The Economic Contribution of Instream Flows to the Lower Connecticut River Watershed, New England, USA

River recreation is a rapidly expanding source of economic productivity. Angler spending has been used as the basis for estimating the regional economic estimates of local income and jobs in several water-limited systems of the western United States and Mexico. However, the contribution of outdoor recreation to the economies of regions that do not experience water scarcity continues to be underappreciated. This paper estimates the economic contribution of angling to the lower Connecticut River Watershed (CRW) economy. The authors draw upon existing angler expenditure, river flow and geographic information system (GIS) data to relate anger use of the lower CRW and expenditures to river flows. The authors then translate angler expenditures into state income and employment using a regional economic multiplier. The results show that fishing expenditures of $62.8 million per year equate to$74.2 million annually in supply chain revenues which supports 1660 jobs. The authors identified a significant positive relationship between fishing intensity and river flow rates, which suggests that decreasing current water diversions on the lower CRW by just 25% would add an additional $37 million and 638 jobs to Connecticut’s economy. The findings demonstrate that investments in managing the health the CRW through flow restoration can have large economic and ecological pay-offs

Mammography : current practice in Australia for the selection of bucky angle in the mediolateral oblique view of the breast

Introduction: Due to the configuration of the breast and its variability between individuals, correct selection of the angle of the bucky (bucky may be interchanged with film holder; image receptor; cassette holder; detector; film holder and compression paddle; image receptor; gantry; column; C-arm) in the mediolateral oblique view of the breast is critical to maximise the amount of breast tissue demonstrated. However, there is no standardisation within the literature to instruct radiographers on how best to determine the correct angle. Most radiographers are taught to ‘‘angle to the pectoral muscle’’. The result is that there is significant variation in the techniques used to select the angle of the bucky. This study set out to investigate the current practice of bucky angle selection in Australia. Method: Surveys were distributed to both BreastScreen Australia and private practice radiographers as a way of collecting a large data sample. Responses were grouped into three categories: sample profile, clinical practice and understanding. Following collation, thematic analysis was undertaken and descriptive statistics developed. Results: One hundred and sixty eight surveys were returned. Overall the study results demonstrate that Australian radiographers were aware of the importance of correct selection of the bucky angle to maximise image quality and breast cancer detection. However significant variations in current practice exist for the method of determination of the angle of the bucky for the mediolateral oblique view of the breast. Conclusion: Current practice for the selection of the angle of the bucky in Australia is varied and non-standardised. Variation in positioning techniques may lead to inconsistency in image quality and reproducibility and could ultimately compromise the diagnostic value of the images produced. Further research into the most appropriate method for the selection of the bucky angle needs to be undertaken to inform a standardised approach to bucky angle selection, to maximise the visualisation of breast tissue and the early detection of breast cancer

Mammography image quality analysis of evaluation criteria using pectoral muscle presentation /

Purpose: To investigate the mammographic presentation of the pectoral muscle on the mediolateral oblique view of the breast and its relationship to current image evaluation criteria. Methods: A retrospective review of 100 paired mediolateral oblique mammograms performed on women undergoing routine mammographic screening with BreastScreen NSW South West, Australia was undertaken. Measurements of length, width, contour type and inferior angle of the pectoral muscle and of the relationship of its inferior aspect to the posterior nipple line and the nipple level were recorded. Results: A wide range of parameter values representing acceptable imaging were found to exist for each of the key imaging criteria. In 75.5% of images reviewed the inferior aspect of the pectoral muscle did not reach the level of the nipple, failing the quality criterion of the image evaluation systems used by the UK National Health Service Breast Screening Programme and the Australian BreastScreen Program. Conclusion: It is recommended that aspects of current image evaluation criteria relating to the presentation of the pectoral muscle should be modified to include quantified ranges to reduce inherent subjectivity and variability in interpretation. The criterion for the inferior aspect of the pectoral muscle to reach the level of the nipple should be reviewed by the national accreditation bodies

Disability and mammography screening : intangible barriers to participation

PURPOSE: The aim of this study was to investigate intangible or non-physical barriers to participation of women with disability in mammography screening. METHOD:  Women with disability were recruited via specific advocacy and support organisations in New South Wales, Australia. Interviews were conducted which focused on issues relating to participants\u27 experience with breast screening services. RESULTS:  A total of 75 women with varying degrees of disability agreed to participate. Three key intangible barriers were identified related to the women\u27s expectations to be informed, to be involved and to be treated with respect. Details of the content, type, timing of appropriately presented information as well as who should provide it were emphasised. Barriers to active involvement to manage their disability and take control over their experience were identified. The women also indicated the specific treatment they received from screening staff which negatively impacted on their experience. CONCLUSIONS:  This study has provided important and clinically significant detail of intangible barriers to participation in screening mammography experienced by women with physical disability. These study outcomes suggest ways in which the satisfaction with the mammogram experience can be increased for these women and contribute to increased participation in mammography screening

Mammography : correlation of pectoral muscle width and the length in the mediolateral oblique view of the breast

Purpose: To investigate the relationship between the width and length of the pectoral muscle in the mediolateral oblique mammogram of the breast.Method: Mammograms reviewed for this study were performed on women undergoing routine mammographic screening with BreastScreen NSW South West, Australia. The study included a total of 2800 randomly selected mediolateral oblique mammograms from examinations taken between July 2004 and September 2006. Measurements of the width and length of the pectoral muscle were recorded.Results: No statistically significant difference was demonstrated between the mean values for right and left width (p = 0.5293) or length (p = 0.2079). Matched pair analysis demonstrated a statistically significant difference width, (p = 0.0069) and length, (p = 0.0369). No relationship could be demonstrated between the width and length of the pectoral muscle, (p = 0.0701).Conclusion: The inability to determine a relationship between the width and length of the ectoral muscle suggests that these criteria should be assessed independently of each other. This new understanding of the presentation of the pectoral muscle will enable clinically relevant redevelopment of current image evaluation systems to include statistically supported mean performance values. Further research is needed to explore the relationship of width and length to other key image evaluation criteria used in mammography image quality evaluatio

Appendix A. Indicator species for each vegetation type identified by cluster analysis of vegetation plots.

Indicator species for each vegetation type identified by cluster analysis of vegetation plots

Women with physical disability and the mammogram : an observational study to identify barriers and facilitators

Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening