upwind. •Dune grassland species utilised ammonia as a nutrient source. •Plant biomass increased at low levels of ammonia and total nitrogen deposition. •Soil C pools are predicted to increase by 9% over 50 years due to the excess ammonia. -- Ammonia from a poultry unit has upwind impacts, exceeding critical levels 800 m and critical loads 2.8 km upwind, and increasing biomass and tissue N of dune grassland species

  14. [Evaluating the impact of the United Nations funding act].

    Science.gov (United States)

    1987-01-01

    Representatives of the principal donors supporting population assistance in India are concerned about the impact of the cuts in funds given by the US to the United Nations Fund for Population Activities (UNFPA). The suppression of US aid to the UNFPA will definitely affect the largest programs, including those in South Asia. India is the country receiving the most assistance from the UNFPA. The UNFPA contributed 63 million dollars for the current 5 year plan which began in April 1985. US spokesmen stated that UNFPA funding was cut off because of that organization's support for coercive family planning programs in China.

  15. Impacts of Climate Change on Human Health in the United ...

    Science.gov (United States)

    Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C

  16. Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

    Directory of Open Access Journals (Sweden)

    Jiming Liu

    Full Text Available INTRODUCTION: Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU on the wait time of cardiac surgery unit (SU. METHODS: This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool. RESULTS: Results show that: (i wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p < 0.01; (ii capacity of CU has a direct positive impact on demand of SU (β = 0.644, p < 0.01; (iii within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU. CONCLUSION: Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

  17. Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

    Science.gov (United States)

    Liu, Jiming; Tao, Li; Xiao, Bo

    2011-01-01

    Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time) of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU) on the wait time of cardiac surgery unit (SU). This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit) to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool. Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p relationships among different characteristics (except for the effect of throughput on wait time in SU). Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

  18. Environmental Impact Assessment for Olkiluoto 4 Nuclear Power Plant Unit in Finland

    International Nuclear Information System (INIS)

    Dersten, Riitta; Gahmberg, Sini; Takala, Jenni

    2008-01-01

    In order to improve its readiness for constructing additional production capacity, Teollisuuden Voima Oyj (TVO) initiated in spring 2007 the environmental impact assessment procedure (EIA procedure) concerning a new nuclear power plant unit that would possibly be located at Olkiluoto. When assessing the environmental impacts of the Olkiluoto nuclear power plant extension project, the present state of the environment was first examined, and after that, the changes caused by the projects as well as their significance were assessed, taking into account the combined impacts of the operations at Olkiluoto. The environmental impact assessment for the planned nuclear power plant unit covers the entire life cycle of the plant unit. (authors)

  19. Environmental Impact Assessment for Olkiluoto 4 Nuclear Power Plant Unit in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Dersten, Riitta; Gahmberg, Sini; Takala, Jenni [Teollisuuden Voima Oyj, Olkiluoto, FI-27160 Eurajoki (Finland)

    2008-07-01

    In order to improve its readiness for constructing additional production capacity, Teollisuuden Voima Oyj (TVO) initiated in spring 2007 the environmental impact assessment procedure (EIA procedure) concerning a new nuclear power plant unit that would possibly be located at Olkiluoto. When assessing the environmental impacts of the Olkiluoto nuclear power plant extension project, the present state of the environment was first examined, and after that, the changes caused by the projects as well as their significance were assessed, taking into account the combined impacts of the operations at Olkiluoto. The environmental impact assessment for the planned nuclear power plant unit covers the entire life cycle of the plant unit. (authors)

  20. Impact of Qualification Framework in United Arab Emirates: A case ...

    African Journals Online (AJOL)

    QFE) on the undergraduate Bachelor of Pharmacy (BPharm) curriculum in the United Arab Emirates (UAE) context. Method: Curriculum developers (faculty and other stakeholders) have selected appropriate teaching, learning and assessment ...

  1. A Design Method for Impact-Loaded Slender Armour Units

    DEFF Research Database (Denmark)

    Burcharth, Hans F.

    It is well known that the bigger a structural member like a beam, the relatively weaker it is. In the end it cannot even support its own weight. The same problem holds for slender armour units such as Dolosse.......It is well known that the bigger a structural member like a beam, the relatively weaker it is. In the end it cannot even support its own weight. The same problem holds for slender armour units such as Dolosse....

  2. Impact of Noise on Nurses in Pediatric Intensive Care Units.

    Science.gov (United States)

    Watson, J'ai; Kinstler, Angela; Vidonish, William P; Wagner, Michael; Lin, Li; Davis, Kermit G; Kotowski, Susan E; Daraiseh, Nancy M

    2015-09-01

    Excessive exposure to noise places nurses at risk for safety events, near-misses, decreased job performance, and fatigue. Noise is particularly a concern in pediatric intensive care units, where highly skilled providers and vulnerable patients require a quiet environment to promote healing. To measure noise levels and noise duration on specialty pediatric intensive care units to explore sources of noise and its effects on the health of registered nurses. In a cross-sectional pilot study, levels and sources of noise in 3 different specialty pediatric intensive care units were assessed. Fifteen nurses were observed for 4-hour sessions during a 24-hour period. Sound pressure levels (noise) and heart rate were measured continuously, and stress ratings were recorded. Descriptive statistics were calculated for noise (level, source, location, and activity), heart rate, and stress. The Pearson correlation coefficient was calculated to analyze the relationship between heart rate and noise. Mean noise level was 71.9 (SD, 9.2) dBA. Mean heart rate was 85.2/min (SD, 15.8/min) and was significantly associated with noise, unit, within-unit location, nurse sources, and noise activities. The most frequent sources of noise were patients' rooms, care activities, and staff communications. Noise levels in pediatric intensive care units exceed recommended thresholds and require immediate attention through effective interventions. Although noise was not associated with stress, a significant correlation with increased heart rate indicates that noise may be associated with adverse health outcomes. ©2015 American Association of Critical-Care Nurses.

  3. Climate change risks to United States infrastructure: impacts on coastal development, roads, bridges, and urban drainage

    Science.gov (United States)

    Changes in temperature, precipitation, sea level, and coastal storms will likely increase the vulnerability of infrastructure across the United States. Using four models of vulnerability, impacts, and adaptation of infrastructure, its deployment, and its role in protecting econom...

  4. The social impact of AIDS in the United States

    National Research Council Canada - National Science Library

    Jonsen, Albert R; Stryker, Jeff

    1993-01-01

    ... on Monitoring the Social Impact of the AIDS Epidemic Committee on AIDS Research and the Behavioral, Social, and Statistical Sciences Commission on Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1993 Copyrightthe cannot be not from book, paper however, version for formatting, original author...

  5. Multi-unit price promotions and their impact on purchase decisions and sales

    NARCIS (Netherlands)

    Drechsler, Salome; Leeflang, Peter S. H.; Bijmolt, Tammo H. A.; Natter, Martin

    2017-01-01

    Purpose - The purpose of this paper is to compare the impact of different multi-unit promotions (MUPs) and a single-unit promotion (SUP) on store-level sales and consumer-level purchase probability and quantity decision. Design/methodology/approach - The paper combines two empirical studies. Study 1

  6. The impact of unit cost reductions on gross profit: Increasing or decreasing returns?

    Directory of Open Access Journals (Sweden)

    Ely Dahan

    2011-09-01

    Full Text Available We suggest that marketers actively participate in reducing unit costs during new product development, consistent with the theme of integrated marketing and manufacturing. Most marketing managers misjudge the impact on gross profit of reducing variable unit manufacturing costs, mistakenly believing that such cost reductions yield decreasing or linear returns while they actually generate increasing returns.

  7. Evaluation of tectonic impact on radon level of lithological units

    International Nuclear Information System (INIS)

    Wolkowicz, S.; Strzelecki, R.

    2000-01-01

    The radon potential maps of the Sudetes Mountains and Upper Silesian Coal Basin have been prepared on a base of arithmetic mean value of radon concentration in soil air in distinguished lithological/stratigraphic units. Both zones of shallow position of ground table and the fault zones influence value of this parameter: the first one affects in specific conditions lowering of background values, the second ones - origin of values several and teen times higher than rock background values. Estimation of power of tectonic influence on general radon potential of the lithological units has been made on a base of examination of histograms of distribution of radon concentration in soil air. In the Sudetes area, 0 % to about 30 % of the measurements is related to fault zones. Higher tectonic engagement (about 30 %) characterizes the Karkonosze Granites, Izera Gneisses and Strzegom Granites. In the cases of Karkonosze Granites and the Strzegom Granites, rock background values concentrations in soil air are a little than 50 kBq/m 3 , what is the value defined for lower threshold of high radon risk areas. In conclusion, presence of numerous fault zones and fissures increases radon risk category with one class. Background modal values of radon emanations, defined for the studied units, in the 5 cases fulfill criteria for medium radon risk areas, and in other cases do not exceed of the threshold 10 kBq/m 3 . It displays, that in the case of low radon potential rocks only a few-percent rich population of measurements related to tectonic zones, is sufficient to substantially deform of the image of the studied unit radon potential. For instance, medium radon potential characterizes the Klodzko - Zloty Stok Granites (the arithmetic mean value of this class is 36.15 kBq/m 3 , n=104) and small tectonic engagement (about 3.8 %). In the result the modal value belongs to the class 20-30 kBq/m 3 . The Poreba Beds in the Upper Silesian Coal Basin are characterised by almost the same radon

  8. Impact of Locality on Location Aware Unit Disk Graphs

    Directory of Open Access Journals (Sweden)

    Evangelos Kranakis

    2008-09-01

    Full Text Available Due to their importance for studies oi wireless networks, recent years have seen a surge of activity on the design of local algorithms for the solution of a variety of network tasks. We study the behaviour of algorithms with very low localities. Despite of this restriction we propose local constant ratio approximation algorithms for solving minimum dominating and connected dominating set, maximum independent set and minimum vertex cover in location aware Unit Disk Graphs. We also prove the first ever lower bounds for local algorithms for these problems with a given locality in the location aware setting.

  9. Nonnative forest insects and pathogens in the United States: impacts and policy options

    Science.gov (United States)

    Gary M. Lovett; Marissa Weiss; Andrew M. Liebhold; Tom Holmes; Brian Leung; Kathy-Fallon Lambert; David A. Orwig; Faith T. Campbell; Jonathan Rosenthal; Deborah G. McCullough; Radka Wildova; Matthew P. Ayres; Charles D. Canham; David R. Foster; Shannon L. LaDeau; Troy Weldy

    2016-01-01

    We review and synthesize information on invasions of nonnative forest insects and diseases in the United States, including their ecological and economic impacts, pathways of arrival, distribution within the United States, and policy options for reducing future invasions. Nonnative insects have accumulated in United States forests at a rate of ~2.5 per yr over the last...

  10. The Impact of Climate Change on the United States Economy

    Science.gov (United States)

    Mendelsohn, Robert; Neumann, James E.

    2004-08-01

    Understanding the impacts of climate change on economic behaviour is an important aspect of deciding when to take policy actions to prevent or mitigate its consequences. This book applies advanced new economics methodologies to assess impacts on potentially vulnerable aspects of the US economy: agriculture, timber, coastal resources, energy expenditure, fishing, outdoor recreation. It is intended to provide improved understanding of key issues raised in the recent Intergovernmental Panel on Climate Change (IPCC) reports. It concludes that some climate change may produce economic gains in the agriculture and forestry sectors, whereas energy, coastal structures, and water sectors may be harmed. The book will serve as an important reference for the scientific, economic, and policy community, and will also be of interest to natural resource/environmental economists as an example of economic valuation techniques. The volume will clearly be of main importance to researchers and policymakers in the US, but will also be influential as a model for assessment of impacts on economies worldwide.

  11. 75 FR 18572 - Supplemental Environmental Impact Statement for Sequoyah Nuclear Plant Units 1 and 2 License...

    Science.gov (United States)

    2010-04-12

    ... TENNESSEE VALLEY AUTHORITY Supplemental Environmental Impact Statement for Sequoyah Nuclear Plant... National Environmental Policy Act. TVA will prepare a supplemental environmental impact statement (SEIS) to update information in the 1974 Final Environmental Statement for Sequoyah Nuclear Plant Units 1 and 2...

  12. Impact of a VAP bundle in Belgian intensive care units.

    Science.gov (United States)

    Jadot, Laurent; Huyghens, Luc; De Jaeger, Annick; Bourgeois, Marc; Biarent, Dominique; Higuet, Adeline; de Decker, Koen; Vander Laenen, Margot; Oosterlynck, Baudewijn; Ferdinande, Patrick; Reper, Pascal; Brimioulle, Serge; Van Cromphaut, Sophie; De Clety, Stéphane Clement; Sottiaux, Thierry; Damas, Pierre

    2018-05-21

    In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients. For each of these, data about the application of the bundle and the possible treatment for VAP were recorded. Between 36.6 and 54.8% of the 120 Belgian ICUs participated in the successive surveys. While the characteristics of ventilated patients remained similar throughout the years, the percentage of ventilated patients and especially the duration of ventilation significantly decreased before and after the national VAP bundle campaign. Ventilator care also profoundly changed: Controlling cuff pressure, head positioning above 30° were obtained in more than 90% of cases. Oral care was more frequently performed within a day, using more concentrated solutions of chlorhexidine. Subglottic suctioning also was used but in only 24.7% of the cases in the last years. Regarding the prevalence of VAP, it significantly decreased from 28% of ventilated patients in 2010 to 10.1% in 2016 (p ≤ 0.0001). Although a causal relationship cannot be inferred from these data, the successive surveys revealed a potential impact of the VAP bundle campaign on both the respiratory care of ventilated patients and the prevalence of VAP in Belgian ICUs encouraging them to follow the guidelines.

  13. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    Science.gov (United States)

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-12-01

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  14. Electric power industry deregulation in the United States: impacts on U.S. and Canadian markets

    Energy Technology Data Exchange (ETDEWEB)

    Hall, G.R. [Putnam, Hayes and Bartlett, Inc., Cambridge, MA (United States)

    1996-10-01

    An overview of the restructuring and deregulation of the United States electric power industry and the implications for the North American natural gas industry was presented. Electric power restructuring and its effect on wholesale and retail competition was discussed. It was suggested that although in the short term electric power deregulation impacts negatively on the natural gas industry, the long term impacts are favourable. The short term impact on the natural gas industry will mean increased competition and downward pressure on gas prices. In contrast, the long term impact could mean increased reliance on gas for electric power generation and convergence of the electric power and natural gas industries.

  15. Extra-regulatory impact tests and analyses of the structural evaluation test unit

    International Nuclear Information System (INIS)

    Ludwigsen, J.S.; Ammerman, D.J.

    1995-01-01

    The structural evaluation test unit is roughly equivalent to a 1/3 scale model of a high level waste rail cask. The test unit was designed to just meet the requirements of NRC Regulatory Guide 7.6 when subjected to a 9 m (30 ft) free drop resulting in an impact velocity of 13.4 m/s (30 mph) onto an unyielding target in the end-on orientation. The test unit was then subjected to impacts with higher velocities to determine the amount of built-in conservatism in this design approach. Test impacts of 13.4, 20.1 and 26.8 m/s (30, 45, and 60 mph) were performed. This paper will describe the design, testing, and comparison of measured strains and deformations to the equivalent analytical predictions

  16. Modelling of an industrial NGL-Recovery unit considering environmental and economic impacts

    International Nuclear Information System (INIS)

    Sharratt, P. N.; Hernandez-Enriquez, A.; Flores-Tlacuahuac, A.

    2009-01-01

    In this work, an integrated model is presented that identifies key areas in the operation of a cryogenic NGL-recovery unit. This methodology sets out to provide deep understanding of various interrelationship across multiple plant operating factors including reliability, which could be essential for substantial improvement of process performance. The integrated model has been developed to predict the economic and environmental impacts of a real cryogenic unit (600 MMCUF/D) during normal operation, and has been built in Aspen TM. (Author)

  17. Biophysical impacts of climate-smart agriculture in the Midwest United States.

    Science.gov (United States)

    Bagley, Justin E; Miller, Jesse; Bernacchi, Carl J

    2015-09-01

    The potential impacts of climate change in the Midwest United States present unprecedented challenges to regional agriculture. In response to these challenges, a variety of climate-smart agricultural methodologies have been proposed to retain or improve crop yields, reduce agricultural greenhouse gas emissions, retain soil quality and increase climate resilience of agricultural systems. One component that is commonly neglected when assessing the environmental impacts of climate-smart agriculture is the biophysical impacts, where changes in ecosystem fluxes and storage of moisture and energy lead to perturbations in local climate and water availability. Using a combination of observational data and an agroecosystem model, a series of climate-smart agricultural scenarios were assessed to determine the biophysical impacts these techniques have in the Midwest United States. The first scenario extended the growing season for existing crops using future temperature and CO2 concentrations. The second scenario examined the biophysical impacts of no-till agriculture and the impacts of annually retaining crop debris. Finally, the third scenario evaluated the potential impacts that the adoption of perennial cultivars had on biophysical quantities. Each of these scenarios was found to have significant biophysical impacts. However, the timing and magnitude of the biophysical impacts differed between scenarios. © 2014 John Wiley & Sons Ltd.

  18. The impact of environmental regulations on United States crude oil supplies

    International Nuclear Information System (INIS)

    Godec, M.L.; Biglarbigi, K.

    1991-01-01

    A number of legislative and regulatory initiatives being considered to protect the environment could affect the economics of oil and gas exploration and production (E and P) in the Unites States. This paper summarizes the results of a comprehensive assessment of the potential cumulative energy and economic impacts of environmental regulatory initiatives on United States crude oil supplies. The results of the analysis clearly will determine the level of impact, but the results show that significant impacts are felt over a wide range of regulations, over a wide range of crude oil prices, and at two levels of development for extraction technologies. The regulations evaluated all have an impact on all resource categories analyzed in the study

  19. Evaluation of unit risk factors in support of the Hanford Remedial Action Environmental Impact Statement

    International Nuclear Information System (INIS)

    Strenge, D.L.; Chamberlain, P.J. II.

    1994-11-01

    This report describes the generation of unit risk factors for use with the Graphical Information System (GIS) being developed by Advanced Sciences, Inc. for the Hanford Remedial Action Environmental Impact Statement. The GIS couples information on source inventory and environmental transport with unit risk factors to estimate the potential risk from contamination at all locations on the Hanford Site. The major components of the effort to generate the unit risk factors were: determination of pollutants to include in the study, definition of media of concern, and definition of exposure assessment scenarios, methods, and parameters. The selection of pollutants was based on inventory lists which indicated the pollutants likely to be encountered at the known waste sites. The final pollutants selected included 47 chemical pollutants and 101 radionuclides. Unit risk factors have been generated for all 148 pollutants per unit initial concentration in five media: soil (per unit mass), soil (per unit area), air, groundwater, and surface water. The exposure scenarios were selected as the basis for the unit risk factor generation. The endpoint in the exposure assessment analysis is expressed as risk of developing cancer for radionuclides and carcinogenic chemicals. For noncarcinogenic chemicals, the risk endpoint is the hazard quotient. The cancer incidence and hazard quotient values are evaluated for all exposure pathways, pollutants, and scenarios. The hazard index values and unit risk values are used by the GIS to produce maps of risk for the Hanford Site

  20. The potential impacts of climate variability and change on health impacts of extreme weather events in the United States.

    Science.gov (United States)

    Greenough, G; McGeehin, M; Bernard, S M; Trtanj, J; Riad, J; Engelberg, D

    2001-05-01

    Extreme weather events such as precipitation extremes and severe storms cause hundreds of deaths and injuries annually in the United States. Climate change may alter the frequency, timing, intensity, and duration of these events. Increases in heavy precipitation have occurred over the past century. Future climate scenarios show likely increases in the frequency of extreme precipitation events, including precipitation during hurricanes, raising the risk of floods. Frequencies of tornadoes and hurricanes cannot reliably be projected. Injury and death are the direct health impacts most often associated with natural disasters. Secondary effects, mediated by changes in ecologic systems and public health infrastructure, also occur. The health impacts of extreme weather events hinge on the vulnerabilities and recovery capacities of the natural environment and the local population. Relevant variables include building codes, warning systems, disaster policies, evacuation plans, and relief efforts. There are many federal, state, and local government agencies and nongovernmental organizations involved in planning for and responding to natural disasters in the United States. Future research on health impacts of extreme weather events should focus on improving climate models to project any trends in regional extreme events and as a result improve public health preparedness and mitigation. Epidemiologic studies of health effects beyond the direct impacts of disaster will provide a more accurate measure of the full health impacts and will assist in planning and resource allocation.

  1. The impact of financial and nonfinancial incentives on business-unit outcomes over time.

    Science.gov (United States)

    Peterson, Suzanne J; Luthans, Fred

    2006-01-01

    Unlike previous behavior management research, this study used a quasi-experimental, control group design to examine the impact of financial and nonfinancial incentives on business-unit (21 stores in a fast-food franchise corporation) outcomes (profit, customer service, and employee turnover) over time. The results showed that both types of incentives had a significant impact on all measured outcomes. The financial incentive initially had a greater effect on all 3 outcomes, but over time, the financial and nonfinancial incentives had an equally significant impact except in terms of employee turnover. (c) 2006 APA, all rights reserved.

  2. The impact of parameter identification methods on drug therapy control in an intensive care unit

    NARCIS (Netherlands)

    Hann, C.E.; Chase, J.G.; Ypma, M.F.; Elfring, J.; Nor, N.H.M.; Lawrence, P.; Shaw, G.M.

    2008-01-01

    This paper investigates the impact of fast parameter identification methods, which do not require any forward simulations, on model-based glucose control, using retrospective data in the Christchurch Hospital Intensive Care Unit. The integral-based identification method has been previously

  3. Economic Impacts of Non-Native Forest Insects in the Continental United States

    Science.gov (United States)

    Juliann E. Aukema; Brian. Leung; Kent Kovacs; Corey Chivers; Jeffrey Englin; Susan J. Frankel; Robert G. Haight; Thomas P. Holmes; Andrew M. Liebhold; Deborah G. McCullough; Betsy. Von Holle

    2011-01-01

    Reliable estimates of the impacts and costs of biological invasions are critical to developing credible management, trade and regulatory policies. Worldwide, forests and urban trees provide important ecosystem services as well as economic and social benefits, but are threatened by non-native insects. More than 450 non-native forest insects are established in the United...

  4. Knowledge Gaps Impacting the Development of Bovine Viral Diarrhea Virus Control Programs in the United States

    Science.gov (United States)

    This paper identifies knowledge gaps that impact on the design of programs to control and or eradicate bovine viral diarrhea viruses (BVDV) in the United States. Currently there are several voluntary regional BVDV control programs in place. These control programs are aimed at the removal of animals ...

  5. Impacts of multiple stresses on water demand and supply across the southeastern United States

    Science.gov (United States)

    Ge Sun; Steven G. McNulty; Jennifer A. Moore Myers; Erika C. Cohen

    2008-01-01

    Assessment of long-term impacts of projected changes in climate, population, and land use and land cover on regional water resource is critical to the sustainable development of the southeastern United States. The objective of this study was to fully budget annual water availability for water supply (precipitation ) evapotranspiration + groundwater supply + return flow...

  6. The Eugenics Movement and Its Impact on Art Education in the United States

    Science.gov (United States)

    Hunter-Doniger, Tracey

    2017-01-01

    This article argues that the eugenics movement has had three major influences on education in the United States, and reveals how these influences have had an impact on visual arts education in particular. The first influence began with a debate between John Dewey and David Snedden that resulted in a two-tiered tracking system that separated…

  7. Climate change impacts on extreme temperature mortality in select metropolitan areas of the United States

    Science.gov (United States)

    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 ...

  8. Climate change impacts on freshwater fish, coral reefs, and related ecosystem services in the United States

    Science.gov (United States)

    We analyzed the potential physical and economic impacts of climate change on freshwater fisheries and coral reefs in the United States, examining a reference scenario and two policy scenarios that limit global greenhouse gas (GHG) emissions. We modeled shifts in suitable habitat ...

  9. Impact of trucking network flow on preferred biorefinery locations in the southern United States

    Science.gov (United States)

    Timothy M. Young; Lee D. Han; James H. Perdue; Stephanie R. Hargrove; Frank M. Guess; Xia Huang; Chung-Hao Chen

    2017-01-01

    The impact of the trucking transportation network flow was modeled for the southern United States. The study addresses a gap in existing research by applying a Bayesian logistic regression and Geographic Information System (GIS) geospatial analysis to predict biorefinery site locations. A one-way trucking cost assuming a 128.8 km (80-mile) haul distance was estimated...

  10. United States versus Mexican Perceptions of the Impact of the North American Free Trade Agreement.

    Science.gov (United States)

    Nicholson, Joel D.; And Others

    1994-01-01

    Surveys U.S. and Mexican managerial attitudes concerning the impact of the North American Free Trade Agreement (NAFTA) process on the United States. Discusses differences in Mexican and U.S. attitudes concerning NAFTA and a number of socioeconomic concerns. (SR)

  11. Analysis of potential impacts of climate change on forests of the United States Pacific Northwest

    Science.gov (United States)

    Gregory Latta; Hailemariam Temesgen; Darius Adams; Tara Barrett

    2010-01-01

    As global climate changes over the next century, forest productivity is expected to change as well. Using PRISM climate and productivity data measured on a grid of 3356 plots, we developed a simultaneous autoregressive model to estimate the impacts of climate change on potential productivity of Pacific Northwest forests of the United States. The model, coupled with...

  12. Environmental impact of accident-free transportation of radioactive material in the United States

    International Nuclear Information System (INIS)

    Taylor, J.M.; Smith, D.R.; Luna, R.E.

    1978-01-01

    A recent study performed for the Nuclear Regulatory Commission (NRC) by Sandia Laboratories which considered transportation of radioactive materials in the United States suggests that a significant portion of the radiological impact results from accident-free transport. This paper explores the basis for that conclusion

  13. Improving teamwork: impact of structured interdisciplinary rounds on a hospitalist unit.

    Science.gov (United States)

    O'Leary, Kevin J; Haviley, Corinne; Slade, Maureen E; Shah, Hiren M; Lee, Jungwha; Williams, Mark V

    2011-02-01

    Effective collaboration and teamwork is essential in providing safe and effective care. Research reveals deficiencies in teamwork on medical units involving hospitalists. The aim of this study was to assess the impact of an intervention, Structured Inter-Disciplinary Rounds (SIDR), on nurses' ratings of collaboration and teamwork. The study was a controlled trial involving an intervention and control hospitalist unit. The intervention, SIDR, combined a structured format for communication with a forum for regular interdisciplinary meetings. We asked nurses to rate the quality of communication and collaboration with hospitalists using a 5-point ordinal scale. We also assessed teamwork and safety climate using a validated instrument. Multivariable regression analyses were used to assess the impact on length of stay (LOS) and cost using both a concurrent and historic control. A total of 49 of 58 (84%) nurses completed surveys. A larger percentage of nurses rated the quality of communication and collaboration with hospitalists as high or very high on the intervention unit compared to the control unit (80% vs. 54%; P = 0.05). Nurses also rated the teamwork and safety climate significantly higher on the intervention unit (P = 0.008 and P = 0.03 for teamwork and safety climate, respectively). Multivariable analyses demonstrated no difference in the adjusted LOS and an inconsistent effect on cost. SIDR had a positive effect on nurses' ratings of collaboration and teamwork on a hospitalist unit, yet no impact on LOS and cost. Further study is required to assess the impact of SIDR on patient safety measures. Copyright © 2010 Society of Hospital Medicine.

  14. International stem cell collaboration: how disparate policies between the United States and the United Kingdom impact research.

    Science.gov (United States)

    Luo, Jingyuan; Flynn, Jesse M; Solnick, Rachel E; Ecklund, Elaine Howard; Matthews, Kirstin R W

    2011-03-08

    As the scientific community globalizes, it is increasingly important to understand the effects of international collaboration on the quality and quantity of research produced. While it is generally assumed that international collaboration enhances the quality of research, this phenomenon is not well examined. Stem cell research is unique in that it is both politically charged and a research area that often generates international collaborations, making it an ideal case through which to examine international collaborations. Furthermore, with promising medical applications, the research area is dynamic and responsive to a globalizing science environment. Thus, studying international collaborations in stem cell research elucidates the role of existing international networks in promoting quality research, as well as the effects that disparate national policies might have on research. This study examined the impact of collaboration on publication significance in the United States and the United Kingdom, world leaders in stem cell research with disparate policies. We reviewed publications by US and UK authors from 2008, along with their citation rates and the political factors that may have contributed to the number of international collaborations. The data demonstrated that international collaborations significantly increased an article's impact for UK and US investigators. While this applied to UK authors whether they were corresponding or secondary, this effect was most significant for US authors who were corresponding authors. While the UK exhibited a higher proportion of international publications than the US, this difference was consistent with overall trends in international scientific collaboration. The findings suggested that national stem cell policy differences and regulatory mechanisms driving international stem cell research in the US and UK did not affect the frequency of international collaborations, or even the countries with which the US and UK most

  15. The Leapfrog initiative for intensive care unit physician staffing and its impact on intensive care unit performance: a narrative review.

    Science.gov (United States)

    Gasperino, James

    2011-10-01

    The field of critical care has changed markedly in recent years to accommodate a growing population of chronically critically ill patients. New administrative structures have evolved to include divisions, departments, and sections devoted exclusively to the practice of critical care medicine. On an individual level, the ability to manage complex multisystem critical illnesses and to introduce invasive monitoring devices defines the intensivist. On a systems level, critical care services managed by an intensivist-led multidisciplinary team are now recognized by their ability to efficiently utilize hospital resources and improve patient outcomes. Due to the numerous cost and quality issues related to the delivery of critical care medicine, intensive care unit physician staffing (IPS) has become a charged subject in recent years. Although the federal government has played a large role in regulating best practices by physicians, other third parties have entered the arena. Perhaps the most influential of these has been The Leapfrog Group, a consortium representing 130 employers and 65 Fortune 500 companies that purchase health care for their employees. This group has proposed specific regulatory guidelines for IPS that are purported to result in substantial cost containment and improved quality of care. This narrative review examines the impact of The Leapfrog Group's recommendations on critical care delivery in the United States. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Offshore Wind Jobs and Economic Development Impacts in the United States: Four Regional Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Tegen, S. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Keyser, D. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Flores-Espino, F. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Miles, J. [James Madison Univ., Harrisonburg, VA (United States); Zammit, D. [James Madison Univ., Harrisonburg, VA (United States); Loomis, D. [Great Lakes Wind Network, Cleveland, OH (United States)

    2015-02-01

    This report uses the offshore wind Jobs and Economic Development Impacts (JEDI) model and provides four case studies of potential offshore deployment scenarios in different regions of the United States: the Southeast, the Great Lakes, the Gulf Coast, and the Mid-Atlantic. Researchers worked with developers and industry representatives in each region to create potential offshore wind deployment and supply chain growth scenarios, specific to their locations. These scenarios were used as inputs into the offshore JEDI model to estimate jobs and other gross economic impacts in each region.

  17. The Application of Load-cell Technique in the Study of Armour Unit Responses to Impact Loads

    OpenAIRE

    Burcharth, H. F.; Liu, Zhou

    1994-01-01

    The slender, complex types of armour units, such as Tetrapods and Dolosse arewidely used for rubble mound breakwaters. Many of the recent failures of such structures were caused by unforeseen early breakage of the units, thus revealing an inbalance between the strength (structural integrity) of the units and the hydraulic stability (resistance to displacements) of the armour layers. Breakage is caused by stresses from static, pulsating and impact loads. Impact load generated stresses are diff...

  18. The Application of Load-cell Technique in the Study of Armour Unit Responses to Impact Loads Tests

    OpenAIRE

    Burcharth, H. F.; Liu, Z.

    1995-01-01

    The slender, complex types of armour units, such as Tetrapods and Dolosse arewidely used for rubble mound breakwaters. Many of the recent failures of suchstructures were caused by unforeseen early breakage of the units, thus revealingan in balance between the strength (structural integrity) of the units and thehydraulic stability (resistance to displacements) of the armour layers. Breakageis caused by stresses from static, pulsating and impact loads. Impact load generated stresses are difficu...

  19. Life-Cycle Assessment of Prototype Unit of Emergency Housing. The search for the zero impact

    Directory of Open Access Journals (Sweden)

    J. M. Ros García

    2017-09-01

    Full Text Available Prototype Unit of Emergency Housing (PUEH is the result of the Applied Research Project VEM (Military Emergency Housing developed in collaboration with Escuela Politécnica Superior (Universidad CEU and the company Air-bus Defense & Space. It is designed as a modular and industrialized unit of basic habitability, with programmed and expandable growth, designed to provide shelter and protection in environments of humanitarian crises or contingencies of social vulnerability in order to ensure sustainable habitat for emergencies.The influence of the construction processes and materials involved in the manufacture of this PUEH have on the environment, analyzed using the methodology of life-cycle assessment (LCA, considered especially critical recycling the mate-rials used. Thus, in order to reduce the environmental impact environmental, each of the component parts of the developed prototype unit are quantified, evaluating the benefits resulting from the methodology DfMA (Design for Manufacturing and Assembly.

  20. Carcinogenic Air Toxics Exposure and Their Cancer-Related Health Impacts in the United States.

    Directory of Open Access Journals (Sweden)

    Ying Zhou

    Full Text Available Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary, and three-component (ternary combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs. We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although

  1. Carcinogenic Air Toxics Exposure and Their Cancer-Related Health Impacts in the United States.

    Science.gov (United States)

    Zhou, Ying; Li, Chaoyang; Huijbregts, Mark A J; Mumtaz, M Moiz

    2015-01-01

    Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs) combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA) by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary), and three-component (ternary) combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs). We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although there are many

  2. The assessment of impact on nuclear power plant structures in the United Kingdom

    International Nuclear Information System (INIS)

    Fullard, K.; Baum, M.R.

    1991-01-01

    Impact research in the United Kingdom has embraced a wide range of topics during the last fifteen years and advice has been provided in the form of guidelines for use in safety assessments and design studies. It is now the intention to produce a comprehensive Impact Assessment Procedure encompassing the definition of loading, whipping pipe effects and the response of steel and concrete targets. This paper is restricted to introducing the methods used for characterising missiles from pressurised vessels and for determining the impact damage produced in concrete targets. Considerable reliance has been placed on the interpretation of experimental data and guidance is therefore limited by the availability of such data. This paper indicates the extent to which advice can be given and the issues which still need further attention. An example is given of the use of the methods for characterising missiles from a cylindrical pressure vessel. (orig.)

  3. Economic impacts of oil spills: Spill unit costs for tankers, pipelines, refineries, and offshore facilities

    International Nuclear Information System (INIS)

    1993-01-01

    The impacts of oil spills -- ranging from the large, widely publicized Exxon Valdez tanker incident to smaller pipeline and refinery spills -- have been costly to both the oil industry and the public. For example, the estimated costs to Exxon of the Valdez tanker spill are on the order of $4 billion, including $2.8 billion (in 1993 dollars) for direct cleanup costs and $1.125 billion (in 1992 dollars) for settlement of damages claims caused by the spill. Application of contingent valuation costs and civil lawsuits pending in the State of Alaska could raise these costs appreciably. Even the costs of the much smaller 1991 oil spill at Texaco's refinery near Anacortes, Washington led to costs of $8 to 9 million. As a result, inexpensive waming, response and remediation technologies could lower oil spin costs, helping both the oil industry, the associated marine industries, and the environment. One means for reducing the impact and costs of oil spills is to undertake research and development on key aspects of the oil spill prevention, warming, and response and remediation systems. To target these funds to their best use, it is important to have sound data on the nature and size of spills, their likely occurrence and their unit costs. This information could then allow scarce R ampersand D dollars to be spent on areas and activities having the largest impact. This report is intended to provide the ''unit cost'' portion of this crucial information. The report examines the three key components of the US oil supply system, namely, tankers and barges; pipelines and refineries; and offshore production facilities. The specific purpose of the study was to establish the unit costs of oil spills. By manipulating this key information into a larger matrix that includes the size and frequency of occurrence of oil spills, it will be possible' to estimate the likely future impacts, costs, and sources of oil spills

  4. Heavy Drinkers and the Potential Impact of Minimum Unit Pricing-No Single or Simple Effect?

    Science.gov (United States)

    Gill, J; Black, H; Rush, R; O'May, F; Chick, J

    2017-11-01

    To explore the potential impact of a minimum unit price (MUP: 50 pence per UK unit) on the alcohol consumption of ill Scottish heavy drinkers. Participants were 639 patients attending alcohol treatment services or admitted to hospital with an alcohol-related condition. From their reported expenditure on alcohol in their index week, and assuming this remained unchanged, we estimated the impact of a MUP (50 ppu) on future consumption. (Around 15% purchased from both the more expensive on-sale outlets (hotels, pubs, bars) and from off-sales (shops and supermarkets). For them we estimated the change in consumption that might follow MUP if (i) they continued this proportion of 'on-sales' purchasing or (ii) their reported expenditure was moved entirely to off-sale purchasing (to maintain consumption levels)). Around 69% of drinkers purchased exclusively off-sale alcohol at sales purchases could support, for some, an increase in consumption. While a proportion of our harmed, heavy drinkers might be able to mitigate the impact of MUP by changing purchasing habits, the majority are predicted to reduce purchasing. This analysis, focusing specifically on harmed drinkers, adds a unique dimension to the evidence base informing current pricing policy. From drink purchasing data of heavy drinkers, we estimated the impact of legislating £0.50 minimum unit price. Over two thirds of drinkers, representing all multiple deprivation quintiles, were predicted to decrease alcohol purchasing; remainder, hypothetically, could maintain consumption. Our data address an important gap within the evidence base informing policy. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  5. Economic and demographic impacts of passenger rail systems : the impact of intercity passenger rails on population and employment change in the United States, 2000-2010.

    Science.gov (United States)

    2015-12-01

    This research examines the impact of intercity passenger rails on change in population and employment at the county level in the continental United States from 2000 to 2010. This research adopts an integrated spatial regression approach that incorpor...

  6. The economics of power generation in Alberta : the pool price impact of Genesee Unit 3

    International Nuclear Information System (INIS)

    Topping, D.

    2003-01-01

    Alberta power pool prices for year 2000 were reviewed. The model assumptions were: studies based on PROSYM market simulations; base-load units offered at incremental cost; and, considerations in those cases where system gas units were modeled as coal units. The current situation in Alberta was reviewed. The Genesee 3 coal-fired facility is expected to be completed in the Winter 2004-2005 with an efficiency of 8 to 18 per cent better than other coal units. A graph was shown to examine the expected impact of Genesee 3 on Alberta prices. Electricity prices would increase during the period 2005-2008 without Genesee 3. Alberta prices are affected by factors such as: load-resource balance, fuel prices, cost of new capacity, offer strategy, available transmission, and tie lines. A capacity surplus is expected for the period 2003-2008. In addition, good correlation is expected for pool prices with gas prices. With Genesee 3 in operation, lower pool prices are expected in Alberta. figs

  7. Impact of a mental health training course for correctional officers on a special housing unit.

    Science.gov (United States)

    Parker, George F

    2009-05-01

    This study determined the impact of a ten-hour mental health training program developed by the Indiana chapter of the National Alliance on Mental Illness (NAMI-Indiana) for correctional officers on a prison special housing ("supermax") unit. The training was delivered to all of the correctional officers on the unit in five weekly sessions and was repeated 15 months later for new unit staff. The number of incidents reported by unit staff in standard monthly reports, consisting of use of force by the officers and battery by bodily waste on the officers by the offenders, was compared for the nine months before and after both training sessions. Attendance at the initial training ranged from 48 to 57 officers per session, and on the basis of Likert ratings, training was well received by the officers. The total number of incidents, the use of force by the officers, and battery by bodily waste all declined significantly after the first mental health training, and the total number of incidents and battery by bodily waste declined significantly after the second training. The provision of ten hours of mental health training to correctional officers was associated with a significant decline in use of force and battery by bodily waste.

  8. Visitation in the intensive care unit: impact on infection prevention and control.

    Science.gov (United States)

    Adams, Sheila; Herrera, Amando; Miller, Laura; Soto, Rhonda

    2011-01-01

    Evidence-based practice has shown that open visitation in the intensive care setting positively impacts patient outcomes. However, many intensive care units continue to strictly limit visitation hours. One concern for nurses is that open visitation will expose their vulnerable patients to an increased risk of infection. This fear is unfounded in professional literature as well as in the experience of a busy intensive care unit in San Antonio, Texas. Keeping our patients safe from hospital-acquired infections requires vigilant attention to infection prevention procedures. Meanwhile, what may actually be bugging our patients is a health care culture that is based on tradition and is blind to the many benefits provided by a more liberal visitation policy rooted in patient-centered care.

  9. Scale dependence of disease impacts on quaking aspen (Populus tremuloides) mortality in the southwestern United States

    Science.gov (United States)

    Bell, David M.; Bradford, John B.; Lauenroth, William K.

    2015-01-01

    Depending on how disease impacts tree exposure to risk, both the prevalence of disease and disease effects on survival may contribute to patterns of mortality risk across a species' range. Disease may accelerate tree species' declines in response to global change factors, such as drought, biotic interactions, such as competition, or functional traits, such as allometry. To assess the role of disease in mediating mortality risk in quaking aspen (Populus tremuloides), we developed hierarchical Bayesian models for both disease prevalence in live aspen stems and the resulting survival rates of healthy and diseased aspen near the species' southern range limit using 5088 individual trees on 281 United States Forest Service Forest Inventory and Analysis plots in the southwestern United States.

  10. Use of Internet Search Data to Monitor Rotavirus Vaccine Impact in the United States, United Kingdom, and Mexico.

    Science.gov (United States)

    Shah, Minesh P; Lopman, Benjamin A; Tate, Jacqueline E; Harris, John; Esparza-Aguilar, Marcelino; Sanchez-Uribe, Edgar; Richardson, Vesta; Steiner, Claudia A; Parashar, Umesh D

    2018-02-19

    Previous studies have found a strong correlation between internet search and public health surveillance data. Less is known about how search data respond to public health interventions, such as vaccination, and the consistency of responses in different countries. In this study, we aimed to study the correlation between internet searches for "rotavirus" and rotavirus disease activity in the United States, United Kingdom, and Mexico before and after introduction of rotavirus vaccine. We compared time series of internet searches for "rotavirus" from Google Trends with rotavirus laboratory reports from the United States and United Kingdom and with hospitalizations for acute gastroenteritis in the United States and Mexico. Using time and location parameters, Google quantifies an internet query share (IQS) to measure the relative search volume for specific terms. We analyzed the correlation between IQS and laboratory and hospitalization data before and after national vaccine introductions. There was a strong positive correlation between the rotavirus IQS and laboratory reports in the United States (R2 = 0.79) and United Kingdom (R2 = 0.60) and between the rotavirus IQS and acute gastroenteritis hospitalizations in the United States (R2 = 0.87) and Mexico (R2 = 0.69) (P United States and by 70% (95% CI, 55%-86%) in Mexico. In the United Kingdom, there was a loss of seasonal variation after vaccine introduction. Rotavirus internet search data trends mirrored national rotavirus laboratory trends in the United States and United Kingdom and gastroenteritis-hospitalization data in the United States and Mexico; lower correlations were found after rotavirus vaccine introduction. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  11. Evaluation of the impact of banking umbilical cord blood units with high cell dose for ethnically diverse patients.

    Science.gov (United States)

    Stritesky, Gretta; Wadsworth, Kimberly; Duffy, Merry; Buck, Kelly; Dehn, Jason

    2018-02-01

    Umbilical cord blood units provide an important stem cell source for transplantation, particularly for patients of ethnic diversity who may not have suitably matched available, adult-unrelated donors. However, with the cost of cord blood unit acquisition from public banks significantly higher than that for adult-unrelated donors, attention is focused on decreasing cost yet still providing cord blood units to patients in need. Historical practices of banking units with low total nucleated cell counts, including units with approximately 90 × 10 7 total nucleated cells, indicates that most banked cord blood units have much lower total nucleated cell counts than are required for transplant. The objective of this study was to determine the impact on the ability to identify suitable cord blood units for transplantation if the minimum total nucleated cell count for banking were increased from 90 × 10 7 to 124 or 149 × 10 7 . We analyzed ethnically diverse patients (median age, 3 years) who underwent transplantation of a single cord blood unit in 2005 to 2016. A cord blood unit search was evaluated to identify units with equal or greater human leukocyte antigen matching and a greater total nucleated cell count than that of the transplanted cord blood unit (the replacement cord blood unit). If the minimum total nucleated cell count for banking increased to 124 or 149 × 10 7 , then from 75 to 80% of patients would still have at least 1 replacement cord blood unit in the current (2016) cord blood unit inventory. The best replacement cord blood units were often found among cords with the same ethnic background as the patient. The current data suggest that, if the minimum total nucleated cell count were increased for banking, then it would likely lead to an inventory of more desirable cord blood units while having minimal impact on the identification of suitable cord blood units for transplantation. © 2017 AABB.

  12. Potential Impacts of Climate Change on Stream Water Temperatures Across the United States

    Science.gov (United States)

    Ehsani, N.; Knouft, J.; Ficklin, D. L.

    2017-12-01

    Analyses of long-term observation data have revealed significant changes in several components of climate and the hydrological cycle over the contiguous United States during the twentieth and early twenty-first century. Mean surface air temperatures have significantly increased in most areas of the country. In addition, water temperatures are increasing in many watersheds across the United States. While there are numerous studies assessing the impact of climate change on air temperatures at regional and global scales, fewer studies have investigated the impacts of climate change on stream water temperatures. Projecting increases in water temperature are particularly important to the conservation of freshwater ecosystems. To achieve better insights into attributes regulating population and community dynamics of aquatic biota at large spatial and temporal scales, we need to establish relationships between environmental heterogeneity and critical biological processes of stream ecosystems at these scales. Increases in stream temperatures caused by the doubling of atmospheric carbon dioxide may result in a significant loss of fish habitat in the United States. Utilization of physically based hydrological-water temperature models is computationally demanding and can be onerous to many researchers who specialize in other disciplines. Using statistical techniques to analyze observational data from 1760 USGS stream temperature gages, our goal is to develop a simple yet accurate method to quantify the impacts of climate warming on stream water temperatures in a way that is practical for aquatic biologists, water and environmental management purposes, and conservation practitioners and policy-makers. Using an ensemble of five global climate models (GCMs), we estimate the potential impacts of climate change on stream temperatures within the contiguous United States based on recent trends. Stream temperatures are projected to increase across the US, but the magnitude of the

  13. Estimating the economic impact of climate change on the freshwater sportsfisheries of the Northeastern United States

    Energy Technology Data Exchange (ETDEWEB)

    Pendleton, L. [Univ. of Southern California, Los Angeles, CA (United States). Dept. of Economics; Mendelsohn, R. [Yale Univ., New Haven, CT (United States). School of Forestry and Environmental Studies

    1997-06-06

    This study links models of global climate circulation, ecology, and economic valuation (hedonic travel cost and random utility models) to value the impact of global warming on freshwater sportfishing in the Northeast. An origin-specific linear random utility model (RUM) is introduced. The results of the RUM are shown to be comparable to those of a hedonic travel cost model. A doubling of atmospheric carbon dioxide is predicted to generate between a $4.6 million loss and a $20.5 million net benefit for the Northeastern United States, depending on the climate scenario.

  14. The Impact of United States Monetary Policy in the Crude Oil futures market

    Science.gov (United States)

    Padilla-Padilla, Fernando M.

    This research examines the empirical impact the United States monetary policy, through the federal fund interest rate, has on the volatility in the crude oil price in the futures market. Prior research has shown how macroeconomic events and variables have impacted different financial markets within short and long--term movements. After testing and decomposing the variables, the two stationary time series were analyzed using a Vector Autoregressive Model (VAR). The empirical evidence shows, with statistical significance, a direct relationship when explaining crude oil prices as function of fed fund rates (t-1) and an indirect relationship when explained as a function of fed fund rates (t-2). These results partially address the literature review lacunas within the topic of the existing implication monetary policy has within the crude oil futures market.

  15. Impact of a hybrid TGfU-Sport Education unit on student motivation in physical education.

    Directory of Open Access Journals (Sweden)

    Alexander Gil-Arias

    Full Text Available The Teaching Games for Understanding (TGfU and Sport Education (SE pedagogical models share several objectives and pedagogical processes. Despite this seemingly uncanny relationship, few studies have examined the efficacy of a hybrid TGfU/SE pedagogical model, particularly how a teacher's utilization of such a model impacts on student motivation. The purpose of the current study was to investigate the effect a hybrid TGfU/SE unit, in comparison to direct instruction, on students' perceptions of various aspects of their motivation to engage in physical education (autonomous motivation, basic psychological needs, enjoyment and intention to be physically active. A crossover design was utilized, using the technique of counterbalancing. One group experienced a hybrid SE/TGfU unit first, followed by a unit of direct instruction. A second group experienced the units in the opposite order. Participants were 55 students. The intervention was conducted over a total of 16 lessons. The hybrid unit was designed according to the characteristics of SE by using seasons, roles, persistent teams, etc. Learning tasks set by the teacher during individual lessons, however, were designed according to the pedagogical principles of TGfU. Student motivation data was generated using validated questionnaires. Results showed that regardless of the order of intervention, the two groups showed significant improvements in autonomy, competence and enjoyment when they were taught using the hybrid model. Instead, in the variables autonomous motivation, relatedness and intention to be physically active there were no significant improvements in one group. These results demonstrate that it is possible to design varied learning situations in which affiliation, leadership and trust are fostered, while tasks are adapted to the characteristics of the students. All this can cause greater autonomous motivation, and consequently, perceived competence in the student, a positive image of

  16. Impact of a hybrid TGfU-Sport Education unit on student motivation in physical education.

    Science.gov (United States)

    Gil-Arias, Alexander; Harvey, Stephen; Cárceles, Adrián; Práxedes, Alba; Del Villar, Fernando

    2017-01-01

    The Teaching Games for Understanding (TGfU) and Sport Education (SE) pedagogical models share several objectives and pedagogical processes. Despite this seemingly uncanny relationship, few studies have examined the efficacy of a hybrid TGfU/SE pedagogical model, particularly how a teacher's utilization of such a model impacts on student motivation. The purpose of the current study was to investigate the effect a hybrid TGfU/SE unit, in comparison to direct instruction, on students' perceptions of various aspects of their motivation to engage in physical education (autonomous motivation, basic psychological needs, enjoyment and intention to be physically active). A crossover design was utilized, using the technique of counterbalancing. One group experienced a hybrid SE/TGfU unit first, followed by a unit of direct instruction. A second group experienced the units in the opposite order. Participants were 55 students. The intervention was conducted over a total of 16 lessons. The hybrid unit was designed according to the characteristics of SE by using seasons, roles, persistent teams, etc. Learning tasks set by the teacher during individual lessons, however, were designed according to the pedagogical principles of TGfU. Student motivation data was generated using validated questionnaires. Results showed that regardless of the order of intervention, the two groups showed significant improvements in autonomy, competence and enjoyment when they were taught using the hybrid model. Instead, in the variables autonomous motivation, relatedness and intention to be physically active there were no significant improvements in one group. These results demonstrate that it is possible to design varied learning situations in which affiliation, leadership and trust are fostered, while tasks are adapted to the characteristics of the students. All this can cause greater autonomous motivation, and consequently, perceived competence in the student, a positive image of the sport to

  17. Impact of a hybrid TGfU-Sport Education unit on student motivation in physical education

    Science.gov (United States)

    Gil-Arias, Alexander; Harvey, Stephen; Cárceles, Adrián; Práxedes, Alba; Del Villar, Fernando

    2017-01-01

    The Teaching Games for Understanding (TGfU) and Sport Education (SE) pedagogical models share several objectives and pedagogical processes. Despite this seemingly uncanny relationship, few studies have examined the efficacy of a hybrid TGfU/SE pedagogical model, particularly how a teacher’s utilization of such a model impacts on student motivation. The purpose of the current study was to investigate the effect a hybrid TGfU/SE unit, in comparison to direct instruction, on students’ perceptions of various aspects of their motivation to engage in physical education (autonomous motivation, basic psychological needs, enjoyment and intention to be physically active). A crossover design was utilized, using the technique of counterbalancing. One group experienced a hybrid SE/TGfU unit first, followed by a unit of direct instruction. A second group experienced the units in the opposite order. Participants were 55 students. The intervention was conducted over a total of 16 lessons. The hybrid unit was designed according to the characteristics of SE by using seasons, roles, persistent teams, etc. Learning tasks set by the teacher during individual lessons, however, were designed according to the pedagogical principles of TGfU. Student motivation data was generated using validated questionnaires. Results showed that regardless of the order of intervention, the two groups showed significant improvements in autonomy, competence and enjoyment when they were taught using the hybrid model. Instead, in the variables autonomous motivation, relatedness and intention to be physically active there were no significant improvements in one group. These results demonstrate that it is possible to design varied learning situations in which affiliation, leadership and trust are fostered, while tasks are adapted to the characteristics of the students. All this can cause greater autonomous motivation, and consequently, perceived competence in the student, a positive image of the sport to

  18. Climate change and health in the United States of America: impacts, adaptations, and research

    International Nuclear Information System (INIS)

    Jouan, R.; Magaud, M.

    2009-11-01

    After a description of the various impacts of climate change on human health, this report describes and comments the impacts of climate change on health in the USA: impacts of heat waves, of air quality degradation, of extreme climate events, of climate change on infectious diseases and allergies, regional impacts of climate change. In a second part, it describes the strategies of adaptation to the 'climate change and health' issue in the USA: mitigation and adaptation to climate change, adaptation challenges, insufficiently prepared public health system, adaptation to heat waves, adaptation to air quality degradation, adaptation to extreme climate events, adaptation to food- and water-based diseases and to vector-based diseases, examples of proactive adaptation. The last part describes the organisation of research on 'climate change and health' in the USA: nowadays and in the future, role of federal agencies, priority research axes. The 'United States Global Change Research Program' is presented in appendix, as well as the most important research centres (mostly in universities)

  19. Socio-economic impacts of nuclear generating stations: Crystal River Unit 3 case study

    International Nuclear Information System (INIS)

    Bergmann, P.A.

    1982-07-01

    This report documents a case study of the socio-economic impacts of the construction and operation of the Crystal River Unit 3 nuclear power station. It is part of a major post-licensing study of the socio-economic impacts at twelve nuclear power stations. The case study covers the period beginning with the announcement of plans to construct the reactor and ending in the period 1980 to 1981. The case study deals with changes in the economy, population, settlement patterns and housing, local government and public services, social structure, and public response in the study area during the construction/operation of the reactor. A regional modeling approach is used to trace the impact of construction/operation on the local economy, labor market, and housing market. Emphasis in the study is on the attribution of socio-economic impacts to the reactor or other causal factors. As part of the study of local public response to the construction/operation of the reactor, the effects of the Three Mile Island accident are examined

  20. Economic impacts on the United States of siting decisions for the international thermonuclear experimental reactor

    International Nuclear Information System (INIS)

    Peerenboom, J.P.; Hanson, M.E.; Huddleston, J.R.

    1996-08-01

    This report presents the results of a study that examines and compares the probable short-term economic impacts of the International Thermonuclear Experimental Reactor (ITER) on the United States (U.S.) if (1) ITER were to be sited in the U.S., or (2) ITER were to be sited in one of the other countries that, along with the U.S., is currently participating in the ITER program. Life-cycle costs associated with ITER construction, operation, and decommissioning are analyzed to assess their economic impact. A number of possible U.S. host and U.S. non-host technology and cost-sharing arrangements with the other ITER Parties are examined, although cost-sharing arrangements and the process by which the Parties will select a host country and an ITER site remain open issues. Both national and local/regional economic impacts, as measured by gross domestic product, regional output, employment, net exports, and income, are considered. These impacts represent a portion of the complex, interrelated set of economic considerations that characterize U.S. host and U.S. non-host participation in ITER. A number of other potentially important economic and noneconomic considerations are discussed qualitatively

  1. Economic impacts on the United States of siting decisions for the International Thermonuclear Experimental Reactor

    International Nuclear Information System (INIS)

    Peerenboom, J.P.; Wolsko, T.D.; Hanson, M.E.

    1997-01-01

    This paper presents the results of a study that examines and compares the probable short-term economic impacts of the International Thermonuclear Experimental Reactor (ITER) on the United States (U.S.) if (1) ITER were to be sited in the U.S., or (2) ITER were to be sited in one of the other countries that along with the U.S., is currently participating in the ITER program. Life-cycle costs associated with ITER construction, operation, and decommissioning are analyzed to assess their economic impact. A number of possible U.S. host and U.S. non-host technology and cost-sharing arrangements with the other ITER Parties are examined, although cost-sharing arrangements and the process by which the Parties will select a host country and an ITER site remain open issues. Both national and local/regional economic impacts, as measured by gross domestic product, regional output, employment, net exports, and income, are considered. These impacts represent a portion of the complex, interrelated set of economic considerations that characterize U.S. host and U.S. non-host participation in ITER. A number of other potentially important economic and noneconomic considerations are discussed qualitatively

  2. Economic impacts on the United States of siting decisions for the international thermonuclear experimental reactor

    Energy Technology Data Exchange (ETDEWEB)

    Peerenboom, J.P.; Hanson, M.E.; Huddleston, J.R. [and others

    1996-08-01

    This report presents the results of a study that examines and compares the probable short-term economic impacts of the International Thermonuclear Experimental Reactor (ITER) on the United States (U.S.) if (1) ITER were to be sited in the U.S., or (2) ITER were to be sited in one of the other countries that, along with the U.S., is currently participating in the ITER program. Life-cycle costs associated with ITER construction, operation, and decommissioning are analyzed to assess their economic impact. A number of possible U.S. host and U.S. non-host technology and cost-sharing arrangements with the other ITER Parties are examined, although cost-sharing arrangements and the process by which the Parties will select a host country and an ITER site remain open issues. Both national and local/regional economic impacts, as measured by gross domestic product, regional output, employment, net exports, and income, are considered. These impacts represent a portion of the complex, interrelated set of economic considerations that characterize U.S. host and U.S. non-host participation in ITER. A number of other potentially important economic and noneconomic considerations are discussed qualitatively.

  3. Health and cost impact of air pollution from biomass burning over the United States

    Science.gov (United States)

    Eslami, E.; Sadeghi, B.; Choi, Y.

    2017-12-01

    Effective assessment of health and cost effects of air pollution associated with wildfire events is critical for supporting sustainable management and policy analysis to reduce environmental damages. Since biomass burning events result in higher ozone, PM2.5, and NOx concentration values in urban regions due to long-range transport, preliminary results indicated that wildfire events cause a considerable increase in incident estimates and costs. This study aims to evaluate the health and cost impact of biomass burning events over the continental United States using combined air quality and health impact modeling. To meet this goal, a comprehensive air quality modeling scenarios containing biomass burning emissions were conducted using the Community Multiscale Air Quality (CMAQ) modeling system from 2011 to 2014 with a spatial resolution of 12 km. The modeling period includes fire seasons between April and October over the course of four years. By using modeled pollutants concentrations, the USEPA's GIS-based computer program Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) provides an inclusive figure of health and cost impact caused by changing gaseous and particulate air pollution due to fire events. The basis of BenMAP-CE is the use of a damage-function approach to estimate the health impact of an applied change in air quality by comparing a biomass burning scenario (the one that includes wildfire events) with a baseline scenario (without biomass emissions). This approach considers several factors containing population, exposure to the pollutants, adverse health effects of a particular pollutant, and economic costs. Hence, this study made it capable of showing how biomass burning across U.S. influences people's health in different months, seasons, and regions. Besides, the cost impact of the wildfire events during study periods has also been estimated at both national and regional levels. The results of this study demonstrate the

  4. The impact of TTIP agreement on the European Union-United States coal trade potential

    Directory of Open Access Journals (Sweden)

    Olkuski Tadeusz

    2016-01-01

    Full Text Available The main aim of the paper is to assess the impact of currently negotiated TTIP agreement (Transatlantic Trade and Investment Partnership on the use of hard coal in the EU and the US. Hard coal is the most important fuel in global electricity generation. This also applies to the United States, a leading manufacturer and exporter of this energy source. The US coal is exported to the EU market. The article presents the estimated exports of hard coal from the US to the EU. Due to the fact that price has a major impact on the size of exports, the paper presents the estimated prices, including freight costs, of power coal for the analyzed scenarios. According to one scenario, the US and European prices will be equalized (including freight costs by 2020, while from 2025 on the comparative advantage and competitiveness of the US hard coal will decrease. Taking into account the fact that the export of coal from the United States is free from customs duties, the acceptance of TIPP should not affect the currently existing trade between the two continents and the amount of exported coal. Nevertheless, the question of hard coal economy cannot be separated from other sectors of the energy market, which can be significantly affected by the future agreement.

  5. Study of environmental impact assessment for Mochovce NPP Units 3 and 4. Executive summary. September 2007

    International Nuclear Information System (INIS)

    Anon

    2007-09-01

    SE/ENEL, on a voluntary basis, has prepared new EIA Study for the completion of Units 3 and 4 of Mochovce Nuclear Power Plant (MO34 NPP) according to International current practices and European Directives. The results of the analysis, according to SE/ENEL Environment and Corporate Social Responsibility policies, will be provided to local Communities and Public Authorities. The Environmental Impact Assessment is performed: - in compliance with appendix 11 of Slovak Act. No. 24/2006 'On the assessment of the effects on the environment and on the modification and enlargement of some laws'; - meeting the requirements of the Exhibit II 'Illustrative list of potential social and environmental issues to be addressed in the Social and Environmental Assessment documentation' as reported in the document 'Equator Principles' of 2006 July developed by the International Finance Corporation (IFC). The area of Mochovce NPP is situated in Central Europe in the south-western region of the Slovak Republic (SR) at the western border of the Levice district. The area lies in the south-western part of the Kozmalovske hills mainly in the Hron highlands. From the point of view of the terrestrial and administrative organization of the SR, Mochovce NPP is situated in the eastern part of the Nitra region, in the north-western part of the Levice district, close to the border with the Nitra and Zlate Moravce districts. Mochovce NPP is approx. 12 km from the district capital Levice, which is the largest town within a 20 km distance from the power plant. Initial site preparation began in August 1983. In April 1998 the first fuel was loaded into Unit 1 of Mochovce NPP. The operation started in August 1998. Unit 2 started operation in January 2000. The original Construction Permit No. Vyst. 2010/86 for MO 34 was issued by the District National Committee in Levice on the basis of the Land Planning Decisions on 12 November 1986. This Permit has been renewed firstly on 5 May 1997 by letter of the

  6. [Economic impact of an automated dispensing system in an intensive care unit].

    Science.gov (United States)

    Kheniene, F; Bedouch, P; Durand, M; Marie, F; Brudieu, E; Tourlonnias, M-M; Bongi, P; Allenet, B; Calop, J

    2008-03-01

    Automated dispensing systems (ADS) allow a reduction of medication errors and an improvement of drug distribution in clinical ward. The objective of this study was to evaluate the economic impact of ADS in an intensive care unit. A cost-benefit model was constructed based on the hospital perspective. The system was evaluated before-after implementation of an ADS in a 12-bed cardiovascular intensive care unit of a French teaching hospital: (a) by a measuring nurse and pharmacy technician working time required for various tasks; (b) by measuring the cost of drug storage and the cost of expired drug; (c) by measuring the nurses' acceptability. After ADS was installed, nursing personnel spent less time on medication-related activities (mean of 1.9 hour/day of nursing time). Pharmacy technicians spent more time on floor-stock activities (mean of 0.7 hour/day of technician time). Implementation reduced the cost of drug storage by 56% (14,742 euros) and cost of expired drug by 9,086 euros per year. Finally, cost-benefit analysis including potential savings in terms of working time showed a net benefit of 71,586 euros (14,317 euros/year). The ADS was given high marks by the nurses; 77% wanted to keep it on their unit. Implementation of ADS is expected to generate direct savings for the hospital and working time reallocation, for nurses to interact with patients and for pharmacy technicians to get involved on the ward.

  7. Environmental impact assessments of a fifth nuclear power plant unit in Finland

    International Nuclear Information System (INIS)

    Aurela, Jorma; Koivisto, Katarina

    2000-01-01

    This paper presents the results of president questionnaires and media monitoring of press cuttings concerned with siting of the new fifth in a row Finnish NPP. Two years ago both Fortum Power and Heat Oy and Teollisuuden Voima Oy (TVO) launched their Environmental impact assessment (EIA) procedures of a new nuclear power unit in Finland. The EIA procedures were launched to investigate the environmental impacts of a fifth nuclear power plant which possibly will be built in Loviisa or at Olkiluoto. In Finland there are four operating NPP units, two in Loviisa (Fortum) and two in Eurajoki, Olkiluoto (TVO). In the EIA procedure citizens and various associations and authorities have an opportunity to express their views on the matters related to the project. The Ministry of Trade and Industry (MTI) as the coordination authority arranges the organisation of the EIA hearings and the collection of statements and opinions. The EIA procedure in Finland takes place in two stages. The first stage i.e. the EIA programme describes the project and presents the plan on how the environmental effects are investigated and assessed. In the second stage the actual assessment of the environmental effects of the project will be submitted. Both Fortum and Teollisuuden Voima Oy (TVO) launched in spring 1998 their EIA procedures. The main alternatives are the Loviisa 3 project includes two plant type alternatives. The size of the plant is between 1000 and 1700 MWe, and the extension project of the Olkiluoto NPP to build a NPP unit of about 1000-1500 MWe at Olkiluoto. The EIA reports were submitted to the MTI in August 1999 and after that they were on display for two months for opinions and statements

  8. Climate Change Impacts on Rivers and Implications for Electricity Generation in the United States

    Science.gov (United States)

    Miara, A.; Vorosmarty, C. J.; Macknick, J.; Corsi, F.; Cohen, S. M.; Tidwell, V. C.; Newmark, R. L.; Prousevitch, A.

    2015-12-01

    The contemporary power sector in the United States is heavily reliant on water resources to provide cooling water for thermoelectric generation. Efficient thermoelectric plant operations require large volumes of water at sufficiently cool temperatures for their cooling process. The total amount of water that is withdrawn or consumed for cooling and any potential declines in efficiencies are determined by the sector's fuel mix and cooling technologies. As such, the impact of climate change, and the extent of impact, on the power sector is shaped by the choice of electricity generation technologies that will be built over the coming decades. In this study, we model potential changes in river discharge and temperature in the contiguous US under a set of climate scenarios to year 2050 using the Water Balance Model-Thermoelectric Power and Thermal Pollution Model (WBM-TP2M). Together, these models quantify, in high-resolution (3-min), river temperatures, discharge and power plant efficiency losses associated with changes in available cooling water that incorporates climate, hydrology, river network dynamics and multi-plant impacts, on both single power plant and regional scales. Results are used to assess the aptness and vulnerability of contemporary and alternative electricity generation pathways to changes in climate and water availability for cooling purposes, and the concomitant impacts on power plant operating efficiencies. We assess the potential impacts by comparing six regions (Northeast, Southeast, Midwest, Great Plains, Southwest, Northwest as in the National Climate Assessment (2014)) across the US. These experiments allow us to assess tradeoffs among electricity-water-climate to provide useful insight for decision-makers managing regional power production and aquatic environments.

  9. Impact of reduced tobacco smoking on lung cancer mortality in the united states during 1975-2000

    NARCIS (Netherlands)

    S. Moolgavkar (Suresh); N.H. Holford; D.T. Levy (David); C.Y. Kong (Chung Yin); M. Foy (Millennia); L. Clarke (Lauren); J. Jeon (Jihyoun); W. Hazelton (William); R. Meza (Rafael); F.W. Schultz (Frank); W.J. McCarthy (William); R. Boer (Rob); O. Gorlova (Olga); G.S. Gazelle (Scott); M. Kimmel (Marek); P.M. McMahon (Pamela); H.J. de Koning (Harry); E. Feuer (Eric)

    2012-01-01

    textabstractBackground Considerable effort has been expended on tobacco control strategies in the United States since the mid-1950s. However, we have little quantitative information on how changes in smoking behaviors have impacted lung cancer mortality. We quantified the cumulative impact of

  10. 75 FR 65012 - Small Hydropower Development in the United States; Notice of Small/Low-Impact Hydropower Webinar

    Science.gov (United States)

    2010-10-21

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. AD09-9-000] Small Hydropower Development in the United States; Notice of Small/Low-Impact Hydropower Webinar October 13, 2010. The Federal Energy Regulatory Commission will host a Small/Low- Impact Hydropower Webinar on November 10, 2010, from...

  11. 76 FR 81929 - Small Hydropower Development in the United States; Notice of Small/Low-Impact Hydropower Webinar

    Science.gov (United States)

    2011-12-29

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. AD09-9-000] Small Hydropower Development in the United States; Notice of Small/Low-Impact Hydropower Webinar The Federal Energy Regulatory Commission will host a Small/Low- Impact Hydropower Webinar on January 25, 2012, from 12:00 noon to 1:30 p.m...

  12. 76 FR 30937 - Small Hydropower Development in the United States; Notice of Small/Low-Impact Hydropower Webinar

    Science.gov (United States)

    2011-05-27

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. AD09-9-000] Small Hydropower Development in the United States; Notice of Small/Low-Impact Hydropower Webinar The Federal Energy Regulatory Commission (FERC) will host a Small/ Low-Impact Hydropower Webinar on June 22, 2011, from 12 noon to 1 p.m...

  13. Draft environmental impact statement. River Bend Nuclear Power Station, Unit 1

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    Federal financing of an undivided ownership interest of River Bend Nuclear Power Station Unit 1 on a 3293-acre site near St. Francisville, Louisiana is proposed in a supplement to the final environmental impact statement of September 1974. The facility would consist of a boiling-water reactor that would produce a maximum of 2894 megawatts (MW) of electrical power. A design level of 3015 MW of electric power could be realized at some time in the future. Exhaust steam would be cooled by mechanical cooling towers using makeup water obtained from and discharged to the Mississippi River. Power generated by the unit would be transmitted via three lines totaling 140 circuit miles traversing portions of the parishes of West Feliciana, East Feliciana, East Baton Rouge, West Baton Rouge, Pointe Coupee, and Iberville. The unit would help the applicant meet the power needs of rural electric consumers in the region, and the applicant would contribute significanlty to area tax base and employment rolls during the life of the unit. Construction related activities would disturb 700 forested acres on the site and 1156 acres along the transmission routes. Of the 60 cubic feet per second (cfs) taken from the river, 48 cfs would evaporate during the cooling process and 12 cfs would return to the river with dissolved solids concentrations increased by 500%. The terrace aquifer would be dewatered for 16 months in order to lower the water table at the building site, and Grants Bayou would be transformed from a lentic to a lotic habitat during this period. Fogging and icing due to evaporation and drift from the cooling towers would increase slightly. During the construction period, farming, hunting, and fishing on the site would be suspended, and the social infractructure would be stressed due to the influx of a maximum of 2200 workers

  14. Logistical Impact Study of Photovoltaic Power Converter Technology to the United States Army and the United States Marine Corps

    National Research Council Canada - National Science Library

    Whiteker, James

    2004-01-01

    The purpose of this MBA Project was to analyze the logistical and fiscal impact of replacing selected disposable batteries with rechargeable batteries and photovoltaic power converter chargers within...

  15. Outpatient Mental Health Treatment Utilization and Military Career Impact in the United States Marine Corps.

    Science.gov (United States)

    Ghahramanlou-Holloway, Marjan; LaCroix, Jessica M; Koss, Kari; Perera, Kanchana U; Rowan, Anderson; VanSickle, Marcus R; Novak, Laura A; Trieu, Theresa H

    2018-04-23

    Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines ( N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines ( N = 40) was matched to a non-treatment-seeking sample of Marines ( N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls ( p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed.

  16. Outside the Continental United States International Travel and Contagion Impact Quick Look Tool

    Energy Technology Data Exchange (ETDEWEB)

    Corley, Courtney D.; Lancaster, Mary J.; Brigantic, Robert T.; Kunkel, Brenda M.; Muller, George; McKenzie, Taylor K.

    2012-11-09

    ABSTRACT This paper describes a tool that will allow public health analysts to estimate infectious disease risk at the country level as a function of different international transportation modes. The prototype focuses on a cholera epidemic originating within Latin America or the Caribbean, but it can be expanded to consider other pathogens as well. This effort leverages previous work in collaboration with the Centers for Disease Control and Prevention to develop the International Travel to Community Impact (IT-CI) model, which analyzes and assesses potential international disease outbreaks then estimates the associated impacts to U.S. communities and the nation as a whole and orient it for use Outside the Continental United States (OCONUS). For brevity, we refer to this refined model as OIT-CI. First, we developed an operationalized meta-population spatial cholera model for Latin America and the Caribbean at the secondary administrative-level boundary. Secondly, we developed a robust function of human airline critical to approximating mixing patterns in the meta- population model. In the prototype version currently presented here, OIT-CI models a cholera epidemic originating in a Latin American or Caribbean country and spreading via airline transportation routes. Disease spread is modeled at the country level using a patch model with a connectivity function based on demographic, geospatial, and human transportation data. We have also identified data to estimate the water and health-related infrastructure capabilities of each country to include this potential impact on disease transmission.

  17. Economic impacts of non-native forest insects in the continental United States.

    Directory of Open Access Journals (Sweden)

    Juliann E Aukema

    Full Text Available Reliable estimates of the impacts and costs of biological invasions are critical to developing credible management, trade and regulatory policies. Worldwide, forests and urban trees provide important ecosystem services as well as economic and social benefits, but are threatened by non-native insects. More than 450 non-native forest insects are established in the United States but estimates of broad-scale economic impacts associated with these species are largely unavailable. We developed a novel modeling approach that maximizes the use of available data, accounts for multiple sources of uncertainty, and provides cost estimates for three major feeding guilds of non-native forest insects. For each guild, we calculated the economic damages for five cost categories and we estimated the probability of future introductions of damaging pests. We found that costs are largely borne by homeowners and municipal governments. Wood- and phloem-boring insects are anticipated to cause the largest economic impacts by annually inducing nearly $1.7 billion in local government expenditures and approximately $830 million in lost residential property values. Given observations of new species, there is a 32% chance that another highly destructive borer species will invade the U.S. in the next 10 years. Our damage estimates provide a crucial but previously missing component of cost-benefit analyses to evaluate policies and management options intended to reduce species introductions. The modeling approach we developed is highly flexible and could be similarly employed to estimate damages in other countries or natural resource sectors.

  18. Impacts of a United States' biofuel policy on New Zealand's agricultural sector

    International Nuclear Information System (INIS)

    Saunders, Caroline; Kaye-Blake, William; Marshall, Liz; Greenhalgh, Suzie; De Aragao Pereira, Mariana

    2009-01-01

    The rise in oil prices has spurred interest in biofuels. Policies in the United States like the renewable fuel standard (RFS) have led to an expansion of ethanol production, while the New Zealand government has mandated a minimum level of biofuel sales. The research used a partial equilibrium model of international trade to quantify the price and farmgate income effects of the US RFS policy. The goal was to examine the competition between food and biofuel production and to quantify the impact of the policy on the agricultural sector in New Zealand. The RFS policy has a significant impact on corn prices, but a small effect on livestock prices and production. There thus appears to be little conflict between food and fuel uses for corn at the level of the RFS mandate. New Zealand's pasture-based livestock sector benefits from the use of corn for ethanol production: it receives better prices for its products, but does not face the same input cost increases as competitors. The results suggest that New Zealand faces an interesting decision: it could support investment in biofuels research, or benefit from the biofuels boom through the indirect impacts on demand and prices for meat and milk. (author)

  19. Quantifying and Valuing Potential Climate Change Impacts on Coral Reefs in the United States

    Science.gov (United States)

    Wobus, C. W.; Lane, D.; Buddemeier, R. W.; Ready, R. C.; Shouse, K. C.; Martinich, J.

    2012-12-01

    Global climate change presents a two-pronged threat to coral reef ecosystems: increasing sea surface temperatures will increase the likelihood of episodic bleaching events, while increasing ocean carbon dioxide concentrations will change the carbonate chemistry that drives coral growth. Because coral reefs have important societal as well as ecological benefits, climate change mitigation policies that ameliorate these impacts may create substantial economic value. We present a model that evaluates both the ecological and the economic impacts of climate change on coral reefs in the United States. We use a coral reef mortality and bleaching model to project future coral reef declines under a range of climate change policy scenarios for south Florida, Puerto Rico and Hawaii. Using a benefits transfer approach, the outputs from the physical model are then used to quantify the economic impacts of these coral reef declines for each of these regions. We find that differing climate change trajectories create substantial changes in projected coral cover and value for Hawaii, but that the ecological and economic benefits of more stringent emissions scenarios are less clear for Florida and Puerto Rico. Overall, our results indicate that the effectiveness of climate change mitigation policies may be region-specific, but that these policies could result in a net increase of nearly $10 billion in economic value from coral reef-related recreational activities alone, over the 21st century.

  20. Impact of overactive bladder on work productivity in the United States: results from EpiLUTS.

    Science.gov (United States)

    Sexton, Chris C; Coyne, Karin S; Vats, Vasudha; Kopp, Zoe S; Irwin, Debra E; Wagner, Todd H

    2009-03-01

    Little research has focused on the impact of overactive bladder (OAB) on work productivity. Consequently, the impact of OAB and other lower urinary tract symptoms (LUTS) on work productivity was evaluated in employed men and women aged 40 to 65 in the United States. Data from a population-based, cross-sectional Internet survey were used to examine the impact of OAB symptoms on work productivity. US participants aged 40 to 65 working full- or part-time were included in the analysis. Participants were asked about the incidence of OAB and other LUTS and a series of questions about work productivity. Descriptive statistics and linear and logistic regressions were used to evaluate outcome differences for men and women by the OAB groups of no/minimal symptoms, continent OAB, and incontinent OAB. The response rate was 60%, and a total of 2876 men and 2820 women were analyzed. Men and women with incontinent OAB reported the lowest levels of work productivity and highest rates of daily work interference. Storage symptoms associated with OAB were most consistently associated with work productivity outcomes; however, significant associations were also found for other storage, voiding, and postmicturition LUTS. In this large US population-based study, OAB was highly prevalent and was associated with lower levels of work productivity. These findings add to the literature documenting the burden of OAB and other LUTS, underscoring the need for increased screening and treatment.

  1. Optimization of a Distillation Unit In Terms of Potential Environmental Impact and Economics

    International Nuclear Information System (INIS)

    Alhassan Salami Tijani; Ramzan, N.

    2013-01-01

    Process energy integration and continuous improvement of process technology are increasing issues to ensure profitability of chemical productions. These objectives are increasingly important due to long-term environmental impact of energy degradation, such as resource depletion, emissions and the release of waste heat. The earlier energy conservation, process economics and environmental aspects are integrated into the process development, the easier and less expensive it is to improve the process design. In this work different distillation process design alternatives have been considered with respect to evaluations of process economics and potential environmental impacts. Optimum design alternatives are analyzed related to these objectives. A multi-criteria decision making technique such as (Analytic Hierarchy Process) AHP is applied for ranking the alternatives. This method reveals that the heat pump distillation unit which has the highest score of 52 % is the best alternative when compare with base case. In terms of the effluent streams the base case has a less potential environmental impact (PEI) compared with heat pump. The lower total PEI/ kg (7.45E-01) of the base case illustrates that the material utilization efficiency of the base case is better than the heat pump whose PEI/ kg is 8.14E-01. (author)

  2. The Application of Load-cell Technique in the Study of Armour Unit Responses to Impact Loads Tests

    DEFF Research Database (Denmark)

    Burcharth, H. F.; Liu, Z.

    1995-01-01

    The slender, complex types of armour units, such as Tetrapods and Dolosse are widely used for rubble mound breakwaters. Many of the recent failures of such structures were caused by unforeseen early breakage of the units, thus revealing an in balance between the strength (structural integrity......) of the units and the hydraulic stability (resistance to displacements) of the armour layers. Breakage is caused by stresses from static, pulsating and impact loads. Impact load generated stresses are difficult to investigate due to non-linear scaling laws. The paper describes a method by which impact loads on....... slender armour units can be studied. by load-cell technique. Moreover, the paper presents DoJos design diagrams for the prediction of both breakage and hydraulic stability...

  3. Impact of selection of cord blood units from the United States and swiss registries on the cost of banking operations.

    Science.gov (United States)

    Bart, Thomas; Boo, Michael; Balabanova, Snejana; Fischer, Yvonne; Nicoloso, Grazia; Foeken, Lydia; Oudshoorn, Machteld; Passweg, Jakob; Tichelli, Andre; Kindler, Vincent; Kurtzberg, Joanne; Price, Thomas; Regan, Donna; Shpall, Elizabeth J; Schwabe, Rudolf

    2013-02-01

    Over the last 2 decades, cord blood (CB) has become an important source of blood stem cells. Clinical experience has shown that CB is a viable source for blood stem cells in the field of unrelated hematopoietic blood stem cell transplantation. Studies of CB units (CBUs) stored and ordered from the US (National Marrow Donor Program (NMDP) and Swiss (Swiss Blood Stem Cells (SBSQ)) CB registries were conducted to assess whether these CBUs met the needs of transplantation patients, as evidenced by units being selected for transplantation. These data were compared to international banking and selection data (Bone Marrow Donors Worldwide (BMDW), World Marrow Donor Association (WMDA)). Further analysis was conducted on whether current CB banking practices were economically viable given the units being selected from the registries for transplant. It should be mentioned that our analysis focused on usage, deliberately omitting any information about clinical outcomes of CB transplantation. A disproportionate number of units with high total nucleated cell (TNC) counts are selected, compared to the distribution of units by TNC available. Therefore, the decision to use a low threshold for banking purposes cannot be supported by economic analysis and may limit the economic viability of future public CB banking. We suggest significantly raising the TNC level used to determine a bankable unit. A level of 125 × 10(7) TNCs, maybe even 150 × 10(7) TNCs, might be a viable banking threshold. This would improve the return on inventory investments while meeting transplantation needs based on current selection criteria.

  4. Modeling of yield and environmental impact categories in tea processing units based on artificial neural networks.

    Science.gov (United States)

    Khanali, Majid; Mobli, Hossein; Hosseinzadeh-Bandbafha, Homa

    2017-12-01

    In this study, an artificial neural network (ANN) model was developed for predicting the yield and life cycle environmental impacts based on energy inputs required in processing of black tea, green tea, and oolong tea in Guilan province of Iran. A life cycle assessment (LCA) approach was used to investigate the environmental impact categories of processed tea based on the cradle to gate approach, i.e., from production of input materials using raw materials to the gate of tea processing units, i.e., packaged tea. Thus, all the tea processing operations such as withering, rolling, fermentation, drying, and packaging were considered in the analysis. The initial data were obtained from tea processing units while the required data about the background system was extracted from the EcoInvent 2.2 database. LCA results indicated that diesel fuel and corrugated paper box used in drying and packaging operations, respectively, were the main hotspots. Black tea processing unit caused the highest pollution among the three processing units. Three feed-forward back-propagation ANN models based on Levenberg-Marquardt training algorithm with two hidden layers accompanied by sigmoid activation functions and a linear transfer function in output layer, were applied for three types of processed tea. The neural networks were developed based on energy equivalents of eight different input parameters (energy equivalents of fresh tea leaves, human labor, diesel fuel, electricity, adhesive, carton, corrugated paper box, and transportation) and 11 output parameters (yield, global warming, abiotic depletion, acidification, eutrophication, ozone layer depletion, human toxicity, freshwater aquatic ecotoxicity, marine aquatic ecotoxicity, terrestrial ecotoxicity, and photochemical oxidation). The results showed that the developed ANN models with R 2 values in the range of 0.878 to 0.990 had excellent performance in predicting all the output variables based on inputs. Energy consumption for

  5. Climate change impact on operation of dams and hydroelectricity generation in the Northeastern United States

    Science.gov (United States)

    Ehsani, N.; Vorosmarty, C. J.; Fekete, B. M.

    2016-12-01

    We are using a large-scale, high-resolution, fully integrated hydrological/reservoir/hydroelectricity model to investigate the impact of climate change on the operation of 11037 dams and generation of electricity from 375 hydroelectric power plants in the Northeastern United States. Moreover, we estimate the hydropower potential of the region by energizing the existing non-powered dams and then studying the impact of climate change on the hydropower potential. We show that climate change increases the impact of dams on the hydrology of the region. Warmer temperatures produce shorter frozen periods, earlier snowmelt and elevated evapotranspiration rates, which when combined with changes in precipitation, are projected to increase water availability in winter but reduce it during summer. As a result, the water that is stored by dams will be more than ever a necessary part of the routine water systems operations to compensate for these seasonal imbalances. The function of dams as emergency water storage for creating drought resiliency will mostly diminish in the future. Building more dams to cope with the local impacts of climate change on water resources and to offset the increased drought vulnerability may thus be inevitable. Annual hydroelectricity generation in the region is 41 Twh. Our estimate of the annual hydropower potential of non-powered dams adds up to 350 Twh. Climate change may reduce hydropower potential from non-powered dams by up to 13% and reduce current hydroelectricity generation by up to 8% annually. Hydroelectricity generation and hydropower potential may increase in winter months and decline in months of summer and fall. These changes call for recalibration of dam operations and may raise conflict of interests in multipurpose dams.

  6. Internal and External Barriers Impacting Non-Food Cellulosic Biofuel Projects in the United States

    Directory of Open Access Journals (Sweden)

    Jeremy Withers

    2015-05-01

    Full Text Available Escalating demand, along with EPAct 2005, has led the United States government to assume a twofold leadership approach of energy security and environmental practices. This has initiated several important issues pertaining to cellulosic biofuel production. However, little is known about what is needed for the U.S. to lead long-term renewable energy security, how the US will develop and implement leading environmental energy practices, what supply capabilities and refining technologies are available to produce renewable fuels, and how funding can be used to adopt available technologies. This article examines geographical aspects, operational status, and barriers tending to prevent the successful commercialization of non-food cellulosic ethanol projects in the U.S. from secondary sources. Outcomes of this research can be used to further understand inhibitors that impact the production and commercialization of ethanol from non-food cellulosic sources.

  7. The impact and implications of undocumented immigration on individual and collective health in the United States.

    Science.gov (United States)

    Hilfinger Messias, DeAnne K; McEwen, Marylyn Morris; Clark, Lauren

    2015-01-01

    A nation of immigrants, the United States currently has more foreign-born residents than any other country; approximately 28% of these foreign-born residents are undocumented immigrants--individuals who either entered or are currently residing in the country without valid immigration or residency documents. The complex and constantly changing social, political, and economic context of undocumented migration has profound effects on individuals, families, and communities. The lack of demographic and epidemiologic data on undocumented immigrants is a major public health challenge. In this article, we identify multiple dimensions of vulnerability among undocumented persons; examine how undocumentedness impacts health and health care access and utilization; and consider the professional, practice, and policy issues and implications for nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Economic impacts of electricity liberalization on the status of nuclear power generation in the United States

    International Nuclear Information System (INIS)

    Hattori, Toru

    2015-01-01

    This paper discusses the economic impact of electricity liberalization on the status of nuclear power generation in the United States. Nuclear power plants have been treated equally with other types of power plants in the liberalized electricity market. The existing nuclear power plants were thought to be competitive in liberalized wholesale electricity market. Competitive pressure from the market also facilitated efficiency improvement among the existing nuclear power plants. Although it was difficult to build new reactor, the U.S. nuclear power generators expanded capacity through up rates. In recent years, however, nuclear power plants suffer from the decline in wholesale power prices and some of them are forced to retire early. Although there are some market design issues that could be improved to maintain the efficient nuclear power plants in competitive environment, it is now argued that some additional arrangements to mitigate the investment risks of the nuclear power plants are necessary. (author)

  9. The impact of crude oil price volatility on agricultural employment in the United States

    International Nuclear Information System (INIS)

    Uri, N.D.

    1996-01-01

    This study addresses the question of whether fluctuations in the price of crude oil have affected agricultural employment in the United States. After reviewing previous assessments of the issue, the existence of an empirical relationship between agricultural employment and crude oil price volatility is established using cointegration tests. Subsequently, the nature of the relationship is estimated with the results suggesting that at least three full years are required before the measurable impacts of a percentage change in the real price of crude oil on the change in agricultural employment are exhausted. Finally, the structural stability of the functional relationship between the change in agricultural employment and the volatility of the price of crude oil, the percentage changes in expected net farm income, realized technological innovation, and the wage rate is examined. (author)

  10. [Clinical impact of opening a human milk bank in a neonatal unit].

    Science.gov (United States)

    Vázquez-Román, S; Bustos-Lozano, G; López-Maestro, M; Rodríguez-López, J; Orbea-Gallardo, C; Samaniego-Fernández, M; Pallás-Alonso, C R

    2014-09-01

    The benefits of donor human milk compared with artificial formulas have been well demonstrated; nevertheless the impact in the clinical practice of opening a human milk bank within a neonatal unit has not yet been studied. The main aim of this study was to analyze the impact on the clinical practice of opening a human milk bank in a neonatal unit to provide donor human milk for preterm infants ≤ 32 weeks of gestational age. A before and after study was designed, with the intervention being the opening a human milk bank. Preterm infants ≤ 32 weeks of gestational age born in the Hospital 12 Octubre from July to December 2005 and January to June 2008 (firsts 6 months after opening the human milk bank) were included. After opening the human milk bank, enteral feedings were started 31h before (Partificial formula, the exposure to formula in the first 15 days of life was reduced from 50% to 16.6%, and it's consumption during the first 28 days of life was significantly reduced. There was a higher consumption of own mother's milk during the hospital stay, and a higher rate of exclusive breastfeeding at hospital discharge (54% vs 40%). The availability of donor human milk has led to quicker progression with enteral feedings and earlier withdrawal of parenteral nutrition. It has reduced the exposure to artificial formulas, and has also increased the intake of own mother's milk during the hospital stay and the rate of exclusive breastfeeding at hospital discharge. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  11. Impacts of urbanization on carbon balance in terrestrial ecosystems of the Southern United States

    International Nuclear Information System (INIS)

    Zhang Chi; Tian Hanqin; Chen, Guangsheng; Chappelka, Arthur; Xu Xiaofeng; Ren Wei; Hui Dafeng; Liu Mingliang; Lu Chaoqun; Pan, Shufen; Lockaby, Graeme

    2012-01-01

    Using a process-based Dynamic Land Ecosystem Model, we assessed carbon dynamics of urbanized/developed lands in the Southern United States during 1945–2007. The results indicated that approximately 1.72 (1.69–1.77) Pg (1P = 10 15 ) carbon was stored in urban/developed lands, comparable to the storage of shrubland or cropland in the region. Urbanization resulted in a release of 0.21 Pg carbon to the atmosphere during 1945–2007. Pre-urbanization vegetation type and time since land conversion were two primary factors determining the extent of urbanization impacts on carbon dynamics. After a rapid decline of carbon storage during land conversion, an urban ecosystem gradually accumulates carbon and may compensate for the initial carbon loss in 70–100 years. The carbon sequestration rate of urban ecosystem diminishes with time, nearly disappearing in two centuries after land conversion. This study implied that it is important to take urbanization effect into account for assessing regional carbon balance. - Highlights: ► A series of spatial and temporal urban/developed land maps were generated. ► Urbanization effects on regional carbon dynamics were studied with a process-based Dynamic Land Ecosystem Model (DLEM). ► Carbon storage of urban/developed land was comparable to that stored in cropland and shrubland in the Southern United States. ► Pre-urbanization vegetation type and time since land conversion were two primary factors determining the extent of urbanization impacts on carbon dynamics. ► Urbanization resulted in carbon emission, but established urban areas may gradually accumulate carbon over time. - Urbanization has resulted in carbon release to the atmosphere, but established urban areas may gradually accumulate carbon over time.

  12. Culture of human cells in experimental units for spaceflight impacts on their behavior.

    Science.gov (United States)

    Cazzaniga, Alessandra; Moscheni, Claudia; Maier, Jeanette Am; Castiglioni, Sara

    2017-05-01

    Because space missions produce pathophysiological alterations such as cardiovascular disorders and bone demineralization which are very common on Earth, biomedical research in space is a frontier that holds important promises not only to counterbalance space-associated disorders in astronauts but also to ameliorate the health of Earth-bound population. Experiments in space are complex to design. Cells must be cultured in closed cell culture systems (from now defined experimental units (EUs)), which are biocompatible, functional, safe to minimize any potential hazard to the crew, and with a high degree of automation. Therefore, to perform experiments in orbit, it is relevant to know how closely culture in the EUs reflects cellular behavior under normal growth conditions. We compared the performances in these units of three different human cell types, which were recently space flown, i.e. bone mesenchymal stem cells, micro- and macrovascular endothelial cells. Endothelial cells are only slightly and transiently affected by culture in the EUs, whereas these devices accelerate mesenchymal stem cell reprogramming toward osteogenic differentiation, in part by increasing the amounts of reactive oxygen species. We conclude that cell culture conditions in the EUs do not exactly mimic what happens in a culture dish and that more efforts are necessary to optimize these devices for biomedical experiments in space. Impact statement Cell cultures represent valuable preclinical models to decipher pathogenic circuitries. This is true also for biomedical research in space. A lot has been learnt about cell adaptation and reaction from the experiments performed on many different cell types flown to space. Obviously, cell culture in space has to meet specific requirements for the safety of the crew and to comply with the unique environmental challenges. For these reasons, specific devices for cell culture in space have been developed. It is important to clarify whether these

  13. Impacts of Changing Marijuana Policies on Alcohol Use in the United States

    Science.gov (United States)

    Guttmannova, Katarina; Lee, Christine M.; Kilmer, Jason R.; Fleming, Charles B.; Rhew, Isaac C.; Kosterman, Rick; Larimer, Mary E.

    2015-01-01

    Background Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in four states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol. Methods The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and non-medical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic search premier, Econlit, Legal collection, Medline, Psych articles, and PsycINFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined. Results The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States. Conclusions Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Further, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the

  14. The impact of municipal solid waste management on greenhouse gas emissions in the United States.

    Science.gov (United States)

    Weitz, Keith A; Thorneloe, Susan A; Nishtala, Subba R; Yarkosky, Sherry; Zannes, Maria

    2002-09-01

    Technological advancements, environmental regulations, and emphasis on resource conservation and recovery have greatly reduced the environmental impacts of municipal solid waste (MSW) management, including emissions of greenhouse gases (GHGs). This study was conducted using a life-cycle methodology to track changes in GHG emissions during the past 25 years from the management of MSW in the United States. For the baseline year of 1974, MSW management consisted of limited recycling, combustion without energy recovery, and landfilling without gas collection or control. This was compared with data for 1980, 1990, and 1997, accounting for changes in MSW quantity, composition, management practices, and technology. Over time, the United States has moved toward increased recycling, composting, combustion (with energy recovery) and landfilling with gas recovery, control, and utilization. These changes were accounted for with historical data on MSW composition, quantities, management practices, and technological changes. Included in the analysis were the benefits of materials recycling and energy recovery to the extent that these displace virgin raw materials and fossil fuel electricity production, respectively. Carbon sinks associated with MSW management also were addressed. The results indicate that the MSW management actions taken by U.S. communities have significantly reduced potential GHG emissions despite an almost 2-fold increase in waste generation. GHG emissions from MSW management were estimated to be 36 million metric tons carbon equivalents (MMTCE) in 1974 and 8 MMTCE in 1997. If MSW were being managed today as it was in 1974, GHG emissions would be approximately 60 MMTCE.

  15. Air quality and human health impacts of grasslands and shrublands in the United States

    Science.gov (United States)

    Gopalakrishnan, Varsha; Hirabayashi, Satoshi; Ziv, Guy; Bakshi, Bhavik R.

    2018-06-01

    Vegetation including canopy, grasslands, and shrublands can directly sequester pollutants onto the plant surface, resulting in an improvement in air quality. Until now, several studies have estimated the pollution removal capacity of canopy cover at the level of a county, but no such work exists for grasslands and shrublands. This work quantifies the air pollution removal capacity of grasslands and shrublands at the county-level in the United States and estimates the human health benefits associated with pollution removal using the i-Tree Eco model. Sequestration of pollutants is estimated based on the Leaf Area Index (LAI) obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS) derived dataset estimates of LAI and the percentage land cover obtained from the National Land Cover Database (NLCD) for the year 2010. Calculation of pollution removal capacity using local environmental data indicates that grasslands and shrublands remove a total of 6.42 million tonnes of air pollutants in the United States and the associated monetary benefits total 268 million. Human health impacts and associated monetary value due to pollution removal was observed to be significantly high in urban areas indicating that grasslands and shrublands are equally critical as canopy in improving air quality and human health in urban regions.

  16. Impact of female-oriented cigarette packaging in the United States.

    Science.gov (United States)

    Hammond, David; Doxey, Juliana; Daniel, Samantha; Bansal-Travers, Maansi

    2011-07-01

    Cigarette packaging is among the most prominent forms of tobacco marketing. This study examined the impact of cigarette pack design among young women in the United States. A national sample of 18- to 19-year-old females in the United States completed an online survey in February 2010. Participants were randomized to view eight cigarette packs designed according to one of four experimental conditions: fully branded female packs, same packs without descriptors (e.g., "slims"), same packs without brand imagery or descriptors ("plain" packs), and branded non-female brands. Participants rated packs on measures of appeal and health risk and completed a behavioral pack selection task. Fully branded female packs were rated significantly more appealing than the same packs without descriptors, "plain" packs, and non-female-branded packs. Female-branded packs were associated with a greater number of positive attributes including glamour, slimness, and attractiveness and were more likely to be perceived as less harmful. Approximately 40% of smokers and nonsmokers requested a pack at the end of the study; female-branded packs were 3 times more likely to be selected than plain packs. Plain packaging and removing descriptors such as "slims" from cigarette packs may reduce smoking susceptibility among young women.

  17. Modeling the status, trends, and impacts of wild bee abundance in the United States.

    Science.gov (United States)

    Koh, Insu; Lonsdorf, Eric V; Williams, Neal M; Brittain, Claire; Isaacs, Rufus; Gibbs, Jason; Ricketts, Taylor H

    2016-01-05

    Wild bees are highly valuable pollinators. Along with managed honey bees, they provide a critical ecosystem service by ensuring stable pollination to agriculture and wild plant communities. Increasing concern about the welfare of both wild and managed pollinators, however, has prompted recent calls for national evaluation and action. Here, for the first time to our knowledge, we assess the status and trends of wild bees and their potential impacts on pollination services across the coterminous United States. We use a spatial habitat model, national land-cover data, and carefully quantified expert knowledge to estimate wild bee abundance and associated uncertainty. Between 2008 and 2013, modeled bee abundance declined across 23% of US land area. This decline was generally associated with conversion of natural habitats to row crops. We identify 139 counties where low bee abundances correspond to large areas of pollinator-dependent crops. These areas of mismatch between supply (wild bee abundance) and demand (cultivated area) for pollination comprise 39% of the pollinator-dependent crop area in the United States. Further, we find that the crops most highly dependent on pollinators tend to experience more severe mismatches between declining supply and increasing demand. These trends, should they continue, may increase costs for US farmers and may even destabilize crop production over time. National assessments such as this can help focus both scientific and political efforts to understand and sustain wild bees. As new information becomes available, repeated assessments can update findings, revise priorities, and track progress toward sustainable management of our nation's pollinators.

  18. Development and Application of a Low Impact Development (LID-Based District Unit Planning Model

    Directory of Open Access Journals (Sweden)

    Cheol Hee Son

    2017-01-01

    Full Text Available The purpose of this study was to develop a low impact development-based district unit planning (LID-DP model and to verify the model by applying it to a test site. To develop the model, we identified various barriers to the urban planning process and examined the advantages of various LID-related techniques to determine where in the urban development process LID would provide the greatest benefit. The resulting model provides (1 a set of district unit planning processes that consider LID standards and (2 a set of evaluation methods that measure the benefits of the LID-DP model over standard urban development practices. The developed LID-DP process is composed of status analysis, comprehensive analysis, basic plan, and sectoral plans. To determine whether the LID-DP model met the proposed LID targets, we applied the model to a test site in Cheongju City, Chungcheongbuk-do Province, Republic of Korea. The test simulation showed that the LID-DP plan reduced nonpoint source pollutants (total nitrogen, 113%; total phosphorous, 193%; and biological oxygen demand, 199%; reduced rainfall runoff (infiltration volume, 102%; surface runoff, 101%; and improved the conservation rate of the natural environment area (132%. The successful application of this model also lent support for the greater importance of non-structural techniques over structural techniques in urban planning when taking ecological factors into account.

  19. Impact of Female-Oriented Cigarette Packaging in the United States

    Science.gov (United States)

    Doxey, Juliana; Daniel, Samantha; Bansal-Travers, Maansi

    2011-01-01

    Introduction: Cigarette packaging is among the most prominent forms of tobacco marketing. This study examined the impact of cigarette pack design among young women in the United States. Method: A national sample of 18- to 19-year-old females in the United States completed an online survey in February 2010. Participants were randomized to view eight cigarette packs designed according to one of four experimental conditions: fully branded female packs, same packs without descriptors (e.g., “slims”), same packs without brand imagery or descriptors (“plain” packs), and branded non-female brands. Participants rated packs on measures of appeal and health risk and completed a behavioral pack selection task. Results: Fully branded female packs were rated significantly more appealing than the same packs without descriptors, “plain” packs, and non–female-branded packs. Female-branded packs were associated with a greater number of positive attributes including glamour, slimness, and attractiveness and were more likely to be perceived as less harmful. Approximately 40% of smokers and nonsmokers requested a pack at the end of the study; female-branded packs were 3 times more likely to be selected than plain packs. Conclusion: Plain packaging and removing descriptors such as “slims” from cigarette packs may reduce smoking susceptibility among young women. PMID:21486994

  20. The impact of a lean rounding process in a pediatric intensive care unit.

    Science.gov (United States)

    Vats, Atul; Goin, Kristin H; Villarreal, Monica C; Yilmaz, Tuba; Fortenberry, James D; Keskinocak, Pinar

    2012-02-01

    Poor workflow associated with physician rounding can produce inefficiencies that decrease time for essential activities, delay clinical decisions, and reduce staff and patient satisfaction. Workflow and provider resources were not optimized when a pediatric intensive care unit increased by 22,000 square feet (to 33,000) and by nine beds (to 30). Lean methods (focusing on essential processes) and scenario analysis were used to develop and implement a patient-centric standardized rounding process, which we hypothesize would lead to improved rounding efficiency, decrease required physician resources, improve satisfaction, and enhance throughput. Human factors techniques and statistical tools were used to collect and analyze observational data for 11 rounding events before and 12 rounding events after process redesign. Actions included: 1) recording rounding events, times, and patient interactions and classifying them as essential, nonessential, or nonvalue added; 2) comparing rounding duration and time per patient to determine the impact on efficiency; 3) analyzing discharge orders for timeliness; 4) conducting staff surveys to assess improvements in communication and care coordination; and 5) analyzing customer satisfaction data to evaluate impact on patient experience. Thirty-bed pediatric intensive care unit in a children's hospital with academic affiliation. Eight attending pediatric intensivists and their physician rounding teams. Eight attending physician-led teams were observed for 11 rounding events before and 12 rounding events after implementation of a standardized lean rounding process focusing on essential processes. Total rounding time decreased significantly (157 ± 35 mins before vs. 121 ± 20 mins after), through a reduction in time spent on nonessential (53 ± 30 vs. 9 ± 6 mins) activities. The previous process required three attending physicians for an average of 157 mins (7.55 attending physician man-hours), while the new process required two

  1. Economic impacts of the total nuclear waste management program envisioned for the United States

    International Nuclear Information System (INIS)

    Busch, L.; Zielen, A.J.; Parry, S.J.S.

    1978-01-01

    This paper presents information on the costs of nuclear waste management and on the impacts of those costs on the price of power and on the capital and labor markets. It is assumed that the LWR would be the sole commercial reactor used through the year 2000. Two fuel cycle options are considered: the throwaway mode (spent fuel is waste), and the full recycle for comparison. Total costs are calculated for all facilities needed to store, package, and reposit all the spent fuel through the lifetime of 380 GW capacity installed by 2000 and operating for 30 y. The economic impact is: the price of power produced by the reactors would be increased by 1.4%; the capital for nuclear plants would apply to waste management; the average annual labor effort needed over the next 50 to 75 years is 3000 to 5000 man years; and the unit cost of spent fuel disposal is $129/kg ($119/kg for full recycle). 7 tables

  2. Partner support and impact on birth outcomes among teen pregnancies in the United States.

    Science.gov (United States)

    Shah, Monisha K; Gee, Rebekah E; Theall, Katherine P

    2014-02-01

    Despite hypothesized relationships between lack of partner support during a woman's pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States. In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes. Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26-0.54)] and nearly 2 times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support. Having partner support or involvement during a teenager's pregnancy may reduce the likelihood of having a poor birth outcome. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  3. Climate change: Potential impacts and interactions in wetlands of the United States

    Science.gov (United States)

    Burkett, Virginia; Kusler, Jon

    2000-01-01

    Wetlands exist in a transition zone between aquatic and terrestrial environments which can be altered by subtle changes in hydrology. Twentieth century climate records show that the United States is generally experiencing a trend towards a wetter, warmer climate; some climate models suggest that his trend will continue and possibly intensify over the next 100 years. Wetlands that are most likely to be affected by these and other potential changes (e.g., sea-level rise) associated with atmospheric carbon enrichment include permafrost wetlands, coastal and estuarine wetlands, peatlands, alpine wetlands, and prairie pothote wetlands. Potential impacts range from changes in community structure to changes in ecological function, and from extirpation to enhancement. Wetlands (particularly boreal peatlands) play an important role in the global carbon cycle, generally sequestering carbon in the form of biomass, methane, dissolved organic material and organic sediment. Wetlands that are drained or partially dried can become a net source of methane and carbon dioxide to the atmosphere, serving as a positive biotic feedback to global warming. Policy options for minimizing the adverse impacts of climate change on wetland ecosystems include the reduction of current anthropogenic stresses, allowing for inland migration of coastal wetlands as sea-level rises, active management to preserve wetland hydrology, and a wide range of other management and restoration options.

  4. The impact of the oil crisis associated with the Persian Gulf conflict on the United States

    International Nuclear Information System (INIS)

    Gill, G.S.; Boyd, R.

    1992-01-01

    This paper analyzes the effects of the Persian Gulf conflict on the level of economic activity, employment and inflation in the United States. Impacts on other countries are not examined in this study. Many of the impacts are difficult to quantify objectively. One factor that can be subjected to analysis is the increase in US government expenditures associated with Operations Desert Shield and Desert Storm. The analytical results of the investigation suggest that the method of financing the increase does make a difference in how the US economy is affected. In two of the three cases considered (i.e. deficit financing and 80% financing by coalition partners), output, personal consumption expenditures, and disposable income increase, but these increases are partly associated with higher prices (i.e. inflation). In the third case (i.e. tax-offset scenario), output, personal consumption expenditures, and disposable income decline, but prices actually fall. Moreover, the magnitudes of the changes are directly proportional to the size of the expenditure increase. (author)

  5. The projected environmental impacts of transportation of radioactive material to the first United States repository site

    International Nuclear Information System (INIS)

    Cashwell, J.W.; Neuhauser, K.S.; Reardon, P.C.; McNair, G.W.

    1987-01-01

    The relative national environmental impacts of transporting spent fuel and other nuclear wastes to each of 9 candidate repository sites in the United States were analyzed for the 26-year period of repository operation. Two scenarios were examined for each repository: 1) shipment of 5-year-old spent fuel and Defence High-Level Waste (DHLW) directly from their points of origin to a repository (reference case); and 2) shipment of 5-year-old spent fuel to a Monitored Retrievable Storage (MRS) facility and shipment (by dedicated rail) of 10-year-old consolidated spent fuel from the MRS to a repository. Transport by either all truck or all rail from the points of origin were analyzed as bounding cases. The computational system used to analyze these impacts included the WASTES II logistics code and the RADTRAN III risk analysis code. The radiological risks for the reference case increased as the total shipment miles to a repository increased for truck; the risks also increased with mileage for rail but at a lower rate. For the MRS scenario the differences between repository sites were less pronounced for both modal options, because of the reduction in total shipment miles possible with the large dedicated rail casks. All the risks reported are small in comparison to the radiological risks due to 'natural background'

  6. Impact of pharmacist’s interventions on cost of drug therapy in intensive care unit. Pharmacy

    Directory of Open Access Journals (Sweden)

    Saokaew S

    2009-06-01

    Full Text Available Pharmacist participation in patient care team has been shown to reduce incidence of adverse drug events, and overall drug costs. However, impact of pharmacist participation in the multidisciplinary intensive care team on cost saving and cost avoidance has little been studied in Thailand.Objective: To describe the characteristics of the interventions and to determine pharmacist’s interventions led to change in cost saving and cost avoidance in intensive care unit (ICU. Methods: A Prospective, standard care-controlled study design was used to compare cost saving and cost avoidance of patients receiving care from patient care team (including a clinical pharmacist versus standard care (no pharmacist on team. All patients admitted to the medical intensive care unit 1 and 2 during the same period were included in the study. The outcome measures were overall drug cost and length of ICU stay. Interventions made by the pharmacist in the study group were documented. The analyses of acceptance and cost saving and/or cost avoidance were also performed. Results: A total of 65 patients were admitted to either ICU 1 or 2 during the 5 week- study period. The pharmacist participated in patient care and made total of 127 interventions for the ICU-1 team. Ninety-eight percent of the interventions were accepted and implemented by physicians. The difference of overall drug cost per patient between two groups was 182.01 USD (1,076.37 USD in study group and 1,258.38 USD in control group, p=0.138. The average length of ICU stay for the intervention group and the control group was not significantly different (7.16 days vs. 6.18 days, p=0.995. The 125 accepted interventions were evaluated for cost saving and cost avoidance. Pharmacist’s interventions yielded a total of 1,971.43 USD from drug cost saving and 294.62 USD from adverse drug event cost avoidance. The net cost saved and avoided from pharmacist interventions was 2,266.05 USD. Interventions involving

  7. The impact of a picture archiving and communication system (PACS) upon an intensive care unit

    International Nuclear Information System (INIS)

    Watkins, Jessamy; Weatherburn, Gwyn; Bryan, Stirling

    2000-01-01

    Objective: The aim of the study was to assess the effect of the introduction of PACS (Picture Archiving and Communication System) upon image availability in an Intensive Care Unit (ICU) and the consequent impact upon the behaviour of the ICU physicians, in terms of the initiation of image-based clinical actions. Design: A before and after study was used to compare the speed of image availability prior to, and following, the implementation of a hospital-wide PACS. Setting: The research was part of an economic evaluation of PACS at Hammersmith Hospital, West London. Patients and participants: All ICU patients who were X-rayed during two pre-PACS and one post-PACS data collection periods were included within the study. Measurements: The times of: the X-ray request; acquisition; availability on ICU; and of any image-based clinical action taken by the ICU physician were recorded by radiographers and ICU physicians. Results: PACS significantly reduced the time between request and image availability on ICU for routine X-rays but did not have any measurable impact upon the time clinical actions were initiated by ICU physicians. The data on non-routine images were statistically inconclusive. Conclusions: This study shows that PACS significantly improves the speed of delivery of routine images to the ICU, but it appears that the instigation of image-based clinical actions is determined by other organisational factors in ICU, such as ward rounds, rather than the availability of the image for viewing. Further work is required on non-routine X-rays to clarify the impact of PACS on physician behaviour in clinically urgent situations

  8. Regional impacts of oil and gas development on ozone formation in the western United States.

    Science.gov (United States)

    Rodriguez, Marco A; Barna, Michael G; Moore, Tom

    2009-09-01

    The Intermountain West is currently experiencing increased growth in oil and gas production, which has the potential to affect the visibility and air quality of various Class I areas in the region. The following work presents an analysis of these impacts using the Comprehensive Air Quality Model with extensions (CAMx). CAMx is a state-of-the-science, "one-atmosphere" Eulerian photochemical dispersion model that has been widely used in the assessment of gaseous and particulate air pollution (ozone, fine [PM2.5], and coarse [PM10] particulate matter). Meteorology and emissions inventories developed by the Western Regional Air Partnership Regional Modeling Center for regional haze analysis and planning are used to establish an ozone baseline simulation for the year 2002. The predicted range of values for ozone in the national parks and other Class I areas in the western United States is then evaluated with available observations from the Clean Air Status and Trends Network (CASTNET). This evaluation demonstrates the model's suitability for subsequent planning, sensitivity, and emissions control strategy modeling. Once the ozone baseline simulation has been established, an analysis of the model results is performed to investigate the regional impacts of oil and gas development on the ozone concentrations that affect the air quality of Class I areas. Results indicate that the maximum 8-hr ozone enhancement from oil and gas (9.6 parts per billion [ppb]) could affect southwestern Colorado and northwestern New Mexico. Class I areas in this region that are likely to be impacted by increased ozone include Mesa Verde National Park and Weminuche Wilderness Area in Colorado and San Pedro Parks Wilderness Area, Bandelier Wilderness Area, Pecos Wilderness Area, and Wheeler Peak Wilderness Area in New Mexico.

  9. Economic and Environmental Impact of Rice Blast Pathogen (Magnaporthe oryzae) Alleviation in the United States.

    Science.gov (United States)

    Nalley, Lawton; Tsiboe, Francis; Durand-Morat, Alvaro; Shew, Aaron; Thoma, Greg

    2016-01-01

    Rice blast (Magnaporthe oryzae) is a key concern in combating global food insecurity given the disease is responsible for approximately 30% of rice production losses globally-the equivalent of feeding 60 million people. These losses increase the global rice price and reduce consumer welfare and food security. Rice is the staple crop for more than half the world's population so any reduction in rice blast would have substantial beneficial effects on consumer livelihoods. In 2012, researchers in the US began analyzing the feasibility of creating blast-resistant rice through cisgenic breeding. Correspondingly, our study evaluates the changes in producer, consumer, and environmental welfare, if all the rice produced in the Mid-South of the US were blast resistant through a process like cisgenics, using both international trade and environmental assessment modeling. Our results show that US rice producers would gain 69.34 million dollars annually and increase the rice supply to feed an additional one million consumers globally by eliminating blast from production in the Mid-South. These results suggest that blast alleviation could be even more significant in increasing global food security given that the US is a small rice producer by global standards and likely experiences lower losses from blast than other rice-producing countries because of its ongoing investment in production technology and management. Furthermore, results from our detailed life cycle assessment (LCA) show that producing blast-resistant rice has lower environmental (fossil fuel depletion, ecotoxicity, carcinogenics, eutrophication, acidification, global warming potential, and ozone depletion) impacts per unit of rice than non-blast resistant rice production. Our findings suggest that any reduction in blast via breeding will have significantly positive impacts on reducing global food insecurity through increased supply, as well as decreased price and environmental impacts in production.

  10. Economic and Environmental Impact of Rice Blast Pathogen (Magnaporthe oryzae Alleviation in the United States.

    Directory of Open Access Journals (Sweden)

    Lawton Nalley

    Full Text Available Rice blast (Magnaporthe oryzae is a key concern in combating global food insecurity given the disease is responsible for approximately 30% of rice production losses globally-the equivalent of feeding 60 million people. These losses increase the global rice price and reduce consumer welfare and food security. Rice is the staple crop for more than half the world's population so any reduction in rice blast would have substantial beneficial effects on consumer livelihoods. In 2012, researchers in the US began analyzing the feasibility of creating blast-resistant rice through cisgenic breeding. Correspondingly, our study evaluates the changes in producer, consumer, and environmental welfare, if all the rice produced in the Mid-South of the US were blast resistant through a process like cisgenics, using both international trade and environmental assessment modeling. Our results show that US rice producers would gain 69.34 million dollars annually and increase the rice supply to feed an additional one million consumers globally by eliminating blast from production in the Mid-South. These results suggest that blast alleviation could be even more significant in increasing global food security given that the US is a small rice producer by global standards and likely experiences lower losses from blast than other rice-producing countries because of its ongoing investment in production technology and management. Furthermore, results from our detailed life cycle assessment (LCA show that producing blast-resistant rice has lower environmental (fossil fuel depletion, ecotoxicity, carcinogenics, eutrophication, acidification, global warming potential, and ozone depletion impacts per unit of rice than non-blast resistant rice production. Our findings suggest that any reduction in blast via breeding will have significantly positive impacts on reducing global food insecurity through increased supply, as well as decreased price and environmental impacts in

  11. AN ANALYSIS OF THE IMPACT OF SPORTS UTILITY VEHICLES IN THE UNITED STATES

    Energy Technology Data Exchange (ETDEWEB)

    Davis, S.C.

    2000-08-16

    During the 1990s, sport utility vehicles (SUVs) became the fastest growing segment of the auto industry, especially those in the medium-size category. In 1999, SUV sales reached almost 19% of the total light vehicle market and the mix of SUVs on the road, as measured by registration data, was about 8.7%. This immense popularity has been called by some a passing fad--vehicle purchases based on the SUV ''image''. But the continued yearly increases in SUV sales seem to indicate a more permanent trend. Additional explanations for SUV popularity include the general economic well being in the United States, a perception of safety, and ''utility''. Generally larger and heavier than the typical automobile, SUVs require more fuel per mile to operate and produce greater amounts of pollutants. They are also driven further annually than are automobiles of the same vintage, a fact that exacerbates the fuel-use and emission problems. Although buyers believe that SUVs are safer than automobiles which they are in some cases, SUVs are more prone to roll-overs than are automobiles. In addition, SUVs, with their higher bumpers and greater weight, may be a threat to other vehicles on the highway, especially in side-impact crashes. With sales projected to grow to over 3 million units per year beginning in 2001, SUVs show no sign of decreasing in popularity. These vehicles are used primarily for general mobility, rather than off-road activities. An emphasis on better fuel economy and improved emissions control could address environmental and oil dependency concerns. In fact, recently, two vehicle manufacturers announced intentions of improving the fuel economy of their SUVs in the next few years. Also, tests simulating crashes involving automobiles and SUVs could provide valuable data for identifying potential safety design issues. It is clear that automobiles and SUVs will be sharing the highways for years to come.

  12. Building capacity for Health Impact Assessment: Training outcomes from the United States

    Energy Technology Data Exchange (ETDEWEB)

    Schuchter, Joseph [Berkeley, CA (United States); Rutt, Candace, E-mail: awr8@cdc.gov [Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, 4770 Buford Highway MS/F-77, Atlanta, GA 30341 (United States); Satariano, William A. [University of California Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, CA (United States); Seto, Edmund [University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA (United States)

    2015-01-15

    Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building.

  13. Building capacity for Health Impact Assessment: Training outcomes from the United States

    International Nuclear Information System (INIS)

    Schuchter, Joseph; Rutt, Candace; Satariano, William A.; Seto, Edmund

    2015-01-01

    Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building

  14. Impact of Neonatal Intensive Care Unit Admission on Bacterial Colonization of Donated Human Milk.

    Science.gov (United States)

    Elmekkawi, Amir; O'Connor, Deborah L; Stone, Debbie; Yoon, Eugene W; Larocque, Michael; McGeer, Allison; Unger, Sharon

    2018-05-01

    Unpasteurized human donor milk typically contains a variety of bacteria. The impact of neonatal intensive care unit (NICU) admission of the donor's infant and duration of lactation on bacterial contamination of human milk is unknown. Research aim: This study aimed (a) to describe the frequency/concentration of skin commensal bacteria and pathogens in unpasteurized human donor milk and (b) to assess the impact of NICU admission and (c) the duration of milk expression on bacterial colonization of donated milk. The authors conducted a retrospective cohort study of human milk donated to the Rogers Hixon Ontario Human Milk Bank from January 2013 to June 2014. Milk samples from each donor were cultured every 2 weeks. The study included 198 donor mothers, of whom 63 had infants admitted to the NICU. Of 1,289 cultures obtained, 1,031 (80%) had detectable bacterial growth and 363 (28%) yielded bacterial growth in excess of 10 7 cfu/L, a local threshold for allowable bacteria prior to pasteurization. The mean (standard deviation) donation period per donor was 13.0 (7.5) weeks. Milk from mothers with NICU exposure had significantly higher concentrations of commensals, but not pathogens, at every time period compared with other mothers. For every 1-month increase in donation from all donors, the odds ratio of presence of any commensal in milk increased by 1.13 (95% confidence interval [1.03, 1.23]) and any pathogen by 1.31 (95% confidence interval [1.20, 1.43]). Commensal bacteria were more abundant in donor milk expressed from mothers exposed to neonatal intensive care. Bacterial contamination increased over the milk donation period.

  15. Prevalence, causes and mental health impact of workplace bullying in the Neonatal Intensive Care Unit environment

    Science.gov (United States)

    Chatziioannidis, Ilias; Bascialla, Francesca Giuseppina; Chatzivalsama, Panagiota; Vouzas, Fotios; Mitsiakos, Georgios

    2018-01-01

    Objectives The aim of this study is to examine the prevalence, to report barriers and mental health impact of bullying behaviours and to analyse whether psychological support at work could affect victims of bullying in the healthcare workplace. Design Self-administered questionnaire survey. Setting 20 in total neonatal intensive care units in 17 hospitals in Greece. Participants 398 healthcare professionals (doctors, nurses). Main outcome measures The questionnaire included information on demographic data, Negative Act Questionnaire-Revised (NAQ-R) behaviour scale, data on sources of bullying, perpetrators profile, causal factors, actions taken and reasons for not reporting bullying, psychological support and 12-item General Health Questionnaire (GHQ-12) scores to investigate psychological distress. Results Prevalence of bullying measured by the NAQ-R was 53.1% for doctors and 53.6% for nurses. Victims of bullying differed from non-bullied in terms of gender and job experience, among demographic data. Crude NAQ-R score was found higher for female, young and inexperienced employees. Of those respondents who experienced bullying 44.9% self-labelled themselves as victims. Witnessing bullying of others was found 83.2%. Perpetrators were mainly females 45–64 years old, most likely being a supervisor/senior colleague. Common reasons for not reporting bullying was self-dealing and fear of consequences. Bullying was attributed to personality trait and management. Those who were bullied, self-labelled as a victim and witnessed bullying of others had higher GHQ-12 score. Moreover, psychological support at work had a favour effect on victims of bullying. Conclusions Prevalence of bullying and witnessing were found extremely high, while half of victims did not consider themselves as sufferers. The mental health impact on victims and witnesses was severe and support at work was necessary to ensure good mental health status among employees. PMID:29478015

  16. Prevalence, causes and mental health impact of workplace bullying in the Neonatal Intensive Care Unit environment.

    Science.gov (United States)

    Chatziioannidis, Ilias; Bascialla, Francesca Giuseppina; Chatzivalsama, Panagiota; Vouzas, Fotios; Mitsiakos, Georgios

    2018-02-24

    The aim of this study is to examine the prevalence, to report barriers and mental health impact of bullying behaviours and to analyse whether psychological support at work could affect victims of bullying in the healthcare workplace. Self-administered questionnaire survey. 20 in total neonatal intensive care units in 17 hospitals in Greece. 398 healthcare professionals (doctors, nurses). The questionnaire included information on demographic data, Negative Act Questionnaire-Revised (NAQ-R) behaviour scale, data on sources of bullying, perpetrators profile, causal factors, actions taken and reasons for not reporting bullying, psychological support and 12-item General Health Questionnaire (GHQ-12) scores to investigate psychological distress. Prevalence of bullying measured by the NAQ-R was 53.1% for doctors and 53.6% for nurses. Victims of bullying differed from non-bullied in terms of gender and job experience, among demographic data. Crude NAQ-R score was found higher for female, young and inexperienced employees. Of those respondents who experienced bullying 44.9% self-labelled themselves as victims. Witnessing bullying of others was found 83.2%. Perpetrators were mainly females 45-64 years old, most likely being a supervisor/senior colleague. Common reasons for not reporting bullying was self-dealing and fear of consequences. Bullying was attributed to personality trait and management. Those who were bullied, self-labelled as a victim and witnessed bullying of others had higher GHQ-12 score. Moreover, psychological support at work had a favour effect on victims of bullying. Prevalence of bullying and witnessing were found extremely high, while half of victims did not consider themselves as sufferers. The mental health impact on victims and witnesses was severe and support at work was necessary to ensure good mental health status among employees. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights

  17. Closure Report for Corrective Action Unit 107: Low Impact Soil Sites, Nevada Test Site, Nevada

    International Nuclear Information System (INIS)

    2009-01-01

    Corrective Action Unit (CAU) 107 is identified in the Federal Facility Agreement and Consent Order (FFACO) as 'Low Impact Soil Sites' and consists of the following 15 Corrective Action Sites (CASs), located in Areas 1, 2, 3, 4, 5, 9, 10, and 18 of the Nevada Test Site: CAS 01-23-02, Atmospheric Test Site - High Alt; CAS 02-23-02, Contaminated Areas (2); CAS 02-23-03, Contaminated Berm; CAS 02-23-10, Gourd-Amber Contamination Area; CAS 02-23-11, Sappho Contamination Area; CAS 02-23-12, Scuttle Contamination Area; CAS 03-23-24, Seaweed B Contamination Area; CAS 03-23-27, Adze Contamination Area; CAS 03-23-28, Manzanas Contamination Area; CAS 03-23-29, Truchas-Chamisal Contamination Area; CAS 04-23-02, Atmospheric Test Site T4-a; CAS 05-23-06, Atmospheric Test Site; CAS 09-23-06, Mound of Contaminated Soil; CAS 10-23-04, Atmospheric Test Site M-10; and CAS 18-23-02, U-18d Crater (Sulky). Closure activities were conducted from February through April 2009 according to the FFACO (1996; as amended February 2008) and Revision 1 of the Streamlined Approach for Environmental Restoration Plan for CAU 107 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2009). The corrective action alternatives included No Further Action and Closure in Place with Administrative Controls. Closure activities are summarized.

  18. Hydropower Impacts on Electrical System Production Costs in the Southwest United States

    Directory of Open Access Journals (Sweden)

    Dominique M. Bain

    2018-02-01

    Full Text Available The Colorado River is an important natural resource for the Southwestern United States. Predicted climate change impacts include increased temperature, decreased rainfall and increased probability of drought in this region. Given the large amount of hydropower on the Colorado River and its importance to the bulk electricity system, this purpose of this study was to quantify the value hydropower in operating the electrical system, and examined changes in hydropower value and electricity costs under different possible future drought conditions and regional generation scenarios. The goal was to better understand how these scenarios affect operating costs of the bulk electrical system, as well as the value of the hydropower produced, and proposed a method for doing so. The calculated value of the hydroelectric power was nearly double the mean locational marginal price in the study area, about $73 to $75 for most scenarios, demonstrating a high value of the hydropower. In general, it was found that reduced water availability increased operating costs, and increased the value of the hydropower. A calculated value factor showed that when less hydroelectric power is available, the hydropower is more valuable. Furthermore, the value factor showed that the value of hydro increases with the addition of solar or the retirement of thermal generating resources.

  19. Vibration characteristics of a hydraulic generator unit rotor system with parallel misalignment and rub-impact

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Zhiwei; Zhou, Jianzhong; Yang, Mengqi; Zhang, Yongchuan [Huazhong University of Science and Technology, College of Hydraulic and Digitalization Engineering, Wuhan, Hubei Province (China)

    2011-07-15

    The object of this research aims at the hydraulic generator unit rotor system. According to fault problems of the generator rotor local rubbing caused by the parallel misalignment and mass eccentricity, a dynamic model for the rotor system coupled with misalignment and rub-impact is established. The dynamic behaviors of this system are investigated using numerical integral method, as the parallel misalignment, mass eccentricity and bearing stiffness vary. The nonlinear dynamic responses of the generator rotor and turbine rotor with coupling faults are analyzed by means of bifurcation diagrams, Poincare maps, axis orbits, time histories and amplitude spectrum diagrams. Various nonlinear phenomena in the system, such as periodic, three-periodic and quasi-periodic motions, are studied with the change of the parallel misalignment. The results reveal that vibration characteristics of the rotor system with coupling faults are extremely complex and there are some low frequencies with large amplitude in the 0.3-0.4 x components. As the increase in mass eccentricity, the interval of nonperiodic motions will be continuously moved forward. It suggests that the reduction in mass eccentricity or increase in bearing stiffness could preclude nonlinear vibration. These might provide some important theory references for safety operating and exact identification of the faults in rotating machinery. (orig.)

  20. Potential impacts of biomass production in the United States on biological diversity

    International Nuclear Information System (INIS)

    Cook, J.H.; Beyea, J.; Keeler, K.H.

    1991-01-01

    This paper reports that biomass could be a renewable source of energy and chemicals that would not add CO 2 to the atmosphere. It will become economically competitive as its cost decreases relative to energy costs, and biotechnology is expected to accelerate this trend by increasing biomass productivity. Pressure to slow global warming may also make biomass more attractive. Substantial dependence on biomass would entail massive changes in land use, risking serious reductions in biodiversity through destruction of habitat for native species. Forests could be managed and harvested more intensively, and virtually all arable land unsuitable for high-value agriculture or silviculture might be used to grow energy crops. The authors estimate that it would require an area equal to that farmed in 1988, about 130 million hectares, just to supply the United States with transportation fuel. Planning at micro to macro scales will be crucial to minimize the ecological impacts of producing biomass. Cropping and harvesting systems will need to provide the spatial and temporal diversity characteristics of natural ecosystems and successional sequences. To maximize habitat value for interior-dependent species, it will be essential to maintain the connectivity of the habitat network, both within biomass farms and to surrounding undisturbed areas

  1. Impact of a clinical microbiology-intensive care consulting program in a cardiothoracic intensive care unit.

    Science.gov (United States)

    Arena, Fabio; Scolletta, Sabino; Marchetti, Luca; Galano, Angelo; Maglioni, Enivarco; Giani, Tommaso; Corsi, Elisabetta; Lombardi, Silvia; Biagioli, Bonizella; Rossolini, Gian Maria

    2015-09-01

    A preintervention-postintervention study was carried out over a 4-year period to assess the impact of an antimicrobial stewardship intervention, based on clinical microbiologist ward rounds (clinical microbiology-intensive care partnership [CMICP]), at a cardiothoracic intensive care unit. Comparison of clinical data for 37 patients with diagnosis of bacteremia (18 from preintervention period, 19 from postintervention period) revealed that CMICP implementation resulted in (1) significant increase of appropriate empirical treatments (+34%, P = .029), compliance with guidelines (+28%, P = .019), and number of de-escalations (+42%, P = .032); and (2) decrease (average = 2.5 days) in time to optimization of antimicrobial therapy and levofloxacin (Δ 2009-2012 = -74 defined daily dose [DDD]/1,000 bed days) and teicoplanin (Δ 2009-2012 = -28 DDD/1,000 bed days) use. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Impact of County-Level Socioeconomic Status on Oropharyngeal Cancer Survival in the United States.

    Science.gov (United States)

    Megwalu, Uchechukwu C

    2017-04-01

    Objective To evaluate the impact of county-level socioeconomic status on survival in patients with oropharyngeal cancer in the United States. Study Design Retrospective cohort study via a large population-based cancer database. Methods Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 18,791 patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012. Results Patients residing in counties with a low socioeconomic status index had worse overall survival (56.5% vs 63.0%, P socioeconomic status index. On multivariable analysis, residing in a county with a low socioeconomic status index was associated with worse overall survival (hazard ratio, 1.21; 95% CI, 1.14-1.29; P status, year of diagnosis, site, American Joint Committee on Cancer stage group, presence of distant metastasis, presence of unresectable tumor, histologic grade, surgical resection of primary site, treatment with neck dissection, and radiation therapy. Conclusion Residing in a county with a low socioeconomic status index is associated with worse survival. Further research is needed to elucidate the mechanism by which socioeconomic status affects survival in oropharyngeal cancer.

  3. Evaluation of the impact of implementation of a Medical Assessment and Planning Unit on length of stay

    NARCIS (Netherlands)

    Brand, Caroline A.; Kennedy, Marcus P.; King-Kallimanis, Bellinda L.; Williams, Ged; Bain, Christopher A.; Russell, David M.

    2010-01-01

    Objective: The Medical Assessment and Planning Unit (MAPU) model provides a multidisciplinary and 'front end loading' approach to acute medical care. The objective of this study was to evaluate the impact of a 10-bed MAPU in Royal Melbourne Hospital (RMH) on hospital length of stay. A pre-post study

  4. Modelling the impact of retention-detention units on sewer surcharge and peak and annual runoff reduction.

    Science.gov (United States)

    Locatelli, Luca; Gabriel, Søren; Mark, Ole; Mikkelsen, Peter Steen; Arnbjerg-Nielsen, Karsten; Taylor, Heidi; Bockhorn, Britta; Larsen, Hauge; Kjølby, Morten Just; Blicher, Anne Steensen; Binning, Philip John

    2015-01-01

    Stormwater management using water sensitive urban design is expected to be part of future drainage systems. This paper aims to model the combination of local retention units, such as soakaways, with subsurface detention units. Soakaways are employed to reduce (by storage and infiltration) peak and volume stormwater runoff; however, large retention volumes are required for a significant peak reduction. Peak runoff can therefore be handled by combining detention units with soakaways. This paper models the impact of retrofitting retention-detention units for an existing urbanized catchment in Denmark. The impact of retrofitting a retention-detention unit of 3.3 m³/100 m² (volume/impervious area) was simulated for a small catchment in Copenhagen using MIKE URBAN. The retention-detention unit was shown to prevent flooding from the sewer for a 10-year rainfall event. Statistical analysis of continuous simulations covering 22 years showed that annual stormwater runoff was reduced by 68-87%, and that the retention volume was on average 53% full at the beginning of rain events. The effect of different retention-detention volume combinations was simulated, and results showed that allocating 20-40% of a soakaway volume to detention would significantly increase peak runoff reduction with a small reduction in the annual runoff.

  5. Impact of distributed generation units with power electronic converters on distribution network protection

    NARCIS (Netherlands)

    Morren, J.; Haan, de S.W.H.

    2008-01-01

    An increasing number of distributed generation units (DG units) are connected to the distribution network. These generators affect the operation and coordination of the distribution network protection. The influence from DG units that are coupled to the network with a power electronic converter

  6. Key performance indicators in an acute surgical unit: have we made an impact?

    Science.gov (United States)

    Hsee, Li; Devaud, Marcelo; Civil, Ian

    2012-10-01

    Timely access to acute surgery is a worldwide issue and New Zealand is similarly affected. Auckland City Hospital is one of the largest metropolitan public hospitals in New Zealand where more than 60 % of surgical admissions fit into the acute category. In January 2009, an Acute Surgical Unit (ASU) was set up to improve acute surgical flow. Key performance indicators (KPIs) were identified as valuable tools in evaluating ASU service performance. Our goals were to describe the current acute patient pathway, present the early trend of KPIs for the ASU and determine whether an impact has been made on acute surgical patients. A retrospective review of patients admitted with acute general surgical conditions from January 2008 (pre-ASU) to October 2010 was performed. Patient data were identified through hospital electronic records. KPIs assessed included: (1) time to assess referred patients from the emergency department (ED) and from GPs [where patient assessment occurs in the assessment and planning unit (APU)]; (2) preoperative length of stay (LOS[PO]); (3) length of stay of nonadmitted patients (LOS[NA]); (4) case volume "in h" (0730-1730) versus "after h"; and (5) readmission rate. Statistical analysis was performed with one-way ANOVA, regression, and χ(2) tests. Results show a reduction of mean time from referral to assessment from 2.28 to 1.6 h in the ED (p ≤ 0.001). Patients are seen in APU after GP referral sooner as well as the time from referral to assessment reducing from 2 to 1.76 h (p < 0.001). The LOS[PO] has not changed significantly overall (34.58 vs. 34.88 h, p = not significant [NS]). However, there are encouraging signs in high-volume procedures, such as appendicectomy. The mean LOS[PO] for appendicectomy was 7.81 h but is now 6.53 h (p ≤ 0.005). The LOS[NA] has decreased from 15.23 to 9.48 h (p < 0.005). Since the development of the ASU, the number of cases operated on "in hours" is increasing with a corresponding decrease in "after hours

  7. The potential impact of increased treatment rates for alcohol dependence in the United Kingdom in 2004.

    Science.gov (United States)

    Shield, Kevin D; Rehm, Jürgen; Rehm, Maximilien X; Gmel, Gerrit; Drummond, Colin

    2014-02-05

    Alcohol consumption has been linked to a considerable burden of disease in the United Kingdom (UK), with most of this burden due to heavy drinking and Alcohol Dependence (AD). However, AD is undertreated in the UK, with only 8% of those individuals with AD being treated in England and only 6% of those individuals with AD being treated in Scotland. Thus, the objective of this paper is to quantify the deaths that would have been avoided in the UK in 2004 if the treatment rate for AD had been increased. Data on the prevalence of AD, alcohol consumption, and mortality were obtained from the Adult Psychiatric Morbidity Survey, the Global Information System on Alcohol and Health, and the 2004 Global Burden of Disease study respectively. Data on the effectiveness of pharmacological treatment and Motivational Interviewing/Cognitive Behavioural Therapy were obtained from Cochrane reviews and meta-analyses. Simulations were used to model the number of deaths under different treatment scenarios. Sensitivity analyses were performed to model the effects of Brief Interventions and to examine the effect of using AD prevalence data obtained from the National Institute for Health and Clinical Excellence. In the UK, 320 female and 1,385 male deaths would have been avoided if treatment coverage of pharmacological treatment had been increased to 20%. This decrease in the number of deaths represents 7.9% of all alcohol-attributable deaths (7.0% of all alcohol-attributable deaths for women and 8.1% of all alcohol-attributable deaths for men). If we used lower AD prevalence rates obtained from the National Institute for Health and Clinical Excellence, then treatment coverage of pharmacological treatment in hospitals for 20% of the population with AD would have resulted in the avoidance of 529 deaths in 2004 (99 deaths avoided for women and 430 deaths avoided for men). Increasing AD treatment in the UK would have led to a large number of deaths being avoided in 2004. Increased AD

  8. Clinical and financial impact of pharmacy services in the intensive care unit: pharmacist and prescriber perceptions.

    Science.gov (United States)

    MacLaren, Robert; Brett McQueen, R; Campbell, Jon

    2013-04-01

    To compare pharmacist and prescriber perceptions of the clinical and financial outcomes of pharmacy services in the intensive care unit (ICU). ICU pharmacists were invited to participate in the survey and were asked to invite two ICU prescriber colleagues to complete questionnaires. ICUs with clinical pharmacy services. The questionnaires were designed to solicit frequency, efficiency, and perceptions about the clinical and financial impact (on a 10-point scale) of pharmacy services including patient care (eight functions), education (three functions), administration (three functions), and scholarship (four functions). Basic services were defined as fundamental, and higher-level services were categorized as desirable or optimal. Respondents were asked to suggest possible sources of funding and reimbursement for ICU pharmacy services. Eighty packets containing one 26-item pharmacy questionnaire and two 16-item prescriber questionnaires were distributed to ICU pharmacists. Forty-one pharmacists (51%) and 46 prescribers (29%) returned questionnaires. Pharmacists had worked in the ICU for 8.3 ± 6.4 years and devoted 50.3 ± 18.7% of their efforts to clinical practice. Prescribers generally rated the impact of pharmacy services more favorably than pharmacists. Fundamental services were provided more frequently and were rated more positively than desirable or optimal services across both groups. The percent efficiencies of providing services without the pharmacist ranged between 40% and 65%. Both groups indicated that salary support for the pharmacist should come from hospital departments of pharmacy or critical care or colleges of pharmacy. Prescribers were more likely to consider other sources of funding for pharmacist salaries. Both groups supported reimbursement of clinical pharmacy services. Critical care pharmacy activities were associated with perceptions of beneficial clinical and financial outcomes. Prescribers valued most services more than pharmacists

  9. Utilizing Telemedicine in the Trauma Intensive Care Unit: Does It Impact Teamwork?

    Science.gov (United States)

    Lazzara, Elizabeth H; Benishek, Lauren E; Patzer, Brady; Gregory, Megan E; Hughes, Ashley M; Heyne, Kyle; Salas, Eduardo; Kuchkarian, Fernanda; Marttos, Antonio; Schulman, Carl

    2015-08-01

    The aim of this study was to examine the impact of a telemedical robot on trauma intensive care unit (TICU) clinician teamwork (i.e., team attitudes, behaviors, and cognitions) during patient rounds. Thirty-two healthcare providers who conduct rounds volunteered to take surveys assessing teamwork attitudes and cognitions at three time periods: (1) the onset of the study, (2) the end of the 30-day control period, and (3) the end of the 30-day experimental period, which immediately followed the control period. Rounds were recorded throughout the 30-day control period and 30-day experimental period to observe provider behaviors. For the initial 30 days, there was no access to telemedicine. For the final 30 days, the rounding healthcare providers had access to the RP-7 robot (Intouch Health Inc., Santa Barbara, CA), a telemedical tool that can facilitate patient rounds conducted away from bedside. Using a one-tailed, one-way repeated-measures analysis of variance (ANOVA) to compare trust at Times 1, 2, and 3, there was no significant effect on trust: F(2, 14)=1.20, p=0.16. When a one-tailed, one-way repeated-measures ANOVA to compare transactive memory systems (TMS) at Times 1, 2, and 3 was conducted, there was no significant effect on TMS: F(2, 15)=1.33, p=0.15. We conducted a one-tailed, one-way repeated-measures ANOVA to compare team psychological safety at Times 1, 2, and 3, and there was no significant effect on team psychological safety: F(2,15)=1.53, p=0.12. There was a significant difference in communication between rounds with and without telemedicine [t(25)=-1.76, p<0.05], such that there was more task-based communication during telerounds. Telemedicine increased task-based communication and did not negatively impact team trust, psychological safety, or TMS during rounds. Telemedicine may offer advantages for some teamwork competencies without sacrificing the efficacy of others and may be adopted by intact rounding teams without hindering teamwork.

  10. Impact of a standardized nurse observation protocol including MEWS after Intensive Care Unit discharge.

    Science.gov (United States)

    De Meester, K; Das, T; Hellemans, K; Verbrugghe, W; Jorens, P G; Verpooten, G A; Van Bogaert, P

    2013-02-01

    Analysis of in-hospital mortality after serious adverse events (SAE's) in our hospital showed the need for more frequent observation in medical and surgical wards. We hypothesized that the incidence of SAE's could be decreased by introducing a standard nurse observation protocol. To investigate the effect of a standard nurse observation protocol implementing the Modified Early Warning Score (MEWS) and a color graphic observation chart. Pre- and post-intervention study by analysis of patients records for a 5-day period after Intensive Care Unit (ICU) discharge to 14 medical and surgical wards before (n=530) and after (n=509) the intervention. For the total study population the mean Patient Observation Frequency Per Nursing Shift (POFPNS) during the 5-day period after ICU discharge increased from .9993 (95% C.I. .9637-1.0350) in the pre-intervention period to 1.0732 (95% C.I. 1.0362-1.1101) (p=.005) in the post-intervention period. There was an increased risk of a SAE in patients with MEWS 4 or higher in the present nursing shift (HR 8.25; 95% C.I. 2.88-23.62) and the previous nursing shift (HR 12.83;95% C.I. 4.45-36.99). There was an absolute risk reduction for SAE's within 120h after ICU discharge of 2.2% (95% C.I. -0.4-4.67%) from 5.7% to 3.5%. The intervention had a positive impact on the observation frequency. MEWS had a predictive value for SAE's in patients after ICU discharge. The drop in SAE's was substantial but did not reach statistical significance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. The United States Atomic Energy Commission programme on isotopes and radiation development and its industrial impact

    Energy Technology Data Exchange (ETDEWEB)

    Fowler, E E [United States Atomic Energy Commission, Division of Isotopes Development, Washington, DC (United States)

    1965-02-01

    The US Atomic Energy Commission isotopes development programme is directed towards (a) encouraging development of beneficial applications of radioisotopes and radiation technology, particularly those designed to meet problems of urgent public interest; (b) accelerating the potential contribution of radioisotopes and radiation applications to the national economy and welfare, and (c) contributing to world development in the peaceful uses of atomic energy. The programme is administered by the Division of Isotopes Development. The programme objectives are being achieved through a multiphase research and development programme including the following major elements: (1) Radiation pasteurization of food, involving development of technology for low dose radiation processing of representative fruit and fishery products to extend their refrigerated shelf life; (2) Process radiation development, directed to fostering development of a broad technology leading to productive use of mega curie quantities of fission products and other radioisotopes for process radiation purposes; (3) Radioisotope technology development, directed to creating a broad base of new and improved technology required for extending and speeding up the application of radioisotopes in science and technology; (4) Radioisotope production and separation technology, directed to insuring availability of radioisotopes to meet the changing needs of advancing science and technology in the USA; (5) Isotopic power and heat sources development, aimed at the development and production of isotopic fuels and fuel forms for a broad spectrum of thermal applications, including SNAP auxiliary electrical power devices; (6) Analysis and applications, whose objective is to identify and analyse radioisotope and radiation research and development activities in the United States of America and abroad; to establish channels of communication with science, government, and industry, and to encourage broad dissemination and productive

  12. Assessing the Impact of Telemedicine on Nursing Care in Intensive Care Units.

    Science.gov (United States)

    Kleinpell, Ruth; Barden, Connie; Rincon, Teresa; McCarthy, Mary; Zapatochny Rufo, Rebecca J

    2016-01-01

    Information on the impact of tele-intensive care on nursing and priority areas of nursing care is limited. To conduct a national benchmarking survey of nurses working in intensive care telemedicine facilities in the United States. In a 2-phased study, an online survey was used to assess nurses' perceptions of intensive care telemedicine, and a modified 2-round Delphi study was used to identify priority areas of nursing. In phase 1, most of the 1213 respondents agreed to strongly agreed that using tele-intensive care enables them to accomplish tasks more quickly (63%), improves collaboration (65.9%), improves job performance (63.6%) and communication (60.4%), is useful in nursing assessments (60%), and improves care by providing more time for patient care (45.6%). Benefits of tele-intensive care included ability to detect trends in vital signs, detect unstable physiological status, provide medical management, and enhance patient safety. Barriers included technical problems (audio and video), interruptions in care, perceptions of telemedicine as an interference, and attitudes of staff. In phase 2, 60 nurses ranked 15 priority areas of care, including critical thinking skills, intensive care experience, skillful communication, mutual respect, and management of emergency patient care. The findings can be used to further inform the development of competencies for tele-intensive care nursing, match the tele-intensive care nursing practice guidelines of the American Association of Critical-Care Nurses, and highlight concepts related to the association's standards for establishing and sustaining healthy work environments. ©2016 American Association of Critical-Care Nurses.

  13. Changing the Translational Research Landscape: A Review of the Impacts of Biomedical Research Units in England.

    Science.gov (United States)

    Marjanovic, Sonja; Soper, Bryony; Ismail, Sharif; Reding, Anais; Ling, Tom

    2012-01-01

    This article describes a review of the Biomedical Research Units (BRU) scheme, undertaken for the Department of Health. This review was a perceptions audit of senior executives involved in the scheme, and explored what impact they felt the scheme is having on the translational research landscape. More specifically, we investigated whether and how institutional relationships between NHS and academic partners, industry and other health research system players are changing because of the scheme; how the scheme is helping build critical mass in specific priority disease areas; and the effects of any changes on efforts to deliver the broader goals set out in Best Research for Best Health. The views presented are those of study informants only. The information obtained through our interviews suggests that the BRU scheme is significantly helping shape the health research system to pursue translational research and innovation, with the clear goal of realising patient benefit. The BRUs are already contributing to observable changes in institutional relationships between the NHS and academic partners: trusts and medical schools are collaborating more closely than in the past, have signed up to the same vision of translational research from bench to bedside, and are managing and governing targeted research resources more professionally and transparently than in the past. There is also a stronger emphasis on engaging industry and more strategic thinking about strengthening regional and national collaboration with other hospital trusts, PCTs, research organisations, networks and development agencies. The scheme is also transforming capacity building in the health research system. This includes (i) developing and modernising facilities and equipment for translation; (ii) building a critical mass of human resources through recruitment and training, as well as improving retention of existing expertise; and (iii) helping ensure a steady flow of funds needed to sustain research

  14. Impact of climate change on mercury concentrations and deposition in the eastern United States.

    Science.gov (United States)

    Megaritis, Athanasios G; Murphy, Benjamin N; Racherla, Pavan N; Adams, Peter J; Pandis, Spyros N

    2014-07-15

    The global-regional climate-air pollution modeling system (GRE-CAPS) was applied over the eastern United States to study the impact of climate change on the concentration and deposition of atmospheric mercury. Summer and winter periods (300 days for each) were simulated, and the present-day model predictions (2000s) were compared to the future ones (2050s) assuming constant emissions. Climate change affects Hg(2+) concentrations in both periods. On average, atmospheric Hg(2+) levels are predicted to increase in the future by 3% in summer and 5% in winter respectively due to enhanced oxidation of Hg(0) under higher temperatures. The predicted concentration change of Hg(2+) was found to vary significantly in space due to regional-scale changes in precipitation, ranging from -30% to 30% during summer and -20% to 40% during winter. Particulate mercury, Hg(p) has a similar spatial response to climate change as Hg(2+), while Hg(0) levels are not predicted to change significantly. In both periods, the response of mercury deposition to climate change varies spatially with an average predicted increase of 6% during summer and 4% during winter. During summer, deposition increases are predicted mostly in the western parts of the domain while mercury deposition is predicted to decrease in the Northeast and also in many areas in the Midwest and Southeast. During winter mercury deposition is predicted to change from -30% to 50% mainly due to the changes in rainfall and the corresponding changes in wet deposition. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Impact of a bundle on prevention and control of healthcare associated infections in intensive care unit.

    Science.gov (United States)

    Gao, Fang; Wu, Yan-yan; Zou, Jun-ning; Zhu, Ming; Zhang, Jie; Huang, Hai-yan; Xiong, Li-juan

    2015-04-01

    Inpatients in the intensive care unit (ICU) are at high risk for healthcare-associated infections (HAIs). In the current study, a bundle of interventions and measures for preventing and controlling HAIs were developed and implemented in the ICU by trained personnel, and the impact of the bundle was evaluated. The incidence of HAIs, the adjusted daily incidence of HAIs and the incidence of three types of catheter-related infections before and after the bundle implementation were compared. The execution rate of the bundle for preventing and controlling ventilator-associated pneumonia (VAP) was increased from 82.06% in 2012 to 96.88% in 2013. The execution rate was increased from 83.03% in 2012 to 91.33% in 2013 for central line-associated bloodstream infection (CLABSI), from 87.00% to 94.40% for catheter-associated urinary tract infection (CAUTI), and from 82.05% to 98.55% for multidrug-resistant organisms (MDROs), respectively. In total, 136 cases (10.37%) in 2012 and 113 cases (7.72%) in 2013 involved HAIs, respectively. Patients suffered from infection of the lower respiratory tract, the most common site of HAIs, in 134 cases (79.29%) in 2012 and 107 cases (74.30%) in 2013 respectively. The incidence of VAP was 32.72‰ and 24.60‰, the number of strains of pathogens isolated was 198 and 173, and the number of MDROs detected in the ICU was 91 and 74 in 2012 and 2013, respectively. The percentage of MDROs among the pathogens causing HAIs was decreased in each quarter of 2013 as compared with the corresponding percentage in 2012. In 2013, the execution rate of the bundle for preventing and controlling HAIs was increased, whereas the incidence of HAIs and VAP decreased as compared with that in 2012.

  16. Parent Participation in Pediatric Intensive Care Unit Rounds via Telemedicine: Feasibility and Impact.

    Science.gov (United States)

    Yager, Phoebe H; Clark, Maureen; Cummings, Brian M; Noviski, Natan

    2017-06-01

    To evaluate feasibility and impact of telemedicine for remote parent participation in pediatric intensive care unit (PICU) rounds when parents are unable to be present at their child's bedside. Parents of patients admitted to a 14-bed PICU were approached, and those unable to attend rounds were eligible subjects. Nurse and physician caregivers were also surveyed. Parents received an iPad (Apple Inc, Cupertino, California) with an application enabling audio-video connectivity with the care team. At a predetermined time for bedside rounds with the PICU team, parents entered a virtual meeting room to participate. Following each telemedicine encounter, participants (parent, physician, nurse) completed a brief survey rating satisfaction (0?=?not satisfied, 10?=?completely satisfied) and disruption (0?=?no disruption at all, 10?=?very disruptive). A total of 153 surveys were completed following 51 telemedicine encounters involving 13 patients. Parents of enrolled patients cited work demands (62%), care for other dependents (46%), and transportation difficulties (31%) as reasons for study participation. The median levels of satisfaction and disruption were 10 (range 5-10) and 0 (range 0-5), respectively. All parents reported that telemedicine encounters had a positive effect on their level of reassurance regarding their child's care and improved communication with the care team. This proof-of-concept study indicates that remote parent participation in PICU rounds is feasible, enhances parent-provider communication, and offers parents reassurance. Providers reported a high level of satisfaction with minimal disruption. Technological advancements to streamline teleconferencing workflow are needed to ensure program sustainability. Copyright © 2017. Published by Elsevier Inc.

  17. Evaluating the public health impacts of legalizing recreational cannabis use in the United States.

    Science.gov (United States)

    Hall, Wayne; Lynskey, Michael

    2016-10-01

    Since 2012 four US states have legalized the retail sale of cannabis for recreational use by adults, and more are likely to follow. This report aimed to (1) briefly describe the regulatory regimes so far implemented; (2) outline their plausible effects on cannabis use and cannabis-related harm; and (3) suggest what research is needed to evaluate the public health impact of these policy changes. We reviewed the drug policy literature to identify: (1) plausible effects of legalizing adult recreational use on cannabis price and availability; (2) factors that may increase or limit these effects; (3) pointers from studies of the effects of legalizing medical cannabis use; and (4) indicators of cannabis use and cannabis-related harm that can be monitored to assess the effects of these policy changes. Legalization of recreational use will probably increase use in the long term, but the magnitude and timing of any increase is uncertain. It will be critical to monitor: cannabis use in household and high school surveys; cannabis sales; the number of cannabis plants legally produced; and the tetrahydrocannabinol (THC) content of cannabis. Indicators of cannabis-related harms that should be monitored include: car crash fatalities and injuries; emergency department presentations; presentations to addiction treatment services; and the prevalence of regular cannabis use among young people in mental health services and the criminal justice system. Plausible effects of legalizing recreational cannabis use in the United States include substantially reducing the price of cannabis and increasing heavy use and some types of cannabis-related harm among existing users. In the longer term it may also increase the number of new users. © 2016 Society for the Study of Addiction.

  18. Assessment of hydrologic impact of extending exploratory shafts into the Calico Hills nonwelded tuff unit at Yucca Mountain, Nevada

    International Nuclear Information System (INIS)

    Nichols, W.E.; Freshley, M.D.; Rockhold, M.L.

    1991-03-01

    The US Department of Energy (DOE) is performing analyses to address an objection by the US Nuclear Regulatory Commission to plans in the Consultation Draft of the Site Characterization Plan for direct excavation of the Calico Hills nonwelded (CHn) unit within the repository exploration block at Yucca Mountain, Nevada. The excavation was planned as part of site characterization activities for the potential high-level nuclear waste repository at Yucca Mountain. This characterization activities for the potential high-level nuclear waste repository at Yucca Mountain. This characterization activity has been deferred, pending the results of a risk/benefit analysis of alternative methods for obtaining needed characterization data from CHn unit. The benefits from characterizing the CHn unit are generally related to obtaining information leading to improved confidence in predictions of site performance. The risks are generally associated with potential adverse impacts to site performance that result from excavation or other intrusion into the CHn unit. The purpose of the risk/benefit analysis is to produce a recommendation to the Director, Regulatory and Site Evaluation Division. DOE/Yucca Mountain Site Characterization Project Office for a strategy for characterizing the CHn unit. The recommendation will describe characterization activities that are expected to provide the needed information while limiting adverse impacts to site performance to the extent practical. The risk/benefit analysis was supported with scoping calculations to provide a quantitative evaluation of the impacts associated with different strategies. The working group responsible for the risk/benefit analysis requested that these scoping calculations to be supported with more detailed performance assessments for evaluating impacts of different characterization activities. This report summarizes the results of these performance assessment analyses. 9 refs., 30 figs., 1 tab

  19. Modelling the impact of retention–detention units on sewer surcharge and peak and annual runoff reduction

    DEFF Research Database (Denmark)

    Locatelli, Luca; Gabriel, S.; Mark, O.

    2015-01-01

    . The impact of retrofitting a retention-detention unit of 3.3 m(3)/100 m(2) (volume/impervious area) was simulated for a small catchment in Copenhagen using MIKE URBAN. The retention-detention unit was shown to prevent flooding from the sewer for a 10-year rainfall event. Statistical analysis of continuous...... simulations covering 22 years showed that annual stormwater runoff was reduced by 68-87%, and that the retention volume was on average 53% full at the beginning of rain events. The effect of different retention-detention volume combinations was simulated, and results showed that allocating 20...

  20. Air quality impacts of increased use of ethanol under the United States’ Energy Independence and Security Act

    Science.gov (United States)

    Cook, Rich; Phillips, Sharon; Houyoux, Marc; Dolwick, Pat; Mason, Rich; Yanca, Catherine; Zawacki, Margaret; Davidson, Ken; Michaels, Harvey; Harvey, Craig; Somers, Joseph; Luecken, Deborah

    2011-12-01

    Increased use of ethanol in the United States fuel supply will impact emissions and ambient concentrations of greenhouse gases, "criteria" pollutants for which the U. S. EPA sets ambient air quality standards, and a variety of air toxic compounds. This paper focuses on impacts of increased ethanol use on ozone and air toxics under a potential implementation scenario resulting from mandates in the U. S. Energy Independence and Security Act (EISA) of 2007. The assessment of impacts was done for calendar year 2022, when 36 billion gallons of renewable fuels must be used. Impacts were assessed relative to a baseline which assumed ethanol volumes mandated by the first renewable fuels standard promulgated by U. S. EPA in early 2007. This assessment addresses both impacts of increased ethanol use on vehicle and other engine emissions, referred to as "downstream" emissions, and "upstream" impacts, i.e., those connected with fuel production and distribution. Air quality modeling was performed for the continental United States using the Community Multi-scale Air Quality Model (CMAQ), version 4.7. Pollutants included in the assessment were ozone, acetaldehyde, ethanol, formaldehyde, acrolein, benzene, and 1,3-butadiene. Results suggest that increased ethanol use due to EISA in 2022 will adversely increase ozone concentrations over much of the U.S., by as much as 1 ppb. However, EISA is projected to improve ozone air quality in a few highly-populated areas that currently have poor air quality. Most of the ozone improvements are due to our assumption of increases in nitrogen oxides (NO x) in volatile organic compound (VOC)-limited areas. While there are some localized impacts, the EISA renewable fuel standards have relatively little impact on national average ambient concentrations of most air toxics, although ethanol concentrations increase substantially. Significant uncertainties are associated with all results, due to limitations in available data. These uncertainties are

  1. High Electricity Demand in the Northeast U.S.: PJM Reliability Network and Peaking Unit Impacts on Air Quality.

    Science.gov (United States)

    Farkas, Caroline M; Moeller, Michael D; Felder, Frank A; Henderson, Barron H; Carlton, Annmarie G

    2016-08-02

    On high electricity demand days, when air quality is often poor, regional transmission organizations (RTOs), such as PJM Interconnection, ensure reliability of the grid by employing peak-use electric generating units (EGUs). These "peaking units" are exempt from some federal and state air quality rules. We identify RTO assignment and peaking unit classification for EGUs in the Eastern U.S. and estimate air quality for four emission scenarios with the Community Multiscale Air Quality (CMAQ) model during the July 2006 heat wave. Further, we population-weight ambient values as a surrogate for potential population exposure. Emissions from electricity reliability networks negatively impact air quality in their own region and in neighboring geographic areas. Monitored and controlled PJM peaking units are generally located in economically depressed areas and can contribute up to 87% of hourly maximum PM2.5 mass locally. Potential population exposure to peaking unit PM2.5 mass is highest in the model domain's most populated cities. Average daily temperature and national gross domestic product steer peaking unit heat input. Air quality planning that capitalizes on a priori knowledge of local electricity demand and economics may provide a more holistic approach to protect human health within the context of growing energy needs in a changing world.

  2. Unit environmental transport assessment of contaminants from Hanford's past-practice waste sites. Hanford Remedial Action Environmental Impact Statement

    International Nuclear Information System (INIS)

    Whelan, G.; Buck, J.W.; Castleton, K.J.

    1995-06-01

    The US Department of Energy, Richland Operations Office (DOE-RL) contracted Pacific Northwest Laboratory (PNL) to provide support to Advanced Sciences, Incorporated (ASI) in implementing tile regional no-action risk assessment in the Hanford Remedial Action Environmental Impact Statement. Researchers at PNL were charged with developing unit concentrations for soil, groundwater, surface water, and air at multiple locations within an 80-km radius from the center of tile Hanford installation. Using the Multimedia Environmental Pollutant Assessment System (MEPAS), PNL simulated (1) a unit release of one ci for each radionuclide and one kg for each chemical from contaminated soils and ponded sites, (2) transport of the contaminants in and through various environmental media and (3) exposure/risk of four exposure scenarios, outlined by the Hanford Site Baseline Remedial Action Methodology. These four scenarios include residential, recreational, industrial, and agricultural exposures. Spacially and temporally distributed environmental concentrations based on unit releases of radionuclides and chemicals were supported to ASI in support of the HRA-EIS. Risk for the four exposure scenarios, based on unit environment concentrations in air, water, and soil. were also supplied to ASI. This report outlines the procedure that was used to implement the unit transport portion of the HRA-EIS baseline risk assessment. Deliverables include unit groundwater, surface water, air, and soil concentrations at multiple locations within an 80-km radius from the center of the Hanford installation

  3. [Impact of quality improvement process upon the state of nutritional support in a critical care unit].

    Science.gov (United States)

    Martinuzzi, A; Ferraresi, E; Orsati, M; Palaoro, A; Chaparro, J; Alcántara, S; Amin, C; Feller, C; Di Leo, M E; Guillot, A; García, V

    2012-01-01

    In a preceding article the state of Nutritional support (NS) in an Intensive Care Unit (ICU) was documented [Martinuzzi A et al. Estado del soporte nutricional en una unidad de Cuidados críticos. RNC 2011; 20: 5-17]. In this follow-up work we set to assess the impact of several organizational, recording and educational interventions upon the current state of NS processes. Interventions comprised presentation of the results of the audit conducted at the ICU before the institution's medical as well as paramedical personnel; their publication in a periodical, peer-reviewed journal; drafting and implementation of a protocol regulating NS schemes to be carried out at the ICU; and conduction of continuous education activities on Nutrition (such as "experts talks", interactive courses, and training in the implementation of the NS protocol). The state of NS processes documented after the interventions was compared with the results annotated in the preceding article. Study observation window ran between March the 1st, 2011 and May 31th, 2011, both included. Study series differed only regarding overall-mortality: Phase 1: 40.0% vs. Phase 2: 20.5%; Difference: 19.5%; Z = 1.927; two-tailed-p = 0.054. Interventions resulted in a higher fulfillment rate of the prescribed NS indication; an increase in the number of patients receiving ≥ 80% of prescribed energy; and a reduction in the number of NS lost days. Mortality was (numerically) lower in patients in which the prescribed NS scheme was fulfilled, NS was early initiated, and whom received ≥ 80% of prescribed energy. Adopted interventions had no effect upon average energy intakes: Phase 1: 574.7 ± 395.3 kcal/24 h⁻¹ vs. Phase 2: 591.1 ± 315.3 kcal/24 h⁻¹; two-tailed-p > 0.05. Educational, recording and organizational interventions might result in a better conduction of NS processes, and thus, in a lower mortality. Hemodynamic instability is still the most formidable obstacle for initiating and completing NS.

  4. A framework for assessing impact of units of scholarly communication based on OAI-PMH harvesting of usage information

    CERN Multimedia

    CERN. Geneva; Van de Sompel, Herbert

    2005-01-01

    The wide-spread implementation of institutional repositories (IR), digital libraries, preprint services, and open access journals has dramatically changed the communication options that are available to scholars. At the same time, scholarship itself is becoming digital, thereby fundamentally extending the notion of a unit of scholarly communication beyond journal papers to include multimedia files, data sets, simulations, visualizations, etc. Meanwhile, the evaluation of scholarly performance remains bound to the use of citation data derived from a subset of all available communication channels (pre-selected journals), and an ever decreasing subset of all communicated units (journal papers). Clearly, there is a need for frameworks that allow measuring scholarly activity and its impact in the context of this new reality. We discuss the architecture of a system that is being developed at the Los Alamos National Laboratory that aims at determining impact and prestige rankings on the basis of aggregated usage dat...

  5. Injury and side impact air bag deployment in near and far sided motor vehicle crashes, United States, 2000-2005.

    Science.gov (United States)

    Stadter, Greg; Grabowski, Jurek G; Burke, Christine; Aldaghlas, Tayseer A; Robinson, Linda; Fakhry, Samir M

    2008-12-01

    Side impact crashes, the most lethal type, account for 26% of all motor vehicle crashes in the United States. The purpose of this study is to delineate side impact airbag (SIAB) deployment rates, injury rates, and analyze crash factors associated with SIAB deployment and occupant injury. All passenger vehicles equipped with SIABs that were involved in a side impact crash were identified from the National Automotive Sampling System database. Crashes with multiple impacts, ejections, unbelted drivers or rollovers were excluded from the study. The outcome variables of interest were SIAB deployment and driver injury. SIAB deployment was compared in similar crashes to analyze the impact on driver's injury severity score. Other crash factors were also examined to analyze what role they play in SIAB deployment rates and injury rates, such as plane of contact, striking object and Delta-V. The data set for this study contained 247 drivers in near and far side crashes in vehicles with installed SIABs. Overall SIAB deployment was 43% in side impact crashes. A significant factor associated with both the SIAB deployment rate and the driver's injury rate was increased Delta-V. SIABs do not deploy consistently in crashes with a high Delta-V or with a lateral primary direction of force and a front plane of contact. In these two scenarios, further research is warranted on SIAB deployments. With SIAB deployment, it appears drivers are able to sustain a higher Delta-V impact without serious injury.

  6. The impact of the struggle for racial equality in the United States on British racialised relations from 1958 to 1968

    OpenAIRE

    Sanderson, N.

    1999-01-01

    During the late 1950s and the 1960s America faced a high level of racial tension. At the same time Britain imposed racially discriminatory immigration controls and passed legislation to outlaw racial discrimination. This thesis asks to what extent the events in the United States had an impact on the response of British institutions to the development of a multi-racial society and increased rate of non-white immigration during these crucial years between the 1958 race riots to t...

  7. Impact of digitalization of mammographic units on average glandular doses in the Flemish Breast Cancer Screening Program

    OpenAIRE

    De Hauwere, An; Thierens, Hubert

    2012-01-01

    The impact of digitalization on the average glandular doses in 49 mammographic units participating in the Flemish Breast Cancer Screening Program was studied. Screen-film was changed to direct digital radiography and computed radiography in 25 and 24 departments respectively. Average glandular doses were calculated before and after digitalization for different PMMA-phantom thicknesses and for groups of 50 successive patients. For the transition from screen-film to computed radiography both ph...

  8. Impact of hazardous waste handling legislation on nuclear installations and radioactive waste management in the United States

    International Nuclear Information System (INIS)

    Trosten, L.M.

    1988-01-01

    The United States has enacted complex legislation to help assure proper handling of hazardous waste and the availability of funds to cover the expenditures. There are a number of uncertainties concerning the impact of this legislation, and regulations promulgated by the Environmental Protection Agency and the states, upon nuclear installations and radioactive waste management. This report provides an overview of the U.S. hazardous waste legislation and examines the outlook for its application to the nuclear industry (NEA) [fr

  9. 78 FR 285 - Supplemental Final Environmental Impact Statement for Healy Power Generation Unit #2, Healy, AK

    Science.gov (United States)

    2013-01-03

    ... Export Authority (AIDEA). The DOE published a Record of Decision for HCCP in 1994, and in 1997 Healy Unit... is a not-for-profit cooperative formed in 1946 with financing from REA to provide electric service to...

  10. Modeling the Impacts of Climate Change on Phytogeographical Units. A Case Study of the Moesz Line

    OpenAIRE

    Bede-Fazekas, Ákos

    2013-01-01

    Regional climate models (RCMs) provide reliable climatic predictions for the next 90 years with high horizontal and temporal resolution. In the 21st century northward latitudinal and upward altitudinal shift of the distribution of plant species and phytogeographical units is expected. It is discussed how the modeling of phytogeographical unit can be reduced to modeling plant distributions. Predicted shift of the Moesz line is studied as case study (with three different modeling approaches) us...

  11. Air Quality and Health Impacts of an Aviation Biofuel Supply Chain Using Forest Residue in the Northwestern United States.

    Science.gov (United States)

    Ravi, Vikram; Gao, Allan H; Martinkus, Natalie B; Wolcott, Michael P; Lamb, Brian K

    2018-04-03

    Forest residue is a major potential feedstock for second-generation biofuel; however, little knowledge exists about the environmental impacts of the development and production of biofuel from such a feedstock. Using a high-resolution regional air quality model, we estimate the air quality impacts of a forest residue based aviation biofuel supply chain scenario in the Pacific Northwestern United States. Using two potential supply chain regions, we find that biomass and biofuel hauling activities will add simulation. Using BenMAP, a health impact assessment tool, we show that avoiding slash pile burning results in a decrease in premature mortality as well as several other nonfatal and minor health effects. In general, we show that most air quality and health benefits result primarily from avoided slash pile burning emissions.

  12. Solar energy development and aquatic ecosystems in the southwestern United States: potential impacts, mitigation, and research needs.

    Science.gov (United States)

    Grippo, Mark; Hayse, John W; O'Connor, Ben L

    2015-01-01

    The cumulative impacts of utility-scale solar energy facilities on aquatic ecosystems in the Southwestern United States are of concern, considering the many existing regional anthropogenic stressors. We review the potential impacts of solar energy development on aquatic habitat and biota. The greatest potential for impacts is related to the loss, fragmentation, or prolonged drying of ephemeral water bodies and drainage networks resulting from the loss of desert washes within the construction footprint of the facility. Groundwater-dependent aquatic habitat may also be affected by operational groundwater withdrawal in the case of water-intensive solar technologies. Solar panels have also been found to attract aquatic insects and waterbirds, potentially resulting in mortality. Avoiding construction activity near perennial and intermittent surface waters is the primary means of reducing impacts on aquatic habitats, followed by measures to minimize erosion, sedimentation, and contaminant inputs into waterways. Currently, significant data gaps make solar facility impact assessment and mitigation more difficult. Examples include the need for more regional and site-specific studies of surface-groundwater connectivity, more detailed maps of regional stream networks and riparian vegetation corridors, as well as surveys of the aquatic communities inhabiting ephemeral streams. In addition, because they often lack regulatory protection, there is also a need to develop valuation criteria for ephemeral waters based on their ecological and hydrologic function within the landscape. By addressing these research needs, we can achieve the goal of greater reliance on solar energy, while at the same time minimizing impacts on desert ecosystems.

  13. The impact of balloon catheter dilation on frequency of sinus surgery in the United States

    Directory of Open Access Journals (Sweden)

    Holy CE

    2014-04-01

    Full Text Available Chantal E Holy,1 John M Ellison,1 Charles Schneider,1 Howard L Levine2,3 1Health Economics and Reimbursement, 2Medical Affairs, Acclarent Inc., a Johnson & Johnson Company, Menlo Park, CA, USA; 3Cleveland Nasal-Sinus and Sleep Center, Cleveland, OH, USA Purpose: Endoscopic sinus surgery for patients with chronic rhinosinusitis (CRS unresponsive to medical therapy has traditionally been performed under general anesthesia and in the operating room. Balloons for catheter dilation of paranasal sinuses were introduced in 2005, allowing sinus surgery to be safely performed either in the operating room or the office care setting, under local anesthesia. This change in care setting has raised concerns of overuse or expanded indications for sinus surgery. This study was thus designed to evaluate changes in surgical volumes in the United States, for the period 2006–2011, and to evaluate the impact of the sinus balloons on surgical practice. Methods: The MarketScan® Commercial Claims and Encounter Database was queried for the period 2006 to 2011 using CRS International Classification of Diseases, Ninth Revision codes (473.X and sinus surgery US-based Common Procedural Terminology (CPT codes (endoscopic sinus surgery: CPT codes 31254–31294 and 31299; balloon catheter dilation: CPT codes 31295–31297. MarketScan's projection methodology was applied to estimate the nationwide prevalence of CRS and the incidence of sinus surgery. Procedural case mix and total average payment per surgery were analyzed. Results: From 2006 to 2011, the yearly prevalence of CRS and sinus surgery volume remained flat with ~430 patients with CRS per 100,000 in the employer-sponsored insured population, of which ~117/100,000 underwent surgery. In 2006, 2.69 paranasal sinuses (95% confidence interval [95% CI]: 2.65–2.71 were treated during each individual sinus surgery, with an additional 1.11 nasal procedures (95% CI: 1.08–1.13 performed concurrently. By 2011, the

  14. Impact of the Gulf of California SST on simulating precipitation and crop productivity in the Southwestern United States

    Science.gov (United States)

    Kim, S.; Kim, J.; Prasad, A. K.; Stack, D. H.; El-Askary, H. M.; Kafatos, M.

    2012-12-01

    Like other ecosystems, agricultural productivity is substantially affected by climate factors. Therefore, accurate climatic data (i.e. precipitation, temperature, and radiation) is crucial to simulating crop yields. In order to understand and anticipate climate change and its impacts on agricultural productivity in the Southwestern United States, the WRF regional climate model (RCM) and the Agricultural Production Systems sIMulator (APSIM) were employed for simulating crop production. 19 years of WRF RCM output show that there is a strong dry bias during the warm season, especially in Arizona. Consequently, the APSIM crop model indicates very low crop yields in this region. We suspect that the coarse resolution of reanalysis data could not resolve the relatively warm Sea Surface Temperature (SST) in the Gulf of California (GC), causing the SST to be up to 10 degrees lower than the climatology. In the Southwestern United States, a significant amount of precipitation is associated with North American Monsoon (NAM). During the monsoon season, the low-level moisture is advected to the Southwestern United States via the GC, which is known to be the dominant moisture source. Thus, high-resolution SST data in the GC is required for RCM simulations to accurately represent a reasonable amount of precipitation in the region, allowing reliable evaluation of the impacts on regional ecosystems.and evaluate impacts on regional ecosystems. To evaluate the influence of SST on agriculture in the Southwestern U.S., two sets of numerical simulations were constructed: a control, using unresolved SST of GC, and daily updated SST data from the MODIS satellite sensor. The meteorological drivers from each of the 6 year RCM runs were provided as input to the APSIM model to determine the crop yield. Analyses of the simulated crop production, and the interannual variation of the meteorological drivers, demonstrate the influence of SST on crop yields in the Southwestern United States.

  15. Economic impacts of oil spills: Spill unit costs for tankers, pipelines, refineries, and offshore facilities. [Task 1, Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-15

    The impacts of oil spills -- ranging from the large, widely publicized Exxon Valdez tanker incident to smaller pipeline and refinery spills -- have been costly to both the oil industry and the public. For example, the estimated costs to Exxon of the Valdez tanker spill are on the order of $4 billion, including $2.8 billion (in 1993 dollars) for direct cleanup costs and $1.125 billion (in 1992 dollars) for settlement of damages claims caused by the spill. Application of contingent valuation costs and civil lawsuits pending in the State of Alaska could raise these costs appreciably. Even the costs of the much smaller 1991 oil spill at Texaco`s refinery near Anacortes, Washington led to costs of $8 to 9 million. As a result, inexpensive waming, response and remediation technologies could lower oil spin costs, helping both the oil industry, the associated marine industries, and the environment. One means for reducing the impact and costs of oil spills is to undertake research and development on key aspects of the oil spill prevention, warming, and response and remediation systems. To target these funds to their best use, it is important to have sound data on the nature and size of spills, their likely occurrence and their unit costs. This information could then allow scarce R&D dollars to be spent on areas and activities having the largest impact. This report is intended to provide the ``unit cost`` portion of this crucial information. The report examines the three key components of the US oil supply system, namely, tankers and barges; pipelines and refineries; and offshore production facilities. The specific purpose of the study was to establish the unit costs of oil spills. By manipulating this key information into a larger matrix that includes the size and frequency of occurrence of oil spills, it will be possible` to estimate the likely future impacts, costs, and sources of oil spills.

  16. Comparing hiking, mountain biking and horse riding impacts on vegetation and soils in Australia and the United States of America.

    Science.gov (United States)

    Pickering, Catherine Marina; Hill, Wendy; Newsome, David; Leung, Yu-Fai

    2010-01-01

    Hiking, horse riding and mountain biking are popular in protected areas in Australia and the United States of America. To help inform the often contentious deliberations about use of protected areas for these three types of activities, we review recreation ecology research in both countries. Many impacts on vegetation, soils and trails are similar for the three activities, although there can be differences in severity. Impacts include damage to existing trails, soil erosion, compaction and nutrification, changes in hydrology, trail widening, exposure of roots, rocks and bedrock. There can be damage to plants including reduction in vegetation height and biomass, changes in species composition, creation of informal trails and the spread of weeds and plant pathogens. Due to differences in evolutionary history, impacts on soil and vegetation can be greater in Australia than in the USA. There are specific social and biophysical impacts of horses such as those associated with manure and urine, grazing and the construction and use of tethering yards and fences. Mountain bike specific impacts include soil and vegetation damage from skidding and the construction of unauthorised trails, jumps, bridges and other trail technical features. There are gaps in the current research that should be filled by additional research: (1) on horse and mountain bike impacts to complement those on hiking. The methods used need to reflect patterns of actual usage and be suitable for robust statistical analysis; (2) that directly compares types and severity of impacts among activities; and (3) on the potential for each activity to contribute to the spread of weeds and plant pathogens. Additional research will assist managers and users of protected areas in understanding the relative impacts of these activities, and better ways to manage them. It may not quell the debates among users, managers and conservationists, but it will help put it on a more scientific footing. 2009 Elsevier Ltd. All

  17. Impact of interactive online units on learning science among students with learning disabilities and English learners

    Science.gov (United States)

    Terrazas-Arellanes, Fatima E.; Gallard M., Alejandro J.; Strycker, Lisa A.; Walden, Emily D.

    2018-03-01

    The purpose of this study was to document the design, classroom implementation, and effectiveness of interactive online units to enhance science learning over 3 years among students with learning disabilities, English learners, and general education students. Results of a randomised controlled trial with 2,303 middle school students and 71 teachers across 13 schools in two states indicated that online units effectively deepened science knowledge across all three student groups. Comparing all treatment and control students on pretest-to-posttest improvement on standards-based content-specific assessments, there were statistically significant mean differences (17% improvement treatment vs. 6% control; p English learner status, indicating that these two groups performed similarly to their peers; students with learning disabilities had significantly lower assessment scores overall. Teachers and students were moderately satisfied with the units.

  18. An assessment of the cyber security legislation and its impact on the United States electrical sector

    Science.gov (United States)

    Born, Joshua

    The purpose of this research was to examine the cyber-security posture for the United States' electrical grid, which comprises a major component of critical infrastructure for the country. The United States electrical sector is so vast, that the Department of Homeland Security (DHS) estimates, it contains more than 6,413 power plants (this includes 3,273 traditional electric utilities and 1,738 nonutility power producers) with approximately 1,075 gigawatts of energy produced on a daily basis. A targeted cyber-security attack against the electric grid would likely have catastrophic results and could even serve as a precursor to a physical attack against the United States. A recent report by the consulting firm Black and Veatch found that one of the top five greatest concerns for United States electric utilities is the risk that cybersecurity poses to their industry and yet, only one-third state they are currently prepared to meet the increasingly likely threat. The report goes on to state, "only 32% of electric utilities surveyed had integrated security systems with the proper segmentation, monitoring and redundancies needed for cyber threat protection. Another 48 % said they did not" Recent estimates indicate that a large-scale cyber-attack against this sector could cost the United States economy as much as a trillion dollars within a weeks' time. Legislative efforts in the past have primarily been focused on creating mandates that encourage public and private partnership, which have been not been adopted as quickly as desired. With 85 % of all electric utilities being privately owned, it is key that the public and private sector partner in order to mitigate risks and respond as a cohesive unit in the event of a major attack. Keywords: Cybersecurity, Professor Riddell, cyber security, energy, intelligence, outlook, electrical, compliance, legislation, partnerships, critical infrastructure.

  19. Climate change impacts on extreme events in the United States: an uncertainty analysis

    Science.gov (United States)

    Extreme weather and climate events, such as heat waves, droughts and severe precipitation events, have substantial impacts on ecosystems and the economy. However, future climate simulations display large uncertainty in mean changes. As a result, the uncertainty in future changes ...

  20. Results of a diesel multiple unit fuel tank blunt impact test

    Science.gov (United States)

    2017-04-04

    The Federal Railroad Administrations Office of Research and Development is conducting research into passenger locomotive fuel tank crashworthiness. A series of impact tests is being conducted to measure fuel tank deformation under two types of dyn...

  1. Potential impacts of climate change on soil erosion vulnerability across the conterminous United States

    Science.gov (United States)

    C. Segura; G. Sun; S. McNulty; Y. Zhang

    2014-01-01

    Rainfall runoff erosivity (R) is one key climate factor that controls water erosion. Quantifying the effects of climate change-induced erosivity change is important for identifying critical regions prone to soil erosion under a changing environment. In this study we first evaluate the changes of R from 1970 to 2090 across the United States under nine climate conditions...

  2. The Impact of International Financial Reporting Standards on Accounting Curriculum in the United States

    Science.gov (United States)

    Yallapragada, RamMohan R.; Toma, Alfred G.; Roe, C. William

    2011-01-01

    According to the time line presently specified by the Securities and Exchange Commission (SEC), business firms in the United States (US) should switch from the existing US accounting reporting guidelines of the Generally Accepted Accounting Principles (GAAP) to International Financial Reporting Standards (IFRS) by the year 2014. The US business…

  3. Human Health Impacts of Forest Fires in the Southern United States: A Literature Review

    Science.gov (United States)

    Cynthia T. Fowler

    2003-01-01

    Forestry management practices can shape patterns of health, illness, and disease. A primary goal for owners federal, state, andprivate forests is to crap ecosystem management plans that simultaneously optimize forest health and human health. Fire-a major forest management issue in the United States-complicates these goals. Wildfires are natural phenomena with...

  4. The Impact of Challenging Geometry and Measurement Units on the Achievement of Grade 2 Students

    Science.gov (United States)

    Gavin, M. Katherine; Casa, Tutita M.; Adelson, Jill L.; Firmender, Janine M.

    2013-01-01

    The primary goal of Project M[superscript 2] was to develop and field-test challenging geometry and measurement units for all K-2 students. This article reports on the achievement results for students in Grade 2 at 12 urban and suburban sites in 4 states using the Iowa Tests of Basic Skills (ITBS) mathematics concepts subtest and an open-response…

  5. Health Utilization and Cost Impact of Childhood Constipation in the United States

    NARCIS (Netherlands)

    Liem, Olivia; Harman, Jeffrey; Benninga, Marc; Kelleher, Kelly; Mousa, Hayat; Di Lorenzo, Carlo

    2009-01-01

    Objective To estimate the total health care utilization and costs for children with constipation in the United States. Study design We analyzed data from 2 consecutive years (2003 and 2004) of the Medical Expenditure Panel Survey (MEPS), a nationally representative household survey. We identified

  6. Environmental Security: What Environmental Issues Impact Regional Stability and Affect United States Foreign Policy with Mexico?

    Science.gov (United States)

    1997-03-01

    extraregional sponsor of Alianza para el Desarrollo Sostenible (Sustainable Development Alliance - ALIDES), along with United States and Canada. ALIDES is...more stable the government the better the country will be able to solve its environmental problems. 42 Glossary ALIDES Alianza para el Desarrollo ... Sostenible (Sustainable Development Alliance) C Centigrade CFCs Chlorofluorocarbons BECC Border Environment Cooperation Commission BNC Binational

  7. Impact of soil moisture deficit on ecosystem function across the United States

    Science.gov (United States)

    Susan Moran; Morgan Ross; Mallory Burns

    2016-01-01

    The cumulative effect of recent prolonged warm drought on regional ecosystem function is still uncertain. Large regions of the United States are experiencing new hydroclimatic conditions with extreme variability in climate drivers such as total precipitation, precipitation patterns (e.g., storm size, intensity and frequency), and seasonal temperatures.

  8. Impact of Interactive Online Units on Learning Science among Students with Learning Disabilities and English Learners

    Science.gov (United States)

    Terrazas-Arellanes, Fatima E.; Gallard M., Alejandro J.; Strycker, Lisa A.; Walden, Emily D.

    2018-01-01

    The purpose of this study was to document the design, classroom implementation, and effectiveness of interactive online units to enhance science learning over 3 years among students with learning disabilities, English learners, and general education students. Results of a randomised controlled trial with 2,303 middle school students and 71…

  9. Projected climate change impacts on skiing and snowmobiling: A case study of the United States

    Science.gov (United States)

    A physically-based water and energy balance model is used to simulate natural snow accumulation at 247 winter recreation locations across the continental United States. We combine this model with projections of snowmaking conditions to determine downhill skiing, cross-country ski...

  10. Modeling the impacts of wood pellet demand on forest dynamics in southeastern United States

    NARCIS (Netherlands)

    Duden, Anna S.; Verweij, Pita A.; Junginger, H. Martin; Abt, Robert C.; Henderson, Jesse D.; Dale, Virginia H.; Kline, Keith L.; Karssenberg, Derek; Verstegen, Judith A.; Faaij, André P.C.; van der Hilst, Floor

    2017-01-01

    The export of wood pellets from the southeastern United States (USA) has grown significantly in recent years, following rising demand from Europe. Increased wood pellet demand could lead to spatially variable changes in timberland management and area in the USA. This study presents an assessment of

  11. The Impact of Accountability on Student Performance in a Secondary Physical Education Badminton Unit

    Science.gov (United States)

    Lund, Jacalyn; Shanklin, Jennifer

    2011-01-01

    The purpose of this study was to examine the effect of accountability on the quality of student motor responses during a 10-day badminton unit with female high school students enrolled in a required physical education class. Students in the control class participated in the same learning activities taught by the same teacher as the treatment…

  12. Impact of a risk management plan on Legionella contamination of dental unit water.

    Science.gov (United States)

    Leoni, Erica; Dallolio, Laura; Stagni, Francesca; Sanna, Tiziana; D'Alessandro, Giovanni; Piana, Gabriela

    2015-02-23

    The study aimed to assess the prevalence of Legionella spp. in dental unit waterlines of a dental clinic and to verify whether the microbiological parameters used as indicators of water quality were correlated with Legionella contamination. A risk management plan was subsequently implemented in the dental health care setting, in order to verify whether the adopted disinfection protocols were effective in preventing Legionella colonization. The water delivered from syringes and turbines of 63 dental units operating in a dental clinic, was monitored for counts of the heterotrophic bacteria P. aeruginosa and Legionella spp. (22 °C and 37 °C). At baseline, output water from dental units continuously treated with disinfection products was more compliant with the recommended standards than untreated and periodically treated water. However, continuous disinfection was still not able to prevent contamination by Legionella and P. aeruginosa. Legionella was isolated from 36.4%, 24.3% and 53.3% of samples from untreated, periodically and continuously treated waterlines, respectively. The standard microbiological parameters used as indicators of water quality proved to be unreliable as predictors of the presence of Legionella, whose source was identified as the tap water used to supply the dental units. The adoption of control measures, including the use of deionized water in supplying the dental unit waterlines and the application of a combined protocol of continuous and periodic disinfection, with different active products for the different devices, resulted in good control of Legionella contamination. The efficacy of the measures adopted was mainly linked to the strict adherence to the planned protocols, which placed particular stress on staff training and ongoing environmental monitoring.

  13. Impact of building technology, state and community programs on United States employment and wage income

    International Nuclear Information System (INIS)

    Scott, M.J.; Hostick, D.J.; Elliott, D.B.; Schultz, R.W.

    1998-04-01

    As part of measuring the impact of government programs on improving the energy efficiency of the nation's building stock, the Department of Energy Office of Building Technology, State and Community Programs (BTS) is interested in assessing the economic impacts of its portfolio of programs, specifically the potential impact on national employment and income. This assessment is being done for the first time in FY99 as a supplement to the Government Performance and Results Act (GPRA--formerly, Quality Metrics) estimates of primary energy savings and environmental and direct financial benefits of the BTS programs. The programmatic needs of BTS suggest that a simple, flexible, user-friendly method is needed to derive national employment and income impacts of individual BTS programs. Therefore, BTS funded Pacific Northwest National Laboratory (PNNL) to develop a special-purpose version of the Impact Analysis for Planning (IMPLAN) national input-output model (Minnesota IMPLAN Group, Inc. 1997) specifically to estimate the employment and income effects of building energy technologies. The special-purpose version of the IMPLAN model used in this study is called ImBuild. Extensive documentation and a user's guide are provided in Scott et al. (1998). Compared with simple economic multiplier approaches, such as the published multipliers from the Department of Commerce Regional Input-Output Modeling System (RIMS 2), ImBuild allows for more complete and automated analysis of the economic impacts of energy efficiency investments in buildings. ImBuild is also easier to use than existing macroeconomic simulation models. In this report, the authors use the ImBuild model to calculate the impact of all 32 BTS programs reported in the BTS GPRA Metrics Estimates, FY99 Budget Request, December 19, 1997

  14. Climate change and health in the United States of America: impacts, adaptations, and research; Changement climatique et santeaux Etats-Unis: impacts, adaptations et recherche

    Energy Technology Data Exchange (ETDEWEB)

    Jouan, R.; Magaud, M

    2009-11-15

    After a description of the various impacts of climate change on human health, this report describes and comments the impacts of climate change on health in the USA: impacts of heat waves, of air quality degradation, of extreme climate events, of climate change on infectious diseases and allergies, regional impacts of climate change. In a second part, it describes the strategies of adaptation to the 'climate change and health' issue in the USA: mitigation and adaptation to climate change, adaptation challenges, insufficiently prepared public health system, adaptation to heat waves, adaptation to air quality degradation, adaptation to extreme climate events, adaptation to food- and water-based diseases and to vector-based diseases, examples of proactive adaptation. The last part describes the organisation of research on 'climate change and health' in the USA: nowadays and in the future, role of federal agencies, priority research axes. The 'United States Global Change Research Program' is presented in appendix, as well as the most important research centres (mostly in universities)

  15. Climate Change Impacts on the Built Environment in the United States and Implications for Sustainability

    Science.gov (United States)

    Quattrochi, Dale A.

    2012-01-01

    As an integral part of the National Climate Assessment (NCA), technical assessment reports for 13 regions in the U.S. that describe the scientific rationale to support climate change impacts within the purview of these regions, and provide adaptation or mitigation measures in response to these impacts. These technical assessments focus on climate change impacts on sectors that are important environmental, biophysical, and social and economic aspects of sustainability within the U.S.: Climate change science, Ecosystems and biodiversity, Water resources, Human health, Energy supply and use, Water/energy/land use, Transportation, Urban/infrastructure/vulnerability, Agriculture, Impacts of climate change on tribal/indigenous and native lands and resources, Forestry, Land use/land cover change, Rural communities development, and Impacts on biogeochemical cycles, with implications for ecosystems and biodiversity. There is a critical and timely need for the development of mitigation and adaptation strategies in response to climate change by the policy and decision making communities, to insure resiliency and sustainability of the built environment in the future.

  16. Estimating the impact of newly arrived foreign-born persons on tuberculosis in the United States.

    Directory of Open Access Journals (Sweden)

    Yecai Liu

    Full Text Available Among approximately 163.5 million foreign-born persons admitted to the United States annually, only 500,000 immigrants and refugees are required to undergo overseas tuberculosis (TB screening. It is unclear what extent of the unscreened nonimmigrant visitors contributes to the burden of foreign-born TB in the United States.We defined foreign-born persons within 1 year after arrival in the United States as "newly arrived", and utilized data from U.S. Department of Homeland Security, U.S. Centers for Disease Control and Prevention, and World Health Organization to estimate the incidence of TB among newly arrived foreign-born persons in the United States. During 2001 through 2008, 11,500 TB incident cases, including 291 multidrug-resistant TB incident cases, were estimated to occur among 20,989,738 person-years for the 1,479,542,654 newly arrived foreign-born persons in the United States. Of the 11,500 estimated TB incident cases, 41.6% (4,783 occurred among immigrants and refugees, 36.6% (4,211 among students/exchange visitors and temporary workers, 13.8% (1,589 among tourists and business travelers, and 7.3% (834 among Canadian and Mexican nonimmigrant visitors without an I-94 form (e.g., arrival-departure record. The top 3 newly arrived foreign-born populations with the largest estimated TB incident cases per 100,000 admissions were immigrants and refugees from high-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of ≥100 cases/100,000 population/year; 235.8 cases/100,000 admissions, 95% confidence interval [CI], 228.3 to 243.3, students/exchange visitors and temporary workers from high-incidence countries (60.9 cases/100,000 admissions, 95% CI, 58.5 to 63.3, and immigrants and refugees from medium-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of 15-99 cases/100,000 population/year; 55.2 cases/100,000 admissions, 95% CI, 51.6 to 58.8.Newly arrived nonimmigrant visitors contribute substantially to the burden of

  17. Estimating the impact of newly arrived foreign-born persons on tuberculosis in the United States.

    Science.gov (United States)

    Liu, Yecai; Painter, John A; Posey, Drew L; Cain, Kevin P; Weinberg, Michelle S; Maloney, Susan A; Ortega, Luis S; Cetron, Martin S

    2012-01-01

    Among approximately 163.5 million foreign-born persons admitted to the United States annually, only 500,000 immigrants and refugees are required to undergo overseas tuberculosis (TB) screening. It is unclear what extent of the unscreened nonimmigrant visitors contributes to the burden of foreign-born TB in the United States. We defined foreign-born persons within 1 year after arrival in the United States as "newly arrived", and utilized data from U.S. Department of Homeland Security, U.S. Centers for Disease Control and Prevention, and World Health Organization to estimate the incidence of TB among newly arrived foreign-born persons in the United States. During 2001 through 2008, 11,500 TB incident cases, including 291 multidrug-resistant TB incident cases, were estimated to occur among 20,989,738 person-years for the 1,479,542,654 newly arrived foreign-born persons in the United States. Of the 11,500 estimated TB incident cases, 41.6% (4,783) occurred among immigrants and refugees, 36.6% (4,211) among students/exchange visitors and temporary workers, 13.8% (1,589) among tourists and business travelers, and 7.3% (834) among Canadian and Mexican nonimmigrant visitors without an I-94 form (e.g., arrival-departure record). The top 3 newly arrived foreign-born populations with the largest estimated TB incident cases per 100,000 admissions were immigrants and refugees from high-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of ≥100 cases/100,000 population/year; 235.8 cases/100,000 admissions, 95% confidence interval [CI], 228.3 to 243.3), students/exchange visitors and temporary workers from high-incidence countries (60.9 cases/100,000 admissions, 95% CI, 58.5 to 63.3), and immigrants and refugees from medium-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of 15-99 cases/100,000 population/year; 55.2 cases/100,000 admissions, 95% CI, 51.6 to 58.8). Newly arrived nonimmigrant visitors contribute substantially to the burden of foreign

  18. Impact of role-, job- and organizational characteristics on Nursing Unit Managers' work related stress and well-being.

    Science.gov (United States)

    Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf

    2014-11-01

    To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.

  19. Assessing the Potential Impacts of Innovative New Policy Proposals on Poverty in the United States

    Directory of Open Access Journals (Sweden)

    Christopher Wimer

    2018-02-01

    Full Text Available This article provides estimates of the potential anti-­poverty impacts of eight proposals presented in this double issue of RSF. Using the 2016 Annual Social and Economic Supplement to the Current Population Survey and the Census Bureau and Bureau of Labor Statistics’ Supplemental Poverty Measure, we first discuss the simulation approach taken for each proposal and then provide a consistent set of poverty estimates across proposals that include reductions in the poverty and deep poverty rates and the poverty gap; demographic differences; and net direct government costs. Anti-­poverty impacts are largest for the most costly proposals, but less costly and more targeted proposals still have substantial potential impacts for key subgroups.

  20. The Impact of Sex of Child on Breastfeeding in the United States.

    Science.gov (United States)

    Shafer, Emily Fitzgibbons; Hawkins, Summer Sherburne

    2017-11-01

    Background Sex of child has been shown to impact breastfeeding duration in India, Australia, Scandinavia, Latin America, and, within the US, in a sample in Eastern Connecticut and in a separate sample of Indian and Chinese immigrants. Objectives The objective of this study is to examine differences in breastfeeding initiation and duration by sex of child across racial/ethnic groups in the US. Methods We used the Pregnancy Risk Assessment Monitoring System 2009-2010 and logistic regression to examine whether sex of child impacts breastfeeding initiation and duration for at least 8 weeks by women's racial/ethnic group. Results Among the 66,107 women in our sample representing 12 different race/ethnic groups, Hispanic women (n = 9049) had lower odds of breastfeeding initiation (adjusted odds ratio [AOR] = 0.81, 95% CI 0.71-0.93) and breastfeeding duration (AOR = .87, 95% CI 0.80-0.96) if they have sons compared to Hispanic women who have daughters. Sex of child did not impact the odds of breastfeeding initiation or duration among any other race/ethnic group. Conclusion We have shown that, for Hispanics in the US, sex of child may have an impact on breastfeeding, a health behavior that has a variety of positive impacts on infants throughout their lives. Boys, relative to girls, were at a disadvantage in breastfeeding initiation and duration. Future work is necessary to unpack the mechanisms behind these findings. In particular, how sex of child impacts how mothers and fathers view the nutritional needs of their children and breastfeeding more broadly.

  1. Impact of a prevention bundle on Clostridium difficile infection rates in a hospital in the Southeastern United States.

    Science.gov (United States)

    Davis, Bionca M; Yin, Jingjing; Blomberg, Doug; Fung, Isaac Chun-Hai

    2016-12-01

    We sought to assess the impact of a multicomponent prevention program on hospital-acquired Clostridium difficile infections in a hospital in the Southeastern United States. We collected retrospective data of 140 patients from years 2009-2014 and applied the Poisson regression model for analysis. We did not find any significant associations of increased risk of Clostridium difficile infections for the preintervention group. Further studies are needed to test multifaceted bundles in hospitals with high infection rates. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Calculations of the radiological impact of disposal of unit activity of selected radionuclides for use in waste management system studies

    International Nuclear Information System (INIS)

    Smith, G.M.

    1985-03-01

    The purpose of the work described is to provide estimates of the radiological impact following disposal of unit activity via each of several options, including shallow burial, engineered trench disposal, disposal in a geologic repository and disposal on the deep ocean bed. Results are presented for a range of important representative radionuclides. No single option is clearly the best from the radiological point of view. However, in conjunction with waste inventory data the results may be used to provide a preliminary view of the relative radiological merits of the various disposal options. (author)

  3. United States Biological Survey: A compendium of its history, personalities, impacts, and conflicts

    Science.gov (United States)

    Schmidly, David J.; Tydeman, W. E.; Gardner, Alfred L.

    2016-01-01

    In 1885, a small three-person unit was created in the U.S. Department of Agriculture to gather and analyze information on bird migrations. Originally called the Section of Economic Ornithology, over the next 55 years this unit underwent three name changes and accumulated ever-increasing responsibilities for the nation’s faunal resources. Transferred to the Department of the Interior in 1939, this agency was merged with the Bureau of Fisheries in 1940 to create the U.S. Fish and Wildlife Service (FWS). The following account details the chronology, directorship, and growth of the U.S. Bureau of Biological Survey up to its renovation as the FWS. This account also profiles some employees of the Biological Survey.

  4. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Science.gov (United States)

    Franzblau, Lauren E.

    2013-01-01

    Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States. PMID:25289258

  5. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Directory of Open Access Journals (Sweden)

    Lauren E. Franzblau, BS

    2013-10-01

    Full Text Available Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  6. Double jeopardy: the impact of neoliberalism on care workers in the United States and South Africa.

    Science.gov (United States)

    Abramovitz, Mimi; Zelnick, Jennifer

    2010-01-01

    Many researchers have explored how neoliberal restructuring of the workplace has reduced the standard of living and increased workplace stress among private sector employees. However, few have focused on how neoliberal restructuring of public policy has had similar effects on the public sector workforce. Using original case study research, the authors examine how two iconic pieces of neoliberal policy--the 1996 welfare reform bill in the United States and the GEAR macroeconomic policy in South Africa--affected public/nonprofit human service workers in New York City, United States, and public sector nurses in KwaZulu-Natal, South Africa. The authors argue that in both situations, despite national differences, these policies created a "double jeopardy," in which patients/clients and care workers are adversely affected by neoliberal public policy. This "double jeopardy" creates significant hardship, but also the opportunity for new social movements.

  7. Impact of medical tourism on cosmetic surgery in the United States.

    Science.gov (United States)

    Franzblau, Lauren E; Chung, Kevin C

    2013-10-01

    Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  8. Draft environmental impact statement. New England Power Units 1 and 2 (NEP 1 and 2)

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Construction of New England Power Company Units 1 and 2 on 120 acres of 604-acre site near Block Island South in Charlestown, Rhode Island is proposed. Each unit would employ a pressurized water reactor to drive a steam turbine generator with a power rating of 1194 megawatts (MWe) of electric power capacity and a net output of 1150 MWe. A once-through flow of water obtained from and discharged into Block Island South at a rate of 1907 cubic feet per second would cool the units' exhaust steam. The station would transmit power through a 6700-foot, 345-kilovolt (kV) transmission line extending underground to the planned Charlestown substation, thence through a total of 70.5 miles of aboveground 345-kV line to the applicant's transmission system. The station would provide area consumers with a 2300-MWe base-load capacity and supply 14 billion kilowatt-hours annually during a 30-year operating life. Construction of the units would generate a total of $640 million in wages, plant operation would employ 250 persons with total wages of $8.4 million annually, and the applicant would contribute 90% of the Charlestown local tax base. Construction activities would cover 350 acres of land, and transmission line rights-of-way would require 1754 acres, including 1300 acres of forestland. Plant structures would mar the landscape, and the cooling system would contribute thermal pollution and some chemical pollutants to the Block Island Sound. Intermittent use of explosives would occur during an eight-to-ten-month period. Entrainment of fish in the cooling system could significantly reduce populations of tautog and cunner in the Block Island Sound

  9. POTENTIAL IMPACTS OF GM WHEAT ON UNITED STATES AND NORTHERN PLAINS WHEAT TRADE

    OpenAIRE

    Taylor, Richard D.; DeVuyst, Eric A.; Koo, Won W.

    2003-01-01

    The potential introduction of genetically modified (GM) wheat has both supporters and opponents waging battle in the popular press and scholarly research. Supporters highlight the benefits to producers, while the opponents highlight the unknown safety factors for consumers. The topic is very important to the United States, as a large portion of the wheat production is exported overseas. Consumer groups in some countries are resisting GM wheat. This study utilizes a spatial equilibrium model t...

  10. Impacts of urbanization on stream water quantity and quality in the United States

    Science.gov (United States)

    Ge Sun; Peter Caldwell

    2015-01-01

    Since the 1950s, the world’s urban population has grown more than 400% to 3.9 billion today. About 60% of the total population is expected to live in urban areas by the year 2025. For the United States (U.S.), 80% of the population lives in urban areas. The Earth has entered into the Anthropocene, a new geological epoch dominated by urbanization and people.

  11. The economic impact of the Australia-United States free trade agreement

    OpenAIRE

    Shiro Armstrong

    2015-01-01

    The Australia–United States free trade agreement (AUSFTA) came into effect in 2005. It was the second preferential trade agreement that Australia signed, after its agreement with Singapore, and marked a departure from the primacy of Australia’s previous trade policy of unilateral and multilateral trade liberalisation towards preferential liberalisation. This paper assesses the economic effects of AUSFTA by applying the Productivity Commission’s gravity model of trade from its Bilateral ...

  12. Potential Climate Change Impacts on the Built Environment in the United States and Implications for Sustainability

    Science.gov (United States)

    Quattrochi, D.

    2012-12-01

    The built environment consists of components that have been made by humans at a range of scales from small (e.g., houses, shopping malls) to large (e.g., transportation networks) to highly modified landscapes such as cities. The impacts of climate change on the built environment, therefore, may have a multitude of effects on humans and the land. The impact of climate change may be exacerbated by the interaction of different events that singly may be minor, but together may have a synergistic set of impacts that are significant. Also, there may be feedback mechanisms wherein the built environment, particularly in the form of cities, may affect weather and the climate on local and regional scales. Besides having a host of such interactions, the impacts of climate change on urban areas will likely have thresholds, below which effects are incidental or of mild consequence, but beyond which the effects quickly become major. Hence, a city may be able to cope with prolonged heat waves, but if this is combined with severe drought, the overall result could be significant or even catastrophic, as accelerating demand for energy to cooling taxes water supplies needed both for energy supply and municipal water needs. Moreover, urban areas may be affected by changes in daily and seasonal high or low temperatures or precipitation, which may have a much more prolonged impact than the direct effect of these events. Thus, the cumulative impacts of multiple events may be more severe than those of any single event. Primary hazards include sea level rise and coastal storms, heat waves, intense precipitation, drought, extreme wind events, urban heat islands, and secondary air pollutants, and cold air events including frozen precipitation. Indicators need to be developed to provide a consistent, objective, and transparent overview of major variations in climate impacts, vulnerabilities, adaptation, and mitigation activities. Overall, indicators of climate change on the built environment

  13. Organizational factors impacting job strain and mental quality of life in emergency and critical care units.

    Science.gov (United States)

    Bellagamba, Gauthier; Gionta, Guillaume; Senergue, Julie; Bèque, Christine; Lehucher-Michel, Marie-Pascale

    2015-01-01

    This study measures the association between hospital staff's job strain (JS), mental quality of life (MQL) and how they are influenced by the organization models within emergency and critical care units. This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer's efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  14. Organizational factors impacting job strain and mental quality of life in emergency and critical care units

    Directory of Open Access Journals (Sweden)

    Gauthier Bellagamba

    2015-04-01

    Full Text Available Objectives: This study measures the association between hospital staff’s job strain (JS, mental quality of life (MQL and how they are influenced by the organization models within emergency and critical care units. Material and Methods: This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Results: Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer’s efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. Conclusions: If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented.

  15. Ambient sound levels at four Department of Interior conservation units in support of Homestead Air Base reuse supplemental environmental impact statement

    Science.gov (United States)

    1999-06-01

    The Federal Aviation Administration (FAA), in cooperation with the United States Air Force (USAF), is developing a Supplemental Environmental Impact Statement (SEIS) in support of the planned commercialization of Homestead Air Base in Southern Florid...

  16. The United States and security in Africa: the impact of the military ...

    African Journals Online (AJOL)

    The focus of this article is to examine the dynamics influencing the militarization of US-Africa relations and their impact on security and transformation in Africa. The article attempts to illuminate the ideological, economic and social forces that influence the conception and practice of the militarization of US policy towards ...

  17. Dairy production systems in the United States: Nutrient budgets and environmental impacts

    Science.gov (United States)

    Across the diversity of US dairy production systems, nutrient management priorities range widely, from feeding regimes to manure handling, storage and application to crop systems. To assess nutrient management and environmental impacts of dairy production systems in the US, we evaluated nutrient bud...

  18. Environmental impact of manufacturing softwood lumber in northeastern and north central United States

    Science.gov (United States)

    Richard D. Bergman; Scott A. Bowe

    2010-01-01

    Finding the environmental impact of building materials is becoming increasingly more important because of public environmental awareness. Accurate and precise life-cycle inventory data on wood products are needed to meet this demand. This study examined softwood lumber manufacturing in the northeastern and north central US using life-cycle inventory methods. Material...

  19. Market impacts of hypothetical fuel treatment thinning programs on federal lands in the western United States

    Science.gov (United States)

    Peter J. Ince; Henry Spelter; Kenneth Skog; Andrew Kramp; Dennis P. Dykstra

    2000-01-01

    This paper addresses the economics of forest fuel thinning programs on federal lands in the U.S. West, and presents a model of regional timber and product market impacts. The issue of economics is vital to the debate about fire management, and this paper presents market implications of two alternative silvicultural strategies, even-aged and uneven-aged...

  20. United States Air Force F-35A Operational Basing Environmental Impact Statement. Appendix E: Comments

    Science.gov (United States)

    2013-09-01

    forbid, tobacco smoking in or around your home. • Switch to non-toXic cleaning products (such as baking soda, hydrogen peroxide and vinegar) and safer...checked false assertion that the Air Force impact study was "a boiler plate document that was not specific to our area." Several reports attributed

  1. The impacts of increasing drought on forest dynamics, structure, and biodiversity in the United States

    Science.gov (United States)

    James S. Clark; Louis Iverson; Christopher W. Woodall; Craig D. Allen; David M. Bell; Don C. Bragg; Anthony W. D' Amato; Frank W. Davis; Michelle H. Hersh; Ines Ibanez; Stephen T. Jackson; Stephen Matthews; Neil Pederson; Matthew Peters; Mark W. Schwartz; Kristen M. Waring; Niklaus E. Zimmermann

    2016-01-01

    We synthesize insights from current understanding of drought impacts at stand-to-biogeographic scales, including management options, and we identify challenges to be addressed with new research. Large stand-level shifts underway in western forests already are showing the importance of interactions involving drought, insects, and fire. Diebacks, changes in composition...

  2. United States Air Force F-35A Operational Basing Environmental Impact Statement. Appendix E: Comments

    Science.gov (United States)

    2013-09-01

    surrounding states are truely in a unique position to contribute to the needs of the nation and I look forward to the outcome of the Enviromental ...to the needs of the nation and I look forward to the outcome of the Enviromental Impact Statement and subsequent Record of Decision. Thank you for

  3. Cultural impacts on public perceptions of agricultural biotechnology: A comparison of South Korea and the United States

    Science.gov (United States)

    Nader, Richard Harrison

    According to Millar (1996), the gulf between science and society is growing. Technologies are tools cultures develop to solve society's problems. The rapid dispersion of science and technology across cultural borders through trade, technology transfer and exchange, increasingly requires people in different cultures to make choices about accepting or rejecting artifacts of science and technology such as genetically modified (GM) foods, which originate primarily from the United States. These issues challenge policy makers and scientists to account for the affects of different cultural perspectives on controversial scientific issues. Given the controversy across cultures over acceptance or rejection of genetically modified (GM) foods, GM foods are an excellent example with which to begin to reveal how culture impacts public perceptions of the risk and benefits of science and technology in different societies. This research will: (1) Define public awareness and understanding of science, specifically GM foods; (2) Examine culture's impact on knowledge, including different cultural approaches to research; and (3) Compare recent findings of a bi-national public opinion survey on GM comparing in South Korea and the United States. The proposed research outlines two research questions: (1) How and in what ways do South Koreans and Americans differ in their opinions about GMOs? This question is important for gathering current points of contrast about how the two cultures may differ; and (2) What role does culture play on opinion formation about GM foods? Through grounded theory, the researcher will investigate how cultural differences help explain opinion on public perceptions of GM foods. Is it possible to identify common cultural factors that impact public perceptions of GM foods between South Koreans and Americans? The study will utilize both qualitative and quantitative methodologies. Higher education is a major producer of new science and technology. The study is

  4. Impacts of reproductive technologies on beef production in the United States.

    Science.gov (United States)

    Dahlen, Carl; Larson, Jamie; Lamb, G Cliff

    2014-01-01

    Estimations of world population growth indicate that by the year 2050 we will reach nine billion habitants on earth. These estimates impose a tremendous challenge in the current agricultural systems as food supply will need to increase by 100 % in the next 40 years (Food and Agriculture Organization of the United Nations 2009). Beef will be a primary protein source that will assist in meeting the requirements for a portion of the protein in diets of this expanding global populace. Beef is a high-quality protein that contains all essential amino acids for the human body and also contains additional essential nutrients such as iron, zinc, B vitamins, riboflavin, selenium, choline, and conjugated linoleic acid (CLA). Adopting reproductive technologies at greater rates than currently used is a viable method to dramatically enhance production efficiency of beef cattle enterprises.Artificial insemination (AI), estrous synchronization and fixed-time AI (TAI), semen and embryo cryopreservation, multiple ovulation and embryo transfer (MOET), in vitro fertilization, sex determination of sperm or embryos, and nuclear transfer are technologies that are used to enhance the production efficiency of beef operations. In many cases, the development of these technologies is responsible for significant changes to traditional livestock production practices. However, adoption of these technologies appears to has not grown at the same rate in the United States as other formidable beef producing nations. For example, sales of beef semen for AI increased from 3.3 to 11.9 million units between 1993 and 2011 in Brazil, whereas that in the United States has increased from 2.9 to 3.8 million units during the same period. The significant increases in adoption of reproductive technologies in developing countries is likely as a result of the development of practical estrous synchronization and TAI systems that have allowed beef producers the opportunity to eliminate detection of estrus in their

  5. Health impact assessment in the United States: Has practice followed standards?

    International Nuclear Information System (INIS)

    Schuchter, Joseph; Bhatia, Rajiv; Corburn, Jason; Seto, Edmund

    2014-01-01

    As an emerging practice, Health Impact Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and impact of practice. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA Practice Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental Impact Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used practice standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health impacts. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published practice standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and impacts. • Evaluation or monitoring plans were generally not included in

  6. Health impact assessment in the United States: Has practice followed standards?

    Energy Technology Data Exchange (ETDEWEB)

    Schuchter, Joseph, E-mail: jws@berkeley.edu [University of California, Berkeley, School of Public Health, Department of Environmental Health Sciences, 50 University Hall, Berkeley, CA 94720-7360 (United States); Bhatia, Rajiv [University of California, Berkeley, Institute of Urban and Regional Development (United States); Corburn, Jason [University of California, Berkeley, College of Environmental Design, Department of City and Regional Planning (United States); Seto, Edmund [University of Washington, School of Public Health, Department of Environmental and Occupational Health (United States)

    2014-07-01

    As an emerging practice, Health Impact Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and impact of practice. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA Practice Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental Impact Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used practice standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health impacts. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published practice standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and impacts. • Evaluation or monitoring plans were generally not included in

  7. On the preparation of environmental impact statements in the United States of America

    Science.gov (United States)

    Carson, James E.

    The National Environmental Policy Act of 1969 (NEPA) requires that an Environmental Impact Statement (FIS) be prepared whenever a federal action is considered that could result in a significant impact on the environment. Such actions include the issuance of construction or operating licenses for nuclear facilities and power plants, hydroelectric dams, or the diversion of water from rivers and lakes. An EIS is usually required if federal funds are involved. The U.S. Environmental Protection Agency and U.S. Council for Environmental Quality have developed guidelines and regulations for the preparation of an EIS. An EIS is not a scientific report. It is a legal document whose primary function is its use by decision-making agencies in approving or not approving the proposed federal action. The EIS is also used to inform the public and other government agencies of the environmental impacts of the proposed facility. The NEPA process allows public input into the decision-making process. An EIS should be short and concise, analytical, conclusory, be written for a non-technical audience, discuss the pros and cons of the proposed facility, and examine the impacts of all alternatives to the proposed action. The EIS should identify all adverse environmental impacts that cannot be avoided. The conclusions reached in the EIS should be clearly stated and supported by discussions and data in the text and by references to show that the agency has made the necessary analyses. The paper discusses the purpose and contents of these documents and the environmental procedures used in the U.S.A., especially as they relate to nuclear power plants.

  8. Health for Life in Primary Schools Program, United Kingdom: a Program Impact Pathways (PIP) analysis.

    Science.gov (United States)

    Passmore, Sandra; Donovan, Martin

    2014-09-01

    The Health for Life in Primary Schools Program helps schools promote healthy, active lifestyles through curriculum support related to healthy eating and cooking, growing food, physical activity, and family involvement. These interrelated strands are shown to have the greatest impact on healthy lifestyles, and the Health for Life in Primary Schools Program seeks to make these not one-off lessons, but a sustainable part of a school's culture. Each school involved with the program develops its own Action Plan in order to achieve program goals. Each school is assessed by an audit of facilities, skills, and curriculum at baseline and follow-up, and the pupils complete an on-line questionnaire at baseline and follow-up. Other impact measures are individual to the school and relate to its own Action Plan. Health for Life in Primary Schools sought to assess the cohesiveness and strength of the program using the Program Impact Pathways (PIP) model. The program was deconstructed to its individual parts, with each part assessed in terms of its contribution to the overall program and constraints upon its effectiveness. The PIP analysis helped clarify the logic and structure of the program, whether its objectives can be achieved, the Critical Quality Control Points (CCPs), and the impact measures required to demonstrate success. The core indicators identified for impact evaluation were knowledge, attitudes, and behaviors of pupils around healthy eating cooking, growing food, and physical activity. The PIP model confirmed that the Health for Life in Primary Schools Program is well structured and is well suited to achieve its goals. The findings were presented at the Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, under the auspices of the Mondelēz International Foundation.

  9. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    DEFF Research Database (Denmark)

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.......To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF....

  10. Impact of Brexit on the United Kingdom’s Housing Market

    OpenAIRE

    Syromiatnikova, Sofia

    2017-01-01

    This thesis aims to analyse the changes in the real estate market in the United Kingdom and trace and identify the factors that would trigger a price change. The dissertation investigates the possible change in the value of housing caused by Brexit, which is a specific group of investment assets and a major component of household wealth for the UK. Understanding the nature and degree of change in housing prices will make market participants aware of the size of their risk exposure and can hel...

  11. The Impact of an Indiana (United States Drug Court on Criminal Recidivism

    Directory of Open Access Journals (Sweden)

    John R. Gallagher

    2014-07-01

    Full Text Available This study evaluated a drug court located in a metropolitan area of Indiana (United States, focusing specifically on identifying variables that predicted recidivism among drug court participants and comparing criminal recidivism patterns among drug court and probation participants. Drug court participants were most likely to recidivate if they were younger, had a violation within the first 30 days of the program, had a previous criminal record, and were terminated unsuccessfully from the program. Furthermore, drug court participants were less likely to recidivate than probationers who had similar offense and demographic characteristics. Implications for drug court practice, policy advocacy, and future research are discussed.

  12. Impacts of Electrification of Light-Duty Vehicles in the United States, 2010 - 2017

    Energy Technology Data Exchange (ETDEWEB)

    Gohlke, David [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division; Zhou, Yan [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division

    2018-01-25

    This report examines the sales of plug-in electric vehicles (PEVs) in the United States from 2010 to 2017, exploring vehicle sales, electricity consumption, petroleum reduction, and battery production, among other factors. Over 750,000 PEVs have been sold, driving nearly 16 billion miles on electricity, thereby reducing gasoline consumption by 0.1% in 2016 and 600 million gallons cumulatively through 2017, while using over 5 terawatt-hours of electricity. Over 23 gigawatt-hours of battery capacity has been placed in vehicles, and 98% of this is still on the road, assuming typical scrappage rates.

  13. Impact of 2001 Building Technology, state and community programs on United States employment and wage income

    International Nuclear Information System (INIS)

    MJ Scott; DJ Hostick; DB Elliott

    2000-01-01

    The Department of Energy Office of Building Technology, State and Community Programs (BTS) is interested in assessing the potential economic impacts of its portfolio of programs on national employment and income. A special purpose version of the IMPLAN input-output model allied In Build is used in this study of all 38 BTS programs included in the FY2001 federal budget. Energy savings, investments, and impacts on U.S. national employment and wage income are reported by program for selected years to the year 2030. Energy savings from these programs have the potential of creating a total of nearly 332,000 jobs and about $5.3 billion in wage income (1995$) by the year 2030. Because the required investments to achieve these savings are capital intensive, the net effect after investment is 304,000 jobs and $5.0 billion

  14. Impact of competitive electricity market on renewable generation technology choice and policies in the United States

    International Nuclear Information System (INIS)

    Sarkar, Ashok

    1999-01-01

    Market objectives based on private value judgments will conflict with social policy objectives toward environmental quality in an emerging restructured electricity industry. This might affect the choice of renewables in the future generation mix. The US electricity industry's long-term capacity planning and operations is simulated for alternative market paradigms to study this impact. The analysis indicates that the share of renewable energy generation sources would decrease and emissions would increase considerably in a more competitive industry, with greater impact occurring in a monopoly market. Alternative environmental policy options can overcome market failures and help achieve appropriate levels of renewable generation. An evaluation of these policies indicate their varying cost-effectiveness, with higher levels of intervention necessary if market power exists. (Author)

  15. The radiological impact of the normal rail transport of radioactive materials in the United Kingdom

    International Nuclear Information System (INIS)

    Mairs, J.H.

    1983-01-01

    Recently the NRPB, under contract to the Health and Safety Executive, and in association with the British Railways Board, has assessed the radiological impact of consignments transported on the British Rail system. The work has shown the radiation exposure of British Rail staff and of the public to be low. This paper identifies the types of radioactive materials transported by rail, outlines the methods used to assess the doses to persons exposed and presents the results of these assessments. (author)

  16. United States Air Force F-35A Operational Basing Environmental Impact Statement. Volume 2, Appendices

    Science.gov (United States)

    2013-09-01

    the natural soundscapes of parks consistent with our Management Policies. NPS Management Policies, Section 4.9, Soundscape Management, states “the...Department will restore to the natural condition wherever possible those park soundscapes that have become degraded by unnatural sounds (noise...and will protect natural soundscapes from unacceptable impacts.” This is consistent with 40 CFR. §1508-27b, “Unique characteristics of the geographic

  17. Assessing the impact of the Australia-United States Free Trade Agreement on Australian and global medicines policy

    Directory of Open Access Journals (Sweden)

    Searles Andrew

    2005-10-01

    Full Text Available Abstract On 1 January 2005, a controversial trade agreement entered into force between Australia and the United States. Though heralded by the parties as facilitating the removal of barriers to free trade (in ways not achievable in multilateral fora, it also contained many trade-restricting intellectual property provisions and others uniquely related to altering pharmaceutical regulation and public health policy in Australia. The latter appear to have particularly focused on the world-respected process of federal government reimbursement after expert cost-effectiveness evaluation, popularly known as the Pharmaceutical Benefits Scheme ('PBS'. It remains uncertain what sort of impacts – if any – the Australia-United States Free Trade Agreement ('AUSFTA' will have on PBS processes such as reference pricing and their important role in facilitating equitable and affordable access to essential medicines. This is now the field of inquiry for a major three year Australian Research Council ('ARC'-funded study bringing together a team of senior researchers in regulatory theory from the Australian National University and pharmacoeconomics from the University of Newcastle. The project proposes to monitor, assess and analyse the real and potential impacts of the AUSFTA in this area, providing Australian policy-makers with continuing expertise and options. To the extent that the AUSFTA medicines provisions may represent animportant precedent in a global strategy by industry oncost-effectiveness evaluation of pharmaceuticals, the study will also beof great interest to policy makers in other jurisdictions.

  18. The Air Quality and Economic Impact of Atmospheric Lead from General Aviation Aircraft in the United States

    Science.gov (United States)

    Wolfe, P. J.; Selin, N. E.; Barrett, S. R. H.

    2015-12-01

    While leaded fuels for automobiles were phased-out of use in the United States by 1996, lead (Pb) continues to be used as an anti-knock additive for piston-driven aircraft. We model the annual concentration of atmospheric lead attributable to piston driven aircraft emissions in the continental United States using the Community Multi-scale Air Quality (CMAQ) model. Using aircraft emissions inventories for 2008, we then calculate annual economic damages from lead as lifetime employment losses for a one-year cohort exposed to elevated atmospheric lead concentrations using a range of concentration response functions from literature. Mean and median estimates of annual damages attributable to lifetime lost earnings are 1.06 and 0.60 billion respectively. Economy-wide impacts of IQ-deficits on productivity and labor increase expected damages by 54%. Damages are sensitive to background lead concentrations; as emissions decrease from other sources, the damages attributable to aviation are expected to increase holding aviation emissions constant. The monetary impact of General Aviation lead emissions on the environment is the same order of magnitude as noise, climate change, and air quality degradation from all commercial operations.

  19. The impact of domestic violence exposure on South Asian children in the United States: Perspectives of domestic violence agency staff.

    Science.gov (United States)

    Ragavan, Maya I; Fikre, Tsion; Millner, Uma; Bair-Merritt, Megan

    2018-02-01

    The South Asian community is the fastest growing ethnic group in the United States, and past research suggests that South Asian domestic violence (DV) survivors may require culturally-specific resources. Similarly, South Asian children in the US exposed to DV may have unique responses and needs, but this has not been explored to date. The objective of this study was to examine the specific needs of South Asian children exposed to DV from the vantage point of staff from South Asian DV agencies across the United States. Thirty interviews were conducted, with data coded and consolidated into larger themes using thematic analysis. Participants described several factors important to understanding the impact of DV on South Asian children including the role of the extended family, identifying with two cultures, fear about what the South Asian community will think, gender differences, and the importance of projecting an image of perfection. Participants also discussed development of culturally-tailored resources. This study suggests the importance of framing South Asian children's experiences within the context of interweaving South Asian and American cultural values, with careful attention paid to how potential culture clashes between parents and children may impact the way children process trauma. Further work should triangulate these themes with children, parents, and extended family, as well as collaborate with South Asian DV agencies to design child-focused programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. The impact of cultural characteristics on colorectal cancer screening adherence among Filipinos in the United States: a pilot study.

    Science.gov (United States)

    Ferrer, Rizaldy R; Ramirez, Marizen; Beckman, Linda J; Danao, Leda L; Ashing-Giwa, Kimlin T

    2011-08-01

    Studies on colorectal cancer screening among specific Asian American groups are limited despite the fact that Asians are comprised of culturally distinct subgroups. The purpose of this study was to investigate the impact of cultural characteristics on colorectal cancer screening adherence among Filipinos in the United States. One hundred and seventeen Filipino men and women aged 50 years or older participated in the cross-section research design. Lifetime proportion of immigration, language preference and cultural beliefs of personal control regarding health outcomes measured cultural characteristics. Demographic and healthcare variables were also measured to describe the study sample. Participant recruitment employed culturally responsive sampling methods. There was no significant association between language preference and screening. Likewise, perceived personal internal control of health outcome was not related to screening. However, personal external control revealed a marginally significant association. The percent of lifetime residence in the United States was significantly greater among those who were adherent to screening than those who were not adherent. After adjusting for demographic and healthcare variables, the relationship between length of immigration and screening adherence was no longer significant. Finally, age and doctor's recommendation showed significant impact on colorectal cancer screening adherence. This pilot study adds to the knowledge regarding cultural factors associated with colorectal cancer screening behaviors among Filipino Americans. Future research is needed to confirm findings that will be useful in developing culturally appropriate strategies to increase screening adherence. Copyright © 2010 John Wiley & Sons, Ltd.

  1. Analysis of impact of general-purpose graphics processor units in supersonic flow modeling

    Science.gov (United States)

    Emelyanov, V. N.; Karpenko, A. G.; Kozelkov, A. S.; Teterina, I. V.; Volkov, K. N.; Yalozo, A. V.

    2017-06-01

    Computational methods are widely used in prediction of complex flowfields associated with off-normal situations in aerospace engineering. Modern graphics processing units (GPU) provide architectures and new programming models that enable to harness their large processing power and to design computational fluid dynamics (CFD) simulations at both high performance and low cost. Possibilities of the use of GPUs for the simulation of external and internal flows on unstructured meshes are discussed. The finite volume method is applied to solve three-dimensional unsteady compressible Euler and Navier-Stokes equations on unstructured meshes with high resolution numerical schemes. CUDA technology is used for programming implementation of parallel computational algorithms. Solutions of some benchmark test cases on GPUs are reported, and the results computed are compared with experimental and computational data. Approaches to optimization of the CFD code related to the use of different types of memory are considered. Speedup of solution on GPUs with respect to the solution on central processor unit (CPU) is compared. Performance measurements show that numerical schemes developed achieve 20-50 speedup on GPU hardware compared to CPU reference implementation. The results obtained provide promising perspective for designing a GPU-based software framework for applications in CFD.

  2. Impact of outlier status on critical care patient outcomes: Does boarding medical intensive care unit patients make a difference?

    Science.gov (United States)

    Ahmad, Danish; Moeller, Katherine; Chowdhury, Jared; Patel, Vishal; Yoo, Erika J

    2018-04-01

    To evaluate the impact of outlier status, or the practice of boarding ICU patients in distant critical care units, on clinical and utilization outcomes. Retrospective observational study of all consecutive admissions to the MICU service between April 1, 2014-January 3, 2016, at an urban university hospital. Of 1931 patients, 117 were outliers (6.1%) for the entire duration of their ICU stay. In adjusted analyses, there was no association between outlier status and hospital (OR 1.21, 95% CI 0.72-2.05, p=0.47) or ICU mortality (OR 1.20, 95% CI 0.64-2.25, p=0.57). Outliers had shorter hospital and ICU lengths of stay (LOS) in addition to fewer ventilator days. Crossover patients who had variable outlier exposure also had no increase in hospital (OR 1.61; 95% CI 0.80-3.23; p=0.18) or ICU mortality (OR 1.05; 95% CI 0.43-2.54; p=0.92) after risk-adjustment. Boarding of MICU patients in distant units during times of bed nonavailability does not negatively influence patient mortality or LOS. Increased hospital and ventilator utilization observed among non-outliers in the home unit may be attributable, at least in part, to differences in patient characteristics. Prospective investigation into the practice of ICU boarding will provide further confirmation of its safety. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Modeled dietary impact of industry-wide food and beverage reformulations in the United States and France.

    Science.gov (United States)

    Gressier, Mathilde; Privet, Lisa; Mathias, Kevin Clark; Vlassopoulos, Antonis; Vieux, Florent; Masset, Gabriel

    2017-07-01

    Background: Food reformulation has been identified as a strategy to improve nutritional intakes; however, little is known about the potential impact of industry-wide reformulations. Objective: The aim of the study was to model the dietary impact of food and beverage reformulation following the Nestlé Nutritional Profiling System (NNPS) standards for children, adolescents, and adults in the United States and France. Design: Dietary intakes of individuals aged ≥4 y were retrieved from nationally representative surveys: the US NHANES 2011-2012 ( n = 7456) and the French Individual and National Survey on Food Consumption ( n = 3330). The composition of all foods and beverages consumed were compared with the NNPS standards for energy, total and saturated fats, sodium, added sugars, protein, fiber, and calcium. Two scenarios were modeled. In the first, the nutrient content of foods and beverages was adjusted to the NNPS standards if they were not met. In the second, products not meeting the standards were replaced by the most nutritionally similar alternative meeting the standards from the same category. Dietary intakes were assessed against local nutrient recommendations, and analyses were stratified by body mass index and socioeconomic status. Results: Scenarios 1 and 2 showed reductions in US adults' mean daily energy (-88 and -225 kcal, respectively), saturated fats (-4.2, -6.9 g), sodium (-406, -324 mg), and added sugars (-29.4, -35.8 g). Similar trends were observed for US youth and in France. The effects on fiber and calcium were limited. In the United States, the social gradient of added sugars intake was attenuated in both scenarios compared with the baseline values. Conclusions: Potential industry-wide reformulation of the food supply could lead to higher compliance with recommendations in both the United States and France, and across all socioeconomic groups. NNPS standards seemed to be especially effective for nutrients consumed in excess. © 2017 American

  4. Infants born preterm, stress, and neurodevelopment in the neonatal intensive care unit: might music have an impact?

    Science.gov (United States)

    Anderson, Dane E; Patel, Aniruddh D

    2018-03-01

    The neonatal intensive care unit (NICU) provides life-saving medical care for an increasing number of newborn infants each year. NICU care, while lifesaving, does have attendant consequences which can include repeated activation of the stress response and reduced maternal interaction, with possible negative long-term impacts on brain development. Here we present a neuroscientific framework for considering the impact of music on neurodevelopment in the NICU of infants born preterm and evaluate current literature on the use of music with this population to determine what is most reliably known of the physiological effects of music interventions. Using online academic databases we collected relevant, experimental studies aimed at determining effects of music listening in infants in the NICU. These articles were evaluated for methodological rigor, ranking the 10 most experimentally stringent as a representative sample. The selected literature seems to indicate that effects are present on the cardio-pulmonary system and behavior of neonates, although the relative effect size remains unclear. These findings indicate a need for more standardized longitudinal studies aimed at determining not only whether NICU music exposure has beneficial effects on the cardio-pulmonary system, but also on the hypothalamic-pituitary-adrenal axis, brain structures, and cognitive behavioral status of these children as well. Provides a neuroscience framework for considering how music might attenuate stress in neonatal intensive care unit (NICU) infants. Considers how repeated stress may cause negative neurodevelopmental impacts in infants born preterm. Posits epigenetics can serve as a mechanistic pathway for music moderating the stress response. © 2018 Mac Keith Press.

  5. The impact of a noise reduction quality improvement project upon sound levels in the open-unit-design neonatal intensive care unit.

    Science.gov (United States)

    Liu, W F

    2010-07-01

    To decrease measured sound levels in the neonatal intensive care unit through implementation of human factor and minor design modification strategies. Prospective time series. Two open-unit-design neonatal centers. Implementation of a coordinated program of noise reduction strategies did not result in any measurable improvement in levels of loudness or quiet. Two centers, using primarily human behavior noise reduction strategies, were unable to demonstrate measurable improvements in sound levels within the occupied open-unit-design neonatal intensive care unit.

  6. Impact of thermal power generation units on floristic diversity of Kota and its environs

    International Nuclear Information System (INIS)

    Jain, Shuchita; Dadhich, K.

    2001-01-01

    The emissions from thermal power plants have great phytotoxic effects on plants due to changes in their morphology and physiology. A floristic study has been conducted near the Thermal Power Station at Kota in Rajasthan to estimate the impact of emissions from the thermal power plant on biota. It is observed that the whole vegetation, especially the perennial trees and shrubs, growing near the station were severely damaged due to effects of air pollutants emitted from the Thermal Power Station. Analysis of the fly ash reveals its composition as composed of silica, alumina, iron oxide etc. (author)

  7. Impact of memory bottleneck on the performance of graphics processing units

    Science.gov (United States)

    Son, Dong Oh; Choi, Hong Jun; Kim, Jong Myon; Kim, Cheol Hong

    2015-12-01

    Recent graphics processing units (GPUs) can process general-purpose applications as well as graphics applications with the help of various user-friendly application programming interfaces (APIs) supported by GPU vendors. Unfortunately, utilizing the hardware resource in the GPU efficiently is a challenging problem, since the GPU architecture is totally different to the traditional CPU architecture. To solve this problem, many studies have focused on the techniques for improving the system performance using GPUs. In this work, we analyze the GPU performance varying GPU parameters such as the number of cores and clock frequency. According to our simulations, the GPU performance can be improved by 125.8% and 16.2% on average as the number of cores and clock frequency increase, respectively. However, the performance is saturated when memory bottleneck problems incur due to huge data requests to the memory. The performance of GPUs can be improved as the memory bottleneck is reduced by changing GPU parameters dynamically.

  8. Impact of income and income inequality on infant health outcomes in the United States.

    Science.gov (United States)

    Olson, Maren E; Diekema, Douglas; Elliott, Barbara A; Renier, Colleen M

    2010-12-01

    The goal was to investigate the relationships of income and income inequality with neonatal and infant health outcomes in the United States. The 2000-2004 state data were extracted from the Kids Count Data Center. Health indicators included proportion of preterm births (PTBs), proportion of infants with low birth weight (LBW), proportion of infants with very low birth weight (VLBW), and infant mortality rate (IMR). Income was evaluated on the basis of median family income and proportion of federal poverty levels; income inequality was measured by using the Gini coefficient. Pearson correlations evaluated associations between the proportion of children living in poverty and the health indicators. Linear regression evaluated predictive relationships between median household income, proportion of children living in poverty, and income inequality for the 4 health indicators. Median family income was negatively correlated with all birth outcomes (PTB, r = -0.481; LBW, r = -0.295; VLBW, r = -0.133; IMR, r = -0.432), and the Gini coefficient was positively correlated (PTB, r = 0.339; LBW, r = 0.398; VLBW, r = 0.460; IMR, r = 0.114). The Gini coefficient explained a significant proportion of the variance in rate for each outcome in linear regression models with median family income. Among children living in poverty, the role of income decreased as the degree of poverty decreased, whereas the role of income inequality increased. Both income and income inequality affect infant health outcomes in the United States. The health of the poorest infants was affected more by absolute wealth than relative wealth.

  9. Climate change impacts on thermoelectric-power generation in the United States

    Science.gov (United States)

    Liu, L.

    2015-12-01

    Thermoelectric-power generation accounts for more than 70% of the total electricity generation in the United States, which requires large amounts of water for cooling purposes. Water withdrawals for thermoelectric-power generation accounted for 45% of total water use in the United States in 2010. Across the country, water demand from power plants is increasing due to pressures from growing populations and other needs, and is straining existing water resources. Moreover, temperature exceedance in receiving waters has increasingly caused power plants shut downs across parts of the country. Thermoelectric power is vulnerable to climate change owing to the combined effects of lower summer river flows and higher receiving water temperatures. In addition, the efficiency of production is reduced as air temperature rises, which propagates to more unfulfilled power demand during peak seasons. Therefore, a holistic modeling framework of water-energy-climate for the contiguous U.S. is presented here to quantify thermal output from power plants and estimate water use and energy production fluctuations due to ambient climate as well as environmental regulations. The model is calibrated on a plant-by-plant basis for year 2010 and 2011 using the available power plant inventory from the Energy Information Administration (EIA). Simulations were carried out for years 2012 and 2013, and results show moderate improvements in capturing thermal output variabilities after calibration. Future power plant operations under scenarios featuring different climate and regulatory settings were investigated. Results demonstrate the interplay among water, energy and climate, and that future changes in climate and socioeconomics significantly affect power plant operations, which may provide insights to climate change mitigation considerations and energy decisions.

  10. The Scope and Impact of Workplace Diversity in the United Arab Emirates – An Initial Study

    Directory of Open Access Journals (Sweden)

    Badreya Al-Jenaibi

    2011-07-01

    Full Text Available Managing workplace diversity has become a priority concern among organizations in the United Arab Emirates (UAE today. The UAE has one of the world's largest net migration rates, and the number of workers from India, the Philippines, Indonesia, Australia, the USA, among other countries, has increased significantly in recent decades (Burns, 2005. The UAE's cross-border mobility has resulted in the interaction of people with diverse language, customs and ethnic backgrounds. Although diversity has been shown to have a number of benefits, including enhanced employee creativity and competence, this recognition is often found more in theory than actual practice. Diversity can also lead to miscommunication, dysfunctional adaptation behaviors and the creation of barriers that reduce the benefits diversity can bring to the organization. Due to the nature of the UAE workplace, which is dominated by a foreign workforce, this study critically analyzes the benefits and challenges organizations face in the diverse workplaces of the United Arab Emirates. The study used a multi-method approach combining survey data from 450 surveys of foreign workers with qualitative data from interviews with native officials of organizations. It is an attempt to compare the views of UAE workplace experience from two different groups—non-native workers and native officials. The research found a generally favorable view toward workplace diversity from the perspective of surveyed employees. However, when asked more detailed questions about company policy, a significant segment of respondents expressed reservations about their employer’s ability to implement successful intercultural communication and diversity practices.

  11. Impact of introduction of an acute surgical unit on management and outcomes of small bowel obstruction.

    Science.gov (United States)

    Musiienko, Anton M; Shakerian, Rose; Gorelik, Alexandra; Thomson, Benjamin N J; Skandarajah, Anita R

    2016-10-01

    The acute surgical unit (ASU) is a recently established model of care in Australasia and worldwide. Limited data are available regarding its effect on the management of small bowel obstruction. We compared the management of small bowel obstruction before and after introduction of ASU at a major tertiary referral centre. We hypothesized that introduction of ASU would correlate with improved patient outcomes. A retrospective review of prospectively maintained databases was performed over two separate 2-year periods, before and after the introduction of ASU. Data collected included demographics, co-morbidity status, use of water-soluble contrast agent and computed tomography. Outcome measures included surgical intervention, time to surgery, hospital length of stay, complications, 30-day readmissions, use of total parenteral nutrition, intensive care unit admissions and overall mortality. Total emergency admissions to the ASU increased from 2640 to 4575 between the two time periods. A total of 481 cases were identified (225 prior and 256 after introduction of ASU). Mortality decreased from 5.8% to 2.0% (P = 0.03), which remained significant after controlling for confounders with multivariate analysis (odds ratio = 0.24, 95% confidence interval 0.08-0.73, P = 0.012). The proportion of surgically managed patients increased (20.9% versus 32.0%, P = 0.003) and more operations were performed within 5 days from presentation (76.6% versus 91.5%, P = 0.02). Fewer patients received water-soluble contrast agent (27.1% versus 18.4%, P = 0.02), but more patients were investigated with a computed tomography (70.7% versus 79.7%, P = 0.02). The ASU model of care resulted in decreased mortality, shorter time to intervention and increased surgical management. Overall complications rate and length of stay did not change. © 2015 Royal Australasian College of Surgeons.

  12. Impact of online toxicology training on health professionals: the Global Educational Toxicology Uniting Project (GETUP).

    Science.gov (United States)

    Wong, Anselm; Vohra, Rais; Dawson, Andrew H; Stolbach, Andrew

    2017-11-01

    The Global Educational Toxicology Uniting Project (GETUP), supported by the American College of Medical Toxicology, links countries with and without toxicology services via distance education with the aim to improve education. Due to the lack of toxicology services in some countries there is a knowledge gap in the management of poisonings. We describe our experience with the worldwide delivery of an online introductory toxicology curriculum to emergency doctors and other health professionals treating poisoned patients. We delivered a 15-module introductory Internet-based toxicology curriculum to emergency doctors and health professionals, conducted from August to December 2016. This Internet-based curriculum was adapted from one used to teach emergency residents toxicology in the United States. Modules covered themes such as pharmaceutical (n = 8), toxidromes (n = 2) and agrochemicals (n = 5) poisoning. Participants completed pre-test and post-test multiple choice questions (MCQs) before and after completing the online module, respectively, throughout the course. We collected information on participant demographics, education and training, and perception of relevance of the curriculum. Participants gave feedback on the course and how it affected their practice. One hundred and thirty-six health professionals from 33 countries participated in the course: 98 emergency doctors/medical officers, 25 physicians, eight pharmacists/poisons information specialists, two toxicologists, two medical students and one nurse. Median age of participants was 34 years. Median number of years postgraduate was seven. Ninety (65%) had access to either a poisons information centre over the phone or toxicologist and 48 (35%) did not. All participants expected the course to help improve their knowledge. Overall median pre-module MCQ scores were 56% (95%CI: 38, 75%) compared to post-module MCQ scores median 89% (95% CI: 67, 100%) (p education to health professionals treating

  13. Impact of the ENHANCE trial on the use of ezetimibe in the United States and Canada.

    Science.gov (United States)

    Lu, Lingyun; Krumholz, Harlan M; Tu, Jack V; Ross, Joseph S; Ko, Dennis T; Jackevicius, Cynthia A

    2014-05-01

    We previously found that the use of ezetimibe increased rapidly with different patterns between the United States (US) and Canada prior to the landmark Ezetimibe and Simvastatin in Hypercholesterolemia Enhance Atherosclerosis Regression (ENHANCE) trial, which was reported in January 2008, and failed to show that the drug slowed the progression of atherosclerosis. What is not known is how practice in the 2 countries changed after the ENHANCE trial. We examined ezetimibe use trends in the US and Canada before and after the reporting of the ENHANCE trial. We conducted a population-based, retrospective, time-series analysis using the data collected by IMS Health in the US and CompuScript in Canada from January 1, 2002, to December 31, 2009. The main outcome measure was monthly number of prescriptions for ezetimibe-containing products. The monthly number of ezetimibe prescriptions/100,000 population rose from 6 to 1,082 in the US from November 2002 to January 2008, then significantly declined to 572/100,000 population by December 2009 after the release of the ENHANCE trial, a decrease of 47.1% (P Canada, use continuously rose from 2 to 495/100,000 population from June 2003 to December 2009 (P = .2). United States expenditures totaled $2.24 billion in 2009. Ezetimibe remains commonly used in both the US and Canada. Ezetimibe use has decreased in the US post-ENHANCE, whereas use has gradually but steadily increased in Canada. The diverging patterns of ezetimibe use in the US and Canada require further investigation, as they reveal that a common evidence base is eliciting very different utilization patterns in neighboring countries. Copyright © 2014 Mosby, Inc. All rights reserved.

  14. Woodrow Wilson's hidden stroke of 1919: the impact of patient-physician confidentiality on United States foreign policy.

    Science.gov (United States)

    Menger, Richard P; Storey, Christopher M; Guthikonda, Bharat; Missios, Symeon; Nanda, Anil; Cooper, John M

    2015-07-01

    World War I catapulted the United States from traditional isolationism to international involvement in a major European conflict. Woodrow Wilson envisaged a permanent American imprint on democracy in world affairs through participation in the League of Nations. Amid these defining events, Wilson suffered a major ischemic stroke on October 2, 1919, which left him incapacitated. What was probably his fourth and most devastating stroke was diagnosed and treated by his friend and personal physician, Admiral Cary Grayson. Grayson, who had tremendous personal and professional loyalty to Wilson, kept the severity of the stroke hidden from Congress, the American people, and even the president himself. During a cabinet briefing, Grayson formally refused to sign a document of disability and was reluctant to address the subject of presidential succession. Wilson was essentially incapacitated and hemiplegic, yet he remained an active president and all messages were relayed directly through his wife, Edith. Patient-physician confidentiality superseded national security amid the backdrop of friendship and political power on the eve of a pivotal juncture in the history of American foreign policy. It was in part because of the absence of Woodrow Wilson's vocal and unwavering support that the United States did not join the League of Nations and distanced itself from the international stage. The League of Nations would later prove powerless without American support and was unable to thwart the rise and advance of Adolf Hitler. Only after World War II did the United States assume its global leadership role and realize Wilson's visionary, yet contentious, groundwork for a Pax Americana. The authors describe Woodrow Wilson's stroke, the historical implications of his health decline, and its impact on United States foreign policy.

  15. Sub-hourly impacts of high solar penetrations in the Western United States

    Energy Technology Data Exchange (ETDEWEB)

    Lew, Debra; Brinkman, Greg; Florita, Anthony; Heaney, Michael; Hodge, Bri-Mathias; Hummon, Marissa; Ibanez, Eduardo [National Renewable Energy Lab. (NREL), Golden, CO (United States); King, Jack [RePPAE, Wexford, PA (United States)

    2012-07-01

    Until recently, it has been difficult to study the impacts of significant penetrations of hypothetical, utility-scale solar photovoltaic (PV) plants over large geographic regions. This was because of the lack of credible data to simulate the output of these plants with appropriate spatial and temporal correlation, especially on a sub-hourly basis. In the Western Wind and Solar Integration Study Phase 2 (WWSIS2), we used new technigues to synthesize sub-hourly high-resolution solar output for PV rooftops, utility-scale PV, and concentrating solar power (CSP). This allowed us to examine implications of 25 % solar (60/40 split of PV and CSP) and 8 % wind. In this paper, we present results of analysis on the sub-hourly impacts of high solar penetrations. Extreme event analysis showed that most of the large ramps were because of sunrise and sunset events, which have a significant predictability component. Variability in general was much higher with high penetrations of solar than with high penetrations of wind. Reserve methodologies that had already been developed for wind were therefore modified to take into account the predictability component of solar variability. Significantly less transmission was required for high solar penetrations than wind and significantly less curtailment occurred in the high solar cases. (orig.)

  16. Prevalence and impact of sleep disorders and sleep habits in the United States.

    Science.gov (United States)

    Ram, Saravanan; Seirawan, Hazem; Kumar, Satish K S; Clark, Glenn T

    2010-02-01

    Epidemiologic studies on sleep disorders in the USA have mostly focused on specific disorders in specific groups of individuals. Most studies on sleep habits and sleep-related difficulties have focused on children and adolescents. The authors describe the prevalence of the three common physician-diagnosed sleep disorders (insomnia, sleep apnea, and restless legs syndrome (RLS)) by age, gender, and race in the US population. In addition, the authors describe the sleep habits and sleep-related difficulties in carrying routine daily activities. The authors also investigate the impact of the sleep disorders on performing routine daily activities. Data from the 2005-2006 National Health and Nutrition Examination Survey for 6,139 individuals over the age of 16 was analyzed for sleep-related parameters. The prevalence was highest for sleep apnea (4.2%), followed by insomnia (1.2%) and RLS (0.4%). Hispanics and Whites reported longer sleep duration than Blacks by 24 to 30 min. The predominant sleep habits were snoring while sleeping (48%), feeling unrested during the day (26.5%), and not getting enough sleep (26%). Difficulty concentrating (25%) or remembering (18%) were the main sleep-related difficulties in our sample. Insomnia, sleep apnea, and RLS had the highest impact on concentration and memory. Our findings suggest that the prevalence of sleep disorders in the USA is much lower than previously reported in the literature suggesting under diagnosis of sleep disorders by primary care physicians.

  17. Long-term User and Community Impacts of High-speed Rail in the United States’ Midwest Corridor

    Directory of Open Access Journals (Sweden)

    Jeffrey C. Peters

    2014-09-01

    Full Text Available This study contributes new insights in the debate over the viability of high-speed rail (HSR in the United States and the value proposition for government investment. The modeling focus of this study is two-fold, and the modeling approach makes a case for a fundamental shift from the current perspective of HSR viability. First, the user and community impact assessment of HSR is conducted in the same manner as traditional transportation system evaluation (i.e., vehicle operating costs (VOC, travel time, safety, emissions, and energy consumption to provide comparable conclusions regarding intercity transportation alternatives. Second, the model presented in this study analyzes both ridership and impacts within the same systematic framework to assess the long-term impacts on the individual transportation modes, total system metrics, and efficacy of alternate policies. Using this model, decision-makers can introduce various externalities to determine both the ideal and problematic conditions for the viability of a new HSR system.

  18. The post-stroke depression and its impact on functioning in young and adult stroke patients of a rehabilitation unit.

    Science.gov (United States)

    Amaricai, Elena; Poenaru, Dan V

    2016-01-01

    Stroke is a leading cause of disability and a major public health problem. To determine frequency and degree of post-stroke depression (PSD) and its impact on functioning in young and adult stroke patients in a rehabilitation unit. The study included 72 stroke patients (aged 29-59 years) who were attending rehabilitation. The patients were assessed for depressive symptoms by Beck Depression Inventory (BDI), and their functioning by using the Stroke Impact Scale (SIS) and the Barthel Index of Activities of Daily Living (ADL). Forty-eight patients had different degrees of depression: borderline clinical depression (13.8%), moderate depression (34.7%), severe depression (15.2%) or extreme depression (2.9%). There were no significant differences of BDI scores in 30-39, 40-49 and 50-59 years groups. Statistically significant correlations were between BDI score and SIS score, between BDI score and ADL index, and between SIS score and ADL index in men, women and total study patients. More than half of the PSD patients had a moderate degree of depression. Significant correlations were noticed between depressive symptoms and functional status evaluated both by an instrument of assessing stroke impact upon general health and an instrument for assessing the everyday activities.

  19. The impact of thalassemia on Southeast Asian and Asian Indian families in the United States: a qualitative study.

    Science.gov (United States)

    Liem, Robert I; Gilgour, Brynnan; Pelligra, Stephanie A; Mason, Maryann; Thompson, Alexis A

    2011-01-01

    To describe the challenges, including sociocultural and socioeconomic barriers, faced by an urban immigrant population in the United States affected by thalassemia major. Ethnographic, semi-structured, 1-on-1 interviews using an interview guide developed for this study. Digital recordings were transcribed and data analyzed using constant comparative method. University-based, Comprehensive Thalassemia Program at Children's Memorial Hospital, Chicago, IL, USA. Fourteen Southeast Asian and Asian Indian parents of children with transfusion dependent thalassemia. Qualitative descriptions of parental experiences, frequency of codes applied to interviews and emergent themes. Thalassemia has its greatest impact on the emotional and social well-being of affected children and their parents. Current and future concerns were related to disease-specific complications and challenges with management such as transfusions and chelation therapy. These perceptions were tied to parental hope for a cure, a frequently coded coping mechanism. Despite their availability, few parents relied on support systems beyond immediate family members due to perceived public knowledge gaps about thalassemia. Culturally based past experiences and barriers did not emerge as dominant themes in our analysis. The impact of thalassemia is tremendous for affected children and their parents and is due more to factors that were either disease-specific or common to other chronic disease models rather than those influenced by culture. The unmet needs of these families require additional investigation to facilitate the development of initiatives aimed at improving quality of life and lessening overall impact of thalassemia

  20. The macroeconomic impact of pandemic influenza: estimates from models of the United Kingdom, France, Belgium and The Netherlands.

    Science.gov (United States)

    Keogh-Brown, Marcus Richard; Smith, Richard D; Edmunds, John W; Beutels, Philippe

    2010-12-01

    The 2003 outbreak of severe acute respiratory syndrome (SARS) showed that infectious disease outbreaks can have notable macroeconomic impacts. The current H1N1 and potential H5N1 flu pandemics could have a much greater impact. Using a multi-sector single country computable general equilibrium model of the United Kingdom, France, Belgium and The Netherlands, together with disease scenarios of varying severity, we examine the potential economic cost of a modern pandemic. Policies of school closure, vaccination and antivirals, together with prophylactic absence from work are evaluated and their cost impacts are estimated. Results suggest GDP losses from the disease of approximately 0.5-2% but school closure and prophylactic absenteeism more than triples these effects. Increasing school closures from 4 weeks at the peak to entire pandemic closure almost doubles the economic cost, but antivirals and vaccinations seem worthwhile. Careful planning is therefore important to ensure expensive policies to mitigate the pandemic are effective in minimising illness and deaths.

  1. 77 FR 29701 - Impact of Construction (Under a Combined License) of New Nuclear Power Plant Units on Operating...

    Science.gov (United States)

    2012-05-18

    ... New Nuclear Power Plant Units on Operating Units at Multi-Unit Sites AGENCY: Nuclear Regulatory... construct and operate new nuclear power plants (NPPs) on multi-unit sites to provide an evaluation of the... License) of New Nuclear Power Plants on Operating Units at Multi-Unit Sites (Package). ML112630039 Federal...

  2. Impact of cough and common cold on productivity, absenteeism, and daily life in the United States: ACHOO Survey.

    Science.gov (United States)

    Dicpinigaitis, Peter V; Eccles, Ron; Blaiss, Michael S; Wingertzahn, Mark A

    2015-08-01

    Although the common cold is among the most frequent ailments encountered in clinical practice, little is known about its impact on productivity, absenteeism, and daily life. The United States Attitudes of Consumers Toward Health, Cough, and Cold (ACHOO) survey was developed to inform healthcare providers on patients' experience of cough/cold. This analysis focuses on the impact of cough/cold on daily activity, productivity, and absenteeism; other results are reported elsewhere. ACHOO was a 36-question online survey. US adult Internet/mobile device users (N = 3333) were recruited in October 2012. Response quotas modeled on 2010 US Census data ensured a demographically representative sample; 75% of completed surveys were randomized as the primary analysis pool. Demographics and impact of cough/cold were reported using means, frequencies, and percentages. Weighted least squares regression or weighted paired t-test were used to identify factors associated with greater impact. The analysis pool (N = 2505) included 1342 (53.6%) women and 1163 (46.4%) men (mean ages, 46.7 and 45.9 years). A majority (84.7%) had ≥1 cold in the past year. Fifty-two percent said cough/cold impacted daily life a fair amount to a lot. Productivity decreased by a mean 26.4%, and 44.5% of respondents reported work/school absenteeism (usually 1-2 days) during a cold. Overall, 93% of survey participants reported sleep difficulty (slight to extreme) during a cough/cold. Among all respondents, 57% reported cough or nasal congestion as the symptoms making sleep difficult. Higher frequency of colds, more cold symptoms, difficulty sleeping, and worse overall health status correlated with greater impact on productivity, absenteeism, and daily life. Study limitations include the potential for recall bias given the retrospective nature of the self-reports. Furthermore, no attempt was made to distinguish treatment effects, if any, from those of the underlying cough/cold. To our knowledge, this is

  3. Economic impact of industrial wood energy use in the Southeast region of the United States

    International Nuclear Information System (INIS)

    Stephenson, C.D.

    1991-01-01

    More than 1,000 commercial and industrial installations in the Southeast burn wood fuels. Collectively, these facilities consume 44.3 million green tons of fuelwood and 41.7 million tons per year of 'black liquor' residues. Considering the entire direct and indirect impacts of industrial wood energy expenditures as they ripple through the economy, activities associated with the use of industrial wood energy resulted in the production of over 71,000 jobs and $1 billion in personal income for the Southeast region in 1987. In addition, a total of $237 million in State and Federal tax revenues were generated through wood energy related economic activities. Growth projections indicate that by the year 2000, industrial wood energy utilization will generate approximately 97,000 jobs and $1.4 billion in income in the Southeast region

  4. An Analysis of the Impact of Sport Utility Vehicles in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Davis, S.C.; Truett, L.F.

    2000-08-01

    It may be labeled sport utility vehicle, SUV, sport-ute, suburban assault vehicle, or a friend of OPEC (Organization for Petroleum Exporting Countries). It has been the subject of comics, the object of high-finance marketing ploys, and the theme of Dateline. Whatever the label or the occasion, this vehicle is in great demand. The popularity of sport utility vehicles (SUVs) has increased dramatically since the late 1970s, and SUVs are currently the fastest growing segment of the motor vehicle industry. Hoping to gain market share due to the popularity of the expanding SUV market, more and more manufacturers are adding SUVs to their vehicle lineup. One purpose of this study is to analyze the world of the SUV to determine why this vehicle has seen such a rapid increase in popularity. Another purpose is to examine the impact of SUVs on energy consumption, emissions, and highway safety.

  5. Impact of naturalistic lighting on hospitalized stroke patients in a rehabilitation unit

    DEFF Research Database (Denmark)

    West, Anders; Jennum, Poul; Simonsen, Sofie Amalie

    2017-01-01

    Introduction and rationale: Stroke is a major cause of acquired cerebral disability among adults, frequently accompanied by depression, anxiety, cognitive impairment, disrupted sleep and fatigue. New ways of intervention to prevent these complications are therefore needed. The major circadian...... a positive impact on the health of poststroke patients admitted to rehabilitation. We test specifically for improved sleep and less fatigue (questionnaires, polysomnography, Actiwatch), improved well-being (questionnaires), lessen anxiety and depression (questionnaires), improved cognition (tests...... on patients during long-term hospitalization in a real hospital setting. The hypotheses are based on preclinical research, as studies using naturalistic light have never been performed before. Investigating the effects of naturalistic light in a clinical setting is therefore much needed....

  6. Budget impact analysis of botulinum toxin A therapy for upper limb spasticity in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Abogunrin S

    2015-04-01

    Full Text Available Seye Abogunrin,1 Linda Hortobagyi,2 Edit Remak,3 Jerome Dinet,4 Sylvie Gabriel,5 Abdel Magid O Bakheit6 1Meta Research, 2Health Economics, Evidera, London, UK; 3Health Economics, Evidera, Budapest, Hungary; 4Health Economics and Outcomes Research (Global, 5Global Market Access and Pricing, Ipsen Pharma, Boulogne-Billancourt, France; 6Neurological Rehabilitation, Moseley Hall Hospital, Birmingham, UK Background: Botulinum toxin A (BoNT-A is an effective treatment for patients with upper limb spasticity (ULS, which is a debilitating feature of upper motor neuron lesions. BoNT-A preparations available in the UK are associated with different costs. Methods: We developed a budget impact model to assess the effect of changing market shares of different BoNT-A formulations – abobotulinumtoxinA, onabotulinumtoxinA, and incobotulinumtoxinA – and best supportive care, from the UK payer perspective, over a 5-year time horizon. Epidemiological and resource use data were derived from published literature and clinical expert opinion. One-way sensitivity analyses were performed to determine parameters most influential on budget impact. Results: Base-case assumptions showed that an increased uptake of abobotulinumtoxinA resulted in a 5-year savings of £6,283,829. Treatment with BoNT-A costs less than best supportive care per patient per year, although treating a patient with onabotulinumtoxinA (£20,861 and incobotulinumtoxinA (£20,717 cost more per patient annually than with abobotulinumtoxinA (£19,800. Sensitivity analyses showed that the most influential parameters on budget were percentage of cerebral palsy and stroke patients developing ULS, and the prevalence of stroke. Conclusion: Study findings suggest that increased use of abobotulinumtoxinA for ULS in the UK could potentially reduce total ULS cost for the health system and society. Keywords: stroke, cerebral palsy, multiple sclerosis, traumatic brain injury 

  7. Communicating with parents in neonatal intensive care units: The impact on parental stress.

    Science.gov (United States)

    Enke, Christian; Oliva Y Hausmann, Andrés; Miedaner, Felix; Roth, Bernhard; Woopen, Christiane

    2017-04-01

    To analyse stress in parents whose infants with very low birth weight have just concluded high-level care in a Neonatal Intensive Care Unit (NICU). More specifically, we aimed 1) to identify groups of parents in the NICU who are particularly at risk of experiencing stress, and 2) to explore the effects of clinical staffś communication on parental stress. Our multi-center-study evaluated views from 1277 parents about care for 923 infants in 66 German NICUs. Answers were linked with separately evaluated medical outcomes of the infants. Separate generalised mixed models estimated the influence of personal, medical and communication-related characteristics on specific parental stress. Parents of a younger age and those of infants with severe prognoses were more likely to experience stress. While empathetic communication as one aspect of staffś communication was shown as appropriate in reducing parental stress, an initial introduction and the quantity of information were only slightly associated with lower levels of stress. Results provide evidence for the need to involve parents empathetically from the beginning of their child's stay in the NICU. Staff in the NICU should communicate empathetically and help to reduce stress in parents particularly at risk. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Impact of coronary intensive care unit in treatment of myocardial infarction

    Directory of Open Access Journals (Sweden)

    Marcia Cristina Todo

    Full Text Available Summary Introduction: The mortality rate attributed to ST-segment elevation myocardial infarction (STEMI has decreased in the world. However, this disease is still responsible for high costs for health systems. Several factors could decrease mortality in these patients, including implementation of cardiac intensive care units (CICU. The aim of this study was to evaluate the effect of CICU implementation on prescribed recommended treatments and mortality 30 days after STEMI. Method: We performed a retrospective study with patients admitted to CICU between 2005 and 2006 (after group and between 2000 and 2002, before CICU implementation (before group. Results: The after group had 101 patients, while the before group had 143 patients. There were no differences in general characteristics between groups. We observed an increase in angiotensin-converting enzyme inhibitors, clopidogrel and statin prescriptions after CICU implementation. We did not find differences regarding number of patients submitted to reperfusion therapy; however, there was an increase in primary percutaneous angioplasty compared with thrombolytic therapy in the after group. There was no difference in 30-day mortality (before: 10.5%; after: 8.9%; p=0.850, but prescription of recommended treatments was high in both groups. Prescription of angiotensin-converting enzyme inhibitors and beta-blocker decreased mortality risk by 4.4 and 4.9 times, respectively. Conclusion: CICU implementation did not reduce mortality after 30 days in patients with STEMI; however, it increased the prescription of standard treatment for these patients.

  9. The impact of federal incentives on the adoption of hybrid electric vehicles in the United States

    International Nuclear Information System (INIS)

    Jenn, Alan; Azevedo, Inês L.; Ferreira, Pedro

    2013-01-01

    Starting in 2004, the federal government in the United States offered several nationwide incentives to consumers to increase the adoption of hybrid electric vehicles. This study assesses the effectiveness of the Energy Policy Act of 2005 in this regard using econometric methods and data between 2000 and 2010. Our model accounts for network externalities by using lagged sales as an independent variable. This approach helps to capture the exponential initial growth associated with the diffusion of new technologies and avoids overestimating the effect of the policy incentives. Our results show that the Energy Policy Act of 2005 increased the sales of hybrids from 3% to 20% depending on the vehicle model considered. In addition, we find that this incentive is only effective when the amount provided is sufficiently large. - Highlights: • We collected data on monthly car sales by vehicle model for 11 years. • Econometric methods are used to model vehicle sales. • Inclusion of a lagged dependent variable is employed to control for natural growth. • Direct monetary incentives are found to be statistically insignificant. • Macro-effects of unemployment and gas prices are important for vehicle sales

  10. The Impact of the Development of Shale Gas in the United States on Europe's Petrochemical Industries

    International Nuclear Information System (INIS)

    Cornot-Gandolphe, Sylvie

    2013-01-01

    The shale gas revolution has led to strong falls in energy prices, reducing significantly the raw material costs of the US petrochemical industry. Between 2008 and 2012, US gas prices fell by two thirds. Ethane comes from natural gas liquids (NGLs) contained in shale gas, and used by the US petrochemical industry as the raw material to make ethylene. Its price fell by 55% between 2008 and 2012. These price cuts are giving the US petrochemical industry a significant competitive advantage, and profits are exploding. The United States has become the region in the world with the second lowest energy and raw material prices, just after the Middle East. This renewed competitiveness is leading to the re-birth of American petrochemicals, whereas the sector was stagnating and even experiencing waves of closures in the middle of the 2000's. An estimated $15 billion is set to be invested in the sector by 2017, generating a 40% increase in ethylene output, the leading petrochemical product. The competitive advantage makes itself felt downstream in the sector. In particular, plastics derived from the transformation of petrochemicals are used in manufacturing in three major consumer industries: packaging, construction and the automotive industry. By 2017, the output capacity of polyethylene, the polymer most used in the production of plastics, should rise by 40%. The economic spillovers of such investments are significant. The American Chemistry Council (ACC) has conducted a study of around one hundred investment projects, identified at the end of March 2013 in the US chemical industry (excluding pharmaceuticals). These projects involved $72 billion in investment, through to 2020. They will raise the turnover of the chemical industry by $67 billion (in 2012 dollars), by 2020, and will create 1.2 million jobs during the phase of construction. By 2020, additional earnings of the US economy will run to $201 billion, with tax revenues of $14 billion. The ACC estimates that these

  11. Impact of aminoglycoside cycling in six tertiary intensive care units: prospective longitudinal interventional study.

    Science.gov (United States)

    Francetić, Igor; Kalenić, Smilja; Huić, Mirjana; Mercep, Iveta; Makar-Ausperger, Ksenija; Likić, Robert; Erdeljić, Viktorija; Tripković, Vesna; Simić, Petra

    2008-04-01

    To determine the effect of aminoglycoside cycling in six tertiary intensive care units (ICU) on the rates of sepsis, aminoglycoside resistance patterns, antibiotic consumption, and costs. This was a prospective longitudinal interventional study that measured the effect of change from first-line gentamicin usage (February 2002-February 2003) to amikacin usage (February 2003-February 2004) on the aminoglycoside resistance patterns, number of patients with gram-negative bacteremia, consumption of antibiotics, and the cost of antimicrobial drugs in 6 tertiary care ICUs in Zagreb, Croatia. The change from first-line gentamicin to amikacin usage led to a decrease in the overall gentamicin resistance of gram-negative bacteria (GNB) from 42% to 26% (PAcinetobacter baumanni (P=0.014). Sepsis rate in ICUs was reduced from 3.6% to 2.2% (P<0.001; chi(2) test), with a decline in the number of nosocomial bloodstream infections from 55/100 patient-days to 26/100 patient-days (P=0.001, chi(2) test). Furthermore, amikacin use led to a 16% decrease in the overall antibiotic consumption and 0.1 euro/patient/d cost reduction. Exclusive use of amikacin significantly reduced the resistance of GNB isolates to gentamicin and netilmicin, the number of GNB nosocomial bacteremias, and the cost of total antibiotic usage in ICUs.

  12. Impacts of global warming on residential heating and cooling degree-days in the United States.

    Science.gov (United States)

    Petri, Yana; Caldeira, Ken

    2015-08-04

    Climate change is expected to decrease heating demand and increase cooling demand for buildings and affect outdoor thermal comfort. Here, we project changes in residential heating degree-days (HDD) and cooling degree-days (CDD) for the historical (1981-2010) and future (2080-2099) periods in the United States using median results from the Climate Model Intercomparison Project phase 5 (CMIP5) simulations under the Representation Concentration Pathway 8.5 (RCP8.5) scenario. We project future HDD and CDD values by adding CMIP5 projected changes to values based on historical observations of US climate. The sum HDD + CDD is an indicator of locations that are thermally comfortable, with low heating and cooling demand. By the end of the century, station median HDD + CDD will be reduced in the contiguous US, decreasing in the North and increasing in the South. Under the unmitigated RCP8.5 scenario, by the end of this century, in terms of HDD and CDD values considered separately, future New York, NY, is anticipated to become more like present Oklahoma City, OK; Denver, CO, becomes more like Raleigh, NC, and Seattle, WA, becomes more like San Jose, CA. These results serve as an indicator of projected climate change and can help inform decision-making.

  13. Phylogenetic Information Content of Copepoda Ribosomal DNA Repeat Units: ITS1 and ITS2 Impact

    Science.gov (United States)

    Zagoskin, Maxim V.; Lazareva, Valentina I.; Grishanin, Andrey K.; Mukha, Dmitry V.

    2014-01-01

    The utility of various regions of the ribosomal repeat unit for phylogenetic analysis was examined in 16 species representing four families, nine genera, and two orders of the subclass Copepoda (Crustacea). Fragments approximately 2000 bp in length containing the ribosomal DNA (rDNA) 18S and 28S gene fragments, the 5.8S gene, and the internal transcribed spacer regions I and II (ITS1 and ITS2) were amplified and analyzed. The DAMBE (Data Analysis in Molecular Biology and Evolution) software was used to analyze the saturation of nucleotide substitutions; this test revealed the suitability of both the 28S gene fragment and the ITS1/ITS2 rDNA regions for the reconstruction of phylogenetic trees. Distance (minimum evolution) and probabilistic (maximum likelihood, Bayesian) analyses of the data revealed that the 28S rDNA and the ITS1 and ITS2 regions are informative markers for inferring phylogenetic relationships among families of copepods and within the Cyclopidae family and associated genera. Split-graph analysis of concatenated ITS1/ITS2 rDNA regions of cyclopoid copepods suggested that the Mesocyclops, Thermocyclops, and Macrocyclops genera share complex evolutionary relationships. This study revealed that the ITS1 and ITS2 regions potentially represent different phylogenetic signals. PMID:25215300

  14. Impact of climate variability on runoff in the north-central United States

    Science.gov (United States)

    Ryberg, Karen R.; Lin, Wei; Vecchia, Aldo V.

    2014-01-01

    Large changes in runoff in the north-central United States have occurred during the past century, with larger floods and increases in runoff tending to occur from the 1970s to the present. The attribution of these changes is a subject of much interest. Long-term precipitation, temperature, and streamflow records were used to compare changes in precipitation and potential evapotranspiration (PET) to changes in runoff within 25 stream basins. The basins studied were organized into four groups, each one representing basins similar in topography, climate, and historic patterns of runoff. Precipitation, PET, and runoff data were adjusted for near-decadal scale variability to examine longer-term changes. A nonlinear water-balance analysis shows that changes in precipitation and PET explain the majority of multidecadal spatial/temporal variability of runoff and flood magnitudes, with precipitation being the dominant driver. Historical changes in climate and runoff in the region appear to be more consistent with complex transient shifts in seasonal climatic conditions than with gradual climate change. A portion of the unexplained variability likely stems from land-use change.

  15. Impacts of global warming on residential heating and cooling degree-days in the United States

    Science.gov (United States)

    Petri, Yana; Caldeira, Ken

    2015-01-01

    Climate change is expected to decrease heating demand and increase cooling demand for buildings and affect outdoor thermal comfort. Here, we project changes in residential heating degree-days (HDD) and cooling degree-days (CDD) for the historical (1981–2010) and future (2080–2099) periods in the United States using median results from the Climate Model Intercomparison Project phase 5 (CMIP5) simulations under the Representation Concentration Pathway 8.5 (RCP8.5) scenario. We project future HDD and CDD values by adding CMIP5 projected changes to values based on historical observations of US climate. The sum HDD + CDD is an indicator of locations that are thermally comfortable, with low heating and cooling demand. By the end of the century, station median HDD + CDD will be reduced in the contiguous US, decreasing in the North and increasing in the South. Under the unmitigated RCP8.5 scenario, by the end of this century, in terms of HDD and CDD values considered separately, future New York, NY, is anticipated to become more like present Oklahoma City, OK; Denver, CO, becomes more like Raleigh, NC, and Seattle, WA, becomes more like San Jose, CA. These results serve as an indicator of projected climate change and can help inform decision-making. PMID:26238673

  16. Climate Change Impacts on Stream Temperature in Regulated River Systems: A Case Study in the Southeastern United States

    Science.gov (United States)

    Cheng, Y.; Niemeyer, R. J.; Zhang, X.; Yearsley, J. R.; Voisin, N.; Nijssen, B.

    2017-12-01

    Climate change and associated changes in air temperature and precipitation are projected to impact natural water resources quantity, quality and timing. In the past century, over 280 major dams were built in the Southeastern United States (SEUS) (GRanD database). Regulation of the river system greatly alters natural streamflow as well as stream temperature. Understanding the impacts of climate change on regulated systems, particularly within the context of the Clean Water Act, can inform stakeholders how to maintain and adapt water operations (e.g. regulation, withdrawals). In this study, we use a new modeling framework to study climate change impacts on stream temperatures of a regulated river system. We simulate runoff with the Variable Infiltration Capacity (VIC) macroscale hydrological model, regulated streamflow and reservoir operations with a large-scale river routing-reservoir model (MOSART-WM), and stream temperature using the River Basin Model (RBM). We enhanced RBM with a two-layer thermal stratification reservoir module. This modeling framework captures both the impact of reservoir regulation on streamflow and the reservoir stratification effects on downstream temperatures. We evaluate changes in flow and stream temperatures based on climate projections from two representative concentration pathways (RCPs; RCP4.5 and RCP8.5) from the Coupled Model Intercomparison Project Phase 5 (CMIP5). We simulate river temperature with meteorological forcings that have been downscaled with the Multivariate Constructed Analogs (MACA) method. We are specifically interested in analyzing extreme periods during which stream temperature exceeds water quality standards. In this study, we focus on identifying whether these extreme temperature periods coincide with low flows, and whether the frequency and duration of these operationally-relevant periods will increase under future climate change.

  17. Climate change impacts on ecosystems and ecosystem services in the United States: Process and prospects for sustained assessment

    Science.gov (United States)

    Grimm, Nancy B.; Groffman, Peter M; Staudinger, Michelle D.; Tallis, Heather

    2016-01-01

    The third United States National Climate Assessment emphasized an evaluation of not just the impacts of climate change on species and ecosystems, but also the impacts of climate change on the benefits that people derive from nature, known as ecosystem services. The ecosystems, biodiversity, and ecosystem services component of the assessment largely drew upon the findings of a transdisciplinary workshop aimed at developing technical input for the assessment, involving participants from diverse sectors. A small author team distilled and synthesized this and hundreds of other technical input to develop the key findings of the assessment. The process of developing and ranking key findings hinged on identifying impacts that had particular, demonstrable effects on the U.S. public via changes in national ecosystem services. Findings showed that ecosystem services are threatened by the impacts of climate change on water supplies, species distributions and phenology, as well as multiple assaults on ecosystem integrity that, when compounded by climate change, reduce the capacity of ecosystems to buffer against extreme events. As ecosystems change, such benefits as water sustainability and protection from storms that are afforded by intact ecosystems are projected to decline across the continent due to climate change. An ongoing, sustained assessment that focuses on the co-production of actionable climate science will allow scientists from a range of disciplines to ascertain the capability of their forecasting models to project environmental and ecological change and link it to ecosystem services; additionally, an iterative process of evaluation, development of management strategies, monitoring, and reevaluation will increase the applicability and usability of the science by the U.S. public.

  18. Assessment of the Impact of Radioactive Disposals and Discharges from the United Kingdom Low Level Waste Repository on the Ecosystem

    International Nuclear Information System (INIS)

    Barber, N.

    2009-01-01

    This paper describes an assessment of the impacts to ecosystems and wildlife species from radioactive discharges and disposals at the United Kingdom's low level waste disposal facility in West Cumbria. The assessment was undertaken in response to a requirement in the site's current authorisation and comprised a detailed desk based review along with an exercise to screen relevant monitoring data from the site against generic assessment criteria and undertake a numerical risk assessment. Much of the site is vegetated, comprising a variety of habitats including grassland, relict dune heath and surface water bodies. Furthermore, the site is located adjacent to a coastal/estuarine area which is protected as it provides a habitat of high ecological value and species of animals and plants are present that are rare, endangered or vulnerable. However, the current impact of aerial and liquid radioactive discharges from the low level waste repository on ecosystems and wildlife species is considered to be low. Site monitoring data also indicate that there has been a reduction of radionuclide activities in ground and surface water and leachates over time, a result of measures initiated to minimise rainwater infiltration and improve leachate management associated with the disposal area. A quantitative assessment was undertaken to assess future impacts to relevant terrestrial, fresh water and marine ecosystems. This showed that modelled peak radionuclide concentrations in the first 4,000 years after site closure were not sufficiently high to cause potential impact to any of these ecosystems or associated wildlife. This cut-off date was chosen as it is considered probable that, due to the effects of future climate and landscape change and, unless actions are taken to defend the coastline, the site is likely to be disrupted by coastal erosion in the next 4,000 years. (authors)

  19. The Impact of a Potential Shale Gas Development in Germany and the United Kingdom on Pollutant and Greenhouse Gas Emissions

    Science.gov (United States)

    Weger, L.; Cremonese, L.; Bartels, M. P.; Butler, T. M.

    2016-12-01

    Several European countries with domestic shale gas reserves are considering extracting this natural gas resource to complement their energy transition agenda. Natural gas, which produces lower CO2 emissions upon combustion compared to coal or oil, has the potential to serve as a bridge in the transition from fossil fuels to renewables. However, the generation of shale gas leads to emissions of CH4 and pollutants such as PM, NOx and VOCs, which in turn impact climate as well as local and regional air quality. In this study, we explore the impact of a potential shale gas development in Europe, specifically in Germany and the United Kingdom, on emissions of greenhouse gases and pollutants. In order to investigate the effect on emissions, we first estimate a range of wells drilled per year and production volume for the two countries under examination based on available geological information and on regional infrastructural and economic limitations. Subsequently we assign activity data and emissions factors to the well development, gas production and processing stages of shale gas generation to enable emissions quantification. We then define emissions scenarios to explore different storylines of potential shale gas development, including low emissions (high level of regulation), high emissions (low level of regulation) and middle emissions scenarios, which influence fleet make-up, emission factor and activity data choices for emissions quantification. The aim of this work is to highlight important variables and their ranges, to promote discussion and communication of potential impacts, and to construct possible visions for a future shale gas development in the two study countries. In a follow-up study, the impact of pollutant emissions from these scenarios on air quality will be explored using the Weather Research and Forecasting model with chemistry (WRF-Chem) model.

  20. Global Warming Impacts on Heating and Cooling Degree-Days in the United States

    Science.gov (United States)

    Petri, Y.; Caldeira, K.

    2014-12-01

    Anthropogenic climate change is expected to significantly alter residential air conditioning and space heating requirements, which account for 41% of U.S. household energy expenditures. The degree-day method can be used for reliable estimation of weather related building energy consumption and costs, as well as outdoor climatic thermal comfort. Here, we use U.S. Climate Normals developed by NOAA based on weather station observations along with Climate Model Intercomparison Project phase 5 (CMIP5) multi-model ensemble simulations. We add the projected change in heating and cooling degree-days based on the climate models to the estimates based on the NOAA U.S. Climate Normals to project future heating and cooling degree-days. We find locations with the lowest and highest combined index of cooling (CDDs) and heating degree-days (HDDs) for the historical period (1981 - 2010) and future period (2080 - 2099) under the Representation Concentration Pathway 8.5 (RCP8.5) climate change scenario. Our results indicate that in both time frames and among the lower 48 states, coastal areas in the West and South California will have the smallest degree-day sum (CDD + HDD), and hence from a climatic perspective become the best candidates for residential real estate. The Rocky Mountains region in Wyoming, in addition to northern Minnesota and North Dakota, will have the greatest CDD + HDD. While global warming is projected to reduce the median heating and cooling demand (- 5%) at the end of the century, CDD + HDD will decrease in the North, with an opposite effect in the South. This work could be helpful in deciding where to live in the United States based on present and future thermal comfort, and could also provide a basis for estimates of changes in heating and cooling energy demand.

  1. Impact of the ENHANCE Trial on the Use of Ezetimibe in the United States and Canada

    Science.gov (United States)

    Lu, Lingyun; Krumholz, Harlan M.; Tu, Jack V.; Ross, Joseph S.; Ko, Dennis T.; Jackevicius, Cynthia A.

    2014-01-01

    Background We previously found the use of ezetimibe increased rapidly with different patterns between the United States (US) and Canada prior to the landmark ENHANCE trial, which was reported in January 2008, and failed to show that the drug slowed the progression of atherosclerosis. What is not known is how practice in the two countries changed after the ENHANCE trial. We examined ezetimibe use trends in the US and Canada before and after the reporting of the ENHANCE trial. Methods We conducted a population-based, retrospective, time-series analysis using the data collected by IMS Health in the US and Compuscript in Canada from January 1, 2002 to December 31, 2009. The main outcome measure was monthly number of prescriptions for ezetimibe-containing products. Results The monthly number of ezetimibe prescriptions/100,000 population rose from 6 to 1082 in the US from November 2002 to January 2008, then significantly declined to 572/100,000 population by December 2009 after the release of the ENHANCE trial, a decrease of 47.1% (PCanada, use continuously rose from 2 to 495/100,000 population from June 2003 to December 2009 (P=0.2). US expenditures totaled $2.24 billion in 2009. Conclusions Ezetimibe remains commonly used in both the US and Canada. Ezetimibe use has decreased in the US post-ENHANCE, whereas use has gradually but steadily increased in Canada. The diverging patterns of ezetimibe use in the US and Canada requires further investigation as it reveals that a common evidence base is eliciting very different utilization patterns in neighboring countries. PMID:24766978

  2. Mapping integration of midwives across the United States: Impact on access, equity, and outcomes.

    Directory of Open Access Journals (Sweden)

    Saraswathi Vedam

    Full Text Available Our multidisciplinary team examined published regulatory data to inform a 50-state database describing the environment for midwifery practice and interprofessional collaboration. Items (110 detailed differences across jurisdictions in scope of practice, autonomy, governance, and prescriptive authority; as well as restrictions that can affect patient safety, quality, and access to maternity providers across birth settings. A nationwide survey of state regulatory experts (n = 92 verified the 'on the ground' relevance, importance, and realities of local interpretation of these state laws. Using a modified Delphi process, we selected 50/110 key items to include in a weighted, composite Midwifery Integration Scoring (MISS system. Higher scores indicate greater integration of midwives across all settings. We ranked states by MISS scores; and, using reliable indicators in the CDC-Vital Statistics Database, we calculated correlation coefficients between MISS scores and maternal-newborn outcomes by state, as well as state density of midwives and place of birth. We conducted hierarchical linear regression analysis to control for confounding effects of race.MISS scores ranged from lowest at 17 (North Carolina to highest at 61 (Washington, out of 100 points. Higher MISS scores were associated with significantly higher rates of spontaneous vaginal delivery, vaginal birth after cesarean, and breastfeeding, and significantly lower rates of cesarean, preterm birth, low birth weight infants, and neonatal death. MISS scores also correlated with density of midwives and access to care across birth settings. Significant differences in newborn outcomes accounted for by MISS scores persisted after controlling for proportion of African American births in each state.The MISS scoring system assesses the level of integration of midwives and evaluates regional access to high quality maternity care. In the United States, higher MISS Scores were associated with significantly

  3. Cultural Landscapes as a Methodology for Understanding Natural Resource Management Impacts in the Western United States

    Directory of Open Access Journals (Sweden)

    Rebecca S. Toupal

    2003-07-01

    Full Text Available Multicultural demands on public lands in the United States continue to challenge federal land managers to address social and cultural concerns in their planning efforts. Specifically, they lack adequate knowledge of cultural concerns, as well as a consistent strategy for acquiring that knowledge for use in decision-making. Current federal approaches to understanding such issues as access, use, and control of resources include public participation, conservation partnerships, government-to-government consultations with American Indian tribes, cultural resource inventories, and landscape analysis. Given that cultural knowledge arises from human-nature relationships and shared perceptions of natural environments, and that landscapes are the ultimate expression of such knowledge, an exploratory methodology was developed to provide a different approach to understanding cultural concerns through landscape perceptions. Using cultural landscape theories and applications from the natural and social sciences, this study examines the landscape perceptions of four groups concerned with management planning of the Baboquivari Wilderness Area in southern Arizona: the Bureau of Land Management, the landowners of the Altar Valley, recreationists, and members of the Tohono O'odham Nation. The methodology is based on a human-nature relationship rather than cultural aspects or features. It takes a holistic approach that differs from other perception studies in that it includes: emic aspects of data collection and analysis; a spatial component (triangulation of data collection through narrative and graphic descriptions; ethnographic, on-site interviews; and cultural consensus analysis and small-sample theory. The results include: verification of four cultural groups; two levels of consensus (in the population of concern, and in each group that overlap in some aspects of landscape perception; descriptions of four cultural landscapes that illustrate similarities and

  4. Missed surgical intensive care unit billing: potential financial impact of 24/7 faculty presence.

    Science.gov (United States)

    Hendershot, Kimberly M; Bollins, John P; Armen, Scott B; Thomas, Yalaunda M; Steinberg, Steven M; Cook, Charles H

    2009-07-01

    To efficiently capture evaluation and management (E&M) and procedural billing in our surgical intensive care unit (SICU), we have developed an electronic billing system that links to the electronic medical record (EMR). In this system, only notes electronically signed and coded by an attending generate billing charges. We hypothesized that capture of missed billing during nighttime and weekends might be sufficient to subsidize 24/7 in-house attending coverage. A retrospective chart EMR review was performed of the EMRs for all SICU patients during a 2-month period. Note type, date, time, attending signature, and coding were analyzed. Notes without attending signature, diagnosis, or current procedural terminology (CPT) code were considered incomplete and identified as "missed billing." Four hundred and forty-three patients had 465 admissions generating 2,896 notes. Overall, 76% of notes were signed and coded by an attending and billed. Incomplete (not billed) notes represented an overall missed billing opportunity of $159,138 for the 2-month time period (approximately $954,000 annually). Unbilled E&M encounters during weekdays totaled $54,758, whereas unbilled E&M and procedures from weeknights and weekends totaled $88,408 ($44,566 and $43,842, respectively). Missed billing after-hours thus represents approximately $530K annually, extrapolating to approximately $220K in collections from our payer mix. Surprisingly, missed E&M and procedural billing during weekdays totaled $70,730 (approximately $425K billing, approximately $170K collections annually), and typically represented patients seen, but transferred from the SICU before attending documentation was completed. Capture of nighttime and weekend ICU collections alone may be insufficient to add faculty or incentivize in-house coverage, but could certainly complement other in-house derived revenues to such ends. In addition, missed daytime billing in busy modern ICUs can be substantial, and use of an EMR to identify

  5. The scope and impact of mobile health clinics in the United States: a literature review.

    Science.gov (United States)

    Yu, Stephanie W Y; Hill, Caterina; Ricks, Mariesa L; Bennet, Jennifer; Oriol, Nancy E

    2017-10-05

    As the U.S. healthcare system transforms its care delivery model to increase healthcare accessibility and improve health outcomes, it is undergoing changes in the context of ever-increasing chronic disease burdens and healthcare costs. Many illnesses disproportionately affect certain populations, due to disparities in healthcare access and social determinants of health. These disparities represent a key area to target in order to better our nation's overall health and decrease healthcare expenditures. It is thus imperative for policymakers and health professionals to develop innovative interventions that sustainably manage chronic diseases, promote preventative health, and improve outcomes among communities disenfranchised from traditional healthcare as well as among the general population. This article examines the available literature on Mobile Health Clinics (MHCs) and the role that they currently play in the U.S. healthcare system. Based on a search in the PubMed database and data from the online collaborative research network of mobile clinics MobileHealthMap.org , the authors evaluated 51 articles with evidence on the strengths and weaknesses of the mobile health sector in the United States. Current literature supports that MHCs are successful in reaching vulnerable populations, by delivering services directly at the curbside in communities of need and flexibly adapting their services based on the changing needs of the target community. As a link between clinical and community settings, MHCs address both medical and social determinants of health, tackling health issues on a community-wide level. Furthermore, evidence suggest that MHCs produce significant cost savings and represent a cost-effective care delivery model that improves health outcomes in underserved groups. Even though MHCs can fulfill many goals and mandates in alignment with our national priorities and have the potential to help combat some of the largest healthcare challenges of this era, there

  6. Characterization of Chemical Suicides in the United States and Its Adverse Impact on Responders and Bystanders

    Directory of Open Access Journals (Sweden)

    Ayana R. Anderson

    2016-11-01

    Full Text Available Introduction: A suicide trend that involves mixing household chemicals to produce hydrogen sulfide or hydrogen cyanide, commonly referred to as a detergent, hydrogen sulfide, or chemical suicide is a continuing problem in the United States (U.S.. Because there is not one database responsible for tracking chemical suicides, the actual number of incidents in the U.S. is unknown. To prevent morbidity and mortality associated with chemical suicides, it is important to characterize the incidents that have occurred in the U.S. Methods: The author analyzed data from 2011-2013 from state health departments participating in the Agency for Toxic Substances and Disease Registry’s National Toxic Substance Incidents Program (NTSIP. NTSIP is a web-based chemical incident surveillance system that tracks the public health consequences (e.g., morbidity, mortality from acute chemical releases. Reporting sources for NTSIP incidents typically include first responders, hospitals, state environmental agencies, and media outlets. To find chemical suicide incidents in NTSIP’s database, the author queried open text fields in the comment, synopsis, and contributing factors variables for potential incidents. Results: Five of the nine states participating in NTSIP reported a total of 22 chemical suicide incidents or attempted suicides during 2011-2013. These states reported a total of 43 victims: 15 suicide victims who died, seven people who attempted suicide but survived, eight responders, and four employees working at a coroner’s office; the remainder were members of the general public. None of the injured responders reported receiving HazMat technician-level training, and none had documented appropriate personal protective equipment. Conclusion: Chemical suicides produce lethal gases that can pose a threat to responders and bystanders. Describing the characteristics of these incidents can help raise awareness among responders and the public about the dangers of

  7. Air quality impacts of distributed energy resources implemented in the northeastern United States.

    Science.gov (United States)

    Carreras-Sospedra, Marc; Dabdub, Donald; Brouwer, Jacob; Knipping, Eladio; Kumar, Naresh; Darrow, Ken; Hampson, Anne; Hedman, Bruce

    2008-07-01

    Emissions from the potential installation of distributed energy resources (DER) in the place of current utility-scale power generators have been introduced into an emissions inventory of the northeastern United States. A methodology for predicting future market penetration of DER that considers economics and emission factors was used to estimate the most likely implementation of DER. The methodology results in spatially and temporally resolved emission profiles of criteria pollutants that are subsequently introduced into a detailed atmospheric chemistry and transport model of the region. The DER technology determined by the methodology includes 62% reciprocating engines, 34% gas turbines, and 4% fuel cells and other emerging technologies. The introduction of DER leads to retirement of 2625 MW of existing power plants for which emissions are removed from the inventory. The air quality model predicts maximum differences in air pollutant concentrations that are located downwind from the central power plants that were removed from the domain. Maximum decreases in hourly peak ozone concentrations due to DER use are 10 ppb and are located over the state of New Jersey. Maximum decreases in 24-hr average fine particulate matter (PM2.5) concentrations reach 3 microg/m3 and are located off the coast of New Jersey and New York. The main contribution to decreased PM2.5 is the reduction of sulfate levels due to significant reductions in direct emissions of sulfur oxides (SO(x)) from the DER compared with the central power plants removed. The scenario presented here represents an accelerated DER penetration case with aggressive emission reductions due to removal of highly emitting power plants. Such scenario provides an upper bound for air quality benefits of DER implementation scenarios.

  8. Prognostic and predictive factors of the breast cancer impact at the Matanzas Provincial Oncology Unit

    International Nuclear Information System (INIS)

    Gonzalo Zambrano, Ruben Dario; Fundora Madruga, Guillermo; Rodriguez Jimenez, Pablo

    2010-01-01

    We carried out a descriptive study of prevalence or cross sectional study to assess predictive and prognostic factors of the breast cancer from recidivism in 406 women treated at the Matanzas Provincial Oncology Unit, and remitted from provincial and territorial hospitals, since January 2004 to December 2008. Data were collected from clinical records and biopsy informs, processed with the Epi Info System, Version 6.04. There was a higher incidence of the breast cancer in post-menopausal women and a higher aggressiveness in pre-menopausal women. Almost half of the patients were diagnosed in the precocious stage and there was a high index of recidivism, mainly in advanced stages. The invasive lobular carcinoma presented more recidivists, while the tubular one had a better prognosis; the ductal carcinoma in situ and the lobular carcinoma in situ had more recurrences than they were expected. The conservative surgery showed a higher number of recidivists in distance than the modified radical mastectomy, while the last one showed local recidivism (2,1 %) and the first, no one; the conservative one was related with a high percent of disease persistence, in which the compromised section edges. The ganglion status, tumour size and histological level were pointed out as the main anatomic-pathological prognosis facts, but not the hormonal receptors. There it was a good answer to tamoxifen and to CMF (cyclophosphamide, metothrexate and 5 flouracil) cycles. In conclusion, we demonstrated the influence of the modifiable and non-modifiable prognostic and predictive facts on the high index of recidivism and recommend taking measures to improve those indicators

  9. Impact of improving vehicle front design on the burden of pedestrian injuries in Germany, the United States, and India.

    Science.gov (United States)

    Moran, Dane; Bose, Dipan; Bhalla, Kavi

    2017-11-17

    European car design regulations and New Car Assessment Program (NCAP) ratings have led to reductions in pedestrian injuries. The aim of this study was to evaluate the impact of improving vehicle front design on mortality and morbidity due to pedestrian injuries in a European country (Germany) and 2 countries (the United States and India) that do not have pedestrian-focused NCAP testing or design regulations. We used data from the International Road Traffic and Accident Database and the Global Burden of Disease project to estimate baseline pedestrian deaths and nonfatal injuries in each country in 2013. The effect of improved passenger car star ratings on probability of pedestrian injury was based on recent evaluations of pedestrian crash data from Germany. The effect of improved heavy motor vehicle (HMV) front end design on pedestrian injuries was based on estimates reported by simulation studies. We used burden of disease methods to estimate population health loss by combining the burden of morbidity and mortality in disability-adjusted life years (DALYs) lost. Extrapolating from evaluations in Germany suggests that improving front end design of cars can potentially reduce the burden of pedestrian injuries due to cars by up to 24% in the United States and 41% in India. In Germany, where cars comply with the United Nations regulation on pedestrian safety, additional improvements would have led to a 1% reduction. Similarly, improved HMV design would reduce DALYs lost by pedestrian victims hit by HMVs by 20% in each country. Overall, improved vehicle design would reduce DALYs lost to road traffic injuries (RTIs) by 0.8% in Germany, 4.1% in the United States, and 6.7% in India. Recent evaluations show a strong correlation between Euro NCAP pedestrian scores and real-life pedestrian injuries, suggesting that improved car front end design in Europe has led to substantial reductions in pedestrian injuries. Although the United States has fewer pedestrian crashes, it would

  10. The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention.

    Science.gov (United States)

    Michelson, Kelly N; Frader, Joel; Sorce, Lauren; Clayman, Marla L; Persell, Stephen D; Fragen, Patricia; Ciolino, Jody D; Campbell, Laura C; Arenson, Melanie; Aniciete, Danica Y; Brown, Melanie L; Ali, Farah N; White, Douglas

    2016-12-01

    Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention.

  11. The impact of sexual harassment on job satisfaction, turnover intentions, and absenteeism: findings from Pakistan compared to the United States.

    Science.gov (United States)

    Merkin, Rebecca S; Shah, Muhammad Kamal

    2014-01-01

    The purpose of this study was to compare and contrast how differences in perceptions of sexual harassment impact productive work environments for employees in Pakistan as compared to the US; in particular, how it affects job satisfaction, turnover, and/or absenteeism. This study analyzed employee responses in Pakistan (n = 146) and the United States (n = 102, 76) using questionnaire data. Significant results indicated that employees who were sexually harassed reported (a) a decrease in job satisfaction (b) greater turnover intentions and (c) a higher rate of absenteeism. Cross-cultural comparisons indicated that (a) Pakistani employees who were sexually harassed had greater job dissatisfaction and higher overall absenteeism than did their US counterparts and (b) Pakistani women were more likely to use indirect strategies to manage sexual harassment than were US targets.

  12. Accidental hazardous material releases with human impacts in the United States: exploration of geographical distribution and temporal trends.

    Science.gov (United States)

    Sengul, Hatice; Santella, Nicholas; Steinberg, Laura J; Chermak, Christina

    2010-09-01

    To investigate the circumstances and geographic and temporal distributions of hazardous material releases and resulting human impacts in the United States. Releases with fatalities, injuries, and evacuations were identified from reports to the National Response Center between 1990 and 2008, correcting for data quality issues identified in previous studies. From more than 550,000 reports, 861 deaths, 16,348 injuries and 741,427 evacuations were identified. Injuries from releases of chemicals at fixed facilities and natural gas from pipelines have decreased whereas evacuations from petroleum releases at fixed facilities have increased. Results confirm recent advances in chemical and pipeline safety and suggest directions for further improvement including targeted training and inspections and adoption of inherently safer design principles.

  13. The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention

    Science.gov (United States)

    Frader, Joel; Sorce, Lauren; Clayman, Marla L; Persell, Stephen D; Fragen, Patricia; Ciolino, Jody D; Campbell, Laura C; Arenson, Melanie; Aniciete, Danica Y; Brown, Melanie L; Ali, Farah N; White, Douglas

    2016-01-01

    Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention. PMID:28725847

  14. Modeling The Economic And Health Impact Of Increasing Children's Physical Activity In The United States.

    Science.gov (United States)

    Lee, Bruce Y; Adam, Atif; Zenkov, Eli; Hertenstein, Daniel; Ferguson, Marie C; Wang, Peggy I; Wong, Michelle S; Wedlock, Patrick; Nyathi, Sindiso; Gittelsohn, Joel; Falah-Fini, Saeideh; Bartsch, Sarah M; Cheskin, Lawrence J; Brown, Shawn T

    2017-05-01

    Increasing physical activity among children is a potentially important public health intervention. Quantifying the economic and health effects of the intervention would help decision makers understand its impact and priority. Using a computational simulation model that we developed to represent all US children ages 8-11 years, we estimated that maintaining the current physical activity levels (only 31.9 percent of children get twenty-five minutes of high-calorie-burning physical activity three times a week) would result each year in a net present value of $1.1 trillion in direct medical costs and $1.7 trillion in lost productivity over the course of their lifetimes. If 50 percent of children would exercise, the number of obese and overweight youth would decrease by 4.18 percent, averting $8.1 billion in direct medical costs and $13.8 billion in lost productivity. Increasing the proportion of children who exercised to 75 percent would avert $16.6 billion and $23.6 billion, respectively. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Impacts of potential CO2-reduction policies on air quality in the United States.

    Science.gov (United States)

    Trail, Marcus A; Tsimpidi, Alexandra P; Liu, Peng; Tsigaridis, Kostas; Hu, Yongtao; Rudokas, Jason R; Miller, Paul J; Nenes, Athanasios; Russell, Armistead G

    2015-04-21

    Impacts of emissions changes from four potential U.S. CO2 emission reduction policies on 2050 air quality are analyzed using the community multiscale air quality model (CMAQ). Future meteorology was downscaled from the Goddard Institute for Space Studies (GISS) ModelE General Circulation Model (GCM) to the regional scale using the Weather Research Forecasting (WRF) model. We use emissions growth factors from the EPAUS9r MARKAL model to project emissions inventories for two climate tax scenarios, a combined transportation and energy scenario, a biomass energy scenario and a reference case. Implementation of a relatively aggressive carbon tax leads to improved PM2.5 air quality compared to the reference case as incentives increase for facilities to install flue-gas desulfurization (FGD) and carbon capture and sequestration (CCS) technologies. However, less capital is available to install NOX reduction technologies, resulting in an O3 increase. A policy aimed at reducing CO2 from the transportation sector and electricity production sectors leads to reduced emissions of mobile source NOX, thus reducing O3. Over most of the U.S., this scenario leads to reduced PM2.5 concentrations. However, increased primary PM2.5 emissions associated with fuel switching in the residential and industrial sectors leads to increased organic matter (OM) and PM2.5 in some cities.

  16. The impact of nosocomially-acquired resistant Pseudomonas aeruginosa infection in a burn unit.

    Science.gov (United States)

    Armour, Alexis D; Shankowsky, Heather A; Swanson, Todd; Lee, Jonathan; Tredget, Edward E

    2007-07-01

    Nosocomially-acquired Pseudomonas aeruginosa remains a serious cause of infection and septic mortality in burn patients. This study was conducted to quantify the impact of nosocomially-transmitted resistant P. aeruginosa in a burn population. Using a TRACS burn database, 48 patients with P. aeruginosa resistant to gentamicin were identified (Pseudomonas group). Thirty-nine were case-matched to controls without resistant P. aeruginosa cultures (control group) for age, total body surface area, admission year, and presence of inhalation injury. Mortality and various morbidity endpoints were examined, as well as antibiotic costs. There was a significantly higher mortality rate in the Pseudomonas group (33% vs. 8%, p products used (packed cells 51.1 +/- 8.0 vs. 21.1 +/- 3.4, p < 0.01; platelets 11.9 +/- 3.0 vs. 1.4 +/- 0.7, p < 0.01) were all significantly higher in the Pseudomonas group. Cost of antibiotics was also significantly higher ($2,658.52 +/- $647.93 vs. $829.22 +/- $152.82, p < 0.01). Nosocomial colonization or infection, or both, of burn patients with aminoglycoside-resistant P. aeruginosa is associated with significantly higher morbidity, mortality, and cost of care. Increased resource consumption did not prevent significantly higher mortality rates when compared with that of control patients. Thus, prevention, identification, and eradication of nosocomial Pseudomonas contamination are critical for cost-effective, successful burn care.

  17. Impact of chronic liver disease in intensive care unit acquired pneumonia: a prospective study.

    Science.gov (United States)

    Di Pasquale, Marta; Esperatti, Mariano; Crisafulli, Ernesto; Ferrer, Miquel; Bassi, Gianluigi Li; Rinaudo, Mariano; Escorsell, Angels; Fernandez, Javier; Mas, Antoni; Blasi, Francesco; Torres, Antoni

    2013-10-01

    To assess the impact of chronic liver disease (CLD) on ICU-acquired pneumonia. This was a prospective, observational study of the characteristics, microbiology, and outcomes of 343 consecutive patients with ICU-acquired pneumonia clustered according to the presence of CLD. Sixty-seven (20%) patients had CLD (67% had liver cirrhosis, LC), MELD score 26 ± 9, 20% Child-Pugh class C). They presented higher severity scores than patients without CLD both on admission to the ICU (APACHE II, LC 19 ± 6 vs. other CLD 18 ± 6 vs. no CLD 16 ± 6; p CLD patients. LC patients had higher 28- and 90-day mortality (63 vs. 28%, p CLD patients. Presence of LC was independently associated with decreased 28- and 90-day survival (95% confidence interval [CI], 1.982-17.250; p = 0.001; 95% confidence interval [CI], 2.915-20.699, p = 0.001, respectively). In critically ill patients with ICU-acquired pneumonia, CLD is associated with a more severe clinical presentation and poor clinical outcomes. Moreover, LC is independently associated with 28- and 90-day mortality. The results of this study are important for future trials focused on mortality.

  18. Decreased term and postterm birthweight in the United States: impact of labor induction.

    Science.gov (United States)

    Zhang, Xun; Joseph, K S; Kramer, Michael S

    2010-08-01

    We sought to assess recent trends in falling mean birthweight (BW) and gestational age (GA) among US non-Hispanic white singleton live births >or=37 weeks of gestation and the contribution of increased rates of induction to these trends. This was an ecological study based on US vital statistics from 1992 through 2003. From 1992 through 2003, mean BW fell by 37 g, mean GA by 3 days, and macrosomia rates by 25%. Rates of induction nearly doubled from 14% to 27%. Our ecological state-level analysis showed that the increased rate of induction was significantly associated with reduced mean BW (r = -0.54; 95% confidence interval [CI], -0.71 to -0.29), mean GA (r = -0.44; 95% CI, -0.65 to -0.17), and rate of macrosomia (r = -0.55; 95% CI, -0.74 to -0.32). Increasing use of induction is a likely cause of the observed recent declines in BW and GA. The impact of these trends on infant and long-term health warrants attention and investigation. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  19. Exploring the impact of permitting and local regulatory processes on residential solar prices in the United States

    International Nuclear Information System (INIS)

    Burkhardt, Jesse; Wiser, Ryan; Darghouth, Naïm; Dong, C.G.; Huneycutt, Joshua

    2015-01-01

    This article statistically isolates the impacts of city-level permitting and other local regulatory processes on residential PV prices in the United States. We combine data from two “scoring” mechanisms that independently capture local regulatory process efficiency with the largest dataset of installed PV prices in the United States. We find that variations in local permitting procedures can lead to differences in average residential PV prices of approximately $0.18/W between the jurisdictions with the least-favorable and most-favorable permitting procedures. Between jurisdictions with scores across the middle 90% of the range (i.e., 5th percentile to 95th percentile), the difference is $0.14/W, equivalent to a $700 (2.2%) difference in system costs for a typical 5-kW residential PV installation. When considering variations not only in permitting practices, but also in other local regulatory procedures, price differences grow to $0.64–$0.93/W between the least-favorable and most-favorable jurisdictions. Between jurisdictions with scores across the middle 90% of the range, the difference is equivalent to a price impact of at least $2500 (8%) for a typical 5-kW residential PV installation. These results highlight the magnitude of cost reduction that might be expected from streamlining local regulatory regimes. - Highlights: • We show local regulatory processes meaningfully affect U.S. residential PV prices. • We use regression analysis and two mechanisms for “scoring” regulatory efficiency. • Local permitting procedure variations can produce PV price differences of $0.18/W. • Broader regulatory variations can produce PV price differences of $0.64–$0.93/W. • The results suggest the cost-reduction potential of streamlining local regulations

  20. Impact of Enhanced Health Interventions for United States-Bound Refugees: Evaluating Best Practices in Migration Health.

    Science.gov (United States)

    Mitchell, Tarissa; Lee, Deborah; Weinberg, Michelle; Phares, Christina; James, Nicola; Amornpaisarnloet, Kittisak; Aumpipat, Lalita; Cooley, Gretchen; Davies, Anita; Tin Shwe, Valerie Daw; Gajdadziev, Vasil; Gorbacheva, Olga; Khwan-Niam, Chutharat; Klosovsky, Alexander; Madilokkowit, Waritorn; Martin, Diana; Htun Myint, Naing Zaw; Yen Nguyen, Thi Ngoc; Nutman, Thomas B; O'Connell, Elise M; Ortega, Luis; Prayadsab, Sugunya; Srimanee, Chetdanai; Supakunatom, Wasant; Vesessmith, Vattanachai; Stauffer, William M

    2018-03-01

    With an unprecedented number of displaced persons worldwide, strategies for improving the health of migrating populations are critical. United States-bound refugees undergo a required overseas medical examination to identify inadmissible conditions (e.g., tuberculosis) 2-6 months before resettlement, but it is limited in scope and may miss important, preventable infectious, chronic, or nutritional causes of morbidity. We sought to evaluate the feasibility and health impact of diagnosis and management of such conditions before travel. We offered voluntary testing for intestinal parasites, anemia, and hepatitis B virus infection, to U.S.-bound refugees from three Thailand-Burma border camps. Treatment and preventive measures (e.g., anemia and parasite treatment, vaccination) were initiated before resettlement. United States refugee health partners received overseas results and provided post-arrival medical examination findings. During July 9, 2012 to November 29, 2013, 2,004 refugees aged 0.5-89 years enrolled. Among 463 participants screened for seven intestinal parasites overseas and after arrival, helminthic infections decreased from 67% to 12%. Among 118 with positive Strongyloides -specific antibody responses, the median fluorescent intensity decreased by an average of 81% after treatment. The prevalence of moderate-to-severe anemia (hemoglobin migration process to improve the health of refugees before resettlement. With more than 250 million migrants globally, this model may offer insights into healthier migration strategies.

  1. Catch per unit efforts and impacts of gears on fish abundance in an oxbow lake ecosystem in Eastern India

    Directory of Open Access Journals (Sweden)

    Dipankar Ghosh

    2017-05-01

    Full Text Available Background: Oxbow lakes are abundant in indigenous fishes, but they are subject to unsustainable fishing practices, potential overexploitation, and indiscriminate use of fine-meshed fishing gear. To quantify the catch per unit effort (CPUE and impact of fishing gears on fish abundance, a survey was carried out in an oxbow lake in eastern India. Methods: The gear-wise CPUE for fish caught in per unit hour of operation was calculated by dividing the total sampling gear catch in biomass, which is the observed value of fish caught by a particular gear, by the total sampling effort hours. A value of P 71%. Cone-framed cast net hauled the maximum catch in biomass (31.51%, and gill nets contributed the maximum number of fish (64.92%. The lower CPUE values of line and hook, gill net, cone-framed cast net and long lines identified them as the most harmful among all gears. Conclusion: Indiscriminate use of gear, particularly line and hook, gill nets, cone-framed cast nets, and long lines, demands regulations and preventions concerning such gear to obtain higher fish abundance.

  2. The impact of safety organizing, trusted leadership, and care pathways on reported medication errors in hospital nursing units.

    Science.gov (United States)

    Vogus, Timothy J; Sutcliffe, Kathleen M

    2011-01-01

    Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on the joint benefits of safety organizing and other contextual factors that help foster safety. Although we know that organizational practices often have more powerful effects when combined with other mutually reinforcing practices, little research exists on the joint benefits of safety organizing and other contextual factors believed to foster safety. Specifically, we examined the benefits of bundling safety organizing with leadership (trust in manager) and design (use of care pathways) factors on reported medication errors. A total of 1033 RNs and 78 nurse managers in 78 emergency, internal medicine, intensive care, and surgery nursing units in 10 acute-care hospitals in Indiana, Iowa, Maryland, Michigan, and Ohio who completed questionnaires between December 2003 and June 2004. Cross-sectional analysis of medication errors reported to the hospital incident reporting system for the 6 months after the administration of the survey linked to survey data on safety organizing, trust in manager, use of care pathways, and RN characteristics and staffing. Multilevel Poisson regression analyses indicated that the benefits of safety organizing on reported medication errors were amplified when paired with high levels of trust in manager or the use of care pathways. Safety organizing plays a key role in improving patient safety on hospital nursing units especially when bundled with other organizational components of a safety supportive system.

  3. Mapping integration of midwives across the United States: Impact on access, equity, and outcomes

    Science.gov (United States)

    Stoll, Kathrin; MacDorman, Marian; Declercq, Eugene; Cramer, Renee; Cheyney, Melissa; Fisher, Timothy; Butt, Emma; Yang, Y. Tony; Powell Kennedy, Holly

    2018-01-01

    birth settings. Significant differences in newborn outcomes accounted for by MISS scores persisted after controlling for proportion of African American births in each state. Conclusion The MISS scoring system assesses the level of integration of midwives and evaluates regional access to high quality maternity care. In the United States, higher MISS Scores were associated with significantly higher rates of physiologic birth, less obstetric interventions, and fewer adverse neonatal outcomes. PMID:29466389

  4. Evolving impact of environmental laws on cross-border power between Mexico and the United States

    International Nuclear Information System (INIS)

    Barron, J.

    2005-01-01

    There has been a growing concern among some United States (US) residents that the increasing number of merchant power plants planned for the Mexican side of the US/Mexican border could contribute to increased air pollution and the misuse of finite water resources in the border region. The case of Border Power Plant Working Group v. DOE, et al. is examined in this paper, providing a focus for a discussion of the border region's future as US merchant power producers continue to position themselves to provide electricity in California. One of the factors in the push to develop power generation on the Mexican side of the border was California's electricity crisis of 2000-2001, and plans have been drawn up to build 22 plants between Mexicali and Ciudad Juarez. A history of the Border Power Plant Working Group (BPPWG) was presented, along with details of the government's granting of permits for the power plants after environmental assessments. By suing the government BPPWG hoped to set a standard for future power plant development in the area. The lawsuit addressed the following 4 primary concerns: air emissions; emission offsets; water cooling; and wastewater discharge. BPPWG aimed to achieve the 3 following results: protective legislation in the 4 U.S. border states that would preclude the use of massive amounts of water in border power plant cooling systems; a critical area designation with pollution limits set low enough to require catalytic control systems; and an overarching annex to the La Paz Agreement that would create a formal bi-national agreement governing the above actions for both countries. A review of environmental law in both countries was presented, along with a description of the proposed plants. A complete review of the lawsuit was provided, along with eventual rulings against the BPPWG. It was concluded that the case showed that power developers had proved that although the plants would contribute to the environmental degradation of the region, the

  5. Impact of an osteoporosis specialized unit on bone health in breast cancer survivals treated with aromatase inhibitors.

    Science.gov (United States)

    Martínez, Purificación; Galve, Elena; Arrazubi, Virginia; Sala, M Ángeles; Fernández, Seila; Pérez, Clara E; Arango, Juan F; Torre, Iñaki

    2017-10-11

    Considering the increased fracture risk in early breast cancer patients treated with aromatase inhibitors (AI), we assessed the impact of a preventive intervention conducted by a specialized osteoporosis unit on bone health at AI treatment start. Retrospective cohort of postmenopausal women who started treatment with AI after breast cancer surgical/chemotherapy treatment and were referred to the osteoporosis unit for a comprehensive assessment of bone health. Bone densitometry and fracture screening by plain X-ray were performed at the baseline visit and once a year for 5 years. The final record included 130 patients. At AI treatment start, 49% had at least one high-risk factor for fractures, 55% had osteopenia, and 39% osteoporosis. Based on the baseline assessment, 79% of patients initiated treatment with bisphosphonates, 88% with calcium, and 79% with vitamin D. After a median of 65 (50-77) months, 4% developed osteopenia or osteoporosis, and 14% improved their densitometric diagnosis. Fifteen fractures were recorded in 11 (8.5%) patients, all of them receiving preventive treatment (10 with bisphosphonates). During the follow-up period, patients with one or more high-risk factors for fracture showed a greater frequency of fractures (15% vs. 3%) and experienced the first fracture earlier than those without high-risk factors (mean of 99 and 102 months, respectively; P=0.023). The preventive intervention of a specialized unit at the start of AI treatment in breast cancer survivors allows the identification of patients with high fracture risk and may contribute to preventing bone events in these patients. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  6. Low-impact sampling under an active solid low-level radioactive waste disposal unit using horizontal drilling technology

    International Nuclear Information System (INIS)

    Puglisi, C.V.; Vold, E.L.

    1995-01-01

    The purpose of this project was to determine the performance of the solid low-level radioactive waste (LLRW) disposal units located on a mesa top at TA-54, Area G, Los Alamos National Laboratory (LANL), Los Alamos, NM, and to provide in-situ (vadose zone) site characterization information to Area G's Performance Assessment. The vadose zone beneath an active disposal unit (DU 37), was accessed by utilizing low-impact, air-rotary horizontal drilling technology. Core samples were pulled, via wire-line core method, in 3 horizontal holes fanning out below DU 37 at approximately 5 foot intervals depending on recovery percentage. Samples were surveyed and prepared in-field following Environmental Restoration (ER) guidelines. Samples were transferred from the field to the CST-9 Radvan for initial radiological screening. Following screening, samples were delivered to CST-3 analytical lab for analyses including moisture content, 23 inorganics, 60 volatile organic compounds (VOC's), 68 semivolatile organic compounds (SVOC's), tritium, lead 210, radium 226 ampersand 228, cesium 137, isotopic plutonium, americium 241, strontium 90, isotopic uranium, and isotopic thorium. Other analyses included matric potential, alpha spectroscopy, gamma spectroscopy, and gross alpha/beta. The overall results of the analysis identified only tritium as having migrated from the DU. Am-241, Eu-152, and Pu-238 were possibly identified above background but the results are not definitive. Of all organics analysed for, only ethyl acetate was tentatively identified slightly above background. All inorganics were found to be well below regulatory limits. Based on the results of the above mentioned analyses, it was determined that Area G's disposal units are performing well and no significant liquid phase migration of contaminants has occurred

  7. The impact of OAB on physical activity in the United States: results from OAB-POLL.

    Science.gov (United States)

    Coyne, Karin S; Sexton, Chris C; Clemens, J Quentin; Thompson, Christine L; Chen, Chieh-I; Bavendam, Tamara; Dmochowski, Roger

    2013-10-01

    To provide data on physical activity among those with and without overactive bladder (OAB) in a large, ethnically diverse U.S. sample. A cross-sectional survey was conducted via the Internet among 10,000 men and women aged 18-70 (2000 African Americans, 2000 Hispanics, and 6000 whites) using the lower urinary tract symptoms (LUTS) tool and questions from the 2007-2008 National Health and Nutrition Examination Survey (NHANES). OAB cases and those with no/minimal symptoms (NMS) were compared on federal guidelines of indices of physical activity: 2008 guidelines and 2010 Healthy People. Descriptive statistics were used to evaluate differences between OAB and NMS. Logistic regressions examined the impact of OAB on physical activity. Response rate, 57%; 818 men and 1505 women with OAB, and 1857 men and 1615 women with NMS. Respondents with other LUTS were excluded from this analysis (2302 men and 1904 women). Those with OAB were significantly less likely to report moderate and vigorous physical activities in their leisure time and to satisfy recommended physical activity levels compared to those with NMS. Symptoms of OAB (men and women: urgency and urinary frequency; women: urinary urge incontinence) were associated with limitations in physical activity in the logistic regressions. This study benchmarks physical activity levels among people with OAB. Men and women with OAB were significantly less likely to achieve recommended physical activity levels than people with NMS. More research is needed to further evaluate how OAB affects physical activity and health status and to determine causal relationships. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Fish passage mitigation of impacts from hydroelectric power projects in the United States

    International Nuclear Information System (INIS)

    Cada, G.F.

    1996-01-01

    Obstruction of fish movements by dams continues to be the major environmental issue facing the hydropower industry in the US. Dams block upstream migrations, which can cut off adult fish form their historical spawning grounds and severely curtail reproduction. Conversely, downstream-migrating fish may be entrained into the turbine intake flow and suffer turbine-passage injury or mortality. Hydroelectric projects can interfere with the migrations of a wide variety of fish. Maintenance, restoration or enhancement of populations of these species may require the construction of facilities to allow for upstream and downstream fish passage. The Federal Energy Regulatory Commission (FERC), by law, must give fish and wildlife resources equal consideration with power production in its licensing decisions, must be satisfied that a project is consistent with comprehensive plans for a waterway (including fisheries management plans), and must consider all federal and state resource agency terms and conditions for the protection of fish and wildlife. As a consequence, FERC often requires fish passage mitigation measures as a condition of the hydropower license when such measures are deemed necessary for the protection of fish. Much of the recent research and development efforts of the US Department of Energy's Hydropower Program have focused on the mitigation of impacts to upstream and downstream fish passage. This paper descries three components of that effort: (1) a survey of environmental mitigation measures at hydropower sites across the country; (2) a critical review of the effectiveness of fish passage mitigation measures at 16 case study sites; and (3) ongoing efforts to develop new turbine designs that minimize turbine-passage mortality

  9. Estimating active transportation behaviors to support health impact assessment in the United States

    Directory of Open Access Journals (Sweden)

    Theodore J Mansfield

    2016-05-01

    Full Text Available Health impact assessment (HIA has been promoted as a means to encourage transportation and city planners to incorporate health considerations into their decision-making. Ideally, HIAs would include quantitative estimates of the population health effects of alternative planning scenarios, such as scenarios with and without infrastructure to support walking and cycling. However, the lack of baseline estimates of time spent walking or biking for transportation (together known as active transportation, which are critically related to health, often prevents planners from developing such quantitative estimates. To address this gap, we use data from the 2009 US National Household Travel Survey to develop a statistical model that estimates baseline time spent walking and biking as a function of the type of transportation used to commute to work along with demographic and built environment variables. We validate the model using survey data from the Raleigh-Durham-Chapel Hill, NC, metropolitan area. We illustrate how the validated model could be used to support transportation-related HIAs by estimating the potential health benefits of built environment modifications that support walking and cycling. Our statistical model estimates that on average, individuals who commute on foot spend an additional 19.8 (95% CI 16.9–23.2 minutes per day walking compared to automobile commuters. Public transit riders walk an additional 5.0 (95% CI 3.5–6.4 minutes per day compared to automobile commuters. Bicycle commuters cycle for an additional 28.0 (95% CI 17.5–38.1 minutes per day compared to automobile commuters. The statistical model was able to predict observed transportation physical activity in the Raleigh-Durham-Chapel Hill region to within 0.5 MET-hours per day (equivalent to about 9 minutes of daily walking time for 83% of observations. Across the Raleigh-Durham-Chapel Hill region, an estimated 38 (95% CI 15–59 premature deaths potentially could be

  10. Estimating Active Transportation Behaviors to Support Health Impact Assessment in the United States.

    Science.gov (United States)

    Mansfield, Theodore J; Gibson, Jacqueline MacDonald

    2016-01-01

    Health impact assessment (HIA) has been promoted as a means to encourage transportation and city planners to incorporate health considerations into their decision-making. Ideally, HIAs would include quantitative estimates of the population health effects of alternative planning scenarios, such as scenarios with and without infrastructure to support walking and cycling. However, the lack of baseline estimates of time spent walking or biking for transportation (together known as "active transportation"), which are critically related to health, often prevents planners from developing such quantitative estimates. To address this gap, we use data from the 2009 US National Household Travel Survey to develop a statistical model that estimates baseline time spent walking and biking as a function of the type of transportation used to commute to work along with demographic and built environment variables. We validate the model using survey data from the Raleigh-Durham-Chapel Hill, NC, USA, metropolitan area. We illustrate how the validated model could be used to support transportation-related HIAs by estimating the potential health benefits of built environment modifications that support walking and cycling. Our statistical model estimates that on average, individuals who commute on foot spend an additional 19.8 (95% CI 16.9-23.2) minutes per day walking compared to automobile commuters. Public transit riders walk an additional 5.0 (95% CI 3.5-6.4) minutes per day compared to automobile commuters. Bicycle commuters cycle for an additional 28.0 (95% CI 17.5-38.1) minutes per day compared to automobile commuters. The statistical model was able to predict observed transportation physical activity in the Raleigh-Durham-Chapel Hill region to within 0.5 MET-hours per day (equivalent to about 9 min of daily walking time) for 83% of observations. Across the Raleigh-Durham-Chapel Hill region, an estimated 38 (95% CI 15-59) premature deaths potentially could be avoided if the entire

  11. Estimating Active Transportation Behaviors to Support Health Impact Assessment in the United States

    Science.gov (United States)

    Mansfield, Theodore J.; Gibson, Jacqueline MacDonald

    2016-01-01

    Health impact assessment (HIA) has been promoted as a means to encourage transportation and city planners to incorporate health considerations into their decision-making. Ideally, HIAs would include quantitative estimates of the population health effects of alternative planning scenarios, such as scenarios with and without infrastructure to support walking and cycling. However, the lack of baseline estimates of time spent walking or biking for transportation (together known as “active transportation”), which are critically related to health, often prevents planners from developing such quantitative estimates. To address this gap, we use data from the 2009 US National Household Travel Survey to develop a statistical model that estimates baseline time spent walking and biking as a function of the type of transportation used to commute to work along with demographic and built environment variables. We validate the model using survey data from the Raleigh–Durham–Chapel Hill, NC, USA, metropolitan area. We illustrate how the validated model could be used to support transportation-related HIAs by estimating the potential health benefits of built environment modifications that support walking and cycling. Our statistical model estimates that on average, individuals who commute on foot spend an additional 19.8 (95% CI 16.9–23.2) minutes per day walking compared to automobile commuters. Public transit riders walk an additional 5.0 (95% CI 3.5–6.4) minutes per day compared to automobile commuters. Bicycle commuters cycle for an additional 28.0 (95% CI 17.5–38.1) minutes per day compared to automobile commuters. The statistical model was able to predict observed transportation physical activity in the Raleigh–Durham–Chapel Hill region to within 0.5 MET-hours per day (equivalent to about 9 min of daily walking time) for 83% of observations. Across the Raleigh–Durham–Chapel Hill region, an estimated 38 (95% CI 15–59) premature deaths potentially could

  12. Closure Report for Corrective Action Unit 107: Low Impact Soil Sites, Nevada Test Site, Nevada with ROTC-1

    International Nuclear Information System (INIS)

    Matthews, Patrick

    2009-01-01

    CAU 107, ''Low Impact Soil Sites'', consists of 15 CASs in Areas 1, 2, 3, 4, 5, 9, 10, and 18 of the NTS. The closure alternatives included No Further Action and Closure in Place with Administrative Controls. This CR provides a summary of completed closure activities. ROTC Justification: The FFACO UR as published in the Closure Report for Corrective Action Unit 107: Low Impact Soil Sites, Nevada Test Site, Nevada (NNSA/NSO, 2009) states that the UR for CAS 18-23-02, U-18d Crater (Sulky), was implemented for assumed radioactive contamination that could cause a dose greater that 25 millirems per year. This document further clarifies that this was based on particulate releases of radionuclides identified in Radiological Effluents Released from U.S. Continental Tests, 1961 through 1992 (DOE/NV, 1996). The radionuclides listed in this document are krypton (Kr)-85, Kr-85m, Kr-87, Kr-88, rubidium (Rb)-87, strontium (Sr)-89, Sr-91, yttrium (Y)-91, iodine (I)-131, I-132, I-133, I-134, I-135, xeon (Xe)-133, Xe-135, Xe-138, cesium (Cs)-135, Cs-138, barium (Ba)-139, and Ba-140.

  13. The ecological impacts of primary education facilities based on a child-friendly neighborhood unit criteria in Surakarta

    Science.gov (United States)

    Rini, E. F.; Putri, R. A.; Mulyanto; Handayani, N.

    2018-03-01

    A city should accommodate the citizen needs, especially for children. The absence of elementary school in a neighborhood unit (NU) will increase the use of transportation by children in the NU, every day at the same time. This activity will produce large quantities of - carbon dioxide (CO2) that can trigger climate change. This article aims at discovering the ecological impacts of CO2 emitted from the transportation used by children when commuting to their school, based on the conformity of each NU to the criteria of the a child-friendly city. Quantitative and spatial analysis techniques were employed in these four stages: (1) dividing the NU; (2) constructing the NU’s typology based on a child-friendly criteria; (3) identifying the characteristic of children movements in each NU when accessing their elementary school; and (4) analyzing the ecological impacts (in CO2 form). The result shows that 88.14% of CO2 emissions in Surakarta can be reduced by interventions through the fulfillment of all NU’s child-friendly criterias.

  14. Economic Impacts of Potential Foot and Mouth Disease Agro-terrorism in the United States: A Computable General Equilibrium Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Oladosu, Gbadebo A [ORNL; Rose, Adam [University of Southern California, Los Angeles; Bumsoo, Lee [University of Illinois

    2013-01-01

    The foot and mouth disease (FMD) virus has high agro-terrorism potential because it is contagious, can be easily transmitted via inanimate objects and can be spread by wind. An outbreak of FMD in developed countries results in massive slaughtering of animals (for disease control) and disruptions in meat supply chains and trade, with potentially large economic losses. Although the United States has been FMD-free since 1929, the potential of FMD as a deliberate terrorist weapon calls for estimates of the physical and economic damage that could result from an outbreak. This paper estimates the economic impacts of three alternative scenarios of potential FMD attacks using a computable general equilibrium (CGE) model of the US economy. The three scenarios range from a small outbreak successfully contained within a state to a large multi-state attack resulting in slaughtering of 30 percent of the national livestock. Overall, the value of total output losses in our simulations range between $37 billion (0.15% of 2006 baseline economic output) and $228 billion (0.92%). Major impacts stem from the supply constraint on livestock due to massive animal slaughtering. As expected, the economic losses are heavily concentrated in agriculture and food manufacturing sectors, with losses ranging from $23 billion to $61 billion in the two industries.

  15. Predicting the environmental impacts of chicken systems in the United Kingdom through a life cycle assessment: egg production systems.

    Science.gov (United States)

    Leinonen, I; Williams, A G; Wiseman, J; Guy, J; Kyriazakis, I

    2012-01-01

    The aim of this study was to apply a life cycle assessment (LCA) method, from cradle to gate, to quantify the environmental burdens per 1,000 kg of eggs produced in the 4 major hen-egg production systems in the United Kingdom: 1) cage, 2) barn, 3) free range, and 4) organic. The analysis was based on an approach that applied a structural model for the industry and mechanistic submodels for animal performance, crop production, and nutrient flows. Baseline feeds representative of those used by the UK egg production industry were used. Typical figures from the UK egg production industry, feed intake, mortality of birds, farm energy, and material use in different systems were applied. Monte Carlo simulations were used to quantify the uncertainties in the outputs and allow for comparisons between the systems. The number of birds required to produce 1,000 kg of eggs was highest in the organic and lowest in the cage system; similarly, the amount of feed consumed per bird was highest in the organic and lowest in the cage system. These general differences in productivity largely affected the differences in the environmental impacts between the systems. Feed production, processing, and transport caused greater impacts compared with those from any other component of production; that is, 54 to 75% of the primary energy use and 64 to 72% of the global warming potential of the systems. Electricity (used mainly for ventilation, automatic feeding, and lighting) had the second greatest impact in primary energy use (16-38%). Gas and oil (used mainly for heating in pullet rearing and incineration of dead layer birds) used 7 to 14% of the total primary energy. Manure had the greatest impact on the acidification and eutrophication potentials of the systems because of ammonia emissions that contributed to both of these potentials and nitrate leaching that only affected eutrophication potential. The LCA method allows for comparisons between systems and for the identification of hotspots

  16. [Impact of an emergency department short-stay unit on clinical management and quality of hospital care indicators].

    Science.gov (United States)

    Richard Espiga, Fernando; Mòdol Deltell, Josep María; Martín-Sánchez, Francisco Javier; Fernández Sierra, Abel; Fernández Pérez, Cristina; Pastor, Antoni Juan

    2017-06-01

    The primary aim was to study the impact that creating a short-stay unit (SSU) had on clinical management and quality of care indicators of a hospital overall and its conventional wards. The secondary aim was to establish values for those indicators and determine the level of satisfaction of patients admitted to the SSU. Quasi-experimental before-after study of the impact of establishing a SSU in a tertiary care teaching hospital. The first period (without the SSU) was in 2012, the second (with the SSU) was from 2013 through 2015. To meet the first objective we selected cases in 2012 in which patients were hospitalized for problems related to the 5 diagnosis-related groups most often admitted to the SSU in the second period. To meet the second objective, we studied all patients admitted to the SSU in the second period Data related to quality of care and clinical management were analyzed retrospectively. and asked them to complete a questionnaire on patient satisfaction. A total of 76 241 admissions were included: 19 090 in the first period and 57 151 in the second (2705 admissions were to the SSU). The mean hospital stay decreased in the second period (incidence rate ratio [IRR], 0.93; 95% CI, 0.91-0.95); the mean stay also decreased on medical wards (IRR, 0.94; 95% CI, 0.92-0.96) with no impact on adverse outcomes. The mean stay in the SSU was under 3 days in spite of an increase in the weighted mean (IRR,1.08; 95% CI, 1.05-1.11). A total of 320 questionnaires were received (11.8% response rate); all aspects were assessed very highly. Our experience suggests that opening a SSU could improve clinical management and quality of care indicators for a hospital overall and for its conventional wards in the context of the GRDs that most frequently lead to admissions.

  17. Air pollution and early deaths in the United States. Part I: Quantifying the impact of major sectors in 2005

    Science.gov (United States)

    Caiazzo, Fabio; Ashok, Akshay; Waitz, Ian A.; Yim, Steve H. L.; Barrett, Steven R. H.

    2013-11-01

    Combustion emissions adversely impact air quality and human health. A multiscale air quality model is applied to assess the health impacts of major emissions sectors in United States. Emissions are classified according to six different sources: electric power generation, industry, commercial and residential sources, road transportation, marine transportation and rail transportation. Epidemiological evidence is used to relate long-term population exposure to sector-induced changes in the concentrations of PM2.5 and ozone to incidences of premature death. Total combustion emissions in the U.S. account for about 200,000 (90% CI: 90,000-362,000) premature deaths per year in the U.S. due to changes in PM2.5 concentrations, and about 10,000 (90% CI: -1000 to 21,000) deaths due to changes in ozone concentrations. The largest contributors for both pollutant-related mortalities are road transportation, causing ∼53,000 (90% CI: 24,000-95,000) PM2.5-related deaths and ∼5000 (90% CI: -900 to 11,000) ozone-related early deaths per year, and power generation, causing ∼52,000 (90% CI: 23,000-94,000) PM2.5-related and ∼2000 (90% CI: -300 to 4000) ozone-related premature mortalities per year. Industrial emissions contribute to ∼41,000 (90% CI: 18,000-74,000) early deaths from PM2.5 and ∼2000 (90% CI: 0-4000) early deaths from ozone. The results are indicative of the extent to which policy measures could be undertaken in order to mitigate the impact of specific emissions from different sectors - in particular black carbon emissions from road transportation and sulfur dioxide emissions from power generation.

  18. The Northeastern United States Energy-Water Nexus: Climate Change Impacts and Alternative Water Management Strategies for the Power Sector

    Science.gov (United States)

    Miara, A.; Macknick, J.; Vorosmarty, C. J.; Cohen, S. M.; Rosenzweig, B.

    2014-12-01

    The Northeastern United States (NE) relies heavily on thermoelectric power plants (90% of total capacity) to provide electricity to more than 70 million people. This region's power plants require consistent, large volumes of water at sufficiently cold temperatures to generate electricity efficiently, and withdraw approximately 10.5 trillion gallons of water annually. Previous findings indicate that assessments of future electricity pathways must account for water availability, water temperature and the changing climate, as changes in these conditions may limit operational efficiency in the future. To account for such electric system vulnerabilities, we have created a link between an electricity system capacity expansion model (ReEDS) and a hydrologic model that is coupled to a power plant simulation model (FrAMES-TP2M) that allows for a new approach to analyze electricity system development, performance, and environmental impacts. Together, these coupled tools allow us to estimate electricity development and operations in the context of a changing climate and impacts on the seasonal spatial and temporal variability of water resources, downstream thermal effluents that cause plant-to-plant interferences and harm aquatic habitat, economic costs of water conservation methods and associated carbon emissions. In this study, we test and compare a business-as-usual strategy with three alternative water management scenarios that include changes in cooling technologies and water sources utilized for the years 2014-2050. Results of these experiments can provide useful insight into the feasibility of the electricity expansion scenarios in terms of associated water use and thermal impacts, carbon emissions, the cost of generating electricity, and also highlight the importance of accounting for water resources in future power sector planning and performance assessments.

  19. Impacts of Anthropogenic Aerosols on Regional Climate: Extreme Events, Stagnation, and the United States Warming Hole

    Science.gov (United States)

    Mascioli, Nora R.

    temperature response pattern in AER and GHG is characterized by strong responses over the western U.S. and weak or opposite signed responses over the southeast U.S., raising the question of whether the observed U.S. "warming hole" could have a forced component. To address this question, I systematically examine observed seasonal temperature trends over all time periods of at least 10 years during 1901-2015. In the northeast and southern U.S., significant summertime cooling occurs from the early 1950s to the mid 1970s, which I partially attribute to increasing anthropogenic aerosol emissions (median fraction of the observed temperature trends explained is 0.69 and 0.17, respectively). In winter, the northeast and southern U.S. cool significantly from the early 1950s to the early 1990s, which I attribute to long-term phase changes in the North Atlantic Oscillation and the Pacific Decadal Oscillation. Rather than being a single phenomenon stemming from a single cause, both the warming hole and its dominant drivers vary by season, region, and time period. Finally, I examine historical and projected future changes in atmospheric stagnation. Stagnation, which is characterized by weak winds and an absence of precipitation, is a meteorological contributor to heat waves, extreme pollution, and drought. Using CM3, I show that regional stagnation trends over the historical period (1860-2005) are driven by changes in anthropogenic aerosol emissions, rather than rising greenhouse gases. In the northeastern and central United States, aerosol-induced changes in surface and upper level winds produce significant decreases in the number of stagnant summer days, while decreasing precipitation in the southeast US increases the number of stagnant summer days. Outside of the U.S., significant drying over eastern China in response to rising aerosol emissions contributed to increased stagnation during 1860-2005. Additionally, this region was found to be particularly sensitive to changes in local

  20. Financial impact of nursing professionals staff required in an Intensive Care Unit.

    Science.gov (United States)

    Araújo, Thamiris Ricci de; Menegueti, Mayra Gonçalves; Auxiliadora-Martins, Maria; Castilho, Valéria; Chaves, Lucieli Dias Pedreschi; Laus, Ana Maria

    2016-11-21

    to calculate the cost of the average time of nursing care spent and required by patients in the Intensive Care Unit (ICU) and the financial expense for the right dimension of staff of nursing professionals. a descriptive, quantitative research, using the case study method, developed in adult ICU patients. We used the workload index - Nursing Activities Score; the average care time spent and required and the amount of professionals required were calculated using equations and from these data, and from the salary composition of professionals and contractual monthly time values, calculated the cost of direct labor of nursing. the monthly cost of the average quantity of available professionals was US$ 35,763.12, corresponding to 29.6 professionals, and the required staff for 24 hours of care is 42.2 nurses, with a monthly cost of US$ 50,995.44. the numerical gap of nursing professionals was 30% and the monthly financial expense for adaptation of the structure is US$ 15,232.32, which corresponds to an increase of 42.59% in the amounts currently paid by the institution. calcular o custo do tempo médio de assistência de enfermagem despendido e requerido pelos pacientes internados em Unidade de Terapia Intensiva (UTI) e o dispêndio financeiro para adequação do quadro de profissionais de enfermagem. pesquisa descritiva, quantitativa, na modalidade de estudo de caso, desenvolvida na UTI de pacientes adultos. Utilizou-se o índice de carga de trabalho - Nursing Activities Score; o tempo médio de assistência despendido, requerido e o quantitativo de profissionais requerido foram calculados por meio de equações e, a partir desses dados, e de valores da composição salarial dos profissionais e tempo mensal contratual, calculou-se o custo da mão de obra direta de enfermagem. o custo mensal do quantitativo médio de profissionais disponível foi de US$ 35.763,12, correspondendo a 29,6 profissionais, e o requerido para 24 horas de cuidado é de 42,2 profissionais de

  1. Analysis of drought impacts on electricity production in the Western and Texas interconnections of the United States.

    Energy Technology Data Exchange (ETDEWEB)

    Harto, C. B.; Yan, Y. E.; Demissie, Y. K.; Elcock, D.; Tidwell, V. C.; Hallett, K.; Macknick, J.; Wigmosta, M. S.; Tesfa, T. K. (Environmental Science Division); (Sandia National Laboratory); (National Renewable Energy Laboratory); (Pacific Northwest National Laboratory)

    2012-02-09

    Electricity generation relies heavily on water resources and their availability. To examine the interdependence of energy and water in the electricity context, the impacts of a severe drought to assess the risk posed by drought to electricity generation within the western and Texas interconnections has been examined. The historical drought patterns in the western United States were analyzed, and the risk posed by drought to electricity generation within the region was evaluated. The results of this effort will be used to develop scenarios for medium- and long-term transmission modeling and planning efforts by the Western Electricity Coordination Council (WECC) and the Electric Reliability Council of Texas (ERCOT). The study was performed in response to a request developed by the Western Governors Association in conjunction with the transmission modeling teams at the participating interconnections. It is part of a U.S. Department of Energy-sponsored, national laboratory-led research effort to develop tools related to the interdependency of energy and water as part of a larger interconnection-wide transmission planning project funded under the American Recovery and Reinvestment Act. This study accomplished three main objectives. It provided a thorough literature review of recent studies of drought and the potential implications for electricity generation. It analyzed historical drought patterns in the western United States and used the results to develop three design drought scenarios. Finally, it quantified the risk to electricity generation for each of eight basins for each of the three drought scenarios and considered the implications for transmission planning. Literature on drought impacts on electricity generation describes a number of examples where hydroelectric generation capacity has been limited because of drought but only a few examples of impact on thermoelectric generation. In all documented cases, shortfalls of generation were met by purchasing power

  2. Cost-effectiveness and budget impact of hepatitis C virus treatment with sofosbuvir and ledipasvir in the United States.

    Science.gov (United States)

    Chhatwal, Jagpreet; Kanwal, Fasiha; Roberts, Mark S; Dunn, Michael A

    2015-03-17

    Sofosbuvir and ledipasvir, which have recently been approved for treatment of chronic hepatitis C virus (HCV) infection, are more efficacious and safer than the old standard of care (oSOC) but are substantially more expensive. Whether and in which patients their improved efficacy justifies their increased cost is unclear. To evaluate the cost-effectiveness and budget impact of sofosbuvir and ledipasvir. Microsimulation model of the natural history of HCV infection. Published literature. Treatment-naive and treatment-experienced HCV population defined on the basis of HCV genotype, age, and fibrosis distribution in the United States. Lifetime. Third-party payer. Simulation of sofosbuvir-ledipasvir compared with the oSOC (interferon-based therapies). Quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and 5-year spending on antiviral drugs. Sofosbuvir-based therapies added 0.56 QALY relative to the oSOC at an ICER of $55 400 per additional QALY. The ICERs ranged from $9700 to $284 300 per QALY depending on the patient's status with respect to treatment history, HCV genotype, and presence of cirrhosis. At a willingness-to-pay threshold of $100 000 per QALY, sofosbuvir-based therapies were cost-effective in 83% of treatment-naive and 81% of treatment-experienced patients. Compared with the oSOC, treating eligible HCV-infected persons in the United States with the new drugs would cost an additional $65 billion in the next 5 years, whereas the resulting cost offsets would be $16 billion. Results were sensitive to drug price, drug efficacy, and quality of life after successful treatment. Data on real-world effectiveness of new antivirals are lacking. Treatment of HCV is cost-effective in most patients, but additional resources and value-based patient prioritization are needed to manage patients with HCV. National Institutes of Health.

  3. Projected impacts of federal tax policy proposals on mortality burden in the United States: A microsimulation analysis.

    Science.gov (United States)

    Kim, Daniel

    2018-06-01

    The public health consequences of federal income tax policies that influence income inequality are not well understood. I aimed to project the impacts on mortality of modifying federal income tax structures based on proposals by two recent United States (U.S.) Presidential candidates: Donald Trump and Senator Bernie Sanders. I performed a microsimulation analysis using the latest U.S. Internal Revenue Service public-use tax file with state identifiers (2008 tax year), containing nationally-representative data from 139,651 tax returns. I considered five tax plan scenarios: 1) actual 2008 tax structures; proposals in 2016 by then-candidates 2) Trump and 3) Sanders; 4) a modified Sanders plan with higher top tax rates (75%); and 5) a modified Sanders plan with higher top rates plus revenue redistribution to lower-income households (Trump and Sanders plans, respectively. Under the modified Sanders plan including higher top rates, 68,919 (95% CI: 25,221-113,561) fewer deaths/year are projected. Under the modified Sanders plan with redistribution, 333,504 (95% CI: 192,897-473,787) fewer deaths/year are expected. Policies that both raise federal income tax rates and redistribute tax revenue could confer large reductions in the total number of annual deaths among Americans. In this era of high income inequality and growing public support to address the rich-poor gap, policymakers should consider joint federal tax and redistributive policies as levers to reduce the burden of mortality in the United States. Copyright © 2017 The Author. Published by Elsevier Inc. All rights reserved.

  4. Essays on empirical analysis of multi-unit auctions: Impacts of financial transmission rights on the restructured electricity industry

    Science.gov (United States)

    Zang, Hailing

    This dissertation uses recently developed empirical methodologies for the study of multi-unit auctions to test the impacts of Financial Transmission Rights (FTRs) on the competitiveness of restructured electricity markets. FTRs are a special type of financial option that hedge against volatility in the cost of transporting electricity over the grid. Policy makers seek to use the prices of FTRs as market signals to incentivize efficient investment and utilization of transmission capacity. However, prices will not send the correct signals if market participants strategically use FTRs. This dissertation uses data from the Texas electricity market to test whether the prices of FTRs are efficient to achieve such goals. The auctions studied are multi-unit, uniform-price, sealed-bid auctions. The first part of the dissertation studies the auctions on the spot market of the wholesale electricity industry. I derive structural empirical models to test theoretical predictions as to whether bidders fully internalize the effect of FTRs on profits into their bidding decisions. I find that bidders are learning as to how to optimally bid above marginal cost for their inframarginal capacities. The bidders also learn to bid to include FTRs into their profit maximization problem during the course of the first year. But starting from the second year, they deviated from optimal bidding that includes FTRs in the profit maximization problems. Counterfactual analysis show that the primary effect of FTRs on market outcomes is changing the level of prices rather than production efficiency. Finally, I find that in most months, the current allocations of FTRs are statistically equivalent to the optimal allocations. The second part of the dissertation studies the bidding behavior in the FTR auctions. I find that FTRs' strategic impact on the FTR purchasing behavior is significant for large bidders---firms exercising market power in the FTR auctions. Second, trader forecasts future FTR credit

  5. Projecting the land cover change and its environmental impacts in the Cedar River Basin in the Midwestern United States

    International Nuclear Information System (INIS)

    Wu Yiping; Liu Shuguang; Sohl, Terry L; Young, Claudia J

    2013-01-01

    The physical surface of the Earth is in constant change due to climate forcing and human activities. In the Midwestern United States, urban area, farmland, and dedicated energy crop (e.g., switchgrass) cultivation are predicted to expand in the coming decades, which will lead to changes in hydrological processes. This study is designed to (1) project the land use and land cover (LULC) by mid-century using the FORecasting SCEnarios of future land-use (FORE-SCE) model under the A1B greenhouse gas emission scenario (future condition) and (2) assess its potential impacts on the water cycle and water quality against the 2001 baseline condition in the Cedar River Basin using the physically based soil and water assessment tool (SWAT). We compared the baseline LULC (National Land Cover data 2001) and 2050 projection, indicating substantial expansions of urban area and pastureland (including the cultivation of bioenergy crops) and a decrease in rangeland. We then used the above two LULC maps as the input data to drive the SWAT model, keeping other input data (e.g., climate) unchanged to isolate the LULC change impacts. The modeling results indicate that quick-response surface runoff would increase significantly (about 10.5%) due to the projected urban expansion (i.e., increase in impervious areas), and the baseflow would decrease substantially (about 7.3%) because of the reduced infiltration. Although the net effect may cause an increase in water yield, the increased variability may impede its use for public supply. Additionally, the cultivation of bioenergy crops such as switchgrass in the newly added pasture lands may further reduce the soil water content and lead to an increase in nitrogen loading (about 2.5% increase) due to intensified fertilizer application. These study results will be informative to decision makers for sustainable water resource management when facing LULC change and an increasing demand for biofuel production in this area. (letter)

  6. Impact of Transpacific Aerosol on Air Quality over the United States: A Perspective from Aerosol-Cloud-Radiation Interactions

    Science.gov (United States)

    Tao, Zhining; Yu, Hongbin; Chin, Mian

    2015-01-01

    Observations have well established that aerosols from various sources in Asia, Europe, and Africa can travel across the Pacific and reach the contiguous United States (U.S.) at least on episodic bases throughout a year, with a maximum import in spring. The imported aerosol not only can serve as an additional source to regional air pollution (e.g., direct input), but also can influence regional air quality through the aerosol-cloud-radiation (ACR) interactions that change local and regional meteorology. This study assessed impacts of the transpacific aerosol on air quality, focusing on surface ozone and PM2.5, over the U.S. using the NASA Unified Weather Research Forecast model. Based on the results of 3- month (April to June of 2010) simulations, the impact of direct input (as an additional source) of transpacific aerosol caused an increase of surface PM2.5 concentration by approximately 1.5 micro-g/cu m over the west coast and about 0.5 micro-g/cu m over the east coast of the U.S. By influencing key meteorological processes through the ACR interactions, the transpacific aerosol exerted a significant effect on both surface PM2.5 (+/-6 micro-g/cu m3) and ozone (+/-12 ppbv) over the central and eastern U.S. This suggests that the transpacific transport of aerosol could either improve or deteriorate local air quality and complicate local effort toward the compliance with the U.S. National Ambient Air Quality Standards.

  7. Impacts of rising air temperatures on electric transmission ampacity and peak electricity load in the United States

    Science.gov (United States)

    Bartos, Matthew; Chester, Mikhail; Johnson, Nathan; Gorman, Brandon; Eisenberg, Daniel; Linkov, Igor; Bates, Matthew

    2016-11-01

    Climate change may constrain future electricity supply adequacy by reducing electric transmission capacity and increasing electricity demand. The carrying capacity of electric power cables decreases as ambient air temperatures rise; similarly, during the summer peak period, electricity loads typically increase with hotter air temperatures due to increased air conditioning usage. As atmospheric carbon concentrations increase, higher ambient air temperatures may strain power infrastructure by simultaneously reducing transmission capacity and increasing peak electricity load. We estimate the impacts of rising ambient air temperatures on electric transmission ampacity and peak per-capita electricity load for 121 planning areas in the United States using downscaled global climate model projections. Together, these planning areas account for roughly 80% of current peak summertime load. We estimate climate-attributable capacity reductions to transmission lines by constructing thermal models of representative conductors, then forcing these models with future temperature projections to determine the percent change in rated ampacity. Next, we assess the impact of climate change on electricity load by using historical relationships between ambient temperature and utility-scale summertime peak load to estimate the extent to which climate change will incur additional peak load increases. We find that by mid-century (2040-2060), increases in ambient air temperature may reduce average summertime transmission capacity by 1.9%-5.8% relative to the 1990-2010 reference period. At the same time, peak per-capita summertime loads may rise by 4.2%-15% on average due to increases in ambient air temperature. In the absence of energy efficiency gains, demand-side management programs and transmission infrastructure upgrades, these load increases have the potential to upset current assumptions about future electricity supply adequacy.

  8. Projecting the land cover change and its environmental impacts in the Cedar River Basin in the Midwestern United States

    Science.gov (United States)

    Wu, Yiping; Liu, Shuguang; Sohl, Terry L.; Young, Claudia

    2013-01-01

    The physical surface of the Earth is in constant change due to climate forcing and human activities. In the Midwestern United States, urban area, farmland, and dedicated energy crop (e.g., switchgrass) cultivation are predicted to expand in the coming decades, which will lead to changes in hydrological processes. This study is designed to (1) project the land use and land cover (LULC) by mid-century using the FORecasting SCEnarios of future land-use (FORE-SCE) model under the A1B greenhouse gas emission scenario (future condition) and (2) assess its potential impacts on the water cycle and water quality against the 2001 baseline condition in the Cedar River Basin using the physically based soil and water assessment tool (SWAT). We compared the baseline LULC (National Land Cover data 2001) and 2050 projection, indicating substantial expansions of urban area and pastureland (including the cultivation of bioenergy crops) and a decrease in rangeland. We then used the above two LULC maps as the input data to drive the SWAT model, keeping other input data (e.g., climate) unchanged to isolate the LULC change impacts. The modeling results indicate that quick-response surface runoff would increase significantly (about 10.5%) due to the projected urban expansion (i.e., increase in impervious areas), and the baseflow would decrease substantially (about 7.3%) because of the reduced infiltration. Although the net effect may cause an increase in water yield, the increased variability may impede its use for public supply. Additionally, the cultivation of bioenergy crops such as switchgrass in the newly added pasture lands may further reduce the soil water content and lead to an increase in nitrogen loading (about 2.5% increase) due to intensified fertilizer application. These study results will be informative to decision makers for sustainable water resource management when facing LULC change and an increasing demand for biofuel production in this area.

  9. The Impact of a Potential Shale Gas Development in Germany and the United Kingdom on Local and Regional Air Quality

    Science.gov (United States)

    Weger, L.; Lupascu, A.; Cremonese, L.; Butler, T. M.

    2017-12-01

    Numerous countries in Europe that possess domestic shale gas reserves are considering exploiting this unconventional gas resource as part of their energy transition agenda. While natural gas generates less CO2 emissions upon combustion compared to coal or oil, making it attractive as a bridge in the transition from fossil fuels to renewables, production of shale gas leads to emissions of CH4 and air pollutants such as NOx, VOCs and PM. These gases in turn influence the climate as well as air quality. In this study, we investigate the impact of a potential shale gas development in Germany and the United Kingdom on local and regional air quality. This work builds on our previous study in which we constructed emissions scenarios based on shale gas utilization in these counties. In order to explore the influence of shale gas production on air quality, we investigate emissions predicted from our shale gas scenarios with the Weather Research and Forecasting model with chemistry (WRF-Chem) model. In order to do this, we first design a model set-up over Europe and evaluate its performance for the meteorological and chemical parameters. Subsequently we add shale gas emissions fluxes based on the scenarios over the area of the grid in which the shale gas activities are predicted to occur. Finally, we model these emissions and analyze the impact on air quality on both a local and regional scale. The aims of this work are to predict the range of adverse effects on air quality, highlight the importance of emissions control strategies in reducing air pollution, to promote further discussion, and to provide policy makers with information for decision making on a potential shale gas development in the two study countries.

  10. Impact of antimicrobial stewardship programme on hospitalized patients at the intensive care unit: a prospective audit and feedback study.

    Science.gov (United States)

    Khdour, Maher R; Hallak, Hussein O; Aldeyab, Mamoon A; Nasif, Mowaffaq A; Khalili, Aliaa M; Dallashi, Ahamad A; Khofash, Mohammad B; Scott, Michael G

    2018-04-01

    Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of antimicrobial stewardship programme (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. A prospective audit with intervention and feedback by ASP team within 48-72 h of antibiotic administration began in September 2015. Four months of pre-ASP data were compared with 4 months of post-ASP data. Data collected included clinical and demographic data; use of antimicrobials measured by defined daily doses, duration of therapy, length of stay, readmission and all-cause mortality. Overall, 176 interventions were made the ASP team with an average acceptance rate of 78.4%. The most accepted interventions were dose optimization (87.0%) followed by de-escalation based on culture results with an acceptance rate of 84.4%. ASP interventions significantly reduces antimicrobial use by 24.3% (87.3 defined daily doses/100 beds vs. 66.1 defined daily doses/100 beds P < 0.001). The median (interquartile range) of length of stay was significantly reduced post ASP [11 (3-21) vs. 7 (4-19) days; P < 0.01]. Also, the median (interquartile range) of duration of therapy was significantly reduced post-ASP [8 (5-12) days vs. 5 (3-9); P = 0.01]. There was no significant difference in overall 30-day mortality or readmission between the pre-ASP and post-ASP groups (26.9% vs. 23.9%; P = 0.1) and (26.1% vs. 24.6%; P = 0.54) respectively. Our prospective audit and feedback programme was associated with positive impact on antimicrobial use, duration of therapy and length of stay. © 2017 The British Pharmacological Society.

  11. Predicting the environmental impacts of chicken systems in the United Kingdom through a life cycle assessment: broiler production systems.

    Science.gov (United States)

    Leinonen, I; Williams, A G; Wiseman, J; Guy, J; Kyriazakis, I

    2012-01-01

    The aim of this study was to apply the life cycle assessment (LCA) method, from cradle to gate, to quantify the environmental burdens per 1,000 kg of expected edible carcass weight in the 3 main broiler production systems in the United Kingdom: 1) standard indoor, 2) free range, and 3) organic, and to identify the main components of these burdens. The LCA method evaluates production systems logically to account for all inputs and outputs that cross a specified system boundary, and it relates these to the useful outputs. The analysis was based on an approach that applied a structural model for the UK broiler industry and mechanistic submodels for animal performance, crop production, and major nutrient flows. Simplified baseline feeds representative of those used by the UK broiler industry were used. Typical UK figures for performance and mortality of birds and farm energy and material use were applied. Monte Carlo simulations were used to quantify the uncertainties in the outputs. The length of the production cycle was longer for free-range and organic systems compared with that of the standard indoor system, and as a result, the feed consumption and manure production per bird were higher in the free-range and organic systems. These differences had a major effect on the differences in environmental burdens between the systems. Feed production, processing, and transport resulted in greater overall environmental impacts than any other components of broiler production; for example, 65 to 81% of the primary energy use and 71 to 72% of the global warming potential of the system were due to these burdens. Farm gas and oil use had the second highest impact in primary energy use (12-25%) followed by farm electricity use. The direct use of gas, oil, and electricity were generally lower in free-range and organic systems compared with their use in the standard indoor system. Manure was the main component of acidification potential and also had a relatively high eutrophication

  12. UNEP (United Nations Environment Program) discussed the environmental impacts of extraction, transportation, and utilization of fossil fuels

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-01

    The UNEP (United Nations Environment Program) discussed the environmental impacts of extraction, transportation, and utilization of fossil fuels at a meeting in Warsaw, the first in a series of UNEP undertakings, to be followed by studies on nuclear energy and renewable energy sources. The major issues examined at the meeting were human health effects of atmospheric emissions, especially SO/sub 2/; effects of SO/sub 2/ on vegetation and bodies of fresh water; long-term ecologic effects of oil spills in the sea; and potential effects on climate from atmospheric CO/sub 2/ arising from fossil fuel combustion. A doubling of the atmospheric CO/sub 2/ concentration would cause an estimated 1.5/sup 0/-3.0/sup 0/C increase in the surface air temperature. With an amount of CO/sub 2/ equivalent to 0.5 x 10/sup 10/ tonnes of carbon annually injected into the atmosphere from fossil fuels, of which only 0.27 x 10/sup 10/ tonnes are removed by some exchange processes with ocean or land. A 17% increase in atmospheric CO/sub 2/ over the 1976 concentration of 332 ppm is expected by the year 2000.

  13. Bioenergy Crop Production in the United States. Potential Quantities, Land Use Changes, and Economic Impacts on the Agricultural Sector

    International Nuclear Information System (INIS)

    Walsh, Marie E.; Torre Ugarte, D.G. de la; Shapouri, H.; Slinsky, S.P.

    2003-01-01

    The U.S. Departments of Agriculture and Energy jointly analyzed the economic potential for, and impacts of, large-scale bioenergy crop production in the United States. An agricultural sector model (POLYSYS) was modified to include three potential bioenergy crops (switchgrass, hybrid poplar, and willow). At farmgate prices of US $2.44/GJ, an estimated 17 million hectares of bioenergy crops, annually yielding 171 million dry Mg of biomass, could potentially be produced at a profit greater than existing agricultural uses for the land. The estimate assumes high productivity management practices are permitted on Conservation Reserve Program lands. Traditional crops prices are estimated to increase 9 to 14 percent above baseline prices and farm income increases annually by US $6.0 billion above baseline. At farmgate prices of US $1.83/GJ, an estimated 7.9 million hectares of bioenergy crops, annually yielding 55 million dry Mg of biomass, could potentially be produced at a profit greater than existing agricultural uses for the land. The estimate assumes management practices intended to achieve high environmental benefits on Conservation Reserve Program lands. Traditional crops prices are estimated to increase 4 to 9 percent above baseline prices and farm income increases annually by US $2.8 billion above baseline

  14. Impact of an educational intervention on hand hygiene compliance and infection rate in a developing country neonatal intensive care unit.

    Science.gov (United States)

    Chhapola, Viswas; Brar, Rekha

    2015-10-01

    Nosocomial infections are a significant problem in neonatal intensive care units (NICUs) and hand hygiene (HH) has been stated as an effective mean to prevent spread of infections. The aim of study was to assess the baseline compliance HH practices and to evaluate the impact of hand washing educational programme on infection rate in a NICU. Continuous surveillance of nosocomial infections was done. A total of 15,797 and 12 ,29 opportunities for HH were observed in pre-intervention and postintervention phases, respectively. Compliance of health-care workers for all HH opportunities combined was 46% before intervention and improved significantly to 69% in postintervention (RR 1.49, CI 1.46-1.52, P Nosocomial sepsis rate showed a significant decline from 96 per 1000 patient-days in pre-intervention to 47 per 1000 patient-days in postintervention phase (RR 0.44, CI 0.33-0.58, P nosocomial infection control approach especially important in developing nations. © 2014 Wiley Publishing Asia Pty Ltd.

  15. Impact of Subspecialty Fellowship Training on Research Productivity Among Academic Plastic Surgery Faculty in the United States.

    Science.gov (United States)

    Sood, Aditya; Therattil, Paul J; Chung, Stella; Lee, Edward S

    2015-01-01

    The impact of subspecialty fellowship training on research productivity among academic plastic surgeons is unknown. The authors' aim of this study was to (1) describe the current fellowship representation in academic plastic surgery and (2) evaluate the relationship between h-index and subspecialty fellowship training by experience and type. Academic plastic surgery faculty (N = 590) were identified through an Internet-based search of all ACGME-accredited integrated and combined residency programs. Research output was measured by h-index from the Scopus database as well as a number of peer-reviewed publications. The Kruskal-Wallis test, with a subsequent Mann-Whitney U test, was used for statistical analysis to determine correlations. In the United States, 72% (n = 426) of academic plastic surgeons had trained in 1 or more subspecialty fellowship program. Within this cohort, the largest group had completed multiple fellowships (28%), followed by hand (23%), craniofacial (22%), microsurgery (15%), research (8%), cosmetic (3%), burn (2%), and wound healing (0.5%). Higher h-indices correlated with a research fellowship (12.5; P productivity compared with their colleagues. Craniofacial-trained physicians also demonstrated a higher marker for academic productivity than multiple other specialties. In this study, we show that the type and number of fellowships influence the h-index and further identification of such variables may help improve academic mentorship and productivity within academic plastic surgery.

  16. The impact of hydraulic flow unit & reservoir quality index on pressure profile and productivity index in multi-segments reservoirs

    Directory of Open Access Journals (Sweden)

    Salam Al-Rbeawi

    2017-12-01

    Full Text Available The objective of this paper is studying the impact of the hydraulic flow unit and reservoir quality index (RQI on pressure profile and productivity index of horizontal wells acting in finite reservoirs. Several mathematical models have been developed to investigate this impact. These models have been built based on the pressure distribution in porous media, depleted by a horizontal well, consist of multi hydraulic flow units and different reservoir quality index. The porous media are assumed to be finite rectangular reservoirs having different configurations and the wellbores may have different lengths. Several analytical models describing flow regimes have been derived wherein hydraulic flow units and reservoir quality index have been included in addition to rock and fluid properties. The impact of these two parameters on reservoir performance has also been studied using steady state productivity index.It has been found that both pressure responses and flow regimes are highly affected by the existence of multiple hydraulic flow units in the porous media and the change in reservoir quality index for these units. Positive change in the RQI could lead to positive change in both pressure drop required for reservoir fluids to move towards the wellbore and hence the productivity index.

  17. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    DEFF Research Database (Denmark)

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    OBJECTIVE: To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF. DESIGN: The NRP was used to identify...

  18. The Impact of a Hybrid Sport Education-Invasion Games Competence Model Soccer Unit on Students' Decision Making, Skill Execution and Overall Game Performance

    Science.gov (United States)

    Mesquita, Isabel; Farias, Claudio; Hastie, Peter

    2012-01-01

    The purpose of this study was to examine the impact of a hybrid Sport Education-Invasion Games Competence Model (SE-IGCM) unit application on students' improvements in decision making, skill execution and overall game performance, during a soccer season. Twenty-six fifth-grade students from a Portuguese public elementary school participated in a…

  19. Weather Regime-Dependent Predictability: Sequentially Linked High-Impact Weather Events over the United States during March 2016

    Science.gov (United States)

    Bosart, L. F.; Winters, A. C.; Keyser, D.

    2016-12-01

    High-impact weather events (HWEs), defined by episodes of excessive precipitation or periods of well above or well below normal temperatures, can pose important predictability challenges on medium-range (8-16 day) time scales. Furthermore, HWEs can contribute disproportionately to temperature and precipitation anomaly statistics for a particular season. This disproportionate contribution suggests that HWEs need to be considered in describing and understanding the dynamical and thermodynamic processes that operate at the weather-climate intersection. HWEs typically develop in conjunction with highly amplified flow patterns that permit an extensive latitudinal exchange of polar and tropical air masses. Highly amplified flow patterns over North America often occur in response to a reconfiguration of the large-scale upstream flow pattern over the North Pacific Ocean. The large-scale flow pattern over the North Pacific, North America, and western North Atlantic during the latter half of March 2016 was characterized by frequent cyclonic wave breaking (CWB). This large-scale flow pattern enabled three sequentially linked HWEs to develop over the continental United States. The first HWE was a challenging-to-predict cyclogenesis event on 23-24 March in the central Plains that resulted in both a major snowstorm along the Colorado Front Range and a severe weather outbreak over the central and southern Plains. The second HWE was a severe weather outbreak that occurred over the Tennessee and Ohio River Valleys on 27-28 March. The third HWE was the development of well below normal temperatures over the eastern United States that followed the formation of a high-latitude omega block over northwestern North America during 28 March-1 April. This study will examine (1) the role that CWB over the North Pacific and North America played in the evolution of the flow pattern during late-March 2016 and the development of the three HWEs and (2) the skill of GFS operational and ensemble

  20. Impact of electronic medical record integration of a handoff tool on sign-out in a newborn intensive care unit

    Science.gov (United States)

    Palma, JP; Sharek, PJ; Longhurst, CA

    2016-01-01

    Objective To evaluate the impact of integrating a handoff tool into the electronic medical record (EMR) on sign-out accuracy, satisfaction and workflow in a neonatal intensive care unit (NICU). Study Design Prospective surveys of neonatal care providers in an academic children’s hospital 1 month before and 6 months following EMR integration of a standalone Microsoft Access neonatal handoff tool. Result Providers perceived sign-out information to be somewhat or very accurate at a rate of 78% with the standalone handoff tool and 91% with the EMR-integrated tool (P < 0.01). Before integration of neonatal sign-out into the EMR, 35% of providers were satisfied with the process of updating sign-out information and 71% were satisfied with the printed sign-out document; following EMR integration, 92% of providers were satisfied with the process of updating sign-out information (P < 0.01) and 98% were satisfied with the printed sign-out document (P < 0.01). Neonatal care providers reported spending a median of 11 to 15 min/day updating the standalone sign-out and 16 to 20 min/day updating the EMR-integrated sign-out (P = 0.026). The median percentage of total sign-out preparation time dedicated to transcribing information from the EMR was 25 to 49% before and <25% after EMR integration of the handoff tool (P < 0.01). Conclusion Integration of a NICU-specific handoff tool into an EMR resulted in improvements in perceived sign-out accuracy, provider satisfaction and at least one aspect of workflow. PMID:21273990

  1. The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States.

    Science.gov (United States)

    Okubo, Yusuke; Nochioka, Kotaro; Testa, Marcia A

    2018-04-01

    Obesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear. We conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2-20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States. We used the International Classification of Diseases, Ninth Revision, Clinical Modification code (278.0×) to classify whether the patient was obese or not. We investigated the associations between pediatric obesity and use of mechanical ventilation using multivariable logistic regression model. In addition, we ascertained the relationships between pediatric obesity, comorbid blood stream infections, mean healthcare cost, and length of hospital stay. We estimated a total of 133 602 hospitalizations with pneumonia and bronchitis among children aged between 2 and 20 years. Obesity was significantly associated with use of mechanical ventilation (adjusted OR 2.90, 95% CI 2.15-3.90), comorbid bacteremia or septicemia (adjusted OR 1.58, 95% CI 1.03-2.44), elevated healthcare costs (adjusted difference $383, 95%CI $276-$476), and prolonged length of hospital stay (difference 0.32 days, 95%CI 0.23-0.40 days), after adjusting for patient and hospital characteristics using multivariable logistic regression models. Pediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations. © 2017 John Wiley & Sons Ltd.

  2. Climate change impacts on flood risk and asset damages within mapped 100-year floodplains of the contiguous United States

    Science.gov (United States)

    Wobus, Cameron; Gutmann, Ethan; Jones, Russell; Rissing, Matthew; Mizukami, Naoki; Lorie, Mark; Mahoney, Hardee; Wood, Andrew W.; Mills, David; Martinich, Jeremy

    2017-12-01

    A growing body of work suggests that the extreme weather events that drive inland flooding are likely to increase in frequency and magnitude in a warming climate, thus potentially increasing flood damages in the future. We use hydrologic projections based on the Coupled Model Intercomparison Project Phase 5 (CMIP5) to estimate changes in the frequency of modeled 1 % annual exceedance probability (1 % AEP, or 100-year) flood events at 57 116 stream reaches across the contiguous United States (CONUS). We link these flood projections to a database of assets within mapped flood hazard zones to model changes in inland flooding damages throughout the CONUS over the remainder of the 21st century. Our model generates early 21st century flood damages that reasonably approximate the range of historical observations and trajectories of future damages that vary substantially depending on the greenhouse gas (GHG) emissions pathway. The difference in modeled flood damages between higher and lower emissions pathways approaches USD 4 billion per year by 2100 (in undiscounted 2014 dollars), suggesting that aggressive GHG emissions reductions could generate significant monetary benefits over the long term in terms of reduced flood damages. Although the downscaled hydrologic data we used have been applied to flood impacts studies elsewhere, this research expands on earlier work to quantify changes in flood risk by linking future flood exposure to assets and damages on a national scale. Our approach relies on a series of simplifications that could ultimately affect damage estimates (e.g., use of statistical downscaling, reliance on a nationwide hydrologic model, and linking damage estimates only to 1 % AEP floods). Although future work is needed to test the sensitivity of our results to these methodological choices, our results indicate that monetary damages from inland flooding could be significantly reduced through substantial GHG mitigation.

  3. Climate change impacts on flood risk and asset damages within mapped 100-year floodplains of the contiguous United States

    Directory of Open Access Journals (Sweden)

    C. Wobus

    2017-12-01

    Full Text Available A growing body of work suggests that the extreme weather events that drive inland flooding are likely to increase in frequency and magnitude in a warming climate, thus potentially increasing flood damages in the future. We use hydrologic projections based on the Coupled Model Intercomparison Project Phase 5 (CMIP5 to estimate changes in the frequency of modeled 1 % annual exceedance probability (1 % AEP, or 100-year flood events at 57 116 stream reaches across the contiguous United States (CONUS. We link these flood projections to a database of assets within mapped flood hazard zones to model changes in inland flooding damages throughout the CONUS over the remainder of the 21st century. Our model generates early 21st century flood damages that reasonably approximate the range of historical observations and trajectories of future damages that vary substantially depending on the greenhouse gas (GHG emissions pathway. The difference in modeled flood damages between higher and lower emissions pathways approaches USD 4 billion per year by 2100 (in undiscounted 2014 dollars, suggesting that aggressive GHG emissions reductions could generate significant monetary benefits over the long term in terms of reduced flood damages. Although the downscaled hydrologic data we used have been applied to flood impacts studies elsewhere, this research expands on earlier work to quantify changes in flood risk by linking future flood exposure to assets and damages on a national scale. Our approach relies on a series of simplifications that could ultimately affect damage estimates (e.g., use of statistical downscaling, reliance on a nationwide hydrologic model, and linking damage estimates only to 1 % AEP floods. Although future work is needed to test the sensitivity of our results to these methodological choices, our results indicate that monetary damages from inland flooding could be significantly reduced through substantial GHG mitigation.

  4. The impact of patient demographics and comorbidities upon burns admitted to Tygerberg Hospital Burns Unit, Western Cape, South Africa.

    Science.gov (United States)

    Cloake, T; Haigh, T; Cheshire, J; Walker, D

    2017-03-01

    In South Africa, burns are a major public health problem responsible for significant morbidity and long-term physical disability. This is, in part, due to a significant proportion of the urban population living in poorly constructed, combustible accommodation. The presence of co-morbid diseases such as diabetes and malignancy in patients with burns has been associated with a poorer outcome. The impact of other diseases such as HIV has yet to be defined. A retrospective data collection study analysed the 221 patients admitted to Tygerberg Hospital Burns Unit in 2011 and the first six months of 2013. Using hospital records, patient demographic data was collected alongside burn agent, ICU admission, complications, and patient outcome in terms of length of stay and mortality. The most common burn agent was hot liquid (45.7%). A significant proportion of patients were subject to intentional attacks (34.3%). Shack fires and flame accounted cumulatively for 85% of total inhalational burns, the highest rates of admission to ICU (85.5%), the highest rate of complications, as well as 92.3% of all total fatalities. HIV+ patients had a higher mortality (13.3% vs 5%, p=0.22) and a higher complication rate (46.7% vs 30%, p=0.21). There was no difference in length of stay between the HIV+ and HIV- cohort (12days vs. 15.5 days, p=0.916). Burns are a significant yet preventable cause of mortality and morbidity. The rising number of shack fires, responsible for extensive burns and resultant mortality is concerning and indicates urgent attention and action. HIV complicates the recovery from burn and is responsible for an increased rate of in hospital mortality. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  5. Transmission dynamics of carbapenemase-producing Klebsiella pneumoniae and anticipated impact of infection control strategies in a surgical unit.

    Directory of Open Access Journals (Sweden)

    Vana Sypsa

    Full Text Available BACKGROUND: Carbapenemase-producing Klebsiella pneumoniae (CPKP has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. METHODOLOGY/PRINCIPAL FINDINGS: Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R(0 (average number of secondary cases per primary case in the absence of infection control and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R(0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%. The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8-12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. CONCLUSIONS/SIGNIFICANCE: Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings.

  6. Transmission Dynamics of Carbapenemase-Producing Klebsiella Pneumoniae and Anticipated Impact of Infection Control Strategies in a Surgical Unit

    Science.gov (United States)

    Sypsa, Vana; Psichogiou, Mina; Bouzala, Georgia-Aikaterina; Hadjihannas, Linos; Hatzakis, Angelos; Daikos, Georgios L.

    2012-01-01

    Background Carbapenemase-producing Klebsiella pneumoniae (CPKP) has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. Methodology/Principal Findings Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R0 (average number of secondary cases per primary case in the absence of infection control) and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%). The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8–12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. Conclusions/Significance Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings. PMID:22859965

  7. Modeling potential impacts of the Garrison Diversion Unit project on Sand Lake and Arrowwood National Wildlife Refuges: a feasibility analysis

    Science.gov (United States)

    Hamilton, David B.; Auble, Gregor T.; Farmer, Adrian H.; Roelle, James E.

    1987-01-01

    The Garrison Diversion Unit (GDU) of the Pick-Sloan Missouri Basin program was authorized in 1965, with the purpose of diverting Missouri River water to the James River for irrigation, municipal and industrial water supply, fish and wildlife habitat, recreation, and flood control. The project was reauthorized in 1986, with the specification that comprehensive studies be conducted to address a variety of issues. One of these ongoing studies addresses potential impacts of GDU construction and operation on lands of the National Wildlife Refuge (NWR) system, including Arrowwood and Sand Lake Refuges (the Refuges) on the James River. A number of concerns at these Refuges have been identified; the primary concerns addressed in this report include increased winter return flows, which would limit control of rough fish; increased turbidity during project construction, which would decrease production of sago pondweed; and increased water level fluctuations in the late spring and early summer, which would destroy the nests of some over-water nesting birds. The facilitated workshop described in this report was conducted February 18-20, 1987, under the joint sponsorship of the U.S. Bureau of Reclamation, the U.S. Fish and Wildlife Service, and the North Dakota Game and Fish Department. The primary objectives of the workshop were to evaluate the feasibility of using simulation modeling techniques to estimate GDU impacts on Arrowwood and Sand Lake Refuges and to suggest enhancements to the James River Refuge monitoring program. The workshop was structured around the formulation of four submodels: a Hydrology and Water Quality submodel to simulate changes in Refuge pool elevations, turnover rates, and water quality parameters (e.g., total dissolved solids, turbidity, dissolved oxygen, nutrients, water temperature, pesticides) due to GDU construction and operation; a Vegetation submodel to simulate concomitant changes in wetland communities (e.g., sago pondweed, wet meadows, deep

  8. Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

    Science.gov (United States)

    Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik

    2014-08-01

    To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout

  9. The Impact of Wind Power Projects on Residential Property Values in the United States: A Multi-Site Hedonic Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hoen, Ben [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cappers, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thayer, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sethi, Gautam [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2009-12-01

    This report uses statistical analysis to evaluate the impact of wind power projects on property values, and fails to uncovers conclusive evidence of the existence of any widespread property value impacts.

  10. The Application of Load-cell Technique in the Study of Armour Unit Responses to Impact Loads

    DEFF Research Database (Denmark)

    Burcharth, H. F.; Liu, Zhou

    1994-01-01

    The slender, complex types of armour units, such as Tetrapods and Dolosse are widely used for rubble mound breakwaters. Many of the recent failures of such structures were caused by unforeseen early breakage of the units, thus revealing an inbalance between the strength (structural integrity) of ...

  11. 78 FR 18325 - Intent To Prepare an Environmental Impact Statement (EIS) for the Formal Training Unit (FTU) and...

    Science.gov (United States)

    2013-03-26

    ... Statement (EIS) for the Formal Training Unit (FTU) and Main Operating Base 1 (MOB 1) for the Beddown of KC... Statement (EIS) for the Formal Training Unit (FTU) and Main Operating Base 1 (MOB 1) for the Beddown of KC...-46A tanker aircraft, associated infrastructure and manpower of the FTU and MOB 1 at existing active...

  12. 77 FR 10775 - United States v. SG Interests I LTD., et al.; Proposed Final Judgment and Competitive Impact...

    Science.gov (United States)

    2012-02-23

    ... a related qui tam case also filed in United States District Court for the District of Colorado... PROPOSED FINAL JUDGMENT The proposed Final Judgment relates to a qui tam action captioned United States ex... this action and the qui tam action arise from common facts related to BLM auctions in February 2005 and...

  13. Impact of stroke unit in a public hospital on length of hospitalization and rate of early mortality of ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Maria Sheila G. Rocha

    2013-10-01

    Full Text Available We ascertained whether a public health stroke unit reduces the length of hospitalization, the rate of inpatient fatality, and the mortality rate 30 days after the stroke. Methods We compared a cohort of stroke patients managed on a general neurology/medical ward with a similar cohort of stroke patients managed in a str oke unit. The in-patient fatality rates and 30-day mortality rates were analyzed. Results 729 patients were managed in the general ward and 344 were treated at a comprehensive stroke unit. The in-patient fatality rates were 14.7% for the general ward group and 6.9% for the stroke unit group (p<0.001. The overall mortality rate 30 days after stroke was 20.9% for general ward patients and 14.2% for stroke unit patients (p=0.005. Conclusions We observed reduced in-patient fatalities and 30-day mortality rates in patients managed in the stroke unit. There was no impact on the length of hospitalization.

  14. Impact of a United Kingdom-wide campaign to tackle antimicrobial resistance on self-reported knowledge and behaviour change.

    Science.gov (United States)

    Chaintarli, Katerina; Ingle, Suzanne M; Bhattacharya, Alex; Ashiru-Oredope, Diane; Oliver, Isabel; Gobin, Maya

    2016-05-12

    As part of the 2014 European Antibiotic Awareness Day plans, a new campaign called Antibiotic Guardian (AG) was launched in the United Kingdom, including an online pledge system to increase commitment from healthcare professionals and members of the public to reduce antimicrobial resistance (AMR). The aim of this evaluation was to determine the impact of the campaign on self-reported knowledge and behaviour around AMR. An online survey was sent to 9016 Antibiotic Guardians (AGs) to assess changes in self-reported knowledge and behaviour (outcomes) following the campaign. Logistic regression models, adjusted for variables including age, sex and pledge group (pledging as member of public or as healthcare professional), were used to estimate associations between outcomes and AG characteristics. 2478 AGs responded to the survey (27.5 % response rate) of whom 1696 (68.4 %) pledged as healthcare professionals and 782 (31.6 %) as members of public (similar proportions to the total number of AGs). 96.3 % of all AGs who responded had prior knowledge of AMR. 73.5 % of participants were female and participants were most commonly between 45 and 54 years old. Two thirds (63.4 %) of participants reported always acting according to their pledge. Members of the public were more likely to act in line with their pledge than professionals (Odds Ratio (OR) =3.60, 95 % Confidence Interval (CI): 2.88-4.51). Approximately half of participants (44.5 %) (both healthcare professionals and members of public) reported that they acquired more knowledge about AMR post-campaign. People that were confused about AMR prior to the campaign acquired more knowledge after the campaign (OR = 3.10, 95 % CI: 1.36-7.09). More participants reported a sense of personal responsibility towards tackling AMR post-campaign, increasing from 58.3 % of participants pre-campaign to 70.5 % post-campaign. This study demonstrated that the campaign increased commitment to tackling AMR in both healthcare

  15. The impact of the hospitalization process on the caregiver of a chronic critical patient hospitalized in a Semi-Intensive Care Unit

    OpenAIRE

    Neves, Letícia; Gondim, Andressa Alencar; Soares, Sara Costa Martins Rodrigues; Coelho, Denis Pontes; Pinheiro, Joana Angélica Marques

    2018-01-01

    Abstract Objective: To understand the impact of the hospitalization process on the family companion of critical patients admitted to a Semi-Intensive Care Unit (SICU). Method: Exploratory research with a qualitative approach, conducted in the months of April to July of 2016 through a semi-structured interview applied to relatives who were accompanying patients hospitalized in an SICU of a high complexity care hospital in Fortaleza. The interviews were submitted to content analysis. Results...

  16. How does a Next Generation Science Standard Aligned, Inquiry Based, Science Unit Impact Student Achievement of Science Practices and Student Science Efficacy in an Elementary Classroom?

    Science.gov (United States)

    Whittington, Kayla Lee

    This study examined the impact of an inquiry based Next Generation Science Standard aligned science unit on elementary students' understanding and application of the eight Science and Engineering Practices and their relation in building student problem solving skills. The study involved 44 second grade students and three participating classroom teachers. The treatment consisted of a school district developed Second Grade Earth Science unit: What is happening to our playground? that was taught at the beginning of the school year. Quantitative results from a Likert type scale pre and post survey and from student content knowledge assessments showed growth in student belief of their own abilities in the science classroom. Qualitative data gathered from student observations and interviews performed at the conclusion of the Earth Science unit further show gains in student understanding and attitudes. This study adds to the existing literature on the importance of standard aligned, inquiry based science curriculum that provides time for students to engage in science practices.

  17. Impact of Expanded North Slope of Alaska Crude Oil Production on Crude Oil Flows in the Contiguous United States

    Energy Technology Data Exchange (ETDEWEB)

    DeRosa, Sean E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Flanagan, Tatiana Paz [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-05-01

    The National Transportation Fuels Model was used to simulate a hypothetical increase in North Slope of Alaska crude oil production. The results show that the magnitude of production utilized depends in part on the ability of crude oil and refined products infrastructure in the contiguous United States to absorb and adjust to the additional supply. Decisions about expanding North Slope production can use the National Transportation Fuels Model take into account the effects on crude oil flows in the contiguous United States.

  18. Impact of Medicare Advantage penetration and hospital competition on technical efficiency of nursing care in US intensive care units.

    Science.gov (United States)

    Min, Ari; Scott, Linda D; Park, Chang; Vincent, Catherine; Ryan, Catherine J; Lee, Taewha

    2018-04-10

    This study aimed to evaluate technical efficiency of US intensive care units and determine the effects of environmental factors on technical efficiency in providing quality of nursing care. Data were obtained from the 2014 National Database of Nursing Quality Indicators and the Centers for Medicare and Medicaid Services. Data envelopment analysis was used to estimate technical efficiency for each intensive care unit. Multilevel modeling was used to determine the effects of environmental factors on technical efficiency. Overall, Medicare Advantage penetration and hospital competition in a market did not create pressure for intensive care units to become more efficient by reducing their inputs. However, these 2 environmental factors showed positive influences on technical efficiency in intensive care units with certain levels of technical efficiency. The implications of the study results for management strategies and health policy may vary according to the levels of technical efficiency in intensive care units. Further studies are needed to examine why and how intensive care units with particular levels of technical efficiency are differently affected by certain environmental factors. Copyright © 2018 John Wiley & Sons, Ltd.

  19. Differences between Magnitudes and Health Impacts of BC Emissions Across the United States using 12 km Scale Seasonal Source Apportionment

    Czech Academy of Sciences Publication Activity Database

    Turner, M.D.; Henze, D.K.; Hakami, A.; Zhao, S.; Resler, Jaroslav; Carmichael, G.; Stanier, C.; Baek, J.; Sandu, A.; Russell, A.G.; Nenes, A.; Jeong, G.; Capps, S.; Percell, P.; Pinder, R.; Napelenok, S.; Bash, J.; Chai, T.

    2015-01-01

    Roč. 49, č. 7 (2015), s. 4362-4371 ISSN 0013-936X Institutional support: RVO:67985807 Keywords : air quality * health impact * source apportionment * adjoint * particulate matter * black carbon Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 5.393, year: 2015

  20. Evaluating the Effectiveness and the Impact of Donated Neurosurgical Equipment on Neurosurgical Units in Low- and Middle-Income Countries: The World Federation of Neurosurgical Societies Experience.

    Science.gov (United States)

    Venturini, Sara; Park, Kee B

    2018-01-01

    Surgical practice highly depends on the availability of surgical equipment; this is particularly relevant to low- and middle-income countries (LMICs), where resources are limited. A key part of the efforts to improve surgical provision globally include providing affordable equipment to LMICs; however, the effectiveness and the impact of these initiatives have not yet been assessed. We aimed to evaluate the World Federation of Neurosurgical Societies neurosurgical equipment program in this context. Recipients were identified from the World Federation of Neurosurgical Societies records; contact details were gathered. An online survey was used to collect data on equipment, including its current use, any malfunctioning issues, suitability, reliability, serviceability, and the impact it has had on the unit. Responses were received from 16 units, totaling 28 pieces of equipment. A total of 75% of the equipment is still in use; of this, 57% is fully functioning, and 43% is used despite some malfunction. We found that 25% of the equipment is broken and unusable; high-maintenance items, such as high-speed drills, feature in this category (100% broken, n = 3). Units reported an increase in number of operation performed in 74% cases, improved surgery quality in 78%, and breadth of operations in 44%. Satisfaction, equipment suitability, reliability, and serviceability scored highly, with median values of 9 for all fields on a 10-point scale. Equipment donation positively impacts neurosurgical units in LMICs by allowing expansion of neurosurgical practice, improved safety and quality, and affordability. Adequate follow-up, considerations regarding equipment durability and maintenance needs, and improved support for repairs should be prioritized to ensure maximal benefit. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Rasmussen, Lars S.; Lohse, Nicolai

    2017-01-01

    Background: Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit. Methods: Prospective, observational study with 5...... patients. Primary outcome was long-term mortality after admission to the stroke unit. Results: Of the 1679 patients admitted to the stroke unit, 1068 were eligible for inclusion. Mortality rates were 9.04 per 100 person-years at risk (PYR) in GEMS patients and 9.71 per 100 PYR in HEMS patients (IRR = 1...... for neurological outcome is probably difficult to detect by considering mortality, but for the secondary analyses we had less statistical power as illustrated by the wide confidence intervals. Conclusion: Helicopter transport of stroke patients was not associated with reduced mortality or disability, nor improved...

  2. Estimated Budget Impact of Adopting the Affordable Care Act's Required Smoking Cessation Coverage on United States Healthcare Payers.

    Science.gov (United States)

    Baker, Christine L; Ferrufino, Cheryl P; Bruno, Marianna; Kowal, Stacey

    2017-01-01

    Despite abundant information on the negative impacts of smoking, more than 40 million adult Americans continue to smoke. The Affordable Care Act (ACA) requires tobacco cessation as a preventive service with no patient cost share for all FDA-approved cessation medications. Health plans have a vital role in supporting smoking cessation by managing medication access, but uncertainty remains on the gaps between smoking cessation requirements and what is actually occurring in practice. This study presents current cessation patterns, real-world drug costs and plan benefit design data, and estimates the 1- to 5-year pharmacy budget impact of providing ACA-required coverage for smoking cessation products to understand the fiscal impact to a US healthcare plan. A closed cohort budget impact model was developed in Microsoft Excel ® to estimate current and projected costs for US payers (commercial, Medicare, Medicaid) covering smoking cessation medicines, with assumptions for coverage and smoking cessation product utilization based on current, real-world national and state-level trends for hypothetical commercial, Medicare, and Medicaid plans with 1 million covered lives. A Markov methodology with five health states captures quit attempt and relapse patterns. Results include the number of smokers attempting to quit, number of successful quitters, annual costs, and cost per-member per-month (PMPM). The projected PMPM cost of providing coverage for smoking cessation medications is $0.10 for commercial, $0.06 for Medicare, and $0.07 for Medicaid plans, reflecting a low incremental PMPM impact of covering two attempts ranging from $0.01 for Medicaid to $0.02 for commercial and Medicare payers. The projected PMPM impact of covering two quit attempts with access to all seven cessation medications at no patient cost share remains low. Results of this study reinforce that the impact of adopting the ACA requirements for smoking cessation coverage will have a limited near-term impact

  3. Comparative study on the impact of coal and uranium mining, processing, and transportation in the western United States

    International Nuclear Information System (INIS)

    Sandquist, G.M.

    1979-06-01

    A comparative study and quantitative assessment of the impacts, costs and benefits associated with the mining, processing and transportation of coal and uranium within the western states, specifically Arizona, California, Colorado, Montana, New Mexico, Oregon, Utah, Washington and Wyoming are presented. The western states possess 49% of the US reserve coal base, 67% of the total identified reserves and 82% of the hypothetical reserves. Western coal production has increased at an average annual rate of about 22% since 1970 and should become the major US coal supplier in the 1980's. The Colorado Plateau (in Arizona, Colorado, New Mexico and Utah) and the Wyoming Basin areas account for 72% of the $15/lb U 3 O 8 resources, 76% of the $30/lb, and 75% of the $50/lb resources. It is apparent that the West will serve as the major supplier of domestic US coal and uranium fuels for at least the next several decades. Impacts considered are: environmental impacts, (land, water, air quality); health effects of coal and uranium mining, processing, and transportation; risks from transportation accidents; radiological impact of coal and uranium mining; social and economic impacts; and aesthetic impacts (land, air, noise, water, biota, and man-made objects). Economic benefits are discussed

  4. Comparative study on the impact of coal and uranium mining, processing, and transportation in the western United States

    Energy Technology Data Exchange (ETDEWEB)

    Sandquist, G.M.

    1979-06-01

    A comparative study and quantitative assessment of the impacts, costs and benefits associated with the mining, processing and transportation of coal and uranium within the western states, specifically Arizona, California, Colorado, Montana, New Mexico, Oregon, Utah, Washington and Wyoming are presented. The western states possess 49% of the US reserve coal base, 67% of the total identified reserves and 82% of the hypothetical reserves. Western coal production has increased at an average annual rate of about 22% since 1970 and should become the major US coal supplier in the 1980's. The Colorado Plateau (in Arizona, Colorado, New Mexico and Utah) and the Wyoming Basin areas account for 72% of the $15/lb U/sub 3/O/sub 8/ resources, 76% of the $30/lb, and 75% of the $50/lb resources. It is apparent that the West will serve as the major supplier of domestic US coal and uranium fuels for at least the next several decades. Impacts considered are: environmental impacts, (land, water, air quality); health effects of coal and uranium mining, processing, and transportation; risks from transportation accidents; radiological impact of coal and uranium mining; social and economic impacts; and aesthetic impacts (land, air, noise, water, biota, and man-made objects). Economic benefits are discussed.

  5. Life cycle air quality impacts of conventional and alternative light-duty transportation in the United States.

    Science.gov (United States)

    Tessum, Christopher W; Hill, Jason D; Marshall, Julian D

    2014-12-30

    Commonly considered strategies for reducing the environmental impact of light-duty transportation include using alternative fuels and improving vehicle fuel economy. We evaluate the air quality-related human health impacts of 10 such options, including the use of liquid biofuels, diesel, and compressed natural gas (CNG) in internal combustion engines; the use of electricity from a range of conventional and renewable sources to power electric vehicles (EVs); and the use of hybrid EV technology. Our approach combines spatially, temporally, and chemically detailed life cycle emission inventories; comprehensive, fine-scale state-of-the-science chemical transport modeling; and exposure, concentration-response, and economic health impact modeling for ozone (O3) and fine particulate matter (PM2.5). We find that powering vehicles with corn ethanol or with coal-based or "grid average" electricity increases monetized environmental health impacts by 80% or more relative to using conventional gasoline. Conversely, EVs powered by low-emitting electricity from natural gas, wind, water, or solar power reduce environmental health impacts by 50% or more. Consideration of potential climate change impacts alongside the human health outcomes described here further reinforces the environmental preferability of EVs powered by low-emitting electricity relative to gasoline vehicles.

  6. Detector Unit

    CERN Multimedia

    1960-01-01

    Original detector unit of the Instituut voor Kernfysisch Onderzoek (IKO) BOL project. This detector unit shows that silicon detectors for nuclear physics particle detection were already developed and in use in the 1960's in Amsterdam. Also the idea of putting 'strips' onto the silicon for high spatial resolution of a particle's impact on the detector were implemented in the BOL project which used 64 of these detector units. The IKO BOL project with its silicon particle detectors was designed, built and operated from 1965 to roughly 1977. Detector Unit of the BOL project: These detectors, notably the ‘checkerboard detector’, were developed during the years 1964-1968 in Amsterdam, The Netherlands, by the Natuurkundig Laboratorium of the N.V. Philips Gloeilampen Fabrieken. This was done in close collaboration with the Instituut voor Kernfysisch Onderzoek (IKO) where the read-out electronics for their use in the BOL Project was developed and produced.

  7. Overview of the Special Issue: A Multi-Model Framework to Achieve Consistent Evaluation of Climate Change Impacts in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Waldhoff, Stephanie T.; Martinich, Jeremy; Sarofim, Marcus; DeAngelo, B. J.; McFarland, Jim; Jantarasami, Lesley; Shouse, Kate C.; Crimmins, Allison; Ohrel, Sara; Li, Jia

    2015-07-01

    The Climate Change Impacts and Risk Analysis (CIRA) modeling exercise is a unique contribution to the scientific literature on climate change impacts, economic damages, and risk analysis that brings together multiple, national-scale models of impacts and damages in an integrated and consistent fashion to estimate climate change impacts, damages, and the benefits of greenhouse gas (GHG) mitigation actions in the United States. The CIRA project uses three consistent socioeconomic, emissions, and climate scenarios across all models to estimate the benefits of GHG mitigation policies: a Business As Usual (BAU) and two policy scenarios with radiative forcing (RF) stabilization targets of 4.5 W/m2 and 3.7 W/m2 in 2100. CIRA was also designed to specifically examine the sensitivity of results to uncertainties around climate sensitivity and differences in model structure. The goals of CIRA project are to 1) build a multi-model framework to produce estimates of multiple risks and impacts in the U.S., 2) determine to what degree risks and damages across sectors may be lowered from a BAU to policy scenarios, 3) evaluate key sources of uncertainty along the causal chain, and 4) provide information for multiple audiences and clearly communicate the risks and damages of climate change and the potential benefits of mitigation. This paper describes the motivations, goals, and design of the CIRA modeling exercise and introduces the subsequent papers in this special issue.

  8. Lessons learnt from the resin release into the primary circuit of the Fessenheim NPP unit 1 in January 2004. Impact on the nuclear safety

    International Nuclear Information System (INIS)

    Georgescu, M.

    2004-01-01

    On January the 24 th , at the Fessenheim NPP unit 1, a human error was committed during a boron demineralizer line-up, caused by lack of preparation. Consequently, a quantity of resin estimated at about 300 liters was released from this demineralizer, through its safety valve, into the head-tank of the chemical and volume control (CVC) system and after that, into the primary circuit. The incident had a real impact on the unit: the CVC filters were clogged, the seal injection flow of the primary circuit main pumps was lost, the primary circuit main pump 2 tripped four days after the incident, as the rate of the recirculated seal leak flow (downstream the seal 1) increased up to the automatic trip set point, the shaft of the running primary circuit feed pump was found seized into the rear hydrostatic bearing following the pump stop (after ten days of successful operation), the thimble plugs were jammed into their guide tubes, the small diameter pipes were plugged. The unit shutdown for over five months was necessary to clean the primary circuit components, repair or replace the affected equipment items and carry out inspections and tests. The reinforced unit in-service monitoring program, set up during the unit start-up, confirms that, up to now, the unit operation has not been adversely affected by the residual amounts of resin which subsist in certain areas of the primary circuit. Nevertheless, it remains to verify that, in the long term, these deposits will have no negative chemical effect in the potential confined areas, such as the thermal barriers of the primary circuit main pumps. Finally, the occurrence of this incident underlines, once more, the importance of normal operating activity preparing and checking. It also reveals the implementation of an ''unforgiving'' design change allowing the installation of a boron demineralizer safety valve having its outlet connected to the primary circuit. (orig.)

  9. Proper context: Comparison studies demonstrate that United States food-animal production antimicrobial uses have minimal impact on antimicrobial resistance

    Science.gov (United States)

    In the United States (US) it is estimated that food-animal production agriculture accounts for >70% of antimicrobial (AM) use leading to concerns that agricultural uses "substantially drive" antimicrobial resistance (AMR). Many studies report AMR in food-animal production settings without comparison...

  10. Strategies for Implementing Postmodern Thinking for Improving Secondary Education in Public Education in the United States of America: National Impact

    Science.gov (United States)

    Jacobs, Karen Dupre; Kritsonis, William Allan

    2007-01-01

    The purpose of this article is to discuss strategies for the secondary, public school educators to implement postmodern thinking in the United States of America. Postmodernism is a set of strategic practices that erase limits or norms to abide by placed upon people in society. The time is now for educators to be recognizant of these changes.…

  11. The Impact of Pecha Kucha Presentations in the Assessment of a Translation Studies Unit at the University of Western Australia

    Science.gov (United States)

    Colombi, Anna Gadd

    2017-01-01

    Results of a case study on the implementation of Pecha Kucha presentations undertaken at The University of Western Australia in 2015 are presented and discussed here. Pecha Kucha, a fast-paced presentation format consisting of 20 slides set to proceed automatically every 20 seconds, was used in the assessment of the unit "Translation…

  12. Assessing the Impact of Socio-Economic Inequities on College Enrolment: Emerging Differences in the United Arab Emirates

    Science.gov (United States)

    Ghazal Aswad, Noor; Vidican, Georgeta; Samulewicz, Diana

    2011-01-01

    As the United Arab Emirates diversifies its economy towards knowledge-based industries, maximising the participation of the national workforce, particularly women, in the science, engineering and technology fields is of utmost importance. To accomplish this, identifying the factors that lead students to select their degree programme, as well as…

  13. Potential impacts of year-round sampling on monitoring presence- absence of invasive flora in the southern United States

    Science.gov (United States)

    Christopher M. Oswalt; Sonja N. Oswalt; W. Keith Moser

    2012-01-01

    Studies suggest that the southern United States is an area of primary concern with regards to the spread of nonnative invasive plant species. Recent data show that species such as Japanese honeysuckle (Lonicera japonica) and Nepalese browntop (Microstegium vimineum) are invading forests and displacing native species throughout the...

  14. The Impact of Iodide-Mediated Ozone Deposition and Halogen Chemistry on Surface Ozone Concentrations Across the Continental United States

    Science.gov (United States)

    The air quality of many large coastal areas in the United States is affected by the confluence of polluted urban and relatively clean marine airmasses, each with distinct atmospheric chemistry. In this context, the role of iodide-mediated ozone (O3) deposition over seawater and m...

  15. Impact of single room design on the spread of multi-drug resistant bacteria in an intensive care unit.

    NARCIS (Netherlands)

    Halaby, Teysir; Al Naiemi, Nashwan; Beishuizen, Bert; Verkooijen, Roel; Ferreira, José A; Klont, Rob; Vandenbroucke-Grauls, Christina

    2017-01-01

    Cross-transmission of nosocomial pathogens occurs frequently in intensive care units (ICU). The aim of this study was to investigate whether the introduction of a single room policy resulted in a decrease in transmission of multidrug-resistant (MDR) bacteria in an ICU.

  16. The Impact of the Demand for Integration in the Large Multi-Business Unit Firm on the IT Organization Structure

    Science.gov (United States)

    Larson, Eric Christopher

    2012-01-01

    Large, multi-business unit firms are decentralizing their overall corporate structures. At the same time, the structures of their IT organizations are becoming more centralized. This is contrary to current wisdom that the IT organization structure will mimic the structure of the corporation, all else being equal. Because the general business…

  17. Impact of the 2008 Global Recession on Air Quality over the United States: Implications for Surface Ozone Levels from Changes in NOx Emissions

    Science.gov (United States)

    Tong, Daniel; Pan, Li; Chen, Weiwei; Lamsal, Lok; Lee, Pius; Tang, Youhua; Kim, Hyuncheol; Kondragunta, Shobha; Stajner, Ivanka

    2016-01-01

    Satellite and ground observations detected large variability in nitrogen oxides (NOx) during the 2008 economic recession, but the impact of the recession on air quality has not been quantified. This study combines observed NOx trends and a regional chemical transport model to quantify the impact of the recession on surface ozone (O3) levels over the continental United States. The impact is quantified by simulating O3 concentrations under two emission scenarios: business-as-usual (BAU) and recession. In the BAU case, the emission projection from the Cross-State Air Pollution Rule is used to estimate the would-be NOx emission level in 2011. In the recession case, the actual NO2 trends observed from Air Quality System ground monitors and the Ozone Monitoring Instrument on the Aura satellite are used to obtain realistic changes in NOx emissions. The model prediction with the recession effect agrees better with ground O3 observations over time and space than the prediction with the BAU emission. The results show that the recession caused a 12ppbv decrease in surface O3 concentration over the eastern United States, a slight increase (0.51ppbv) over the Rocky Mountain region, and mixed changes in the Pacific West. The gain in air quality benefits during the recession, however, could be quickly offset by the much slower emission reduction rate during the post-recession period.

  18. Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

    Science.gov (United States)

    Kurtz, Steven M; Ong, Kevin L; Lau, Edmund; Bozic, Kevin J

    2014-04-16

    Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total

  19. Impact of a New Palliative Care Program on Health System Finances: An Analysis of the Palliative Care Program Inpatient Unit and Consultations at Johns Hopkins Medical Institutions.

    Science.gov (United States)

    Isenberg, Sarina R; Lu, Chunhua; McQuade, John; Chan, Kelvin K W; Gill, Natasha; Cardamone, Michael; Torto, Deirdre; Langbaum, Terry; Razzak, Rab; Smith, Thomas J

    2017-05-01

    Palliative care inpatient units (PCUs) can improve symptoms, family perception of care, and lower per-diem costs compared with usual care. In March 2013, Johns Hopkins Medical Institutions (JHMI) added a PCU to the palliative care (PC) program. We studied the financial impact of the PC program on JHMI from March 2013 to March 2014. This study considered three components of the PC program: PCU, PC consultations, and professional fees. Using 13 months of admissions data, the team calculated the per-day variable cost pre-PCU (ie, in another hospital unit) and after transfer to the PCU. These fees were multiplied by the number of patients transferred to the PCU and by the average length of stay in the PCU. Consultation savings were estimated using established methods. Professional fees assumed a collection rate of 50%. The total positive financial impact of the PC program was $3,488,863.17. There were 153 transfers to the PCU, 60% with cancer, and an average length of stay of 5.11 days. The daily loss pretransfer to the PCU of $1,797.67 was reduced to $1,345.34 in the PCU (-25%). The PCU saved JHMI $353,645.17 in variable costs, or $452.33 per transfer. Cost savings for PC consultations in the hospital, 60% with cancer, were estimated at $2,765,218. $370,000 was collected in professional fees savings. The PCU and PC program had a favorable impact on JHMI while providing expert patient-centered care. As JHMI moves to an accountable care organization model, value-based patient-centered care and increased intensive care unit availability are desirable.

  20. The Impact of Wind Power Projects on Residential Property Values in the United States: A Multi-Site Hedonic Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hoen, Ben; Wiser, Ryan; Cappers, Peter; Thayer, Mark; Sethi, Gautam

    2009-12-02

    With wind energy expanding rapidly in the U.S. and abroad, and with an increasing number of communities considering wind power development nearby, there is an urgent need to empirically investigate common community concerns about wind project development. The concern that property values will be adversely affected by wind energy facilities is commonly put forth by stakeholders. Although this concern is not unreasonable, given property value impacts that have been found near high voltage transmission lines and other electric generation facilities, the impacts of wind energy facilities on residential property values had not previously been investigated thoroughly. The present research collected data on almost 7,500 sales of singlefamily homes situated within 10 miles of 24 existing wind facilities in nine different U.S. states. The conclusions of the study are drawn from eight different hedonic pricing models, as well as both repeat sales and sales volume models. The various analyses are strongly consistent in that none of the models uncovers conclusive evidence of the existence of any widespread property value impacts that might be present in communities surrounding wind energy facilities. Specifically, neither the view of the wind facilities nor the distance of the home to those facilities is found to have any consistent, measurable, and statistically significant effect on home sales prices. Although the analysis cannot dismiss the possibility that individual homes or small numbers of homes have been or could be negatively impacted, it finds that if these impacts do exist, they are either too small and/or too infrequent to result in any widespread, statistically observable impact.

  1. Energy sprawl or energy efficiency: climate policy impacts on natural habitat for the United States of America.

    Directory of Open Access Journals (Sweden)

    Robert I McDonald

    Full Text Available Concern over climate change has led the U.S. to consider a cap-and-trade system to regulate emissions. Here we illustrate the land-use impact to U.S. habitat types of new energy development resulting from different U.S. energy policies. We estimated the total new land area needed by 2030 to produce energy, under current law and under various cap-and-trade policies, and then partitioned the area impacted among habitat types with geospatial data on the feasibility of production. The land-use intensity of different energy production techniques varies over three orders of magnitude, from 1.9-2.8 km(2/TW hr/yr for nuclear power to 788-1000 km(2/TW hr/yr for biodiesel from soy. In all scenarios, temperate deciduous forests and temperate grasslands will be most impacted by future energy development, although the magnitude of impact by wind, biomass, and coal to different habitat types is policy-specific. Regardless of the existence or structure of a cap-and-trade bill, at least 206,000 km(2 will be impacted without substantial increases in energy efficiency, which saves at least 7.6 km(2 per TW hr of electricity conserved annually and 27.5 km(2 per TW hr of liquid fuels conserved annually. Climate policy that reduces carbon dioxide emissions may increase the areal impact of energy, although the magnitude of this potential side effect may be substantially mitigated by increases in energy efficiency. The possibility of widespread energy sprawl increases the need for energy conservation, appropriate siting, sustainable production practices, and compensatory mitigation offsets.

  2. Environmental impacts of the production and use of nuclear energy. A summary of the United Nations Environment Programme Study

    International Nuclear Information System (INIS)

    Ahmed, J.U.; Daw, H.T.

    1980-01-01

    In order to assess the environmental impacts of nuclear energy, the document considers the various operations involved in the nuclear power industry. These operations are the mining and milling of uranium, enrichment, fabrication of fuel elements, reactor operation, reprocessing of irradiated fuels (in the case of the recycle option), the management of radioactive wastes produced in all steps of the nuclear fuel cycle, decommissioning of nuclear facilities, and transport of radioactive materials. The environmental impacts of the various operations have been normalized to the net production of one gigawatt-year (GWy)

  3. The impact of an international initiative on exposures to liquid laundry detergent capsules reported to the United Kingdom National Poisons Information Service between 2008 and 2015.

    Science.gov (United States)

    Day, Rachael; Eddleston, Michael; Thomas, Simon H L; Thompson, John P; Vale, J Allister

    2017-03-01

    Although the majority of those exposed to liquid laundry detergent capsules remain asymptomatic or suffer only minor clinical features after exposure, a small proportion develop central nervous system depression, stridor, pulmonary aspiration and/or airway burns following ingestion or conjunctivitis and corneal ulceration following eye exposure. As a consequence, the International Association for Soaps, Detergents and Maintenance Products (AISE) established a Product Stewardship Programme in Europe, requiring that safety measures be implemented to reduce the visibility of, and restrict access to, these detergent capsules by small children. Implementation occurred in the United Kingdom over several months during the first half of 2013. This study investigated whether the AISE Programme had an impact on the number and severity of exposures reported to the United Kingdom National Poisons Information Service. Telephone enquiries to the National Poisons Information Service relating to liquid laundry detergent capsules were analysed for the period January 2008 to December 2015. While there was a significant difference (p = 0.0002) between the mean number of annual exposures (469.4) reported between 2008 and 2012 and the mean number reported between 2014 and 2015 (403.5), the number of exposures was decreasing steadily prior to implementation of the Programme in 2013, which did not impact this fall from 2013 onwards. In addition, the number of exposures per million units sold was not impacted by the Programme. There was no significant difference (p = 0.68) between the mean number of exposures (11.8) with PSS ≥2 reported between 2008 and 2012 and the mean number (13.0) reported between 2014 and 2015. Although there was a 28.7% decrease between 2010-2012 and 2014-2015 in the number of exposures with PSS ≥2 per million units sold, this decrease was not statistically significant (p = 0.18). There is no evidence that the Product Stewardship Programme had a

  4. Potential Impact of Minimum Unit Pricing for Alcohol in Ireland: Evidence from the National Alcohol Diary Survey.

    Science.gov (United States)

    Cousins, Gráinne; Mongan, Deirdre; Barry, Joe; Smyth, Bobby; Rackard, Marion; Long, Jean

    2016-11-01

    One of the main provisions of the Irish Public Health (Alcohol) Bill is the introduction of a minimum unit price (MUP) for alcohol in Ireland, set at €1.00/standard drink. We sought to identify who will be most affected by the introduction of a MUP, examining the relationship between harmful alcohol consumption, personal income, place of purchase and price paid for alcohol. A nationally representative survey of 3187 respondents aged 18-75 years, completing a diary of their previous week's alcohol consumption. The primary outcome was purchasing alcohol at  5), low personal annual income (target those suffering the greatest harm, and reduce alcohol-attributable mortality in Ireland. Further prospective studies are needed to monitor consumption trends and associated harms following the introduction of minimum unit pricing of alcohol. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  5. Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health

    OpenAIRE

    Gutierrez, Kristie S.; LePrevost, Catherine E.

    2016-01-01

    Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are ...

  6. United Nations Impact on Child Soldier Use in Eastern Democratic Republic of the Congo: 1999-2007

    Science.gov (United States)

    2008-12-12

    remained at large at the time of writing ( Malinowski 2008). Psychological Effects and Indoctrination Some works defined the psychological effect of...imprisonment. Biyoyo subsequently escaped from prison and remained at large at the time of writing ( Malinowski 2008). From a purely judicial...Armed Conflict on Children. Report of the expert of the Secretary General, New York: United Nations. Malinowski , Tom. 2008. Child Soldiers

  7. Climate variability and change in the United States: potential impacts on vector- and rodent-borne diseases.

    OpenAIRE

    Gubler, D J; Reiter, P; Ebi, K L; Yap, W; Nasci, R; Patz, J A

    2001-01-01

    Diseases such as plague, typhus, malaria, yellow fever, and dengue fever, transmitted between humans by blood-feeding arthropods, were once common in the United States. Many of these diseases are no longer present, mainly because of changes in land use, agricultural methods, residential patterns, human behavior, and vector control. However, diseases that may be transmitted to humans from wild birds or mammals (zoonoses) continue to circulate in nature in many parts of the country. Most vector...

  8. Dual impact of organisational change on subsequent exit from work unit and sickness absence: a longitudinal study among public healthcare employees.

    Science.gov (United States)

    Jensen, Johan Høy; Flachs, Esben Meulengracht; Skakon, Janne; Rod, Naja Hulvej; Bonde, Jens Peter

    2018-05-14

    We investigated work-unit exit, total and long-term sickness absence following organisational change among public healthcare employees. The study population comprised employees from the Capital Region of Denmark (n=14 388). Data on reorganisation at the work-unit level (merger, demerger, relocation, change of management, employee layoff or budget cut) between July and December 2013 were obtained via surveys distributed to the managers of each work unit. Individual-level data on work-unit exit, total and long-term sickness absence (≥29 days) in 2014 were obtained from company registries. For exposure to any, each type or number of reorganisations (1, 2 or ≥3), the HRs and 95% CIs for subsequent work-unit exit were estimated by Cox regression, and the risk for total and long-term sickness absence were estimated by zero-inflated Poisson regression. Reorganisation was associated with subsequent work-unit exit (HR 1.10, 95% CI 1.01 to 1.19) in the year after reorganisation. This association was specifically important for exposure to ≥3 types of changes (HR 1.52, 95% CI 1.30 to 1.79), merger (HR 1.29, 95% CI 1.12 to 1.49), demerger (HR 1.41, 95% CI 1.16 to 1.71) or change of management (HR 1.24, 95% CI 1.11 to 1.38). Among the employees remaining in the work unit, reorganisation was also associated with more events of long-term sickness absence (OR 1.15, 95% CI 1.00 to 1.33), which was particularly important for merger (OR 1.31, 95% CI 1.00 to 1.72) and employee layoff (OR 1.31, 95% CI 1.08 to 1.59). Specific types of reorganisation seem to have a dual impact on subsequent work-unit exit and sickness absence in the year after change. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Modeling number of bacteria per food unit in comparison to bacterial concentration in quantitative risk assessment: impact on risk estimates.

    Science.gov (United States)

    Pouillot, Régis; Chen, Yuhuan; Hoelzer, Karin

    2015-02-01

    When developing quantitative risk assessment models, a fundamental consideration for risk assessors is to decide whether to evaluate changes in bacterial levels in terms of concentrations or in terms of bacterial numbers. Although modeling bacteria in terms of integer numbers may be regarded as a more intuitive and rigorous choice, modeling bacterial concentrations is more popular as it is generally less mathematically complex. We tested three different modeling approaches in a simulation study. The first approach considered bacterial concentrations; the second considered the number of bacteria in contaminated units, and the third considered the expected number of bacteria in contaminated units. Simulation results indicate that modeling concentrations tends to overestimate risk compared to modeling the number of bacteria. A sensitivity analysis using a regression tree suggests that processes which include drastic scenarios consisting of combinations of large bacterial inactivation followed by large bacterial growth frequently lead to a >10-fold overestimation of the average risk when modeling concentrations as opposed to bacterial numbers. Alternatively, the approach of modeling the expected number of bacteria in positive units generates results similar to the second method and is easier to use, thus potentially representing a promising compromise. Published by Elsevier Ltd.

  10. NRC analysis of the environmental impacts and licensing policies for expanded spent fuel storage in the United States

    International Nuclear Information System (INIS)

    Smith, C.V. Jr.

    1978-01-01

    This paper reviews the findings of the U.S. environmental impact studies on spent fuel storage to the year 2000, addresses design criteria for independent spent fuel storage installations and expresses the position of the NRC for licensing expanded spent fuel storage capabilities until such time as final solutions are established

  11. The Impact of Support at the Workplace on Transfer of Training: A Study of an Indian Manufacturing Unit

    Science.gov (United States)

    Chauhan, Ragini; Ghosh, Piyali; Rai, Alka; Shukla, Divya

    2016-01-01

    This study aims to assess the individual impacts of two components of support at the workplace, namely, support from peers and supervisor, on transfer of training in a post-training environment. Mediation by motivation to transfer in the relationship of supervisor and peer support with transfer of training has also been examined. Data on 149…

  12. NRC Analysis of the environmental impacts and licensing policies for expanded spent fuel storage in the United States

    International Nuclear Information System (INIS)

    Clifford, V.S.

    1978-01-01

    The findings of the U.S. environmental impact studies on spent fuel storage to the year 2000 are reviewed, the design criteria for independent spent fuel storage installations are addressed and the position of the NRC for licensing expanded spent fuel storage capabilities, until such time as final solutions are established, is expressed. (author)

  13. Socioeconomic impacts of natural gas curtailments: a study of the textile industry in the southeastern United States. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jennings, D.M.

    1980-01-01

    A study was undertaken to identify the effects of fuel curtailments in the textile industry in North and South Carolina. Regional economic and social structures were affected with natural gas curtailments in 1976 and 1977. This document presents results of the effects of production shutdown resulting from the curtailments. Chapter II presents background information on the pipelines that service the region. Chapters III and IV describe the affected communities and the observed increase in government expenditures to counteract the impacts. Chapter V contains a complete list of textile plants in the study area that had to either work under abbreviated schedules or close entirely during the winter of 1976-1977. Attention was given to economic impacts at the industrial level that may have been attributable to the curtailment. Chapter VI covers these topics. In some instances, textile mills have relocated their plant facilities because they could not be guaranteed continuous fuel service at their original site. These data are the main concern of Chapter VII. Chapter VIII concentrates on social impacts; many facilities which provide services essential to human needs were subjected to gas curtailments so that the critical energy supplies could be diverted to industry. Chapter VIII also discusses an interesting geographic separation between social and economic impacts.

  14. 78 FR 20133 - Notice of Intent To Prepare an Environmental Impact Statement for the Proposed Bull Mountain Unit...

    Science.gov (United States)

    2013-04-03

    ... associated pads, access roads, gas and water pipelines, screw compressors and overhead electric lines. This... projected air quality impacts. The project was initially scoped from October 29 to December 12, 2008, for 55..., the BLM has identified the following preliminary issues: Air quality; water quality and supply...

  15. Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim.

    Science.gov (United States)

    Grewal, Simrun; Ramsey, Scott; Balu, Sanjeev; Carlson, Josh J

    2018-05-18

    Biosimilars can directly reduce the cost of treating patients for whom a reference biologic is indicated by offering a highly similar, lower priced alternative. We examine factors related to biosimilar regulatory approval, uptake, pricing, and financing and the potential impact on drug expenditures in the U.S. We developed a framework to illustrate how key factors including regulatory policies, provider and patient perception, pricing, and payer policies impact biosimilar cost-savings. Further, we developed a budget impact cost model to estimate savings from filgrastim biosimilars under various scenarios. The model uses publicly available data on disease incidence, treatment patterns, market share, and drug prices to estimate the cost-savings over a 5-year time horizon. We estimate five-year cost savings of $256 million, of which 18% ($47 million) are from reduced patient out-of-pocket costs, 34% ($86 million) are savings to commercial payers, and 48% ($123 million) are savings for Medicare. Additional scenarios demonstrate the impact of uncertain factors, including price, uptake, and financing policies. A variety or interrelated factors influence the development, uptake, and cost-savings for Biosimilars use in the U.S. The filgrastim case is a useful example that illustrates these factors and the potential magnitude of costs savings.

  16. Climate Change Impacts on Electricity Demand and Supply in the United States: A Multi-Model Comparison

    Science.gov (United States)

    This paper compares the climate change impacts on U.S. electricity demand and supply from three models: the Integrated Planning Model (IPM), the Regional Energy Deployment System (ReEDS) model, and GCAM. Rising temperatures cause an appreciable net increase in electricity demand....

  17. Quantifying the co-impacts of energy sector decarbonisation on outdoor air pollution in the United Kingdom

    International Nuclear Information System (INIS)

    Lott, Melissa C.; Pye, Steve; Dodds, Paul E.

    2017-01-01

    The energy sector is a major contributor to greenhouse gas (GHG) emissions and other types of air pollution that negatively impact human health and the environment. Policy targets to achieve decarbonisation goals for national energy systems will therefore impact levels of air pollution. Advantages can be gained from considering these co-impacts when analysing technology transition scenarios in order to avoid tension between climate change and air quality policies. We incorporated non-GHG air pollution into a bottom-up, technoeconomic energy systems model that is at the core of UK decarbonisation policy development. We then used this model to assess the co-impacts of decarbonisation on other types of air pollution and evaluated the extent to which transition pathways would be altered if these other pollutants were considered. In a scenario where the UK meets its existing decarbonisation targets to 2050, including the costs of non-GHG air pollution led to a 40% and 45% decrease in PM_1_0 and PM_2_._5 pollution (respectively) between 2010 and 2050 due to changes in technology choice in residential heating. Conversely, limited change in the pollution profile for transportation were observed, suggesting that other policy strategies will be necessary to reduce pollution from transport. - Highlights: • Strategies to decarbonise energy systems should consider other air pollutants. • Energy systems models can show decarbonisation pathway co-impacts on PM, NO_x and SO_x. • Considering non-GHG pollution eliminates carbon & air quality policy tensions. • Transport particulate pollution challenges will only be addressed by modal shifting.

  18. Research of the impact of coupling between unit cells on performance of linear-to-circular polarization conversion metamaterial with half transmission and half reflection

    Science.gov (United States)

    Guo, Mengchao; Zhou, Kan; Wang, Xiaokun; Zhuang, Haiyan; Tang, Dongming; Zhang, Baoshan; Yang, Yi

    2018-04-01

    In this paper, the impact of coupling between unit cells on the performance of linear-to-circular polarization conversion metamaterial with half transmission and half reflection is analyzed by changing the distance between the unit cells. An equivalent electrical circuit model is then built to explain it based on the analysis. The simulated results show that, when the distance between the unit cells is 23 mm, this metamaterial converts half of the incident linearly-polarized wave into reflected left-hand circularly-polarized wave and converts the other half of it into transmitted left-hand circularly-polarized wave at 4.4 GHz; when the distance is 28 mm, this metamaterial reflects all of the incident linearly-polarized wave at 4.4 GHz; and when the distance is 32 mm, this metamaterial converts half of the incident linearly-polarized wave into reflected right-hand circularly-polarized wave and converts the other half of it into transmitted right-hand circularly-polarized wave at 4.4 GHz. The tunability is realized successfully. The analysis shows that the changes of coupling between unit cells lead to the changes of performance of this metamaterial. The coupling between the unit cells is then considered when building the equivalent electrical circuit model. The built equivalent electrical circuit model can be used to perfectly explain the simulated results, which confirms the validity of it. It can also give help to the design of tunable polarization conversion metamaterials.

  19. Socioeconomic impacts of nuclear generating stations: Crystal River Unit 3 case study. Technical report 1 Oct 78-4 Jan 82

    International Nuclear Information System (INIS)

    Bergmann, P.A.

    1982-07-01

    The report documents a case study of the socioeconomic impacts of the construction and operation of the Crystal River Unit 3 nuclear power station. It is part of a major post-licensing study of the socioeconomic impacts at twelve nuclear power stations. The case study covers the period beginning with the announcement of plans to construct the reactor and ending in the period, 1980-81. The case study deals with changes in the economy, population, settlement patterns and housing, local government and public services, social structure, and public response in the study area during the construction/operation of the reactor. A regional modeling approach is used to trace the impact of construction/operation on the local economy, labor market, and housing market. Emphasis in the study is on the attribution of socioeconomic impacts to the reactor or other causal factors. As part of the study of local public response to the construction/operation of the reactor, the effects of the Three Mile Island accident are examined

  20. The impact of socioeconomic inequalities and lack of health insurance on physical functioning among middle-aged and older adults in the United States.

    Science.gov (United States)

    Kim, Jinhyun; Richardson, Virginia

    2012-01-01

    Socioeconomic inequalities and lack of private health insurance have been viewed as significant contributors to health disparities in the United States. However, few studies have examined their impact on physical functioning over time, especially in later life. The current study investigated the impact of socioeconomic inequalities and lack of private health insurance on individuals' growth trajectories in physical functioning, as measured by activities of daily living. Data from the Health and Retirement Study (1994-2006) were used for this study, 6519 black and white adults who provided in-depth information about health, socioeconomic, financial and health insurance information were analysed. Latent growth curve modelling was used to estimate the initial level of physical functioning and its rate of change over time. Results showed that higher level of income and assets and having private health insurance significantly predicted better physical functioning. In particular, decline in physical functioning was slower among those who had private health insurance. Interestingly, changes in economic status, such as decreases in income and assets, had a greater impact on women's physical functioning than on men's. Black adults did not suffer more rapid declines in physical functioning than white adults after controlling for socioeconomic status. The current longitudinal study suggested that anti-poverty and health insurance policies should be enhanced to reduce the negative impact of socioeconomic inequalities on physical functioning throughout an individual's life course. © 2011 Blackwell Publishing Ltd.

  1. Black lives matter: a theological response to racism's impact on the black body in the United States

    OpenAIRE

    Mitchell, Christine M.; Williams, David R.

    2017-01-01

    After the killing of 18-year-old Michael Brown by police in Ferguson, Missouri in August 2014, there has been a renewed movement in the United States and across the world in support of black lives. The movement, under the guiding framework of Black Lives Matter, has resulted in a national conversation on police brutality and racism, and the violent effects these have on the black body. Using the framework of black theological thought on the body, this paper identifies the many ways that racis...

  2. Impacts

    NARCIS (Netherlands)

    Hellmuth, M.; Kabat, P.

    2003-01-01

    Even without the impacts of climate change, water managers face prodigious challenges in meeting sustainable development goals. Growing populations need affordable food, water and energy. Industrial development demands a growing share of water resources and contaminates those same resources with its

  3. The impact of increased efficiency in the industrial use of energy: A computable general equilibrium analysis for the United Kingdom

    International Nuclear Information System (INIS)

    Allan, Grant; Hanley, Nick; McGregor, Peter; Swales, Kim; Turner, Karen

    2007-01-01

    The conventional wisdom is that improving energy efficiency will lower energy use. However, there is an extensive debate in the energy economics/policy literature concerning 'rebound' effects. These occur because an improvement in energy efficiency produces a fall in the effective price of energy services. The response of the economic system to this price fall at least partially offsets the expected beneficial impact of the energy efficiency gain. In this paper we use an economy-energy-environment computable general equilibrium (CGE) model for the UK to measure the impact of a 5% across the board improvement in the efficiency of energy use in all production sectors. We identify rebound effects of the order of 30-50%, but no backfire (no increase in energy use). However, these results are sensitive to the assumed structure of the labour market, key production elasticities, the time period under consideration and the mechanism through which increased government revenues are recycled back to the economy

  4. Public Health Impact and Economic Costs of Volkswagen’s Lack of Compliance with the United States’ Emission Standards

    Directory of Open Access Journals (Sweden)

    Lifang Hou

    2016-09-01

    Full Text Available The U.S. Environmental Protection Agency (EPA recently issued a notice of violation against Volkswagen (VW for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx. We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA’s Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles’ lack of compliance on the health and well-being of the U.S. population.

  5. Impact of IFRS on the quality of financial information in the United Kingdom and France: Evidence from a new perspective

    OpenAIRE

    Perafán Peña, Héctor Fabio; Benavides Franco, Julián

    2017-01-01

    Purpose: To assess the impact of the mandatory adoption of the International Financial Reporting Standards (IFRS) on the quality of the financial information available on listed companies in the UK and France. Design/methodology: This research uses panel regressions to analyze the relationship between the idiosyncratic risk of stock returns and the opacity of financial reports, before and after the mandatory adoption of IFRS. Opacity calculations include different proxies of ...

  6. Impacts of future climate change and effects of biogenic emissions on surface ozone and particulate matter concentrations in the United States

    Directory of Open Access Journals (Sweden)

    Y. F. Lam

    2011-05-01

    Full Text Available Simulations of present and future average regional ozone and PM2.5 concentrations over the United States were performed to investigate the potential impacts of global climate change and emissions on regional air quality using CMAQ. Various emissions and climate conditions with different biogenic emissions and domain resolutions were implemented to study the sensitivity of future air quality trends from the impacts of changing biogenic emissions. A comparison of GEOS-Chem and CMAQ was performed to investigate the effect of downscaling on the prediction of future air quality trends. For ozone, the impacts of global climate change are relatively smaller when compared to the impacts of anticipated future emissions reduction, except for the Northeast area, where increasing biogenic emissions due to climate change have stronger positive effects (increases to the regional ozone air quality. The combination effect from both climate change and emission reductions leads to approximately a 10 % or 5 ppbv decrease of the maximum daily average eight-hour ozone (MDA8 over the Eastern United States. For PM2.5, the impacts of global climate change have shown insignificant effect, where as the impacts of anticipated future emissions reduction account for the majority of overall PM2.5 reductions. The annual average 24-h PM2.5 of the future-year condition was found to be about 40 % lower than the one from the present-year condition, of which 60 % of its overall reductions are contributed to by the decrease of SO4 and NO3 particulate matters. Changing the biogenic emissions model increases the MDA8 ozone by about 5–10 % or 3–5 ppbv in the Northeast area. Conversely, it reduces the annual average PM2.5 by 5 % or 1.0 μg m−3 in the Southeast region.

  7. The impact of state certification of community health workers on team climate among registered nurses in the United States.

    Science.gov (United States)

    Siemon, Mark; Shuster, Geoff; Boursaw, Blake

    2015-04-01

    A number of states have adopted certification programs for community health workers (CHWs) to improve recognition of CHWs as members of health care teams, increase oversight, and to provide sustainable funding. There has been little research into the impact of state CHW certification on the diffusion and adoption of CHWs into existing health care systems. This study examined the impact of state CHW certification on the perceptions of team climate among registered nurses (RNs) who work with CHWs in states with and without CHW certification programs. The study recruited RNs using a purposeful sampling method and used an online survey, which included the Team Climate Inventory (TCI), and compared the perceptions of team climate between the two groups. The study found no significant differences in the overall mean TCI score or TCI subscale scores between RNs who work in states with CHW certification programs (n = 81) and those who work in states without CHW certification programs (n = 115). There was a statistically significant difference on one survey question regarding whether RNs believe state certification of CHWs improved the ability of their health care team to deliver quality care. More research is needed to assess impact of state certification of CHWs and other factors that influence the diffusion and adoption of CHWs into the current health care system.

  8. The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Porhomayon Jahan

    2015-06-01

    Full Text Available Background: The practice of low vs. high sedation dosing strategy may impact the cognitive and mental health function in the intensive care unit (ICU. We aim to demonstrate that high sedation strategy will result in change of mental health function in ICU patients. Methods: We performed a systemic search and meta-analysis of medical databases in MEDLINE(from 1966 to March 2013 and EMBASE (from 1980 to March 2013, as well as the Cochrane Library using the MESH terms "Intensive Care Unit," and "Mental Health, for assessing the impact of sedation on posttraumatic stress disorder (PTSD or anxiety/depression and deliriumin the mix ICU setting including cardiac surgery patients. A total of 1216 patients were includedin the final analysis.Results: We included 11 studies in the final analysis and concluded that high dose sedationstrategy resulted in higher incidence of cognitive dysfunction with P value of 0.009. Theresult for subgroup of delirium showed P = 0.11 and PTSD/depression or anxiety of P = 0.001,Heterogeneity I2 was 64%. Overall analysis was statistically significant with a P value of 0.002.Conclusion: High sedation dosing strategy will negatively affect cognitive function in criticallyill patients. Large randomized trials are needed to address cognitive dysfunction in subgroup of patients with delirium.

  9. The Impact of Pecha Kucha Presentations in the Assessment of a Translation Studies Unit at The University of Western Australia

    Directory of Open Access Journals (Sweden)

    Anna Gadd Colombi

    2017-12-01

    Full Text Available Results of a case study on the implementation of Pecha Kucha presentations undertaken at The University of Western Australia in 2015 are presented and discussed here. Pecha Kucha, a fast-paced presentation format consisting of 20 slides set to proceed automatically every 20 seconds, was used in the assessment of the unit “Translation Localisation” for two reasons: it is a time-effective method to assess a large number of students in a short time, and it has the potential to teach students whilst also assessing them, thus killing two birds with one stone. Recent studies show that the Pecha Kucha style can improve presenting skills and English speaking skills in general. This has particular relevance when teaching large numbers of international students, such as in “Translation Localisation”, where 84% of students spoke English as their second language. The paper ultimately shows how the use of Pecha Kucha presentations in the assessment of a unit carries important pedagogical implications for students of English for Academic Purposes.

  10. Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health.

    Science.gov (United States)

    Gutierrez, Kristie S; LePrevost, Catherine E

    2016-02-03

    Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015) literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate.

  11. The impact of movements and animal density on continental scale cattle disease outbreaks in the United States.

    Directory of Open Access Journals (Sweden)

    Michael G Buhnerkempe

    Full Text Available Globalization has increased the potential for the introduction and spread of novel pathogens over large spatial scales necessitating continental-scale disease models to guide emergency preparedness. Livestock disease spread models, such as those for the 2001 foot-and-mouth disease (FMD epidemic in the United Kingdom, represent some of the best case studies of large-scale disease spread. However, generalization of these models to explore disease outcomes in other systems, such as the United States's cattle industry, has been hampered by differences in system size and complexity and the absence of suitable livestock movement data. Here, a unique database of US cattle shipments allows estimation of synthetic movement networks that inform a near-continental scale disease model of a potential FMD-like (i.e., rapidly spreading epidemic in US cattle. The largest epidemics may affect over one-third of the US and 120,000 cattle premises, but cattle movement restrictions from infected counties, as opposed to national movement moratoriums, are found to effectively contain outbreaks. Slow detection or weak compliance may necessitate more severe state-level bans for similar control. Such results highlight the role of large-scale disease models in emergency preparedness, particularly for systems lacking comprehensive movement and outbreak data, and the need to rapidly implement multi-scale contingency plans during a potential US outbreak.

  12. Feasibility of coupled empirical and dynamic modeling to assess climate change and air pollution impacts on temperate forest vegetation of the eastern United States.

    Science.gov (United States)

    McDonnell, T C; Reinds, G J; Sullivan, T J; Clark, C M; Bonten, L T C; Mol-Dijkstra, J P; Wamelink, G W W; Dovciak, M

    2018-03-01

    Changes in climate and atmospheric nitrogen (N) deposition caused pronounced changes in soil conditions and habitat suitability for many plant species over the latter half of the previous century. Such changes are expected to continue in the future with anticipated further changing air temperature and precipitation that will likely influence the effects of N deposition. To investigate the potential long-term impacts of atmospheric N deposition on hardwood forest ecosystems in the eastern United States in the context of climate change, application of the coupled biogeochemical and vegetation community model VSD+PROPS was explored at three sites in New Hampshire, Virginia, and Tennessee. This represents the first application of VSD+PROPS to forest ecosystems in the United States. Climate change and elevated (above mid-19th century) N deposition were simulated to be important factors for determining habitat suitability. Although simulation results suggested that the suitability of these forests to support the continued presence of their characteristic understory plant species might decline by the year 2100, low data availability for building vegetation response models with PROPS resulted in uncertain results at the extremes of simulated N deposition. Future PROPS model development in the United States should focus on inclusion of additional foundational data or alternate candidate predictor variables to reduce these uncertainties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. The Accreditation Council for Graduate Medical Education resident duty hour new standards: history, changes, and impact on staffing of intensive care units.

    Science.gov (United States)

    Pastores, Stephen M; O'Connor, Michael F; Kleinpell, Ruth M; Napolitano, Lena; Ward, Nicholas; Bailey, Heatherlee; Mollenkopf, Fred P; Coopersmith, Craig M

    2011-11-01

    The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine convened a task force to develop a white paper on the impact of changes in resident duty hours on the critical care workforce and staffing of intensive care units. A multidisciplinary group of professionals with expertise in critical care education and clinical practice. Relevant medical literature was accessed through a systematic MEDLINE search and by requesting references from all task force members. Material published by the Accreditation Council for Graduate Medical Education and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force corresponded by electronic mail and held several conference calls to finalize this report. The new rules mandate that all first-year residents work no more than 16 hrs continuously, preserving the 80-hr limit on the resident workweek and 10-hr period between duty periods. More senior trainees may work a maximum of 24 hrs continuously, with an additional 4 hrs permitted for handoffs. Strategic napping is strongly suggested for trainees working longer shifts. Compliance with the new Accreditation Council for Graduate Medical Education duty-hour standards will compel workflow restructuring in intensive care units, which depend on residents to provide a substantial portion of care. Potential solutions include expanded utilization of nurse practitioners and physician assistants, telemedicine, offering critical care training positions to emergency medicine residents, and partnerships with hospitalists. Additional research will be necessary to evaluate the impact of the new standards on patient safety, continuity of care, resident learning, and staffing in the intensive care unit.

  14. IMPACTS !

    CERN Multimedia

    2008-01-01

    (Photo courtesy of Don Davis / NASA)The University of Geneva (UNIGE) and the Ecole Polytechnique Fédérale of Lausanne (EPFL) are organising the 4th series of public lectures on astronomy, on the theme of "Impacts". The schedule is as follows: Il y a 100 ans : une explosion dans la Tunguska – Dr. Frédéric COURBIN, EPFL Les impacts sur Terre – Prof. Didier Queloz, UNIGE La fin des dinosaures – Dr. Stéphane Paltani, UNIGE Wednesday 7 May 2008, from 7.00 p.m. to 9.00 p.m. Auditoire CO1, EPFL, Ecublens Thursday 08 May 2008, from 7.00 p.m. to 9.00 p.m. Auditoire Rouiller, Uni-Dufour, Genève All 3 lectures will be givent each evening! Admission free Information: 022 379 22 00

  15. Assessment of the Long Term Trends in Extreme Heat Events and the Associated Health Impacts in the United States

    Science.gov (United States)

    Bell, J.; Rennie, J.; Kunkel, K.; Herring, S.; Cullen, H. M.

    2017-12-01

    Land surface air temperature products have been essential for monitoring the evolution of the climate system. Before a temperature dataset is included in such reports, it is important that non-climatic influences be removed or changed so the dataset is considered homogenous. These inhomogeneities include changes in station location, instrumentation and observing practices. While many homogenized products exist on the monthly time scale, few daily products exist, due to the complication of removing breakpoints that are truly inhomogeneous rather than solely by chance (for example, sharp changes due to synoptic conditions). Recently, a sub monthly homogenized dataset has been developed using data and software provided by NOAA's National Centers for Environmental Information (NCEI). Homogeneous daily data are useful for identification and attribution of extreme heat events over a period of time. Projections of increasing temperatures are expected to result in corresponding increases in the frequency, duration, and intensity of extreme heat events. It is also established that extreme heat events can have significant public health impacts, including short-term increases in mortality and morbidity. In addition, it can exacerbate chronic health conditions in vulnerable populations, including renal and cardiovascular issues. To understand how heat events impact a specific population, it will be important to connect observations on the duration and intensity of extreme heat events with health impacts data including insurance claims and hospital admissions data. This presentation will explain the methodology to identify extreme heat events, provide a climatology of heat event onset, length and severity, and explore a case study of an anomalous heat event with available health data.

  16. Climate change is projected to have severe impacts on the frequency and intensity of peak electricity demand across the United States.

    Science.gov (United States)

    Auffhammer, Maximilian; Baylis, Patrick; Hausman, Catherine H

    2017-02-21

    It has been suggested that climate change impacts on the electric sector will account for the majority of global economic damages by the end of the current century and beyond [Rose S, et al. (2014) Understanding the Social Cost of Carbon: A Technical Assessment ]. The empirical literature has shown significant increases in climate-driven impacts on overall consumption, yet has not focused on the cost implications of the increased intensity and frequency of extreme events driving peak demand, which is the highest load observed in a period. We use comprehensive, high-frequency data at the level of load balancing authorities to parameterize the relationship between average or peak electricity demand and temperature for a major economy. Using statistical models, we analyze multiyear data from 166 load balancing authorities in the United States. We couple the estimated temperature response functions for total daily consumption and daily peak load with 18 downscaled global climate models (GCMs) to simulate climate change-driven impacts on both outcomes. We show moderate and heterogeneous changes in consumption, with an average increase of 2.8% by end of century. The results of our peak load simulations, however, suggest significant increases in the intensity and frequency of peak events throughout the United States, assuming today's technology and electricity market fundamentals. As the electricity grid is built to endure maximum load, our findings have significant implications for the construction of costly peak generating capacity, suggesting additional peak capacity costs of up to 180 billion dollars by the end of the century under business-as-usual.

  17. Clinical Impact of a Pharmaceutical Care Programme Developed in a Family Health Unit: Results of a Pharmacist-Physician Collaboration in the Treatment of Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Mónica Condinho

    2016-07-01

    Full Text Available Introduction: The positive impact of pharmacist-physician collaborative care has been reported in the international literature, although examples of this impact are limited in Portugal. We aim to underline the clinical added value for hypertensive patients that results from pharmacist-physician collaborations. Methods: A community trial was conducted at a Portuguese family health unit for 19 months. The intervention group was randomly selected from the global records and members of the group received pharmaceutical care in addition to physician care. The comparison group received only physician care. Both groups were comparable at the beginning of the study. In the intervention group, we analysed the hypertensive patients to evaluate the impact of pharmacist-physician collaboration on the patients’ blood pressure levels. This evaluation was performed by comparing the obtained blood pressure levels with the levels at baseline and between the groups. Results: A total of 17 patients with hypertension were enrolled in the pharmaceutical care programme, 12 of whom were female. The mean age was 68.50±3.26 years and, on average, each patient consumed 6.06±0.93 medicinal products. Thirteen patients were uncontrolled. Compared with the baseline, the intervention group achieved mean reductions of 28.85±5.90 mmHg (p < 0.0005 and 11.23±2.75 mmHg (p < 0.005 in their systolic and diastolic blood pressure, respectively. Considering the comparison group, improvements of 18.63±6.44 mmHg (p = 0.011 in systolic blood pressure and 9.03±2.63 mmHg ( p < 0.005 in diastolic blood pressure were observed. Conclusion: Pharmacist-physician collaborative care adds clinical value to the typical physician care provided to hypertensive patients within the context of a Portuguese family health unit.

  18. A novel approach for evaluating the impact of fixed variables on photovoltaic (PV) solar installations using enhanced meta data analysis among higher education institutions in the United States

    Science.gov (United States)

    De Hoyos, Diane N.

    The global demand for electric energy has continuously increased over the last few decades. Some mature, alternative generation methods are wind, power, photovoltaic panels, biogas and fuel cells. In order to find alternative sources of energy to aid in the reduction of our nation's dependency on non-renewable fuels, energy sources include the use of solar energy panels. The intent of these initiatives is to provide substantial energy savings and reduce dependence on the electrical grid and net metering savings during the peak energy-use hours. The focus of this study explores and provides a clearer picture of the adoption of solar photovoltaic technology in institutions of higher education. It examines the impact of different variables associated with a photovoltaic installation in an institutions of higher education in the United States on the production generations for universities. Secondary data was used with permission from the Advancement of Suitability in Higher Education (AASHE). A multiple regression analysis was performed to determine the impact of different variables on the energy generation production. A Meta Data transformation analysis offered a deeper investigation into the impact of the variables on the photovoltaic installations. Although a review of a significant number of journal articles, dissertations and thesis in the area of photovoltaic solar installations are available, there were limited studies of actual institutions of higher education with the significant volume of institutions. However a study where the database included a significant number of data variables is unique and provides a researcher the opportunity to investigate different facets of a solar installation. The data of the installations ranges from 1993-2015. Included in this observation are the researcher's experience both in the procurement industry and as a team member of a solar institution of higher education in the southern portion of the United States.

  19. The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model

    OpenAIRE

    Chesson, Harrell W.; Markowitz, Lauri E.; Hariri, Susan; Ekwueme, Donatus U.; Saraiya, Mona

    2016-01-01

    Introduction: The objective of this study was to assess the incremental costs and benefits of the 9-valent HPV vaccine (9vHPV) compared with the quadrivalent HPV vaccine (4vHPV). Like 4vHPV, 9vHPV protects against HPV types 6, 11, 16, and 18. 9vHPV also protects against 5 additional HPV types 31, 33, 45, 52, and 58. Methods: We adapted a previously published model of the impact and cost-effectiveness of 4vHPV to include the 5 additional HPV types in 9vHPV. The vaccine strategies we examined w...

  20. The Impact of Adjuvant Radiation Therapy for High-Grade Gliomas by Histology in the United States Population

    Energy Technology Data Exchange (ETDEWEB)

    Rusthoven, Chad G., E-mail: Chad.Rusthoven@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Carlson, Julie A.; Waxweiler, Timothy V. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Dally, Miranda J.; Barón, Anna E. [Department of Biostatistics and Informatics, University of Colorado School of Medicine, Aurora, Colorado (United States); Yeh, Norman; Gaspar, Laurie E.; Liu, Arthur K. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Ney, Douglas E.; Damek, Denise M. [Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado (United States); Lillehei, Kevin O. [Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado (United States); Kavanagh, Brian D. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

    2014-11-15

    Purpose: To compare the survival impact of adjuvant external beam radiation therapy (RT) for malignant gliomas of glioblastoma (GBM), anaplastic astrocytoma (AA), anaplastic oligodendroglioma (AO), and mixed anaplastic oligoastrocytoma (AOA) histology. Methods and Materials: The Surveillance, Epidemiology, and End Results (SEER) database was queried from 1998 to 2007 for patients aged ≥18 years with high-grade gliomas managed with upfront surgical resection, treated with and without adjuvant RT. Results: The primary analysis totaled 14,461 patients, with 12,115 cases of GBM (83.8%), 1312 AA (9.1%), 718 AO (4.9%), and 316 AOA (2.2%). On univariate analyses, adjuvant RT was associated with significantly improved overall survival (OS) for GBMs (2-year OS, 17% vs 7%, p<.001), AAs (5-year OS, 38% vs 24%, p<.001), and AOAs (5-year OS, 55% vs 44%, p=.026). No significant differences in OS were observed for AOs (5-year OS, with RT 50% vs 56% without RT, p=.277). In multivariate Cox proportional hazards models accounting for extent of resection, age, sex, race, year, marital status, and tumor registry, RT was associated with significantly improved OS for both GBMs (HR, 0.52; 95% CI, 0.50-0.55; P<.001) and AAs (HR, 0.57; 95% CI, 0.48-0.68; P<.001) but only a trend toward improved OS for AOAs (HR, 0.70; 95% CI, 0.45-1.09; P=.110). Due to the observation of nonproportional hazards, Cox regressions were not performed for AOs. A significant interaction was observed between the survival impact of RT and histology overall (interaction P<.001) and in a model limited to the anaplastic (WHO grade 3) histologies. (interaction P=.024), characterizing histology as a significant predictive factor for the impact of RT. Subgroup analyses demonstrated greater hazard reductions with RT among patients older than median age for both GBMs and AAs (all interaction P≤.001). No significant interactions were observed between RT and extent of resection. Identical patterns of significance were

  1. Impacts of an oil spill on the marine environment of the United Arab Emirates along the Gulf of Oman

    International Nuclear Information System (INIS)

    Shriadah, M.M.A.

    1998-01-01

    On the evening of 31 March 1994, a quantity (16 000 t) of Iranian crude oil leaked into the Gulf of Oman 9.5 miles outside the Al-Fujirah port entrance after a collision between the tanker 'Baynunah' and the supertanker 'Seki'. Clean-up operations which started within 1 h and 40 min of the collision could remove only 2000 t of oil from the sea, and failed to contain the spill. After 4 days, the floating oil hit the shoreline of the United Arab Emirates and contaminated about 20 km of shoreline. The main objectives of this paper are to evaluate the concentrations of petroleum hydrocarbons and organic carbon contents at the time of the incident and to assess, in July and November 1994, the recovery of the marine environment after a period of about 8 months. (author)

  2. The impact of a neuro-intensivist on patients with stroke admitted to a neurosciences intensive care unit.

    Science.gov (United States)

    Varelas, Panayiotis N; Schultz, Lonni; Conti, Mary; Spanaki, Marianna; Genarrelli, Thomas; Hacein-Bey, Lotfi

    2008-01-01

    Stroke Units improve the outcome in patients with mild to moderate severity strokes. We sought to examine the role that a full-time neurointensivist (NI) might play on the outcomes of patients with more severe strokes admitted to a Neurosciences Intensive Care Unit (NICU). Data regarding 433 stroke patients admitted to a 10-bed university hospital NICU were prospectively collected in two 19-month periods, before and after the appointment of a NI. Outcomes and disposition of patients with ischemic stroke (IS), intracerebral hemorrhage (ICH) or subarachnoid hemorrhage (SAH) were compared between the two periods, using univariate and multivariate analyses. One hundred and seventy-four patients with strokes were admitted in the period before and 259 in the period after the NI. Observed mortality did not differ between the two periods. More patients were discharged home in the after period (75% vs. 54% in the before period (P = 0.003). After adjusting for covariates, the NICU and hospital LOS were shorter for each type of stroke in the after period (Cox proportional hazard ratios, 95% CI were 2.37, 1.4-4.1 and 1.8, 1.04-3 for IS, 1.98, 1.3-3 and 1.2, 0.8-1.9 for ICH, and 1.6, 1.1-2.3 and 1.4, 1.01-2 for SAH, respectively) or for all strokes (1.92, 1.52-2.43 and 1.7, 1.28-2.25 for the first 12 days of hospital admission). The direct patient care offered and the organizational changes implemented by a NI shortened the NICU and hospital LOS and improved the disposition of patients with strokes admitted to a NICU.

  3. [Revolution of the health care delivery system and its impacts on laboratory testing in the United States].

    Science.gov (United States)

    Takemura, Y; Ishibashi, M

    2000-02-01

    Failure to slow the exponential growth of total health care expenditures in the United States through the government policies resulted in a rapid and progressive penetration of managed care organizations(MCOs) in the early 1990s. Diagnostic testing is viewed as a "commodity" rather than a medical service under the managed care environment. Traditional hospital-based laboratories are placed in a downward spiral with the advent of managed care era. A massive reduction of in-house testing resulted from shorter lengths of patients' hospital stay and a marked decrease in admission under the dominance of managed care urges them to develop strategies for restoring tests deprived by the managed care-associated new businesses: consolidation and networking, participation in the outreach-testing market, and point-of-care/satellite laboratory testing in non-traditional, ambulatory settings are major strategies for survival of hospital laboratories. A number of physicians' office laboratories(POLs) have been closed owing to regulatory restrictions imposed by the Clinical Laboratory Improvement Amendments of 1988(CLIA '88), and to the expanded penetration of MCOs which limit reimbursement to a very few in-house procedures. It seems likely that POLs and hospital laboratories continue to reduce test volumes, while commercial reference laboratories(CRLs) gain more tests through contracting with MCOs. In the current stream of managed care dominance in the United States, clinical laboratories are changing their basic operation focus and mission in response to the aggressively changing landscape. Traditional laboratories which are unwilling to adapt themselves to the new environment will not survive in this country.

  4. Impact of the design of neonatal intensive care units on neonates, staff, and families: a systematic literature review.

    Science.gov (United States)

    Shahheidari, Marzieh; Homer, Caroline

    2012-01-01

    Newborn intensive care is for critically ill newborns requiring constant and continuous care and supervision. The survival rates of critically ill infants and hospitalization in neonatal intensive care units (NICUs) have improved over the past 2 decades because of technological advances in neonatology. The design of NICUs may also have implications for the health of babies, parents, and staff. It is important therefore to articulate the design features of NICU that are associated with improved outcomes. The aim of this study was to explore the main features of the NICU design and to determine the advantages and limitations of the designs in terms of outcomes for babies, parents, and staff, predominately nurses. A systematic review of English-language, peer-reviewed articles was conducted for a period of 10 years, up to January 2011. Four online library databases and a number of relevant professional Web sites were searched using key words. There were 2 main designs of NICUs: open bay and single-family room. The open-bay environment develops communication and interaction with medical staff and nurses and has the ability to monitor multiple infants simultaneously. The single-family rooms were deemed superior for patient care and parent satisfaction. Key factors associated with improved outcomes included increased privacy, increased parental involvement in patient care, assistance with infection control, noise control, improved sleep, decreased length of hospital stay, and reduced rehospitalization. The design of NICUs has implications for babies, parents, and staff. An understanding of the positive design features needs to be considered by health service planners, managers, and those who design such specialized units.

  5. Hounsfield units variations: impact on CT-density based conversion tables and their effects on dose distribution.

    Science.gov (United States)

    Zurl, B; Tiefling, R; Winkler, P; Kindl, P; Kapp, K S

    2014-01-01

    Determination of dose error margins in radiation therapy planning due to variations in Hounsfield Units (HU) values dependent on the use of different CT scanning protocols. Based on a series of different CT scanning protocols used in clinical practice, conversion tables for radiation dose calculations were generated and subsequently tested on a phantom. These tables were then used to recalculate the radiation therapy plans of 28 real patients after an incorrect scanning protocol had inadvertently been used for these patients. Different CT parameter settings resulted in errors of HU values of up to 2.6% for densities of 1.1 g/cm(3). The largest errors were associated with changes in the tube voltage. Tests on a virtual water phantom with layers of variable thickness and density revealed a sawtooth-shaped curve for the increase of dose differences from 0.3 to 0.6% and 1.5% at layer thicknesses of 1, 3, and 7 cm, respectively. Use of a beam hardening filter resulted in a reference dose difference of 0.6% in response to a density change of 5%. The recalculation of data from 28 patients who received radiation therapy to the head revealed an overdose of 1.3 ± 0.4% to the bone and 0.7 ± 0.1% to brain tissue. On average, therefore, one monitor unit (range 0-3 MU) per 100 MU more than the correct dose had been given. Use of different CT scanning protocols leads to variations of up to 20% in the HU values. This can result in a mean systematic dose error of 1.5%. Specific conversion tables and automatic CT scanning protocol recognition could reduce dose errors of these types.

  6. Impact of resident duty hour limits on safety in the intensive care unit: a national survey of pediatric and neonatal intensivists.

    Science.gov (United States)

    Typpo, Katri V; Tcharmtchi, M Hossein; Thomas, Eric J; Kelly, P Adam; Castillo, Leticia D; Singh, Hardeep

    2012-09-01

    Resident duty-hour regulations potentially shift the workload from resident to attending physicians. We sought to understand how current or future regulatory changes might impact safety in academic pediatric and neonatal intensive care units. Web-based survey. U.S. academic pediatric and neonatal intensive care units. Attending pediatric and neonatal intensivists. We evaluated perceptions on four intensive care unit safety-related risk measures potentially affected by current duty-hour regulations: 1) attending physician and resident fatigue; 2) attending physician workload; 3) errors (self-reported rates by attending physicians or perceived resident error rates); and 4) safety culture. We also evaluated perceptions of how these risks would change with further duty-hour restrictions. We administered our survey between February and April 2010 to 688 eligible physicians, of whom 360 (52.3%) responded. Most believed that resident error rates were unchanged or worse (91.9%) and safety culture was unchanged or worse (84.4%) with current duty-hour regulations. Of respondents, 61.9% believed their own work-hours providing direct patient care increased and 55.8% believed they were more fatigued while providing direct patient care. Most (85.3%) perceived no increase in their own error rates currently, but in the scenario of further reduction in resident duty-hours, over half (53.3%) believed that safety culture would worsen and a significant proportion (40.3%) believed that their own error rates would increase. Pediatric intensivists do not perceive improved patient safety from current resident duty-hour restrictions. Policies to further restrict resident duty-hours should consider unintended consequences of worsening certain aspects of intensive care unit safety.

  7. Hands in medicine: understanding the impact of competency-based education on the formation of medical students' identities in the United States.

    Science.gov (United States)

    Gonsalves, Catherine; Zaidi, Zareen

    2016-01-01

    There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on 'doing the work of a physician' rather than identity formation and 'being a physician.' This study aims to understand how competency-based education impacts the development of a medical student's identity. Three ceramic models representing three core competencies 'medical knowledge,' 'patient care,' and 'professionalism' were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Students across all four years of medical school related to the 'professionalism' competency domain (50%). They reflected that 'being an empathetic physician' was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized 'professionalism' as a competency. Students perceive 'professionalism' as a competency that impacts their identity formation in the social role of 'being a doctor,' albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

  8. American Pro-Biofuel and Climate Policies: Impact on the Energy Choices of Brazil and the United States and the Carbon Footprint

    International Nuclear Information System (INIS)

    Chakravorty, Ujjayant; Hubert, Marie-Helene; Moreaux, Michel

    2010-01-01

    In this paper, a partial trade equilibrium model is developed to explore the impacts of US energy policies on the use and trade of first-generation biofuels (ethanol) and second-generation biofuels (ligno-cellulosic ethanol) in the United-States and Brazil. In addition, we investigate their impacts on direct and indirect carbon emissions. The first policy is the biofuels mandatory target. The second defines a cap on carbon emissions. Our study reveals that the biofuels mandatory target encourages ligno-cellulosic ethanol production, reductions in carbon emissions being marginal. The second policy increases energy prices leading to a decrease in energy consumption as well as in direct carbon emissions. However, this policy has a significant impact on deforestation in Brazil resulting in a rise in indirect carbon emissions. The biofuels subsidy needed to reach the mandatory target amounts to US $ 1.1 per gallon. The US carbon tax reaches US $ 120 per ton equivalent carbon. A differential tax is imposed on gasoline, ethanol and ligno-cellulosic ethanol based on the carbon content. It is respectively equal to US $ 0.38, US $ 0.204 and US $ 0.024

  9. The impact of kin availability, parental religiosity, and nativity on fertility differentials in the late 19th-century United States.

    Science.gov (United States)

    Hacker, J David; Roberts, Evan

    2017-12-01

    Most quantitative research on fertility decline in the United States ignores the potential impact of cultural and familial factors. We rely on new complete-count data from the 1880 U.S. census to construct couple-level measures of nativity/ethnicity, religiosity, and kin availability. We include these measures with a comprehensive set of demographic, economic, and contextual variables in Poisson regression models of net marital fertility to assess their relative importance. We construct models with and without area fixed effects to control for unobserved heterogeneity. All else being equal, we find a strong impact of nativity on recent net marital fertility. Fertility differentials among second generation couples relative to the native-born white population of native parentage were in most cases less than half of the differential observed among first generation immigrants, suggesting greater assimilation to native-born American childbearing norms. Our measures of parental religiosity and familial propinquity indicated a more modest impact on marital fertility. Couples who chose biblical names for their children had approximately 3% more children than couples relying on secular names while the presence of a potential mother-in-law in a nearby households was associated with 2% more children. Overall, our results demonstrate the need for more inclusive models of fertility behavior that include cultural and familial covariates.

  10. Scatter radiation intensities around a clinical digital breast tomosynthesis unit and the impact on radiation shielding considerations

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Kai, E-mail: kyang11@mgh.harvard.edu; Li, Xinhua; Liu, Bob [Division of Diagnostic Imaging Physics, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114 (United States)

    2016-03-15

    Purpose: To measure the scattered radiation intensity around a clinical digital breast tomosynthesis (DBT) unit and to provide updated data for radiation shielding design for DBT systems with tungsten-anode x-ray tubes. Methods: The continuous distribution of scattered x-rays from a clinical DBT system (Hologic Selenia Dimensions) was measured within an angular range of 0°–180° using a linear-array x-ray detector (X-Scan 0.8f3-512, Detection Technology, Inc., Finland), which was calibrated for the x-ray spectrum range of the DBT unit. The effects of x-ray field size, phantom size, and x-ray kVp/filter combination were investigated. Following a previously developed methodology by Simpkin, scatter fraction was determined for the DBT system as a function of angle around the phantom center. Detailed calculations of the scatter intensity from a DBT system were demonstrated using the measured scatter fraction data. Results: For the 30 and 35 kVp acquisition, the scatter-to-primary-ratio and scatter fraction data closely matched with data previously measured by Simpkin. However, the measured data from this study demonstrated the nonisotropic distribution of the scattered radiation around a DBT system, with two strong peaks around 25° and 160°. The majority scatter radiation (>70%) originated from the imaging detector assembly, instead of the phantom. With a workload from a previous survey performed at MGH, the scatter air kerma at 1 m from the phantom center for wall/door is 1.76 × 10{sup −2} mGy patient{sup −1}, for floor is 1.64 × 10{sup −1} mGy patient{sup −1}, and for ceiling is 3.66 × 10{sup −2} mGy patient{sup −1}. Conclusions: Comparing to previously measured data for mammographic systems, the scatter air kerma from Holgoic DBT is at least two times higher. The main reasons include the harder primary beam with higher workload (measured with total mAs/week), added tomosynthesis acquisition, and strong small angle forward scattering. Due to the

  11. Impact of flow induced vibration acoustic loads on the design of the Laguna Verde Unit 2 steam dryer

    International Nuclear Information System (INIS)

    Forsyth, D. R.; Wellstein, L. F.; Theuret, R. C.; Han, Y.; Rajakumar, C.; Amador C, C.; Sosa F, W.

    2015-09-01

    Industry experience with Boiling Water Reactors (BWRs) has shown that increasing the steam flow through the main steam lines (MSLs) to implement an extended power up rate (EPU) may lead to amplified acoustic loads on the steam dryer, which may negatively affect the structural integrity of the component. The source of these acoustic loads has been found to be acoustic resonance of the side branches on the MSLs, specifically, coupling of the vortex shedding frequency and natural acoustic frequency of safety relief valves (SRVs). The resonance that results from this coupling can contribute significant acoustic energy into the MSL system, which may propagate upstream into the reactor pressure vessel steam dome and drive structural vibration of steam dryer components. This can lead to high-cycle fatigue issues. Lock-in between the vortex shedding frequency and SRV natural frequency, as well as the ability for acoustic energy to propagate into the MSL system, are a function of many things, including the plant operating conditions, geometry of the MSL/SRV junction, and placement of SRVs with respect to each other on the MSLs. Comision Federal de Electricidad and Westinghouse designed, fabricated, and installed acoustic side branches (ASBs) on the MSLs which effectively act in the system as an energy absorber, where the acoustic standing wave generated in the side-branch is absorbed and dissipated inside the ASB. These ASBs have been very successful in reducing the amount of acoustic energy which propagates into the steam dome. In addition, modifications to the Laguna Verde Nuclear Power Plant Unit 2 steam dryer have been completed to reduce the stress levels in critical locations in the dryer. The objective of this paper is to describe the acoustic side branch concept and the design iterative processes that were undertaken at Laguna Verde Unit 2 to achieve a steam dryer design that meets the guidelines of the American Society of Mechanical Engineers, Boiler and Pressure

  12. Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection.

    Science.gov (United States)

    Lam, Barbara C C; Lee, Josephine; Lau, Y L

    2004-11-01

    Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this study was to assess the frequency and nature of patient contacts in neonatal intensive care units and observe the compliance and technique of hand hygiene among HCWs before and after the implementation of a multimodal intervention program. The nature and frequency of patient contacts, the hand hygiene compliance, and hand-washing techniques of HCWs were observed unobtrusively to reflect the baseline compliance and to investigate factors for noncompliance. The intervention consisted of problem-based and task-orientated hand hygiene education, enhancement of minimal handling protocol and clustering of nursing care, liberal provision of alcohol-based hand antiseptic, improvement in hand hygiene facilities, ongoing regular hand hygiene audit, and implementation of health care-associated infection surveillance. The observational study was repeated 6 months after the completion of the intervention program, which extended over 1-year period. Overall hand hygiene compliance increased from 40% to 53% before patient contact and 39% to 59% after patient contact. More marked improvement was observed for high-risk procedures (35%-60%). The average number of patient contacts also decreased from 2.8 to 1.8 per patient per hour. There was improvement in most aspects of hand-washing technique in the postintervention stage. The health care-associated infection rate decreased from 11.3 to 6.2 per 1000 patient-days. A problem-based and task-orientated education program can improve hand hygiene compliance. Enhancement of minimal handling and clustering of nursing procedures reduced the total patient contact episodes, which could help to overcome the major barrier of time constraints

  13. The warmer the weather, the more gram-negative bacteria - impact of temperature on clinical isolates in intensive care units.

    Directory of Open Access Journals (Sweden)

    Frank Schwab

    Full Text Available BACKGROUND: We investigated the relationship between average monthly temperature and the most common clinical pathogens causing infections in intensive care patients. METHODS: A prospective unit-based study in 73 German intensive care units located in 41 different hospitals and 31 different cities with total 188,949 pathogen isolates (102,377 Gram-positives and 86,572 Gram-negatives from 2001 to 2012. We estimated the relationship between the number of clinical pathogens per month and the average temperature in the month of isolation and in the month prior to isolation while adjusting for confounders and long-term trends using time series analysis. Adjusted incidence rate ratios for temperature parameters were estimated based on generalized estimating equation models which account for clustering effects. RESULTS: The incidence density of Gram-negative pathogens was 15% (IRR 1.15, 95%CI 1.10-1.21 higher at temperatures ≥ 20°C than at temperatures below 5°C. E. cloacae occurred 43% (IRR=1.43; 95%CI 1.31-1.56 more frequently at high temperatures, A. baumannii 37% (IRR=1.37; 95%CI 1.11-1.69, S. maltophilia 32% (IRR=1.32; 95%CI 1.12-1.57, K. pneumoniae 26% (IRR=1.26; 95%CI 1.13-1.39, Citrobacter spp. 19% (IRR=1.19; 95%CI 0.99-1.44 and coagulase-negative staphylococci 13% (IRR=1.13; 95%CI 1.04-1.22. By contrast, S. pneumoniae 35% (IRR=0.65; 95%CI 0.50-0.84 less frequently isolated at high temperatures. For each 5°C increase, we observed a 3% (IRR=1.03; 95%CI 1.02-1.04 increase of Gram-negative pathogens. This increase was highest for A. baumannii with 8% (IRR=1.08; 95%CI 1.05-1.12 followed by K. pneumoniae, Citrobacter spp. and E. cloacae with 7%. CONCLUSION: Clinical pathogens vary by incidence density with temperature. Significant higher incidence densities of Gram-negative pathogens were observed during summer whereas S. pneumoniae peaked in winter. There is increasing evidence that different seasonality due to physiologic changes underlies

  14. The warmer the weather, the more gram-negative bacteria - impact of temperature on clinical isolates in intensive care units.

    Science.gov (United States)

    Schwab, Frank; Gastmeier, Petra; Meyer, Elisabeth

    2014-01-01

    We investigated the relationship between average monthly temperature and the most common clinical pathogens causing infections in intensive care patients. A prospective unit-based study in 73 German intensive care units located in 41 different hospitals and 31 different cities with total 188,949 pathogen isolates (102,377 Gram-positives and 86,572 Gram-negatives) from 2001 to 2012. We estimated the relationship between the number of clinical pathogens per month and the average temperature in the month of isolation and in the month prior to isolation while adjusting for confounders and long-term trends using time series analysis. Adjusted incidence rate ratios for temperature parameters were estimated based on generalized estimating equation models which account for clustering effects. The incidence density of Gram-negative pathogens was 15% (IRR 1.15, 95%CI 1.10-1.21) higher at temperatures ≥ 20°C than at temperatures below 5°C. E. cloacae occurred 43% (IRR=1.43; 95%CI 1.31-1.56) more frequently at high temperatures, A. baumannii 37% (IRR=1.37; 95%CI 1.11-1.69), S. maltophilia 32% (IRR=1.32; 95%CI 1.12-1.57), K. pneumoniae 26% (IRR=1.26; 95%CI 1.13-1.39), Citrobacter spp. 19% (IRR=1.19; 95%CI 0.99-1.44) and coagulase-negative staphylococci 13% (IRR=1.13; 95%CI 1.04-1.22). By contrast, S. pneumoniae 35% (IRR=0.65; 95%CI 0.50-0.84) less frequently isolated at high temperatures. For each 5°C increase, we observed a 3% (IRR=1.03; 95%CI 1.02-1.04) increase of Gram-negative pathogens. This increase was highest for A. baumannii with 8% (IRR=1.08; 95%CI 1.05-1.12) followed by K. pneumoniae, Citrobacter spp. and E. cloacae with 7%. Clinical pathogens vary by incidence density with temperature. Significant higher incidence densities of Gram-negative pathogens were observed during summer whereas S. pneumoniae peaked in winter. There is increasing evidence that different seasonality due to physiologic changes underlies host susceptibility to different bacterial pathogens

  15. Impact of flow induced vibration acoustic loads on the design of the Laguna Verde Unit 2 steam dryer

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, D. R.; Wellstein, L. F.; Theuret, R. C.; Han, Y.; Rajakumar, C. [Westinghouse Electric Company LLC, Cranberry Township, PA 16066 (United States); Amador C, C.; Sosa F, W., E-mail: forsytdr@westinghouse.com [Comision Federal de Electricidad, Central Nucleoelectrica Laguna Verde, Km 42.5 Carretera Cardel-Nautla, 91680 Alto Lucero, Veracruz (Mexico)

    2015-09-15

    Industry experience with Boiling Water Reactors (BWRs) has shown that increasing the steam flow through the main steam lines (MSLs) to implement an extended power up rate (EPU) may lead to amplified acoustic loads on the steam dryer, which may negatively affect the structural integrity of the component. The source of these acoustic loads has been found to be acoustic resonance of the side branches on the MSLs, specifically, coupling of the vortex shedding frequency and natural acoustic frequency of safety relief valves (SRVs). The resonance that results from this coupling can contribute significant acoustic energy into the MSL system, which may propagate upstream into the reactor pressure vessel steam dome and drive structural vibration of steam dryer components. This can lead to high-cycle fatigue issues. Lock-in between the vortex shedding frequency and SRV natural frequency, as well as the ability for acoustic energy to propagate into the MSL system, are a function of many things, including the plant operating conditions, geometry of the MSL/SRV junction, and placement of SRVs with respect to each other on the MSLs. Comision Federal de Electricidad and Westinghouse designed, fabricated, and installed acoustic side branches (ASBs) on the MSLs which effectively act in the system as an energy absorber, where the acoustic standing wave generated in the side-branch is absorbed and dissipated inside the ASB. These ASBs have been very successful in reducing the amount of acoustic energy which propagates into the steam dome. In addition, modifications to the Laguna Verde Nuclear Power Plant Unit 2 steam dryer have been completed to reduce the stress levels in critical locations in the dryer. The objective of this paper is to describe the acoustic side branch concept and the design iterative processes that were undertaken at Laguna Verde Unit 2 to achieve a steam dryer design that meets the guidelines of the American Society of Mechanical Engineers, Boiler and Pressure

  16. The Impact of School Tobacco Policies on Student Smoking in Washington State, United States and Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Richard F. Catalano

    2010-02-01

    Full Text Available This paper measures tobacco polices in statewide representative samples of secondary and mixed schools in Victoria, Australia and Washington, US (N = 3,466 students from 285 schools and tests their association with student smoking. Results from confounder-adjusted random effects (multi-level regression models revealed that the odds of student perception of peer smoking on school grounds are decreased in schools that have strict enforcement of policy (odds ratio (OR = 0.45; 95% CI: 0.25 to 0.82; p = 0.009. There was no clear evidence in this study that a comprehensive smoking ban, harsh penalties, remedial penalties, harm minimization policy or abstinence policy impact on any of the smoking outcomes.

  17. Impact of month of birth on the development of autoimmune thyroid disease in the United Kingdom and Europe

    DEFF Research Database (Denmark)

    Hamilton, Alexander; Newby, Paul R; Carr-Smith, Jacqueline D

    2014-01-01

    detected in GD females or males across all three collections. In HT females from the OXAGEN AITD Caucasian Family Collection, slightly higher birth rates were detected in autumn (Walter's test statistic = 7.47, P = .024) however, this was not seen in the HT females from the case-control cohort. CONCLUSION......CONTEXT: Viral/bacterial infection is proposed as a trigger for the autoimmune thyroid diseases (AITD): Graves' disease (GD) and Hashimoto's thyroiditis (HT). Previous studies in European Caucasian AITD subjects found higher birth rates in the autumn/winter, suggesting those born in the autumn....../winter experience increased viral/bacterial exposure after birth, impacting upon immune system development and predisposing to AITD later in life. OBJECTIVE: Month of birth effects were investigated in three independent European Caucasian AITD datasets. DESIGN: Variation in GD and HT onset was compared across...

  18. AbobotulinumtoxinA in the management of cervical dystonia in the United Kingdom: a budget impact analysis

    Directory of Open Access Journals (Sweden)

    Abogunrin S

    2015-09-01

    Full Text Available Seye Abogunrin,1 Sarah Brand,2 Kamal Desai,3 Jerome Dinet,4 Sylvie Gabriel,5 Timothy Harrower61Meta Research, Evidera, London, UK; 2Health Economics, Evidera, Bethesda, MD, USA; 3Health Economics, Evidera, London, UK; 4Health Economics and Outcomes Research (Global, 5Global Market Access and Pricing, Ipsen Pharma, Boulogne-Billancourt, France; 6Royal Devon and Exeter NHS Foundation Trust, Exeter, UKBackground: Cervical dystonia (CD can be effectively managed by a combination of botulinum neurotoxin A (BoNT-A and conventional therapy (skeletal muscle relaxants and rehabilitative therapy, but the costs of different interventions in the UK vary.Methods: A budget impact model was developed from the UK payer perspective with a 5-year time horizon to evaluate the effects of changing market shares of abobotulinumtoxinA, nabotulinumtoxinA, and incobotulinumtoxinA, and best supportive care from the UK payer perspective. Epidemiological and resource use data were retrieved from the published literature and clinical expert opinion. Deterministic sensitivity analyses were performed to determine the parameters most influential on the budgetary findings under base case assumptions.Results: Under base case assumptions, an increased uptake of abobotulinumtoxinA showed an accumulated savings of £2,250,992 by year 5. Treatment per patient per year with onabotulinumtoxinA and incobotulinumtoxinA costs more when compared to treatment with abobotulinumtoxinA. One-way sensitivity analyses showed that the prevalence of CD, dose per injection of each of the BoNT-As, and time to reinjection of incobotulinumtoxinA and abobotulinumtoxinA influenced the base case findings most.Conclusion: There is potential for cost savings associated with the greater use of abobotulinumtoxinA rather than other BoNT-A treatments, permitting more patients to benefit more from effective BoNT-A treatment with a fixed budget. Keywords: cervical dystonia, torticollis, botulinum toxin A, budget

  19. Potential urban runoff impacts and contaminant distributions in shoreline and reservoir environments of Lake Havasu, southwestern United States.

    Science.gov (United States)

    Wilson, Doyle C

    2018-04-15

    Heavy metal, nutrient, and hydrocarbon levels in and adjacent to Lake Havasu, a regionally significant water supply reservoir with a highly controlled, dynamic flow regime, are assessed in relation to possible stormwater runoff impacts from an arid urban center. Shallow groundwater and sediment analyses from ephemeral drainage (wash) mouths that convey stormwater runoff from Lake Havasu City, Arizona to the reservoir, provided contaminant control points and correlation ties with the reservoir environment. Fine-grain sediments tend to contain higher heavy metal concentrations whereas nutrients are more evenly distributed, except low total organic carbon levels from young wash mouth surfaces devoid of vegetation. Heavy metal and total phosphate sediment concentrations in transects from wash mouths into the reservoir have mixed and decreasing trends, respectively. Both series may indicate chemical depositional influences from urban runoff, yet no statistically significant concentration differences occur between specific wash mouths and corresponding offshore transects. Heavy metal pollution indices of all sediments indicate no discernible to minor contamination, indicating that runoff impacts are minimal. Nevertheless, several heavy metal concentrations from mid-reservoir sediment sites increase southward through the length of the reservoir. Continual significant water flow through the reservoir may help to disperse locally derived runoff particulates, which could mix and settle down gradient with chemical loads from upriver sources and local atmospheric deposition. Incorporating the shoreline environment with the reservoir investigation provides spatial continuity in assessing contaminant sources and distribution patterns. This is particularly acute in the investigation of energetic, flow-through reservoirs in which sources may be overlooked if solely analyzing the reservoir environment. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. A stepwise approach for introducing numerical modeling in Environmental Engineering MSc unit: The impact of clear assessment criteria and detailed feedback

    Science.gov (United States)

    Rosolem, R.; Pritchard, J.

    2017-12-01

    An important aspect for the new generation of hydrologists and water resources managers is the understanding of hydrological processes through the application of numerical environmental models. Despite its importance, teaching numerical modeling subjects to young students in our MSc Water and Environment Management programme has been difficult, for instance, due to the wide range of student background and lack or poor contact with numerical modeling tools in the past. In previous years, this numerical skills concept has been introduced as a project assignment in our Terrestrial Hydrometeorology unit. However, previous efforts have shown non-optimal engagement by students with often signs of lack of interest or anxiety. Given our initial experience with this unit, we decided to make substantial changes to the coursework format with the aim to introduce a more efficient learning environment to the students. The proposed changes include: (1) a clear presentation and discussion of the assessment criteria at the beginning of the unit, (2) a stepwise approach in which students use our learning environment to acquire knowledge for individual components of the model step-by-step, and (3) access to timely and detailed feedback allowing for particular steps to be retraced or retested. In order to understand the overall impact on assessment and feedback, we carried out two surveys at the beginning and end of the module. Our results indicate a positive impact to student learning experience, as the students have clearly benefited from the early discussion on assignment criteria and appeared to have correctly identified the skills and knowledge required to carry out the assignment. In addition, we have observed a substantial increase in the quality of the reports. Our results results support that student engagement has increased since changes to the format of the coursework were introduced. Interestingly, we also observed a positive impact on the assignment to the final exam

  1. Evaluating the energy and CO2 emissions impacts of shifts in residential water heating in the United States

    International Nuclear Information System (INIS)

    Sanders, Kelly T.; Webber, Michael E.

    2015-01-01

    Water heating represented nearly 13% of 2010 residential energy consumption making it an important target for energy conservation efforts. The objective of this work is to identify spatially-resolved strategies for energy conservation, since little analysis has been done to identify how regional characteristics affect the energy consumed for water heating. We present a first-order thermodynamic analysis, utilizing ab initio calculations and regression methods, to quantify primary energy consumption and CO 2 emissions with regional specificity by considering by considering local electricity mixes, heat rates, solar radiation profiles, heating degrees days, and water heating unit sales for 27 regions of the US. Results suggest that shifting from electric towards natural gas or solar water heating offered primary energy and CO 2 emission reductions in most US regions, but these reductions varied considerably according to regional electricity mix and solar resources. We find that regions that would benefit most from technology transitions, are often least likely to switch due to limited economic incentives. Our results suggest that federal energy factor metrics, which ignore upstream losses in power generation, are insufficient in informing consumers about the energy performance of residential end use appliances. - Highlights: • US energy factor ratings for water heaters ignore upstream losses. • Switching from electric storage water heating reduces CO 2 emissions in most US regions. • Regions with greatest potential for CO 2 avoidance are least likely to shift technologies. • Benefits vary significantly according to climate and regional electricity fuel mix

  2. The impact of invisibility on the health of migrant farmworkers in the southeastern United States: a case study from georgia.

    Science.gov (United States)

    Bail, Kari M; Foster, Jennifer; Dalmida, Safiya George; Kelly, Ursula; Howett, Maeve; Ferranti, Erin P; Wold, Judith

    2012-01-01

    Migrant farmworkers represent one of the most marginalized and underserved populations in the United States. Acculturation theory cannot be easily mapped onto the transnational experience of migrant farmworkers, who navigate multiple physical and cultural spaces yearly, and who are not recognized by the state they constitute, "the Citizen's Other" (Kerber, 2009). This paper utilizes narrative analysis of a case study to illustrate, through the relationship of the narrator to migrant farmworkers and years of participant observation by the coauthors, how isolation from family and community, as well as invisibility within institutions, affect the health and well-being of migrant farmworkers in southeastern Georgia. Invisibility of farmworkers within institutions, such as health care, the educational system, social services, domestic violence shelters, and churches contribute to illness among farmworkers. The dominant American discourse surrounding immigration policy addresses the strain immigrants put on the social systems, educational system, and the health care system. Nurses who work with farmworkers are well positioned to bring the subjective experience of farmworkers to light, especially for those engaged with socially just policies. Those who contribute to the abundant agricultural produce that feeds Americans deserve the recognition upon which social integration depends.

  3. Potential impact of the growth hormone and other technology on the United States dairy industry by the year 2000.

    Science.gov (United States)

    Mix, L S

    1987-02-01

    The United States dairy industry is projected to go through a major transition by the 2000 with some regions experiencing more change than others. Population growth plus medical discoveries favorable to certain dairy products combined with strengthened marketing programs could increase consumption of milk equivalent from the present 66.3 to 72.1 million metric tons by the yr 2000. Ongoing genetic, feeding, and management improvements could raise average milk production per cow from the 1984 level of 5,680 kg to 7,425 kg by 2000. If growth hormone biotechnology is adopted, average production per cow could reach 9,281 kg by the 21st century. This could reduce US dairy cow numbers 30% from the present 11.1 million to 7.8 million by the yr 2000. Likewise, the dairy industry and others could expect approximately 92,500 fewer commercial dairy farms, a decrease of 51%. This would mean 195,000 fewer employees and 3.6 to 4.1 million fewer crop hectares would be required. A transition of this magnitude will require indepth planning by legislators, policy makers, university teaching, research, and extension personnel, agribusiness, industry representatives, and dairy producers to cope with the necessary adjustments.

  4. Impacts of different regulatory regimes in the unitization of production; Impactos dos diferentes regimes regulatorios na individualizacao da producao

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Vinicius Farias; Moreira, Robson Prates [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

    2012-07-01

    The unitization process is required in most regulatory models around the world when it identifies that a reservoir straddles to out of the contracted area. This procedure aims to ensure a greater exploitation of petroleum. In Brazil is no different; however there are still many ambiguities in this process. The introduction of new tax regimes in the country broadened the doubts, as we may have a reservoir straddling between concession, production sharing, assignment of rights areas and areas not yet contracted. The objective of the present paper is to explore the uncertainties that must be addressed by the oil and gas sector in order to ensure low legal, regulatory and fiscal risks in the oil industry. The main topics discussed are the rules for production allocation, reserves and expenditures, the ANP and PPSA roles' conflicts, restriction of parties' rights, adjustment of contractual rules and also mitigate or eliminate economic, financial and fiscal uncertainties. This article does not propose solutions to all lacks raised. (author)

  5. Impact of the mother-nurse partnership programme on mother and infant outcomes in paediatric cardiac intensive care unit.

    Science.gov (United States)

    Uhm, Ju-Yeon; Kim, Hee Soon

    2018-04-04

    To identify the effects of a mother-nurse partnership programme based on the core components of information sharing, negotiation and participation in care. Specifically, we examined the programme's effects on parental satisfaction, parental self-efficacy, perceived partnership and anxiety, as well as infants' time to reach full oral feeding and length of postoperative hospital stay, following cardiac surgery on infants at a paediatric intensive care unit with a restrictive visiting policy. Quasi-experimental study. An analysis of covariance was used to investigate between-group differences while ensuring homogeneity. A paediatric cardiac ICU. Parental satisfaction, parental self-efficacy, perceived partnership and anxiety. Data from 37 and 36 mothers in the control and experimental groups respectively, were analysed. Compared with controls, experimental group mothers reported significantly higher parental satisfaction (F = 39.29, p partnership (F = 62.30, p < .001) and lower anxiety (F = 12.93, p < .001), upon transfer to the ward. Infant outcomes did not differ between the groups. This programme appears to facilitate collaboration between nurses and mothers and positively influences mothers' emotional and cognitive outcomes following infants' cardiac surgery. Copyright © 2018. Published by Elsevier Ltd.

  6. Impact of stylolitization on diagenesis of a Lower Cretaceous carbonate reservoir from a giant oilfield, Abu Dhabi, United Arab Emirates

    Science.gov (United States)

    Paganoni, Matteo; Al Harthi, Amena; Morad, Daniel; Morad, Sadoon; Ceriani, Andrea; Mansurbeg, Howri; Al Suwaidi, Aisha; Al-Aasm, Ihsan S.; Ehrenberg, Stephen N.; Sirat, Manhal

    2016-04-01

    Bed-parallel stylolites are a widespread diagenetic feature in Lower Cretaceous limestone reservoirs, Abu Dhabi, United Arab Emirates (UAE). Diagenetic calcite, dolomite, kaolin and small amounts of pyrite, fluorite, anhydrite and sphalerite occur along and in the vicinity of the stylolites. Petrographic observations, negative δ18OVPDB, fluid inclusion microthermometry, and enrichment in 87Sr suggest that these cements have precipitated from hot basinal brines, which migrated along the stylolites and genetically related microfractures (tension gashes). Fluid migration was presumably related to lateral tectonic compression events related to the foreland basin formation. The low solubility of Al3 + in formation waters suggests that kaolin precipitation was linked to derivation of organic acids during organic matter maturation, probably in siliciclastic source rocks. The mass released from stylolitization was presumably re-precipitated as macro- and microcrystalline calcite cement in the host limestones. The flanks of the oilfield (water zone) display more frequent presence and higher amplitude of stylolites, lower porosity and permeability, higher homogenization temperatures and more radiogenic composition of carbonates compared to the crest (oil zone). This indicates that oil emplacement retards diagenesis. This study demonstrates that stylolitization plays a crucial role in fluid flow and diagenesis of carbonate reservoirs during basin evolution.

  7. Health Assimilation among Hispanic Immigrants in the United States: The Impact of Ignoring Arrival-cohort Effects.

    Science.gov (United States)

    Hamilton, Tod G; Palermo, Tia; Green, Tiffany L

    2015-12-01

    A large literature has documented that Hispanic immigrants have a health advantage over their U.S.-born counterparts upon arrival in the United States. Few studies, however, have disentangled the effects of immigrants' arrival cohort from their tenure of U.S. residence, an omission that could produce imprecise estimates of the degree of health decline experienced by Hispanic immigrants as their U.S. tenure increases. Using data from the 1996-to-2014 waves of the March Current Population Survey, we show that the health (i.e., self-rated health) of Hispanic immigrants varies by both arrival cohort and U.S. tenure for immigrants hailing from most of the primary sending countries/regions of Hispanic immigrants. We also find evidence that acculturation plays an important role in determining the health trajectories of Hispanic immigrants. With respect to self-rated health, however, our findings demonstrate that omitting arrival-cohort measures from health assimilation models may result in overestimates of the degree of downward health assimilation experienced by Hispanic immigrants. © American Sociological Association 2015.

  8. Childhood maltreatment among Hispanic women in the United States: an examination of subgroup differences and impact on psychiatric disorder.

    Science.gov (United States)

    Warner, Lynn A; Alegría, Margarita; Canino, Glorisa

    2012-05-01

    Prevalence rates of childhood maltreatment among Hispanic women in the United States are presented separately for nativity status and ethnic origin subgroups, and the associations between different types of maltreatment and the development of anxiety and depressive disorders are examined. Analyses used self-report data from 1,427 Hispanic women who participated in the National Latino and Asian American Survey. Foreign-born Hispanic women compared to U.S.-born Hispanic women reported significantly lower rates of sexual assault and witnessing interpersonal violence, and a significantly higher rate of being beaten. Ethnic subgroups reported similar rates of maltreatment, with the exception of rape. Bivariate analyses were remarkably consistent in that regardless of nativity status or ethnic subgroup, each type of maltreatment experience increased the risk of psychiatric disorder. In multivariate models controlling for all types of victimization and proxies of acculturation, having been beaten and witnessing interpersonal violence remained significant predictors of both disorders, but sexual abuse increased risk of anxiety only. A significant interaction effect of family cultural conflict and witnessing violence on anxiety provided very limited support for the hypothesis that acculturation moderates the influence of maltreatment on mental health outcomes. Implications for culturally relevant prevention and intervention approaches are presented.

  9. Study the impact of rainfall on the United Arab Emirates dams using remote sensing and image processing techniques

    Science.gov (United States)

    Al Marzouqi, Fatima A.; Al Besher, Shaikha A.; Al Mansoori, Saeed H.

    2017-10-01

    The United Arab Emirates (UAE) has given great attention to the environment and sustainable development through applications of best practices of global standards that ensure optimal investment in natural resources. Since the UAE is located in an arid region which is known as dry, sandy and get a small amount of rainfall, thus the water resources are limited and accordingly, the government has initiated an integrated water resources management (IWRM) strategy to meet the increasing demands of water. Dams are considered as one of the important strategies that are suitable for this arid region. An event of rainfall if between heavy to severe in a short duration could cause flash floods and damages to population centers and areas of agriculture nearby. To prevent that from happening, several dams and barriers were built to protect human life and infrastructure. Besides contribution to enhance the water resources and use them optimally to irrigate the growing agricultural areas across the country. Geographically, most of the dams were located in the northern and eastern part of the UAE, around mountainous areas. This study aims to monitor the changes that occurred to five dams of the north-eastern region of the UAE during 2015 and 2016 through the use of remote sensing technology of optical images captured by "DubaiSat-2". The segmentation approach utilized in this study is based on a band ratio technique called Normalized Difference Water Index (NDWI). The experimental results revealed that the proposed approach is efficient in detecting dams from multispectral satellite images.

  10. Impacts of different characterizations of large-scale background on simulated regional-scale ozone over the continental United States

    Science.gov (United States)

    Hogrefe, Christian; Liu, Peng; Pouliot, George; Mathur, Rohit; Roselle, Shawn; Flemming, Johannes; Lin, Meiyun; Park, Rokjin J.

    2018-03-01

    This study analyzes simulated regional-scale ozone burdens both near the surface and aloft, estimates process contributions to these burdens, and calculates the sensitivity of the simulated regional-scale ozone burden to several key model inputs with a particular emphasis on boundary conditions derived from hemispheric or global-scale models. The Community Multiscale Air Quality (CMAQ) model simulations supporting this analysis were performed over the continental US for the year 2010 within the context of the Air Quality Model Evaluation International Initiative (AQMEII) and Task Force on Hemispheric Transport of Air Pollution (TF-HTAP) activities. CMAQ process analysis (PA) results highlight the dominant role of horizontal and vertical advection on the ozone burden in the mid-to-upper troposphere and lower stratosphere. Vertical mixing, including mixing by convective clouds, couples fluctuations in free-tropospheric ozone to ozone in lower layers. Hypothetical bounding scenarios were performed to quantify the effects of emissions, boundary conditions, and ozone dry deposition on the simulated ozone burden. Analysis of these simulations confirms that the characterization of ozone outside the regional-scale modeling domain can have a profound impact on simulated regional-scale ozone. This was further investigated by using data from four hemispheric or global modeling systems (Chemistry - Integrated Forecasting Model (C-IFS), CMAQ extended for hemispheric applications (H-CMAQ), the Goddard Earth Observing System model coupled to chemistry (GEOS-Chem), and AM3) to derive alternate boundary conditions for the regional-scale CMAQ simulations. The regional-scale CMAQ simulations using these four different boundary conditions showed that the largest ozone abundance in the upper layers was simulated when using boundary conditions from GEOS-Chem, followed by the simulations using C-IFS, AM3, and H-CMAQ boundary conditions, consistent with the analysis of the ozone fields

  11. The impact of normal saline on the incidence of exposure keratopathy in patients hospitalized in intensive care units

    Directory of Open Access Journals (Sweden)

    Zohreh Davoodabady

    2018-01-01

    Full Text Available Background: Patients in the intensive care unit (ICU have impaired ocular protective mechanisms that lead to an increased risk of ocular surface diseases including exposure keratopathy (EK. This study was designed to evaluate the effect of normal saline (NS on the incidence and severity of EK in critically ill patients. Materials and Methods: This single-blind randomized controlled trial was conducted on 50 patients admitted to ICUs. The participants were selected through purposive sampling. One eye of each patient, randomly was allocated to intervention group (standard care with NS and the other eye to control group (standard care. In each patient, one eye (control group randomly received standard care and the other eye (intervention group received NS every 6 h in addition to standard care. The presence and severity of keratopathy was assessed daily until day 7 of hospitalization using fluorescein and an ophthalmoscope with cobalt blue filter. Chi-square test was used for statistical analysis in SPSS software. Results: Before the study ( first day there were no statistically significant differences in the incidence and severity of EK between groups. Although, the incidence and severity of EK after the study (7th day was higher in the intervention group compared to the control group, their differences were not statistically significant. Although, the incidence and severity of EK, from the 1st day until the 7th, increased within both groups, this increase was statistically significant only in the intervention (NS group. Conclusions: The use of NS as eye care in patients hospitalized in ICUs can increase the incidence and severity of EK and is not recommended.

  12. ASAS Centennial Paper: Impact of animal science research on United States goat production and predictions for the future.

    Science.gov (United States)

    Sahlu, T; Dawson, L J; Gipson, T A; Hart, S P; Merkel, R C; Puchala, R; Wang, Z; Zeng, S; Goetsch, A L

    2009-01-01

    Goat research in the United States has increased but at a rate less than that in production. Research on goat meat includes nutritional quality, packaging, color, sensory characteristics, and preslaughter management. Goat skins have value for leather, but quality of goat leather has not been extensively studied. Research in the production, quality, antibiotic residues, and sensory characteristics of goat milk and its products has aided development of the US dairy goat industry. Limited progress has been made in genetic improvement of milk or meat production. There is need to explore applications of genomics and proteomics and improve consistency in texture and functionality of goat cheeses. New goat meat and milk products are needed to increase demand and meet the diverse tastes of the American public. Despite research progress in control of mohair and cashmere growth, erratic prices and sale of raw materials have contributed to further declines in US production. Innovative and cooperative ventures are needed for profit sharing up to the consumer level. Internal parasites pose the greatest challenge to goat production in humid areas largely because of anthelmintic resistance. Study of alternative controls is required, including immunity enhancement via nutrition, vaccination, pasture management such as co-grazing with cattle, and genetic resistance. Similarly, the importance of health management is increasing related in part to a lack of effective vaccines for many diseases. Nutrition research should address requirements for vitamins and minerals, efficiencies of protein utilization, adjusting energy requirements for nutritional plane, acclimatization, and grazing conditions, feed intake prediction, and management practices for rapid-growth production systems. Moreover, efficient technology transfer methods are needed to disseminate current knowledge and that gained in future research.

  13. Streamlined Approach for Environmental Restoration Plan for Corrective Action Unit 107: Low Impact Soil Sites, Nevada Test Site, Nevada

    International Nuclear Information System (INIS)

    2008-01-01

    This Streamlined Approach for Environmental Restoration Plan covers activities associated with Corrective Action Unit (CAU) 107 of the Federal Facility Agreement and Consent Order (FFACO, 1996 (as amended February 2008)). CAU 107 consists of the following Corrective Action Sites (CASs) located in Areas 1, 2, 3, 4, 5, 9, 10, and 18 of the Nevada Test Site. (1) CAS 01-23-02, Atmospheric Test Site - High Alt; (2) CAS 02-23-02, Contaminated Areas (2); (3) CAS 02-23-03, Contaminated Berm; (4) CAS 02-23-10, Gourd-Amber Contamination Area; (5) CAS 02-23-11, Sappho Contamination Area; (6) CAS 02-23-12, Scuttle Contamination Area; (7) CAS 03-23-24, Seaweed B Contamination Area; (8) CAS 03-23-27, Adze Contamination Area; (9) CAS 03-23-28, Manzanas Contamination Area; (10) CAS 03-23-29, Truchas-Chamisal Contamination Area; (11) CAS 04-23-02, Atmospheric Test Site T4-a; (12) CAS 05-23-06, Atmospheric Test Site; (13) CAS 09-23-06, Mound of Contaminated Soil; (14) CAS 10-23-04, Atmospheric Test Site M-10; and (15) CAS 18-23-02, U-18d Crater (Sulky). Based on historical documentation, personnel interviews, site process knowledge, site visits, photographs, engineering drawings, field screening, analytical results, and the results of data quality objectives process (Section 3.0), closure in place with administrative controls or no further action will be implemented for CAU 107. CAU 107 closure activities will consist of verifying that the current postings required under Title 10 Code of Federal Regulations (CFR) Part 835 are in place and implementing use restrictions (URs) at two sites, CAS 03-23-29 and CAS 18-23-02. The current radiological postings combined with the URs are adequate administrative controls to limit site access and worker dose

  14. Streamlined Approach for Environmental Restoration Plan for Corrective Action Unit 107: Low Impact Soil Sites, Nevada Test Site, Nevada

    International Nuclear Information System (INIS)

    2009-01-01

    This Streamlined Approach for Environmental Restoration Plan covers activities associated with Corrective Action Unit (CAU) 107 of the Federal Facility Agreement and Consent Order (1996 (as amended February 2008)). CAU 107 consists of the following Corrective Action Sites (CASs) located in Areas 1, 2, 3, 4, 5, 9, 10, and 18 of the Nevada Test Site. (sm b ullet) CAS 01-23-02, Atmospheric Test Site - High Alt(sm b ullet) CAS 02-23-02, Contaminated Areas (2)(sm b ullet) CAS 02-23-03, Contaminated Berm(sm b ullet) CAS 02-23-10, Gourd-Amber Contamination Area(sm b ullet) CAS 02-23-11, Sappho Contamination Area(sm b ullet) CAS 02-23-12, Scuttle Contamination Area(sm b ullet) CAS 03-23-24, Seaweed B Contamination Area(sm b ullet) CAS 03-23-27, Adze Contamination Area(sm b ullet) CAS 03-23-28, Manzanas Contamination Area(sm b ullet) CAS 03-23-29, Truchas-Chamisal Contamination Area(sm b ullet) CAS 04-23-02, Atmospheric Test Site T4-a(sm b ullet) CAS 05-23-06, Atmospheric Test Site(sm b ullet) CAS 09-23-06, Mound of Contaminated Soil(sm b ullet) CAS 10-23-04, Atmospheric Test Site M-10(sm b ullet) CAS 18-23-02, U-18d Crater (Sulky) Based on historical documentation, personnel interviews, site process knowledge, site visits, photographs, engineering drawings, field screening, analytical results, and the results of data quality objectives process (Section 3.0), closure in place with administrative controls or no further action will be implemented for CAU 107.

  15. Acute renal failure requiring renal replacement therapy in the intensive care unit: impact on prognostic assessment for shared decision making.

    Science.gov (United States)

    Johnson, Robert F; Gustin, Jillian

    2011-07-01

    A 69-year-old female was receiving renal replacement therapy (RRT) for acute renal failure (ARF) in an intensive care unit (ICU). Consultation was requested from the palliative medicine service to facilitate a shared decision-making process regarding goals of care. Clinician responsibility in shared decision making includes the formulation and expression of a prognostic assessment providing the necessary perspective for a spokesperson to match patient values with treatment options. For this patient, ARF requiring RRT in the ICU was used as a focal point for preparing a prognostic assessment. A prognostic assessment should include the outcomes of most importance to a discussion of goals of care: mortality risk and survivor functional status, in this case including renal recovery. A systematic review of the literature was conducted to document published data regarding these outcomes for adult patients receiving RRT for ARF in the ICU. Forty-one studies met the inclusion criteria. The combined mean values for short-term mortality, long-term mortality, renal-function recovery of short-term survivors, and renal-function recovery of long-term survivors were 51.7%, 68.6%, 82.0%, and 88.4%, respectively. This case example illustrates a process for formulating and expressing a prognostic assessment for an ICU patient requiring RRT for ARF. Data from the literature review provide baseline information that requires adjustment to reflect specific patient circumstances. The nature of the acute primary process, comorbidities, and severity of illness are key modifiers. Finally, the prognostic assessment is expressed during a family meeting using recommended principles of communication.

  16. Do State-Based Policies Have an Impact on Teen Birth Rates and Teen Abortion Rates in the United States?

    Science.gov (United States)

    Chevrette, Marianne; Abenhaim, Haim Arie

    2015-10-01

    The United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely, as do policies on abortion and sex education. The objective of our study is to assess whether US state-level policies regarding abortion and sexual education are associated with different teen birth and teen abortion rates. We carried out a state-level (N = 51 [50 states plus the District of Columbia]) retrospective observational cross-sectional study, using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to study the association of different state policies with teen birth and teen abortion rates. The state-level mean birth rates, when stratifying between policies protective and nonprotective of teen births, were not statistically different-for sex education policies, 39.8 of 1000 vs 45.1 of 1000 (P = .2187); for mandatory parents' consent to abortion 45 of 1000, vs 38 of 1000 when the minor could consent (P = .0721); and for deterrents to abortion, 45.4 of 1000 vs 37.4 of 1000 (P = .0448). Political affiliation (35.1 of 1000 vs 49.6 of 1000, P births. Lower teen abortion rates were, however, associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent. While teen birth rates do not appear to be influenced by state-level sex education policies, state-level policies that restrict abortion appear to be associated with lower state teen abortion rates. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  17. The greenhouse gas and energy impacts of using wood instead of alternatives in residential construction in the United States

    International Nuclear Information System (INIS)

    Upton, Brad; Miner, Reid; Spinney, Mike; Heath, Linda S.

    2008-01-01

    Data developed by the Consortium for Research on Renewable Industrial Materials were used to estimate savings of greenhouse gas emissions and energy consumption associated with use of wood-based building materials in residential construction in the United States. Results indicate that houses with wood-based wall systems require 15-16% less total energy for non-heating/cooling purposes than thermally comparable houses employing alternative steel- or concrete-based building systems. Results for non-renewable energy consumption are essentially the same as those for total energy, reflecting the fact that most of the displaced energy is in fossil fuels. Over a 100-year period, net greenhouse gas emissions associated with wood-based houses are 20-50% lower than emissions associated with thermally comparable houses employing steel- or concrete-based building systems. Assuming 1.5 million single-family housing starts per year, the difference between wood and non-wood building systems represents about 9.6 Mt of CO 2 equivalents per year. The corresponding energy benefit associated with wood-based building materials is approximately 132 PJ year -1 . These estimates represent about 22% of embodied energy and 27% of embodied greenhouse gas emissions in the residential sector of the US economy. The results of the analysis are very sensitive to assumptions and uncertainties regarding the fate of forestland that is taken out of wood production due to reduced demand for wood, the continued production of co-products where demand for wood products is reduced, and the rate at which carbon accumulates in forests

  18. Impact and outcomes of nutritional support team intervention in patients with gastrointestinal disease in the intensive care unit.

    Science.gov (United States)

    Park, Yong Eun; Park, Soo Jung; Park, Yehyun; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho

    2017-12-01

    Nutritional support has become an important intervention for critically ill patients. Many studies have reported on the effects of nutritional support for the patients within the intensive care unit (ICU); however, no studies have specifically assessed patients with gastrointestinal diseases who may have difficulty absorbing enteral nutrition (EN) in the ICU.Sixty-two patients with gastrointestinal disease were admitted to the ICU between August 2014 and August 2016 at a single tertiary university hospital. We analyzed 2 different patient groups in a retrospective cohort study: those who received nutritional support team (NST) intervention and those who did not.Forty-four (71.0%) patients received nutritional support in ICU and 18 (29.0%) did not. Variables including male sex, high albumin or prealbumin level at the time of ICU admission, and short transition period into EN showed statistically significant association with lower mortality on the univariate analysis (all P < .05). Multivariate analysis revealed that longer length of hospital stay (P = .013; hazard ratio [HR], 0.972; 95% confidence interval [CI], 0.951-0.994), shorter transition into EN (P = .014; HR, 1.040; 95% CI, 1.008-1.072), higher prealbumin level (P = .049; HR, 0.988; 95% CI, 0.976-1.000), and NST intervention (P = .022; HR, 0.356; 95% CI, 0.147-0.862) were independent prognostic factors for lower mortality.In conclusion, NST intervention related to early initiated EN, and high prealbumin levels are beneficial to decrease mortality in the acutely ill patients with GI disease.

  19. Impact of dedicated space, dialysis equipment, and nursing staff on the transmission of hepatitis C virus in a hemodialysis unit of the middle east.

    Science.gov (United States)

    Saxena, Anil K; Panhotra, B R; Sundaram, D S; Naguib, Mohammed; Venkateshappa, C K; Uzzaman, Wahid; Mulhim, Khalifa Al

    2003-02-01

    Infection with the hepatitis C virus (HCV) is endemic in hemodialysis (HD) units, especially in Middle Eastern countries. The meticulous isolation policy recommended for patients with the hepatitis B virus (HBV) in an HD unit resulted in a significant drop in HBV incidence globally. This study was developed to prospectively investigate the impact of an identical isolation policy on incidence of nosocomial HCV infection in this HD unit of the Middle East. In phase I of the study, we retrospectively reviewed the records of 189 patients with a mean age of 47.5 +/- 11.4 years (range, 15-85 years) who were receiving maintenance HD from December 7, 1995, to December 6, 2000, for the mean duration of 73 +/- 6.3 months (range, 3-144 months) to record the prevalence of HCV. Factors such as blood transfusions and dialytic age (time span that patient has received dialysis since its initiation) implicated in transmission of HCV in the HD unit also were recorded. Phase II involved stringent isolation of anti-HCV positive patients detected during phase I through provision of dedicated space, dialysis equipment, and nursing staff from December 7, 2000, to December 6, 2001. Liver function and anti-HCV tests were repeated for all the 198 patients every 6 months to identify new HCV seroconversions. An HCV prevalence rate of 43.9% (83/189) and an annual HCV seroconversion rate of 6.8% were identified in this cohort. No significant association with blood tranfusion was observed. Eighty-three anti-HCV positive (43.9%) patients had a mean dialytic age of 48.5 +/- 14.2 months compared with 25.0 +/- 8.6 months among 106 (56.1%) anti-HCV negative patients (relative risk [RR], 1.89; 95% confidence interval [CI], 1.39-5.86; P <.001). Only 2 new HCV seroconversions (1.01% [2/198]) were identified. Evidently, the sharing of facilities in a high-risk HD environment for a prolonged dialytic age facilitates the nosocomial transmission of HCV infection. A significant decline of annual

  20. [Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review].

    Science.gov (United States)

    Servel, A-C; Rideau Batista Novais, A

    2016-09-01

    The quality of the environment is an essential point in the care of preterm newborns. The design of neonatal intensive care units (NICUs) (open-bay, single-patient room, single-family room) directly affects both the preterm newborns and their caregivers (parents, healthcare staff). The aim of this systematic review was to evaluate the impact of single-family rooms on the preterm newborn, its parents, and the staff. Single-family rooms improve outcome for the preterm newborn, with increasing parental involvement and better control of the environment (fewer inappropriate stimulations such as high levels of noise and illumination). This kind of NICU design also improves parental and staff satisfaction. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. The impact of hospital closures on geographical access: Evidence from four southeastern states of the United States

    Directory of Open Access Journals (Sweden)

    M.L. Burkey

    Full Text Available This paper examines the effects of hospital closures on geographical access by potential patients, using data from four southeastern U.S. states. Using optimization models designed to minimize the adverse effects of hospital closures, extensive computations are performed and the results are discussed. The effects of the closures on the rural areas is also investigated. Finally, the paper determines which hospitals are most likely among those to be closed assuming that up to 10% of the existing hospitals in each of the four states were to be shut down. The overall conclusion of the empirical findings is that while differences exist among the states, efficiency, coverage, and equality measures for geographical access do not suffer significantly if only a few hospitals are closed in each state, provided these closures are done optimally to minimize impact. Further, for efficiency objectives, decision makers can follow a sequential strategy for closures and still be guaranteed optimality. The paper also discusses the effects of hospital closures on equity and it examines whether or not rural areas are disproportionately affected by closures. Keywords: Health care, Access to health care, Proximity, Hospital closures, Location problems, Facility planning

  2. The impact of climate and CO{sub 2} changes on ecosystem dynamics of the continental United States

    Energy Technology Data Exchange (ETDEWEB)

    Ojima, D.S. [Colorado State Univ., Ft. Collins, CO (United States)

    1995-06-01

    The VEMAP study used three biogeochemical (BGC) models to investigate the impact of changes in climate and CO{sub 2} concentrations over the continental US. These models were Biome-BGC, CENTURY, and TEM. Differences among the BGC models and the climate scenarios (three different GCM-derived 2xCO{sub 2} climates were used) contributed equally to the variation in estimates of C dynamics under changing climate and CO,. The response of the individual biogeochemical models to increases in temperature and tp water stress are largely responsible for their behavior under climate change. All three models generally predict increases in C uptake when increases in temperature are not vastly greater than increases in precipitation, such as seen in the GFDL scenario. Differences in the biotic response to elevated CO{sub 2} determined the overall response of NPP and total system C storage due to differences on the manner in which plant C/N, transpiration, and photosynthesis are modified by the three different BGC models.

  3. Gun control and suicide: the impact of state firearm regulations in the United States, 1995-2004.

    Science.gov (United States)

    Rodríguez Andrés, Antonio; Hempstead, Katherine

    2011-06-01

    To empirically assess the impact of firearm regulation on male suicides. A negative binomial regression model was applied by using a panel of state level data for the years 1995-2004. The model was used to identify the association between several firearm regulations and male suicide rates. Our empirical analysis suggest that firearms regulations which function to reduce overall gun availability have a significant deterrent effect on male suicide, while regulations that seek to prohibit high risk individuals from owning firearms have a lesser effect. Restricting access to lethal means has been identified as an effective approach to suicide prevention, and firearms regulations are one way to reduce gun availability. The analysis suggests that gun control measures such as permit and licensing requirements have a negative effect on suicide rates among males. Since there is considerable heterogeneity among states with regard to gun control, these results suggest that there are opportunities for many states to reduce suicide by expanding their firearms regulations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Working Life Expectancy at Age 50 in the United States and the Impact of the Great Recession.

    Science.gov (United States)

    Dudel, Christian; Myrskylä, Mikko

    2017-12-01

    A key concern about population aging is the decline in the size of the economically active population. Working longer is a potential remedy. However, little is known about the length of working life and how it relates to macroeconomic conditions. We use the U.S. Health and Retirement Study for 1992-2011 and multistate life tables to analyze working life expectancy at age 50 and study the impact of the Great Recession in 2007-2009. Despite declines of one to two years following the recession, in 2008-2011, American men aged 50 still spent 13 years, or two-fifths of their remaining life, working; American women of the same age spent 11 years, or one-third of their remaining life, in employment. Although educational differences in working life expectancy have been stable since the mid-1990s, racial differences started changing after the onset of the Great Recession. Our results show that although Americans generally work longer than people in other countries, considerable subpopulation heterogeneity exists. We also find that the time trends are fluctuating, which may prove troublesome as the population ages. Policies targeting the weakest performing groups may be needed to increase the total population trends.

  5. The impact of local immigration enforcement policies on the health of immigrant hispanics/latinos in the United States.

    Science.gov (United States)

    Rhodes, Scott D; Mann, Lilli; Simán, Florence M; Song, Eunyoung; Alonzo, Jorge; Downs, Mario; Lawlor, Emma; Martinez, Omar; Sun, Christina J; O'Brien, Mary Claire; Reboussin, Beth A; Hall, Mark A

    2015-02-01

    We sought to understand how local immigration enforcement policies affect the utilization of health services among immigrant Hispanics/Latinos in North Carolina. In 2012, we analyzed vital records data to determine whether local implementation of section 287(g) of the Immigration and Nationality Act and the Secure Communities program, which authorizes local law enforcement agencies to enforce federal immigration laws, affected the prenatal care utilization of Hispanics/Latinas. We also conducted 6 focus groups and 17 interviews with Hispanic/Latino persons across North Carolina to explore the impact of immigration policies on their utilization of health services. We found no significant differences in utilization of prenatal care before and after implementation of section 287(g), but we did find that, in individual-level analysis, Hispanic/Latina mothers sought prenatal care later and had inadequate care when compared with non-Hispanic/Latina mothers. Participants reported profound mistrust of health services, avoiding health services, and sacrificing their health and the health of their family members. Fear of immigration enforcement policies is generalized across counties. Interventions are needed to increase immigrant Hispanics/Latinos' understanding of their rights and eligibility to utilize health services. Policy-level initiatives are also needed (e.g., driver's licenses) to help undocumented persons access and utilize these services.

  6. Economic Impact of Hearing Loss and Reduction of Noise-Induced Hearing Loss in the United States.

    Science.gov (United States)

    Neitzel, Richard L; Swinburn, Tracy K; Hammer, Monica S; Eisenberg, Daniel

    2017-01-01

    Hearing loss (HL) is pervasive and debilitating, and noise-induced HL is preventable by reducing environmental noise. Lack of economic analyses of HL impacts means that prevention and treatment remain a low priority for public health and environmental investment. This article estimates the costs of HL on productivity by building on established estimates for HL prevalence and wage and employment differentials between those with and without HL. We estimate that HL affects more than 13% of the working population. Not all HL can be prevented or treated, but if the 20% of HL resulting from excessive noise exposure were prevented, the economic benefit would be substantial-we estimate a range of $58 billion to $152 billion annually, with a core estimate of $123 billion. We believe this is a conservative estimate, because consideration of additional costs of HL, including health care and special education, would likely further increase the benefits associated with HL prevention. HL is costly and warrants additional emphasis in public and environmental health programs. This study represents an important first step in valuing HL prevention-in particular, prevention of noise-induced HL-where new policies and technologies appear promising.

  7. Estimating the Impact of Raising Prices and Eliminating Discounts on Cigarette Smoking Prevalence in the United States.

    Science.gov (United States)

    Marynak, Kristy L; Xu, Xin; Wang, Xu; Holmes, Carissa Baker; Tynan, Michael A; Pechacek, Terry

    2016-01-01

    The average retail price per pack of cigarettes is less than $6, which is substantially lower than the $10 per-pack target established in 2014 by the Surgeon General to reduce the smoking rate. We estimated the impact of three cigarette pricing scenarios on smoking prevalence among teens aged 12-17 years, young adults aged 18-25 years, and adults aged ≥26 years, by state: (1) $0.94 federal tax increase on cigarettes, as proposed in the fiscal year 2017 President's budget; (2) $10 per-pack retail price, allowing discounts; and (3) $10 per-pack retail price, eliminating discounts. We conducted Monte Carlo simulations to generate point estimates of reductions in cigarette smoking prevalence by state. We found that each price scenario would substantially reduce cigarette smoking prevalence. A $10 per-pack retail price eliminating discounts could result in 637,270 fewer smokers aged 12-17 years; 4,186,954 fewer smokers aged 18-25 years; and 7,722,460 fewer smokers aged ≥26 years. Raising cigarette prices and eliminating discounts could substantially reduce cigarette smoking prevalence as well as smoking-related death and disease.

  8. Impact of etanercept on work and activity impairment in employed moderate to severe rheumatoid arthritis patients in the United States.

    Science.gov (United States)

    Hone, Devon; Cheng, Annie; Watson, Crystal; Huang, Baisong; Bitman, Bojena; Huang, Xing-Yue; Gandra, Shravanthi R

    2013-10-01

    To quantify the impact of etanercept on work and activity impairment in employed US patients with moderate to severe rheumatoid arthritis (RA). This prospective, observational, longitudinal study recruited RA patients initiating etanercept (50 mg/week) between January 2009 and March 2010. The Work Productivity and Activity Impairment Questionnaire (WPAI) and domestic productivity questionnaire were administered by telephone interviews at baseline and at 1, 2, 3, and 6 months after etanercept initiation. The human capital approach was used to estimate the costs of work impairment. Changes in WPAI measures were analyzed using Wilcoxon's signed rank test. RA patients (n = 204) initiating etanercept were a mean ± SD age of 46.6 ± 10.9 years and 72% were women. After 6 months, 153 patients continued treatment (continuers) and showed significant decreases in overall work impairment (41.9% at baseline versus 25.2% at 6 months; P work hours lost weekly due to RA (3.2 versus 0.8; P = 0.0001). The projected 12-month gain in work productivity for continuers was 284.5 hours per patient, equating to $3,233-22,533 depending on annual income level, which partially or completely offset the annual cost of etanercept ($20,190). Domestic productivity improved from 41.5% at baseline to 69.6% at 6 months (P work and activity impairment; the value of increased work productivity partially or completely offset the cost of treatment. Copyright © 2013 by the American College of Rheumatology.

  9. Visitor Preferences for Visual Changes in Bark Beetle-Impacted Forest Recreation Settings in the United States and Germany

    Science.gov (United States)

    Arnberger, Arne; Ebenberger, Martin; Schneider, Ingrid E.; Cottrell, Stuart; Schlueter, Alexander C.; von Ruschkowski, Eick; Venette, Robert C.; Snyder, Stephanie A.; Gobster, Paul H.

    2018-02-01

    Extensive outbreaks of tree-killing insects are increasing across forests in Europe and North America due to climate change and other factors. Yet, little recent research examines visitor response to visual changes in conifer forest recreation settings resulting from forest insect infestations, how visitors weigh trade-offs between physical and social forest environment factors, or how visitor preferences might differ by nationality. This study explored forest visitor preferences with a discrete choice experiment that photographically simulated conifer forest stands with varying levels of bark beetle outbreaks, forest and visitor management practices, and visitor use levels and compositions. On-site surveys were conducted with visitors to State Forest State Park in Colorado ( n = 200), Lake Bemidji State Park in Minnesota ( n = 228), and Harz National Park in Germany ( n = 208). Results revealed that the condition of the immediate forest surrounding was the most important variable influencing visitors' landscape preferences. Visitors preferred healthy mature forest stands and disliked forests with substantial dead wood. The number of visitors was the most important social factor influencing visitor landscape preferences. Differences in the influence of physical and social factors on visual preferences existed between study sites. Findings suggest that both visual forest conditions and visitor use management are important concerns in addressing landscape preferences for beetle-impacted forest recreation areas.

  10. The McDonaldization of appraisal? Doctors' views of the early impacts of medical revalidation in the United Kingdom.

    Science.gov (United States)

    Archer, Julian; Nunn, Suzanne; Regan de Bere, Sam

    2017-09-01

    Medical regulation is rapidly changing with claims that systems such as revalidation/relicensing will reassure the public. Yet the impact of such initiatives is unknown. Using the principles of efficiency, calculability, predictability and control through technology, identified by Ritzer, and exampled by the McDonalds business model, we analyzed interviews with doctors between May 2012-Dec 2013 which focused on doctor experiences of appraisal and revalidation in SW England. The research found significant changes in appraisals since the launch of revalidation in December 2012. Appraisal has been standardized with a list of supporting information that must be collected by doctors. The success of implementation is measured in the numbers of appraisals completed but less is known about the quality of the appraisal itself. Such efficiencies have been supported by IT systems that themselves might be at risk of driving the process. There are potential advantages to McDonaldization including appraisals available to all, not just for doctors working in the NHS, and a potentially more appetizing recipe for their completion. As yet a state of McAppraisal has not been reached; with a complete transfer of trust in the doctor to trust in the appraisal process within revalidation. However policymakers will need to continue to ensure that regulatory initiatives, such as revalidation, are not just a process for their own sake. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. An exploration of the impact of family background factors on the science achievement of Afro-Caribbean and African American students in the United States

    Science.gov (United States)

    Pinder, Patrice J.

    Ogbu and Simons (1998) defined voluntary immigrants as individuals who chose to migrate to the United States (U.S.). Involuntary immigrants are defined as individuals whose ancestors were brought to the U.S. by force (Obgu & Simons, 1998). There have been recent reports indicating that voluntary immigrants are outperforming involuntary immigrants (Fisher, 2005; Williams, Fleming, Jones, & Griffin, 2007). There seems to be a trend in voluntary immigrants exhibiting a higher academic achievement pattern than involuntary immigrants (Fisher, 2005; Rong & Preissle, 1998; Williams et al., 2007). However, the reason for the groups' differences in achievement has not been extensively explored. The primary objective of this research study was to explore the impact of family background on the academic achievement patterns of Afro-Caribbean and African American students in the United States. The study utilized two research designs; a causal-comparative and a correlational design. A questionnaire was distributed to a sample of eighty-seven high school students. Eighteen of the participants were Afro-Caribbean students, and sixty-seven were African American students. Chemistry test scores for the students were also provided. The results of the study indicated that Afro-Caribbean students outperformed African American students on the test of science achievement. The difference was statistically significant (t= 2.43, pstudents' family backgrounds. Moreover, the findings of this study suggest that the positive impact of arrival status on the first-generation of Afro-Caribbean immigrants may be influencing their children's academic success in science. The present study holds a few implications for parents and teachers of immigrant minority students. Additionally, the current researcher has offered several implications for future research on ethnicity, immigration pattern, parenting, and achievement.

  12. Impact of mobile intensive care unit use on total ischemic time and clinical outcomes in ST-elevation myocardial infarction patients - real-world data from the Acute Coronary Syndrome Israeli Survey.

    Science.gov (United States)

    Koifman, Edward; Beigel, Roy; Iakobishvili, Zaza; Shlomo, Nir; Biton, Yitschak; Sabbag, Avi; Asher, Elad; Atar, Shaul; Gottlieb, Shmuel; Alcalai, Ronny; Zahger, Doron; Segev, Amit; Goldenberg, Ilan; Strugo, Rafael; Matetzky, Shlomi

    2017-01-01

    Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units. There was a significant increase in rates of mobile intensive care unit utilization from 36% in 2000 to over 50% in 2010 ( pcare unit use were Killip>1 (odds ratio=1.32, pcare units benefitted from increased rates of primary reperfusion therapy (odds ratio=1.58, pcare unit benefitted from shorter median total ischemic time compared with non-mobile intensive care unit patients (175 (interquartile range 120-262) vs 195 (interquartile range 130-333) min, respectively ( pcare unit use was the most important predictor in achieving door-to-balloon time care unit group (odds ratio=0.79, 95% confidence interval (0.66-0.94), p=0.01). Among patients with ST-elevation myocardial infarction, the utilization of mobile intensive care units is associated with increased rates of primary reperfusion, a reduction in the time interval to reperfusion, and a reduction in one-year adjusted mortality.

  13. Impact of a National Controlled Donation After Circulatory Death (DCD) Program on Organ Donation in the United Kingdom: A 10-Year Study.

    Science.gov (United States)

    Hodgson, R; Young, A L; Attia, M A; Lodge, J P A

    2017-12-01

    Organ transplantation is the most successful treatment for some forms of organ failure, yet a lack of organs means many die on the waiting list. In the United Kingdom, the Organ Donation Taskforce was set up to identify barriers to organ donation and in 2008 released its first report (Organ Donation Taskforce Report; ODTR). This study assesses the success since the ODTR and examines the impact of the United Kingdom's controlled donation after circulatory death (DCD) program and the controversies surrounding it. There were 12 864 intended donation after brain death (DBD) or DCD donors from April 2004 to March 2014. When the 5 years preceding the ODTR was compared to the 5 years following, intended DCD donors increased 292% (1187 to 4652), and intended DBD donors increased 11% (3327 to 3698). Organs retrieved per intended DBD donor remained static (3.30 to 3.26), whereas there was a decrease in DCD (1.54 to 0.99) due to a large rise in donors who did not proceed to donation (325 to 2464). The majority of DCD donors who proceeded did so within 30 min from time of withdrawal. Our study suggests further work on converting eligible referrals to organ donation and exploring methods of converting DCD to DBD donors. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  14. [Cost effectiveness and budget impact analysis of inhaled nitric oxide in a neonatal unit from the perspective of the public health system].

    Science.gov (United States)

    Kilchemmann Fuentes, Carlos; Vallejos Vallejos, Carlos; Román Navarro, Andrés

    Inhaled nitric oxide (iNO) is currently the first-line therapy in severe hypoxaemic respiratory failure of the newborn. Most of regional neonatal centres in Chile do not have this therapeutic alternative. To determine the cost effectiveness of inhaled nitric oxide in the treatment of respiratory failure associated with pulmonary hypertension of the newborn compared to the usual care, including the transfer to a more complex unit. A clinical decision tree was designed from the perspective of Chilean Public Health Service. Incremental cost effectiveness rates (ICER) were calculated, deterministic sensitivity analysis was performed, and probabilistic budget impact was estimated using: TreeAge Pro Healthcare 2014 software. The iNO option leads to an increase in mean cost of $ 11.7 million Chilean pesos (€15,000) per patient treated, with an ICER compared with the usual care of $23 million pesos (€30,000) in case of death or ECMO avoided. By sensitising the results by incidence, it was found that from 7 cases and upwards treated annually, inhaled nitric oxide is less costly than the transfer to a more complex unit. From the perspective of a Chilean regional hospital, incorporating inhaled nitric oxide into the management of neonatal respiratory failure is the optimal alternative in most scenarios. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Changing climate, changing forests: the impacts of climate change on forests of the northeastern United States and eastern Canada

    Science.gov (United States)

    Rustad, Lindsey; Campbell, John; Dukes, Jeffrey S.; Huntington, Thomas; Lambert, Kathy Fallon; Mohan, Jacqueline; Rodenhouse, Nicholas

    2012-01-01

    Decades of study on climatic change and its direct and indirect effects on forest ecosystems provide important insights for forest science, management, and policy. A synthesis of recent research from the northeastern United States and eastern Canada shows that the climate of the region has become warmer and wetter over the past 100 years and that there are more extreme precipitation events. Greater change is projected in the future. The amount of projected future change depends on the emissions scenarios used. Tree species composition of northeast forests has shifted slowly in response to climate for thousands of years. However, current human-accelerated climate change is much more rapid and it is unclear how forests will respond to large changes in suitable habitat. Projections indicate significant declines in suitable habitat for spruce-fir forests and expansion of suitable habitat for oak-dominated forests. Productivity gains that might result from extended growing seasons and carbon dioxide and nitrogen fertilization may be offset by productivity losses associated with the disruption of species assemblages and concurrent stresses associated with potential increases in atmospheric deposition of pollutants, forest fragmentation, and nuisance species. Investigations of links to water and nutrient cycling suggest that changes in evapotranspiration, soil respiration, and mineralization rates could result in significant alterations of key ecosystem processes. Climate change affects the distribution and abundance of many wildlife species in the region through changes in habitat, food availability, thermal tolerances, species interactions such as competition, and susceptibility to parasites and disease. Birds are the most studied northeastern taxa. Twenty-seven of the 38 bird species for which we have adequate long-term records have expanded their ranges predominantly in a northward direction. There is some evidence to suggest that novel species, including pests and

  16. The impact of weather changes on air quality and health in the United States in 1994–2012

    Science.gov (United States)

    Jhun, Iny; Coull, Brent A; Schwartz, Joel; Hubbell, Bryan; Koutrakis, Petros

    2016-01-01

    Air quality is heavily influenced by weather conditions. In this study, we assessed the impact of long-term weather changes on air quality and health in the US during 1994–2012. We quantified past weather-related increases, or ‘weather penalty’, in ozone (O3) and fine particulate matter (PM2.5), and thereafter estimated the associated excess deaths. Using statistical regression methods, we derived the weather penalty as the additional increases in air pollution relative to trends assuming constant weather conditions (i.e., weather-adjusted trends). During our study period, temperature increased and wind speed decreased in most US regions. Nationally, weather-related 8 h max O3 increases were 0.18 ppb per year (95% CI: 0.06, 0.31) in the warm season (May–Octobe