Pesticide Effects on Orthopteroid Distribution in Southern Michigan Farmlands

The occulrence and abundance of 22 species of orthopteroids is compared for isolated farm yards surrounded by corn fields which were either treated or not treated with a pesticide combination consisting of the herbicides Sutan and AAtrex, and the insecticide Dyfonate. All 22 species were present in the untreated plots, whereas only 12 were recorded in the treated plots, a 45.5% reduction. Species characteristics determining the observed differences, in the order of decreasing importance, are: general abundance in non-treated areas, seasonal periodism, and vagility. More common species and fewer uncommon species were present in the treated areas, apparently because of the more diverse feeding habits of the former. Nearly all vernal species were absent from the treated areas, possibly because of direct mortality incurred at the time of pesticide application (spring). Those species with greater flight ability were better represented in the treated areas; evidently the corn fields to which the pesticides were applied formed an effective barrier that inhibited immigration of at least the short-winged or flightless species

Primary Health Care: a strategic framework for the prevention and control of chronic non-communicable disease

In 2014, chronic, non-communicable diseases (NCDs) represent the leading causes of global mortality and disability. Government-level concern, and resulting policy changes, are manifesting. However, there continues to be a paucity of guiding frameworks for legislative measures. The surge of NCDs will require strong and effective governance responses, particularly in low and middle-income countries. Simultaneously following the 2008 World Health Report, there has recently been renewed interest in Primary Health Care (PHC) and its core principles. With this, has come strengthened support for revitalizing this approach, which aims for equitable and cost-effective population-health attainment. In this light and reflecting recent major global reports, declarations and events, we propose and critique a PHC approach to NCDs, highlighting PHC, with its core themes, as a valuable guiding framework for health promotion and policy addressing this group of diseases

Educating Nurses How to Critique Research Reports

When bedside acute care nurses support their clinical practice with current best evidence, patient outcomes improve. Most bedside acute care nurses base their clinical decision-making on tradition and not the application of evidence based practice (EBP). The ability to appraise research is a critical component in the application of EBP and best care practices. The purpose of the DNP project was to obtain 5 content experts\u27 evaluations of an education module for bedside nurses on how to analyze a research report, complete a literature review, and create a table of evidence (TOE). The theoretical framework guiding the project was the Advancing Research and Clinical Practice through Close Collaboration (ARCC) Model, which supports the integration of research in clinical practice. The content experts provided qualitative, summative evaluations to strengthen the content. Recommendations included adding information to the content of the module that would identify the differences in analyzing quantitative and qualitative research, providing more information related to the 51 criteria of the RAC used to guide nurses when analyzing a research article, and providing a script and talking points to assist other facilitators when implementing the module. A final suggestion by the experts included presenting the EBP module in two parts: part 1, how to analyze an article and part 2, how to pool the data. The project has the potential to improve nurses\u27 knowledge and the application of evidence based practice to enhance social change through improved clinical outcomes for patients

Can systemic administration of drag reducing agents reduce the risk of metastasizing after cancer surgery? A hydrodynamics based hypothesis

The human blood and lymphatic systems serve as transport media for circulating tumor cells. Hydrodynamic analysis suggests that the systemic administration of drag-reducing agents (DRA) in nanomolar concentrations may reduce the risk of metastasizing of circulating tumor cells. After testing this hypothesis on animal models, it could become a new complementary post-operative treatment for cancer patients or even replace classical cancer aftercare for patients with severe intolerance against chemo- or radio-therapy. Our approach is based on the following considerations:- Circulating tumor cells need for settling down a favorable environment in terms of nutrition and after settling also in its first stage of development an extra nutrient supply in order to survive and grow finally into the interstice.- The attachment of circulating tumor cells therefore tends to occur at sites in the human circulatory system characterized by localized turbulence, which enhances the mass transfer of nutrients, e.g., at sites of vessel branching and bending with plasma skimming.- Also restrictions to blood flow, such as plaques (atherosclerosis), red blood cell (RBC) rouleaux, and even tumor cells in its first stage of development attached to the inner vessel wall may produce local vortices that increase mass transfer, i.e., food supply.- DRA have the ability to smooth (laminarise) localized turbulence in the circulatory system and to reduce mass transfer. The systemic administration of DRA could therefore serve in a first step to defuse potential settling points, i.e., to make them harmless.- Depriving freshly settled down tumor cells of their required nutrient levels should therefore in a second step reduce the probability of creating metastatic tumors, and may even lead to its starvation-induced death before they grow into the interstice.In the first part of our essay we demonstrate how flow constrictions decrease the mean blood flow velocity, wall shear rates, and Reynolds numbers respectively, and increase the friction factor.Experimentally derived apparent viscosity data from literature will be used to determine the probability of RBC rouleaux formation. This is of importance since RBC rouleaux are typically associated with turbulent blood flow patterns. An increase in apparent viscosity at low flow rates will be attributed to the formation of RBC rouleaux.In part two we discuss the application of the Lockhart/Martinelli method to determine the pressure drop in blood vessels. The objective is to determine a mass transfer coefficient characterizing the mass transfer between the center and the wall of both healthy and constricted blood vessels. This coefficient indicates the nutrient supply available to tumor cells in its first stage of development under different flow conditions and shows the effect of administration of DRA.Our hydrodynamic approach contrasts with previous studies of the possible benefits of DRA administration, which were focused on improving blood supply. We emphasize the reduction of the mass transfer rate as a tool to withhold turbulence induced supplementary food supply to circulating tumor cells in the process of settling and in its first stage of development.Due to the hypothetical character of our approach and the possibility of unexpected side effects when administrating DRA (including their mechanical degradation products) animal models are indispensable before clinical trials

Does improved functional performance help to reduce urinary incontinence in institutionalized older women? a multicenter randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>Urinary incontinence (UI) is a major problem in older women. Management is usually restricted to dealing with the consequences instead of treating underlying causes such as bladder dysfunction or reduced mobility.</p> <p>The aim of this multicenter randomized controlled trial was to compare a group-based behavioral exercise program to prevent or reduce UI, with usual care. The exercise program aimed to improve functional performance of pelvic floor muscle (PFM), bladder and physical performance of women living in homes for the elderly.</p> <p>Methods</p> <p>Twenty participating Dutch homes were matched and randomized into intervention or control homes using a random number generator. Homes recruited 6–10 older women, with or without UI, with sufficient cognitive and physical function to participate in the program comprising behavioral aspects of continence and physical exercises to improve PFM, bladder and physical performance. The program consisted of a weekly group training session and homework exercises and ran for 6 months during which time the control group participants received care as usual. Primary outcome measures after 6 months were presence or absence of UI, frequency of episodes (measured by participants and caregivers (not blinded) using a 3-day bladder diary) and the Physical Performance Test (blinded). Linear and logistic regression analysis based on the Intention to Treat (ITT) principle using an imputed data set and per protocol analysis including all participants who completed the study and intervention (minimal attendance of 14 sessions).</p> <p>Results</p> <p>102 participants were allocated to the program and 90 to care as usual. ITT analysis (n = 85 intervention, n = 70 control) showed improvement of physical performance (intervention +8%; control −7%) and no differences on other primary and secondary outcome measures. Per protocol analysis (n = 51 intervention, n = 60 control) showed a reduction of participants with UI (intervention −40%; control −28%) and in frequency of episodes (intervention −51%; control −42%) in both groups; improvement of physical performance (intervention + 13%; control −4%) was related to participation in the exercise program.</p> <p>Conclusions</p> <p>This study shows that improving physical performance is feasible in institutionalized older women by exercise. Observed reductions in UI were not related to the intervention. [Current Controlled Trials ISRCTN63368283]</p

Resolving incomparability

When confronted with an important choice between two very different options, an agent often will be at a loss as to how to decide between them. This is often true even if the agent has a good understanding of the pros and cons of each option, and even if she is committed to something like the best overall decision for me. One way to analyze this situation is to assert that the options are incomparable for the agent. Incomparability arises when, for two options, it seems that one is neither better nor worse than, nor equal to, the other. If cases of incomparability exist, they raise a serious issue for rational decision making. How can an agent make rational decisions if the options she is choosing between are incomparable? My dissertation sets out to define this problem clearly and to provide an original solution to it that allows for the possibility of rational choice in the face of incomparable options

Prozessgetriebene Risikoanalyse zur Bewertung maritimer Operationen

Maritime Operationen stellen aufgrund der besonderen Witterungsbedingungen und Distanz zum Festland hohe Herausforderungen an beteiligte Personen, eingesetzte Techniken, Equipment und die Arbeitsabläufe dar. Zur Planung und anschließenden Analyse maritimer Operationen wurde in dieser Arbeit ein Ansatz zur systematischen und formalisierten Risikoanalyse mit Hilfe graphischer Prozessmodelle entwickelt. Innerhalb des systematischen Vorgehens wird ein solches Prozessmodell genutzt und um erforderliche Informationen wie beispielsweise Gefährdungen, mögliche Ursachen oder risikomindernde Maßnahmen erweitert. Dabei kann unterstützend eine entwickelte Wissensbasis zur Bereitstellung von Informationen vergangener Planungsvorgänge genutzt werden. Diese Informationen dienen zur Planung der Operation und formalisierten Risikoanalyse mit Hilfe von Fehlerbäumen, die in dem entwickelten Ansatz automatisch erstellt und ausgewertet werden

Do health systems delay the treatment of poor children? A qualitative study of child deaths in rural Tanzania.

Child mortality remains one of the major public-health problems in Tanzania. Delays in receiving and accessing adequate care contribute to these high rates. The literature on public health often focuses on the role of mothers in delaying treatment, suggesting that they contact the health system too late and that they prefer to treat their children at home, a perspective often echoed by health workers. Using the three-delay methodology, this study focus on the third phase of the model, exploring the delays experienced in receiving adequate care when mothers with a sick child contact a health-care facility. The overall objective is to analyse specific structural factors embedded in everyday practices at health facilities in a district in Tanzania which cause delays in the treatment of poor children and to discuss possible changes to institutions and social technologies. The study is based on qualitative fieldwork, including in-depth interviews with sixteen mothers who have lost a child, case studies in which patients were followed through the health system, and observations of more than a hundred consultations at all three levels of the health-care system. Data analysis took the form of thematic analysis. Focusing on the third phase of the three-delay model, four main obstacles have been identified: confusions over payment, inadequate referral systems, the inefficient organization of health services and the culture of communication. These impediments strike the poorest segment of the mothers particularly hard. It is argued that these delaying factors function as 'technologies of social exclusion', as they are embedded in the everyday practices of the health facilities in systematic ways. The interviews, case studies and observations show that it is especially families with low social and cultural capital that experience delays after having contacted the health-care system. Reductions of the various types of uncertainty concerning payment, improved referral practices and improved communication between health staff and patients would reduce some of the delays within health facilities, which might feedback positively into the other two phases of delay