The Opportunity Spectrum -- Concept and Behavioral Information in Outdoor Recreation Resource Supply Inventories: Background and Application

The paper describes an outdoor recreation resource (ORR) Supply Inventory and Classification (SIC) System that is being developed for multiple use natural resource planning. Four previously developed ORR SIC’s on which this system was built are described briefly. A general model for natural resource planning is presented to show how the proposed ORR SIC fits into a larger planning framework. The proposed SIC System is described and its application for regional and unit planning is explained. Relationships between OR consumers\u27 preferences for specific types of satisfying experiences and their preferences for specific attributes of the physical, social, and managerial settings are translated into specific and objective criteria proposed for inventorying and classifying lands as to their potential for providing particular types of OR opportunities on the spectrum

Differences in the epidemiology of theileriosis on smallholder dairy farms in contrasting agro-ecological and grazing strata of highland Kenya

A prospective cohort study was conducted in five purposively-sampled agro-ecological zone (AEZ)-grazing system strata in Murang’a District, Kenya, between March 1995 and June 1996. The study strata were selected based on a preliminary characterization study to represent the widest range of risks to East Coast fever (ECF) in the District and included zero-grazing and open-grazing farms. In total, 225 calves from 188 smallholder farms were examined from birth to 6 months of age and visited within the first 2 weeks of life and thereafter at bi-weekly intervals for up to 14 visits. The purpose of the study was to characterize the differences in epidemiology (risks of infection, morbidity and mortality) and potential control of ECF between the selected strata. Evidence of Theileria parva infection was assessed by increased antibody levels as measured in an indirect ELISA assay by the percent positivity (PP) of serum samples relative to a strong positive reference serum. Sero-conversion risks of T. parva were highest in the open-grazing strata. Antibody prevalence in adult cattle and ECF morbidity and mortality risks were also highest in open-grazing strata. While different, all five AEZ-grazing strata were considered to be endemically unstable for ECF. East Coast fever challenge was low in all zero-grazing strata and this challenge is likely to remain low due to continuing intensification of smallholder farming in the central highlands. In the open-grazing strata, there was higher challenge and a greater impact of ECF. ILRI publication no.: 99017

Exploring the Effect of Sexual Education on Sexual Health Risk Behaviors: Analysis of the 2003 and 2007 Youth Risk Behavior Surveys in Florida and Alabama

The purpose of this study was to explore the relationship between sexual health education content and sexual health risk behaviors, and the mediating effect of demographic variables. A cross-sectional research design employing secondary data analysis explored these associations in a sample of African American and non-Hispanic White male and female adolescents that took part in the Youth Risk Behavior Survey (YRBS) for the years 2003 and 2007 in the aforementioned southern states. Significant associations were observed between race and reported condom use and alcohol and/or drug use during last intercourse. For both Alabama and Florida, sexual health education was associated with reported condom usage as well as alcohol and/or drug use at last sexual intercourse. Those receiving sexual education of either type were more likely to report using a condom at their last sexual encounter, and less likely to report alcohol and/or drug use. However, the multivariate analysis did not support all of the findings of the bivariate analysis for both reported condom and alcohol and/or drug use. These findings suggest there is need for continued sexual education in this vulnerable demographic group

Use of Denosumab in Children With Osteoclast Bone Dysplasias: Report of Three Cases.

Denosumab has been used successfully to treat disease-associated osteoclast overactivity, including giant cell tumor of bone. Given its mechanism of action, denosumab is a potent potential treatment of other osteoclast bone dysplasias including central giant cell granuloma (CGCG), aneurysmal bone cyst (ABC), and cherubism. Relatively little is known about the safety and efficacy of denosumab in patients with these conditions, especially in children. We report on 3 pediatric patients treated with denosumab over a 3-year period at UCLA Medical Center (Los Angeles and Santa Monica, CA, USA): a 12-year-old with recurrent ABC of the pelvis, a 14-year-old with CGCG of the mandible, and a 12-year-old with cherubism. All were started on a 1-year course of 15 doses 120 mg s.c., given monthly with two loading doses on day 8 and 15. All patients demonstrated rapid and pronounced clinical improvement while on denosumab, including a significant reduction in pain and sclerosis of lytic lesions on radiographs. Within 1 month of initiating therapy, 2 patients experienced hypocalcemia (Common Terminology Criteria for Adverse Events [CTCAE] grade 2) and hypophosphatemia, with 1 patient experiencing symptoms. One patient went on to experience symptomatic rebound hypercalcemia (CTCAE grade 4) 5 months after completing therapy, requiring bisphosphonates and calcitonin. For the second patient, we developed a schedule to wean denosumab involving the progressive lengthening of time between doses from 1 to 4 months in 1-month increments before cessation. We found that denosumab therapy results in significant clinical and radiographic improvement for pediatric patients with nonresectable ABC, CGCG, and cherubism. Problems with serum calcium may be more common in younger patients, with symptomatic and protracted rebound hypercalcemia after cessation of therapy the most significant. We present a potential solution to this problem with progressive spacing of doses. Potential serious adverse events from alterations in calcium homeostasis should be explored in prospective clinical trials. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research

A synoptic view of solar transient evolution in the inner heliosphere using the Heliospheric Imagers on STEREO

By exploiting data from the STEREO/heliospheric imagers (HI) we extend a well-established technique developed for coronal analysis by producing time-elongation plots that reveal the nature of solar transient activity over a far more extensive region of the heliosphere than previously possible from coronagraph images. Despite the simplicity of these plots, their power in demonstrating how the plethora of ascending coronal features observed near the Sun evolve as they move antisunward is obvious. The time-elongation profile of a transient tracked by HI can, moreover, be used to establish its angle out of the plane-of-the-sky; an illustration of such analysis reveals coronal mass ejection material that can be clearly observed propagating out to distances beyond 1AU. This work confirms the value of the time-elongation format in identifying/characterising transient activity in the inner heliosphere, whilst also validating the ability of HI to continuously monitor solar ejecta out to and beyond 1A

Knowledge and Perceptions of HPV Vaccine Acceptance among African-American College Women

Human papillomavirus (HPV) is the most prevalent sexually transmitted disease in the United States. Prevalence rates among sexually active young women are approximately 50%. An HPV vaccine has been created that has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, and genital warts caused by four HPV subtypes. The purpose of this study was to assess African-American college women’s knowledge and perceptions of HPV, and their association with the acceptance of HPV vaccination. Variable selection was guided by the Health Belief Model and the Theory of Planned Behavior. Written surveys were administered to 122 African-American women between the ages of 18 and 26 who were enrolled as undergraduates at Florida Agricultural and Mechanical University (FAMU). Statistically significant associations were found between planning to get vaccinated against HPV and several perception variables. Health education efforts aimed at African-American women in college should be renewed, given the high percentage of misconceptions about HPV among members of the study population. Interventions should appeal to social networks of the young women, as their opinions regarding the vaccine weighs in their decision to plan to get vaccinated. This study underscores the need for continuous and consistent health education interventions directed at African-American women of college age

Competing Risk of Death and Time-Varying Covariates in Cardiovascular Epidemiologic Research: Modeling the Hazards of Coronary Heart Disease in the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study

Competing risk of death and time-varying covariates, often overlooked during statistical analyses of longitudinal studies, can alter the magnitude of estimates of the effect of covariates on the hazards of health outcomes. This study aimed to investigate whether estimates obtained when modeling the effect of risk factors on the hazards of coronary heart disease (CHD) varied significantly while accounting for the presence of competing risk of death and time-varying covariates. We used data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study (n=6346) to model estimates of the effect of risk factors on the hazards of CHD using Cox proportional hazards model, Cox extension with time-varying covariates, and the Fine Gray approach. We used a chi-square test to compare coefficient estimates obtained from the three modeling techniques. We obtained a P-value > 0.05 when comparing coefficient estimates for body mass index, age, cholesterol, smoking, and diabetes after fitting the three models. Coefficient estimates obtained when modeling the effect of risk factors on the hazards of CHD did not vary significantly in the presence of competing risk of death and time-varying covariates. Researchers should consider exploring these concepts more systematically in cohort studies with cardiovascular outcomes

After Implementation of the ACA – Coverage Gaps among Rural Latinos Still Remain

In this study, we assessed health needs and insurance coverage among a rural Latino population. A health needs survey was conducted in 2015 with approximately 100 Latino residents living in a rural Florida county. The survey included questions on socio-economic characteristics, type of insurance coverage, lapses in coverage, delays in care and satisfaction with health services. Only 15% of respondents had insurance through their employer, and 11% had Medicaid. Over 45% of participants had no health insurance, and 20% had no insurance for more than three years. One in ten had a medication delay due to lack of coverage/money, and 17% expressed they had medical bills they were paying off. Gaps in coverage highlight the need for targeted outreach efforts, while gaps in access and affordability highlight the need for new strategies to address barriers to care and out of pocket expenses for those with health insurance

Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016

The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC’s utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) were confirmed cases, 168 (49.0%) were considered false-positive, and 17 (5.0%) were not cases but not clearly false-positive. Estimated specificity of SHC was 95.0%. Overall, 48.5% of positives became confirmed cases (PPV). PPV varied according to prevalence of syphilis in populations tested. Staff (90%) thought SHC helped identify new cases but expressed concern regarding discordance between reactive SHC and lab-based testing. Programmatic outcomes assessment showed shorter time to treatment and increased numbers of partners tested for the SHC group; these enhanced outcomes may better mitigate the spread of syphilis compared to traditional syphilis testing alone, but more research is needed

Correspondence between T. Melden, George C. Stokes, and John Shary

Correspondence regarding lot 282, Shary Subdivision between November 1, 1930 and October 15, 1942 between T. Melden, George C. Stokes, John Shary, Pearl Stokes, and attorneys for the United Irrigation Company.https://scholarworks.utrgv.edu/johnshary/1024/thumbnail.jp