Defining localities of inadequate treatment for childhood asthma: A GIS approach

BACKGROUND: The use of Geographic Information Systems (GIS) has great potential for the management of chronic disease and the analysis of clinical and administrative health care data. Asthma is a chronic disease associated with substantial morbidity, mortality, and health care use. Epidemiologic data from all over the world show an increasing prevalence of asthma morbidity and mortality despite the availability of effective treatment. These facts led to the emergence of strategies developed to improve the quality of asthma care. THE OBJECTIVE: To develop an efficient tool for quality assurance and chronic disease management using a Geographic Information System (GIS). GEOGRAPHIC LOCATION: The southern region of Israel. January 1998 – October 2000. DATABASES: Administrative claims data of the largest HMO in Israel: drug dispensing registry, demographic data, Emergency Room visits, and hospitalization data bases. METHODS: We created a list of six markers for inadequate pharmaceutical treatment of childhood asthma from the Israeli clinical guidelines. We used this list to search the drug dispensing registry to identify asthmatic children who received inadequate treatment and to assess their health care utilization and bad outcomes: emergency room visits and hospitalizations. Using GIS we created thematic maps on which we located the clinics with a high percentage of children for whom the treatment provided was not in adherence with the clinical guidelines. RESULTS: 81% of the children were found to have at least one marker for inadequate treatment; 17.5% were found to have more than one marker. Children with markers were found to have statistically significant higher rates of Emergency Room visits, hospitalizations and longer length of stay in hospital compared with children without markers. The maps show in a robust way which clinics provided treatment not in accord with the clinical guidelines. Those clinics have high rates of Emergency Room visits, hospitalizations and length of stay. CONCLUSION: Integration of clinical guidelines, administrative data and GIS can create an efficient interface between administrative and clinical information. This tool can be used for allocating sites for quality assurance interventions

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Partners No More: Relational Transformation and the Turn to Litigation in Two Conservationist Organizations

The rise in litigation against administrative bodies by environmental and other political interest groups worldwide has been explained predominantly through the liberalization of standing doctrines. Under this explanation, termed here the floodgate model, restrictive standing rules have dammed the flow of suits that groups were otherwise ready and eager to pursue. I examine this hypothesis by analyzing processes of institutional transformation in two conservationist organizations: the Sierra Club in the United States and the Society for the Protection of Nature in Israel (SPNI). Rather than an eagerness to embrace newly available litigation opportunities, as the floodgate model would predict, the groups\u27 history reveals a gradual process of transformation marked by internal, largely intergenerational divisions between those who abhorred conflict with state institutions and those who saw such conflict as not only appropriate but necessary to the mission of the group. Furthermore, in contrast to the pluralist interactions that the floodgate model imagines, both groups\u27 relations with pertinent agencies in earlier eras better accorded with the partnership-based corporatist paradigm. Sociolegal research has long indicated the importance of relational distance to the transformation of interpersonal disputes. I argue that, at the group level as well, the presence or absence of a (national) partnership-centered relationship determines propensities to bring political issues to court. As such, well beyond change in groups\u27 legal capacity and resources, current increases in levels of political litigation suggest more fundamental transformations in the structure and meaning of relations between citizen groups and the state

Sulfate Fertilization Preserves Tomato Fruit Nutritional Quality

Sulfur is an essential mineral in human nutrition, involved in vital biochemical processes. Sulfur deficient soil is becoming a severe issue, resulting from increased agricultural production and decreased sulfur emissions. Tomato cultivation using sulfur-poor soils and desalinated water is becoming widespread, and might result in plant and fruit sulfur deficiency. In the current work, we aimed at evaluating the effect of sulfur fertilization (0.1–4 mM) on fruit sulfur concentrations, under both low (4 mM) and high (11 mM) nitrogen fertilization, to assess fruit sulfur biofortification, alongside the effect on fruit mineral composition, and on tomato plants. The experiment was performed on a semi-commercial scale, during two seasons, with a real-life fertilization range. We evaluated fruit elemental composition, in addition to young (diagnostic) leaves, as an indication to nutritional status. Our results show no harmful effect of low sulfur treatment on plant growth and high yield. Increased fertilization-sulfur exclusively induced sulfur accumulation in the fruit, while increasing fertilization-nitrogen subsequently increased fruit nitrogen. Sulfur treatments resulted in a consistent negative effect on fruit molybdenum and calcium, as well as a positive effect on fruit sodium levels. At the same time, other fruit minerals, including phosphorus, potassium, magnesium, iron, zinc, manganese, and copper, remained unaltered by sulfur treatments. Leaf response trends generally adhered to those of fruit. Taken together, our findings suggest that sulfur fertilization can biofortify tomato with sulfur while retaining fruit mineral composition and nutritional quality, excluding a decrease in Molybdenum levels, to assure food security and maintain fruit and vegetables as a significant source of sulfur and other minerals. Possibilities of practical application of this work’s results include optimization of fertilization levels in crop cultivation under sulfur deficiency for yield and nutritional quality, alongside the biofortification of tomatoes with sulfur and nitrogen with no adverse effect to other fruit minerals

Sulfate Fertilization Preserves Tomato Fruit Nutritional Quality

Sulfur is an essential mineral in human nutrition, involved in vital biochemical processes. Sulfur deficient soil is becoming a severe issue, resulting from increased agricultural production and decreased sulfur emissions. Tomato cultivation using sulfur-poor soils and desalinated water is becoming widespread, and might result in plant and fruit sulfur deficiency. In the current work, we aimed at evaluating the effect of sulfur fertilization (0.1–4 mM) on fruit sulfur concentrations, under both low (4 mM) and high (11 mM) nitrogen fertilization, to assess fruit sulfur biofortification, alongside the effect on fruit mineral composition, and on tomato plants. The experiment was performed on a semi-commercial scale, during two seasons, with a real-life fertilization range. We evaluated fruit elemental composition, in addition to young (diagnostic) leaves, as an indication to nutritional status. Our results show no harmful effect of low sulfur treatment on plant growth and high yield. Increased fertilization-sulfur exclusively induced sulfur accumulation in the fruit, while increasing fertilization-nitrogen subsequently increased fruit nitrogen. Sulfur treatments resulted in a consistent negative effect on fruit molybdenum and calcium, as well as a positive effect on fruit sodium levels. At the same time, other fruit minerals, including phosphorus, potassium, magnesium, iron, zinc, manganese, and copper, remained unaltered by sulfur treatments. Leaf response trends generally adhered to those of fruit. Taken together, our findings suggest that sulfur fertilization can biofortify tomato with sulfur while retaining fruit mineral composition and nutritional quality, excluding a decrease in Molybdenum levels, to assure food security and maintain fruit and vegetables as a significant source of sulfur and other minerals. Possibilities of practical application of this work’s results include optimization of fertilization levels in crop cultivation under sulfur deficiency for yield and nutritional quality, alongside the biofortification of tomatoes with sulfur and nitrogen with no adverse effect to other fruit minerals

Treated wastewater in agriculture: use and impacts on the soil environment and crops

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Hydroponic Agriculture and Microbial Safety of Vegetables: Promises, Challenges, and Solutions

Hydroponics is a farming technique for growing plants with mineral nutrients using a soil-free medium. The plant roots are submerged in soil-free media, such as vermiculite or perlite, or just in mineral nutrient solutions. This allows for high production yields throughout the year with less water and agro-chemical inputs. Consequently, hydroponics is considered a sustainable agriculture technology. Hydroponically grown crops are usually protected from the diseases transmitted through soil or animals in open fields. Therefore, they require fewer chemicals for pest control and are safer than conventionally grown crops in terms of possible chemical contamination. Nevertheless, hydroponics guarantees neither plant health nor the microbial safety of fresh produce. In the case of microbial contamination by human pathogens, unlike soil-grown crops, the pathogens may rapidly spread through the circulating water and simultaneously infect all the plants in the facility. This review summarizes the up-to-date knowledge regarding the microbial safety of hydroponically grown crops and discusses the role of the hydroponic system in reducing the microbial hazards for leafy and fruity crops as well as the potential risks for contamination by human pathogens. Finally, it outlines the approaches and the available science-based practices to ensure produce safety. The contamination risk in hydroponic systems may be diminished by using novel planting materials and the appropriate decontamination treatment of a recirculating liquid substrate; by modulating the microbiota interactions; and by following strict phytosanitary measures and workers’ hygienic practices. There is a timely need to adopt measures, such as the Good Agricultural Practice (GAP) guidelines, to mitigate the risks and ensure safe hydroponically grown vegetables for consumers

Characterization of Physicochemical and Hydraulic Properties of Organic and Mineral Soilless Culture Substrates and Mixtures

Many arid and semiarid regions of the world face serious water shortages that are projected to have significant adverse impacts on irrigated agriculture and create unprecedented challenges for providing food and water security for the rapidly growing human population in a changing global climate. Consequently, there is a momentous incentive to shift to more resource-efficient soilless greenhouse production systems. Though there is considerable empirical and theoretical research devoted to specific issues related to control and management of soilless culture systems, a comprehensive approach that quantitatively considers relevant physicochemical processes within containerized soilless growth modules is missing. An important first step towards development of advanced soilless culture management strategies is a comprehensive characterization of hydraulic and physicochemical substrate properties. In this study we applied state-of-the-art measurement techniques to characterize six soilless substrates and substrate mixtures [i.e., coconut coir, perlite, volcanic tuff, perlite/coconut coir (50/50 vol.-%), tuff/coconut coir (70/30 vol.-%), and Growstone(R)/coconut coir (50/50 vol.-%)] that are used in commercial production in Israel and the United States. The measured substrate properties include water retention characteristics, saturated hydraulic conductivity, packing and particle densities, as well as phosphorus and ammonium adsorption isotherms. In addition, integral water availability and integral energy parameters were calculated to compare investigated substrates and provide valuable information for irrigation and fertigation management.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Improving Rabbiteye Blueberry Performance in a Calcareous Soil by Growing Plants in Pits Filled with Low-CaCO₃ Growth Media

Calcareous soils are not suitable for blueberry cultivation. Our aim was to improve the performance of blueberry plants in calcareous soils by using pits filled with growth media in combination with high levels of RNH4+ (proportion of N-NH4+ among the total applied N). Rabbiteye blueberry (Vaccinium virgatum Ait. cv. Ochlockonee) plants were grown in pits filled with a tuff/peat mixture (TP), a sandy soil (S) or a calcareous (CC), in full factorial combination with three levels of RNH4+: 33%, 66% or 100%. The two higher RNH4+ treatments decreased the pH of the low-CaCO3 (S) and no-CaCO3 (TP) media to ≤6.0 over 250 days of fertilization, but did not affect the pH of the CC soil over 650 days. Plant performance was superior in the TP and S media, as compared to the CC soil. The type of growth medium was the dominant factor accounting for the improved plant performance. The plants were sensitive to Mn deficiency in leaves during the spring period. The current results suggest that growing blueberry in pits filled with good aeration and low pH buffering capacity medium in combination with a high level of RNH4+ is a positive approach for its cultivation in calcareous soils

Calcium translocation and whole plant transpiration: spatial and temporal measurements using radio-Strontium as tracer

Calcium (Ca) in plants has essential roles related to tissue mechanical strength and plant tolerance to stress, and understanding what affects its translocation and partition is of high value. Ca was shown to accumulate in transpiring organs and is considered to be coupled to water transport. However, being translocated mostly in the xylem, a conduit under tension, en-route sampling cause cessation of flow yielding fragmented understanding. To enable in-vivo, real time exploration of the coupling hypothesis, we developed and used a noninvasive sensing system to track translocation of gamma emitting Sr, an accepted Ca tracer, together with transpiration measurements. Tomato seedlings were grown in a continuously aerated hydroponic solution under controlled climatic conditions. Having three fruit bearing trusses, plants were moved to a growth room and arranged in pairs were one plant was continuously weighted and the other installed with high sensitivity gamma radiation detectors at various locations. A mixture of 85Sr and 88Sr was added to the solution of the 2nd plant around noon and has been followed for several days. Root applied Sr showed a fast sequential arrival to the main stem detectors along the expected water flow path. During the first few days, early morning transpiration and Sr translocation seemed to be coupled while later in the day a complex pattern emerged probably due to absorption-desorption dynamics as well as loading-unloading activity. As days passed, upstream radiation levels declined while downstream terminal organs levels increased, showing long-term accumulation pattern there. Fruit radiation pattern showed day inflow, which contradicts with the accepted fruit night-fill of xylem-borne ions. Fruit maturity is suggested as a possible explanation. Our custom made system, having both spatial and temporal capabilities, enabled following translocation patterns of radio-Sr within the plant. Together with indicative transpiration measurements, interesting insights were gained in reference to Ca-water coupling