Alien Registration- Bowie, Mary J. (Gardiner, Kennebec County)

https://digitalmaine.com/alien_docs/29107/thumbnail.jp

Using contingent valuation to measure the economic impact of climate change on hiker recreation during New England peak foliage

This paper seeks to define and develop an economic tool for measuring willingness to pay for hiking recreation in the face of climate change in New England during the peak foliage season. Potential climate change impacts to New England are defined, along with relevant economic tools for measuring the market value of non-marketed goods. Ultimately, contingent valuation is chosen as the most viable option, and a survey is developed, pretested, and ready for implementation at the trailhead of Mt. Major in New Hampshire

Risk factors for chest infection in acute stroke: a prospective cohort study

<p><b>Background and Purpose:</b> Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.</p> <p><b>Methods:</b> We studied a series of consecutive patients with acute stroke who were admitted to hospital. Detailed evaluation included the modified National Institutes of Health Stroke Scale; the Abbreviated Mental Test; and measures of swallow, respiratory, and oral health status. Pneumonia was diagnosed by set criteria. Patients were followed up at 3 months after stroke.</p> <p><b>Results:</b> We studied 412 patients, 391 (94.9%) with ischemic stroke and 21 (5.1%) with hemorrhagic stroke; 78 (18.9%) met the study criteria for pneumonia. Subjects who developed pneumonia were older (mean±SD age, 75.9±11.4 vs 64.9±13.9 years), had higher modified National Institutes of Health Stroke Scale scores, a history of chronic obstructive pulmonary disease, lower Abbreviated Mental Test scores, and a higher oral cavity score, and a greater proportion tested positive for bacterial cultures from oral swabs. In binary logistic-regression analysis, independent predictors (P<0.05) of pneumonia were age >65 years, dysarthria or no speech due to aphasia, a modified Rankin Scale score ≥4, an Abbreviated Mental Test score <8, and failure on the water swallow test. The presence of 2 or more of these risk factors carried 90.9% sensitivity and 75.6% specificity for the development of pneumonia.</p> <p><b>Conclusions:</b> Pneumonia after stroke is associated with older age, dysarthria/no speech due to aphasia, severity of poststroke disability, cognitive impairment, and an abnormal water swallow test result. Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.</p&gt

The gas phase cyclization of deprotonated N-aryl-2-cyano-2-diazoacetamides

The document attached has been archived with permission from the publisher.1-Aryl-4-cyano-5-hydroxy-1,2,3-triazoles can be obtained in solution by base-catalysed cyclization of N-aryl-2-cyano-2-diazoacetamides. A similar reaction was shown to take place under conditions of negative ion chemical ionization in the ion source of a mass spectrometer. High resolution mass spectrometry, tandem mass spectrometry, charge reversal spectra, synthesis of the ions with known structures and quantum chemical calculations were used to prove the latter statement. The fact of the observed cyclization demonstrates once again the ability of mass spectrometry to study the gas phase chemical reactions that take place in solution.Vladislav V. Lobodin, Yuriy Yu. Morzherin, Tom Blumenthal, Daniel Bilusich, Vladimir V. Ovcharenko, John H. Bowie, and Albert T. Lebede

Never events in UK general practice: a survey of the views of general practitioners on their frequency and acceptability as a safety improvement approach

Background: Never events (NEs) are serious preventable patient safety incidents and are a component of formal quality and safety improvement (Q&SI) policies in the United Kingdom and elsewhere. A preliminary list of NEs for UK general practice has been developed, but the frequency of these events, or their acceptability to general practitioner (GPs) as a Q&SI approach, is currently unknown. The study aims to estimate (1) the frequency of 10 NEs occurring within GPs' own practices and (2) the extent to which the NE approach is perceived as acceptable for use. Methods: General practitioners were surveyed, and mixed-effects logistic regression models examined the relationship between GP opinions of NE, estimates of NE frequency, and the characteristics of the GPs and their practices. Results: Responses from 556 GPs in 412 practices were analyzed. Most participants (70%-88%, depending on the NE) agreed that the described incident should be designated as a NE. Three NEs were estimated to have occurred in less than 4% of practices in the last year; however, two NEs were estimated to have occurred in 45% to 61% of the practices. General practitioners reporting that a NE had occurred in their practice in the last year were significantly less likely to agree with the designation as a NE compared with GPs not reporting a NE (odds ratio, 0.42; 95% CI = 0.36-0.49). Conclusions: The NE approach may have Q&SI potential for general practice, but further work to adapt the concept and content is required