The Effectiveness of a Volume-Based Enteral Feeding Protocol to Provide Energy Intake in Hospitalized Critically Ill Adults

Background: Patients determined to be at high nutrition risk are most likely to benefit from early enteral nutrition (EN) therapy. The use of enteral feeding protocols has been associated with significant improvements in nutrition practice and overall nutrition adequacy. The effect of a combined-approach volume-based enteral feeding protocol on the percent of calories received by patients is unknown. Objective: The aim of this study was to determine if a newly implemented combined-approach volume-based enteral feeding (VBF) protocol is more effective in the delivery of EN volume and calories in intensive care unit (ICU) patients compared with the previous rate-based protocol where 88% of patients achieved 85% of their caloric requirements. Participants/setting: Eighteen critically ill adults hospitalized in either the burn or neurological ICU at a large urban hospital. Main outcome measure: The percentage of calories delivered for each patient after a minimum of 7 days of protocol compliance. Results: Ten patients (50% male, 70% Caucasian) received VBF in compliance with protocol for a median of 5.5 days (Interquartile Range; 4.8, 14.0). The percent of goal volume delivered for those who received at least 7 days of treatment (n = 4) was 104.2 ± 7.9. Conclusions: The delivery of goal EN volume using VBF exceeded the average volume provided by the previous rate-based approach in a small sample of critically ill adults. This study supports the use of feeding protocols in order to increase overall percentage of volume delivered. Additional research in a larger patient population is needed to determine the impact of this increase in volume delivery on patient outcomes

Translating \u3ci\u3eUnocal\u3c/i\u3e: The Expanding Web of Liability for Business Entities Implicated in International Crimes

The Ninth Circuit ruled that a corporation could be held liable under the federal Alien Tort Claims Act for its complicity in a violation of international criminal law occurring outside the U.S. (Doe I v. Unocal Corp., 395 F.3d 932 (9th Cir. 2002)). Since then, litigants have filed increasing numbers of such cases. These cases raise two questions: (1) Is the United States the only country that provides judicial accountability for business entities involved in international crimes abroad? and (2) How are other countries translating the basic kinds of accountability that Unocal recognized into their own legal systems? This Article attempts to answer these questions by presenting the results of a comparative law survey involving sixteen countries that invited lawyers and legal scholars to examine questions relating to the status of international criminal law in each country. Their responses examine the incorporation into domestic penal codes of international criminal law from the Rome Statute of the International Criminal Court and other international covenants; describe applicable concepts of third-party liability; and evaluate the status of corporate liability under domestic penal codes. The responses reveal other sources of criminal liability for illicit business conduct abroad, such as bribery of foreign officials, money laundering, and dealing in stolen property. Finally, they provide analyses of the laws and legal customs relating to the rights of victims to access civil courts in the various countries in search of compensation and other remedies. The responses present compelling evidence of the existence of what has been termed an emerging transnational web of liability for business entities implicated in international crimes. Since the sixteen countries in the survey represent both civil and common law traditions, parties and nonparties to the ICC, and a wide geographic range, we believe conclusions reached may be extrapolated more broadly

Estimating stand-level economic impacts of black bear damage to intensively managed forests

Black bears (Ursus americanus Pallas, 1780) peel conifers in early spring to forage on energy-rich vascular tissues, resulting in damage to timber stands. The objective of our study was to develop and demonstrate a conceptual framework and methods for estimating stand-level volume and economic losses from black bear damage. We created tree lists from surveys of healthy and bear-damaged trees in timber stands of western Washington and Oregon. The forest growth model Forest Vegetation Simulator (FVS) was used to project stand volume under two damage scenarios and an undamaged scenario. One damage scenario (salvage) accounted for mortality and volume losses of fully and partially girdled trees; a second scenario (total loss) assumed complete loss of all trees peeled by black bears, regardless of peeling severity. The Fuel Reduction Cost Simulator (FRCS) was applied to estimate the value of logs delivered to the mill after accounting for logging and hauling costs associated with harvest. Present value of stands was calculated to translate volume losses into economic losses associated with bear damage. Economic losses ranged from 4% to 16% (salvage) and from 17% to 46% (total loss) of net present value. Our approach can be adapted for other forest settings and for forest management plans that assess wildlife damage. L’ours noir (Ursus americanus Pallas, 1780) arrache l’écorce des conifères tôt au printemps pour se nourrir des tissus vasculaires riches en énergie et cause des dommages aux peuplements forestiers. L’objectif de notre étude consistait à élaborer et présenter un cadre conceptuel et des méthodes pour estimer à l’échelle du peuplement les pertes de volume ainsi que financières dues aux dommages causés par l’ours noir. Nous avons créé des listes d’arbres sains et d’arbres endommagés par les ours à partir des inventaires de peuplements forestiers de l’ouest des États de Washington et de l’Oregon. Un modèle de croissance de la forêt, le simulateur de végétation forestière, a été utilisé pour prévoir le volume d’un peuplement selon deux scénarios comportant des dommages et un troisième qui n’en comporte pas. Un scénario comportant des dommages (récupération) tenait compte de la mortalité et des pertes de volume des arbres partiellement et complètement annelés; un second scénario (perte totale) assumait la perte complète de tous les arbres endommagés par les ours noirs, peu importe la sévérité des dommages. Le simulateur du coût de réduction des combustibles a été appliqué pour estimer la valeur des billes livrées à l’usine après avoir pris en compte les coûts de la coupe et du débardage associés à la récolte. La valeur actualisée des peuplements a été calculée pour traduire les pertes de volume en pertes financières associées aux dommages causés par les ours. Les pertes financières variaient de 4–16 % (récupération) et de 17–46 % (perte totale) de la valeur actualisée nette. Notre approche peut être adaptée à d’autres situations ainsi qu’aux plans d’aménagement forestier qui évaluent les dommages causés par la faune

Estimating economic impact of black bear damage to western conifers at a landscape scale

Black bear (Ursus americanus) damage to trees in the Pacific Northwest is common, although volume and economic losses are unknown. Common measures to quantify bear damage to conifers at large scales rely solely on aerial estimates of red tree crowns (caused by complete girdling) and broad assumptions about stand characteristics. We surveyed 122 vulnerable stands in the Coast Range and western Cascades of Oregon using both aerial surveys and ground surveys. Then, we modeled 4 damage scenarios (Salvage; Total Loss; Root Disease; and Combined Damage) with the Forest Vegetation Simulator (FVS) growth and yield model and the Fuel Reduction Cost Simulator (FRCS). Damage polygons, digitized in real time from aerial surveys identifying red (dead or dying) tree crowns, overestimated bear damage by approximately 5-fold due to misclassification with root disease, and failed to detect partially peeled trees that contributed to economic loss. Damage polygons assessed from the air generally did not include red crowns, and were a mean distance of 58.8m (SE=8.8) from damage polygons’ outer edges to the nearest red crown. We accounted for mortality and volume losses from partially girdled trees that did not show red crowns in our Salvage scenario, whereas we assumed that all bear-peeled trees resulted in complete loss in the Total Loss scenario. At the landscape scale, economic loss was ≤0.35% of net present value under both damage scenarios, while processing bear damage trees (Salvage) was the most efficacious option. At the landscape scale, our worst-case scenario (Total Loss) resulted in an estimated loss of $56/ha to bear damage, 10-fold less than a previously reported estimate of$585/ha. Root disease was a more prevalent damage agent than bear damage but did not affect net present value at harvest. The majority (92%) of bear damage observed in ground surveys was older (\u3e 2 yrs) and existed at a low frequency (1.5 bear damaged trees/ha) and severity across the landscape. Our results suggest that black bear damage is not uniformly distributed and that perceived impact varies with spatial scale. On-the-ground monitoring of the status of bear damage across the western Oregon landscape will identify hot spots of severe peeling and provide an understanding of these changes over time

Estimating the Total Economic Impact of Black Bear Peeling in Western Oregon Using GIS and REMI

In parts of the Pacific Northwest, black bears emerge from winter dens with depleted fat reserves and feed on mature conifers by stripping bark and consuming sugar-rich sapwood. Peeling by bears affects commercial conifers through direct loss of the tree or degraded log quality at stand harvest. Bears generally peel trees from 15-30 years old in intensively managed forests until preferred foods such as fruits and berries are available, and a single bear can peel several trees per day. Dying trees have a signature red canopy and are detected in annual aerial forest health surveys; however, trees that scar over peeling are not detected by aerial surveys. Previous studies reported results of damage summaries for northwest Oregon from flights, adjusted for bias; however, they offered no estimates of economic impact. Using landowner survey data, another study estimated an annual timber loss to bears at approximately $11.5 million across part of western Oregon. While informative, these estimates used broad assumptions to derive primary impacts and did not address secondary impacts. We used aerial health surveys, the national land cover database, and the Regional Economic Models Inc. (REMI) PI+ model to estimate the primary and secondary (indirect and induced) impacts of bear peeling in western Oregon. Because the accuracy and precision of aerial estimates (i.e., percentage of dead trees/polygon) was unknown, we calculated 4 scenarios of loss: 1$0.9-$89 million annually, and resulted in an annual loss of between 11 and 1,012 jobs in the state. We will explain our methodology in this study as well as current efforts to improve the accuracy and precision of damage estimates, and ultimately our understanding of the economic impacts of black bear peeling

Blogging About Feminist lnterdisciplinarity in the Study of Communication, Language, and Gender

This article provides information about several blog posts discussed during a round-table discussion on feminist interdisciplinary studies in relation to communication, language, and gender. Topics under discussion include the nature of interdisciplinarity and its relevance to feminist studies, intercultural communication, and the study and teaching of gender in women\u27s studies programs in higher education

David Ross Locke, consistent advocate

David Ross Locke was a newspaper editor, novelist, satirist, and lecturer prominent during and immediately after the Civil War period. He gained widespread fame because of his creation, "Petroleum Vesuvius Nasby." In Nasby, Locke created a character to satirize the Northern Democrats who sympathized with the Southern point of view. On a weekly basis, Nasby wrote letters to the editor which chronicled his misadventures. Because of his bigotry and narrow, self-serving motivations, Nasby always came to bad ends. Locke's contemporaries considered the Nasby letters invaluable in maintaining Northern morale during the war. Because of the prominence he gained through Nasby, Locke was asked to lecture nationally. His three major lectures, "Cussid Be Canaan," "The Struggles of a Conservative with the Woman Question," and "In Search of the Man of Sin," proved very popular with his audiences. The lectures are comprehensive statements of his positions toward the major social issues of his day—slavery, women's suffrage, and corruption. These lectures are also satires. Humor, however, was not Locke's primary goal. He considered himself a reformer, and sought, through his lectures, to persuade. The analyst of his lectures must evaluate them in that light in order to properly assess their worth

Protecting disabled children : what the latest research tells us

A recent study of child protection practice in Scotland suggests that disabled children fare less well in child protection services than their non-disabled peers. A group of academics highlight the lessons for social workers from the latest studies of safeguarding disabled children