Measurement of the impact of Winona Health Online

The purpose of this article is to present the methodology to study the clinical and financial outcomes associated with the use of Winona Health Online, a novel community-wide interactive healthcare Website in Winona, Minnesota. Outcome methodology was developed by the University of Minnesota School of Public Health and the Carlson School of Management in cooperation with nationally recognized outcomes and disease state management experts, healthcare practitioners in Winona, statisticians, and health economists. The main areas of measurement include health status, satisfaction, cost and utilization of services, and clinical quality

Effects of Oil Shale Leachate on Phytoplankton Productivity

The effects of oil shale leachate and salinity additions on the productivity of freshwater algae were studied in the laboratory using batch bioassays. These batch bioassays were used to screen variations of ten salts in single and multiple additions of all possible combinations of the ten salts; water extractions of different processed and unprocessed oil shales; and the concentration effects of both the salts from 0.3 N to 0.05 N as NaCl and the oil shale extractions on the growth of standard test algae and indigenous algae from Lake Powell. The batch bottle bioassays were conducted following the standard algal assay procedure as closely as possible. Variations in the standard algal assay procedure included media variation with the use of indigenous algal species isolated from Lake Powell and the use of three different algal species isolated from Lake Powell and the use of three different algal species for test innoculum in the bioassay procedure. The biomass was monitored using optical density, chlorophyll a fluorescence, and/or cell counts. The indegenous algal species were found to be negatively affected but more tolerant to all salinity additions than the standard test alga. The growth of the indigenous algal species

Utah Surface Impoundment Assessment Report

Executive Summary: The Surface Impoundment Assessment process presented an organized consistent systme for evaluating potential threats to groundwater resources from surface impoundments of wastes. This assessment established a data base which locates wastes surface impoundments in Utah and assesses the majority of these impoundments with this prescribed system (Appendix F). This data base may be used to identify surface impoundments in Utah which may create problems with regard to groundwater contamination. Data Summary: The potential hazards of the surface impoundments assessed to groundwater is based on two values established during the assessment procedure. These values are identified as the pollution potential and the health hazard of the sruface impoundment. The pollution potential rating is based on the first four steps of the assessment procedure. out of the 711 impoundments assessed during this study 154 impoundments, of 22 percent of these impoundment, exhibited a pollution potential value high enough to be of concern (greater than 19 assessment units). The health hazard ratin gis based on the proximity of an impoundment to a water well and the anticipated direction of movement of the waste plume. Out of the 154 impoundments exhibility high pollution potentials, 35 impoundments, or 23 percent of these impoundments, also exhibilited a health hazard rating which may be cause for concern (Case A). These 35 impoundments exhibility a combination of a high pollution potential and health hazard values are located on 13 sites. They represent sites from every category studied. These sites may pose a threat to groundwater supplies as identified by the assessment process. The assessment data are discussed in more detail in Chapter 4. There have been instances of groundwater contamination in Utah. On e of these instances has been documented through legal action. These instances are discussed in Chapter 6. State Program for Protecting Groundwater: The Utah State Board of Health is a body politic recommended by the Governor and approved by the Utah Senate that serves as the regulatory authority for the State Department of Health (Holt, 1979). Regulatory and enforcement authroity is vested in the State Board of Health by Section 26-15-5 of the Utah Cose Annotated, 1953, as amended. Additional regulatory committees have been authorized by state law to promulgate rules for the control of specific health or environmental programs as have been deemed necessary with increasing demands on the state\u27s natural resources and environmental protection programs. The state water pollution control organziation consists of the Dibision of Environmental Health within the State Health Department (Pitkin, 1979). The Division of Environmental Health includes Bureaus of Water Pollution Control, Public Water Supply, and Solid Waste Management, each working under separate state legislative authority and under separate federal acts: The Federal Clean Water Act, and Safe Drinking Water Act, and the Resource Conservation and Recovery Act. The organization of the state environment health programs is currently under review by a state appointed reorganization committee. Therefore, this organication may change within the near future (Dalley, 1980). Under present State Health Department policy, the Bureau of Water Pollution Control has been designated as the lead agency for conductin gthe permitting and operational requirements for pits, ponds and lagoons and for the construction of facilities for the containment of sludges from water and sewage treatment plants (Holt, 1979). It should be understood, howeber, that a dual regulatory responsibility exists between the Bureaus of Water Pollution Control and Solid Waste Mangement for control and disposal of sewage and wastewater sludges. The Bureau of Solid Waste Management presently assumes a significant role in establishing policy for the management of sewage and water treatment sludge. Conclusions and Recommendations: At the present time, no specific groundwater program exists in the State Division of Health. Therefore, responsibility for the protection of groundwater is also shared by the state agencies mentioned above. A staff would be necessary to achieve protection of drinking water supplies by addressing specific needs within this state. One area requiring attention is enforcement of existing laws. In order to adequately enforce these laws there is a need for increased public education and manpower within the state (Georgeson, 1979a; Gray 1979; Pitkin, 1979a; Thompson, 1979). The enforcement interpretation of these laws must allow enough flexibility to prevent illegal actions. For example, the closure of a small dump may promote illegal actions. For example, the closure of a small dump may promote illegal dumping (Gray, 1979). Enforcement capabilities require an adequate data base, monitoring program, and staff expertise. Inadequacies exist in baseline groundwater quality data (Pitkin, 1979a) and hydrogeology data (Georgeson, 1979a) especially in remote areas of the state. Also, more quality data are needed on the wastes being treated (Maxwell, 1979). Increased monitoring is necessary to create an adequate data base and to identify problems before public complaints call attention to them

Passion in the Workplace: Empirical Insights from Team Sport Organisations

Although sport management scholars have focused on a fairly wide number of psychologically-related constructs in the workplace, passion has not been part of this research agenda. The present study is the first attempt to fill this gap by exploring employees’ passion in the workplace setting of sport organisations. It does so by applying for the first time the dualistic model of passion developed by Vallerand et al. (2003), which measures two distinct types of passion: harmonious and obsessive. Online survey data were gathered from administrative employees in the United Kingdom’s football industry, responsible for either business-related functions or the clubs’ social agenda (N=236) in order to measure the passion experienced by individuals guided by different institutional logics. The particular instrument has two components: harmonious and obsessive passion towards the job. Besides the passion scales, the survey contained measures related to demographic variables (e.g., age, gender and education), to employment position in the organisation and to previous job experience. Data were statistically analysed in Confirmatory Factor Analysis (CFA) and analysis of variance, using SPSS and Amos 18.0. To determine the effect of contextual variables on the passion for the job, t-test and ANOVA were also used. Both groups of employees are passionate about their job. They remain harmoniously passionate throughout their career and show low level of obsessive passion. The type of work activities influences both levels of harmonious and obsessive passion experienced by personnel within sport organisations with employees responsible for the social agenda being slightly more harmoniously and obsessively passionate compared to those responsible for the business agenda. Vallerand et al.’s (2003) dualistic model of passion has been adapted to measure passion at workplace within sport organisations. The particular working environment that forms these organisations attracts and/or facilitates employees to experience a positive work–life balance

Layered Atom Arrangements in Complex Materials

In this report, we develop an atom layer stacking model to describe systematically the crystal structures of complex materials. To illustrate the concepts, we consider a sequence of oxide compounds in which the metal cations progress in oxidation state from monovalent (M{sup 1+}) to tetravalent (M{sup 4+}). We use concepts relating to geometric subdivisions of a triangular atom net to describe the layered atom patterns in these compounds (concepts originally proposed by Shuichi Iida). We demonstrate that as a function of increasing oxidation state (from M{sup 1+} to M{sup 4+}), the layer stacking motifs used to generate each successive structure (specifically, motifs along a 3 symmetry axis), progress through the following sequence: MMO, MO, M{sub r}O, MO{sub r/s}O{sub u/v}, MOO (where M and O represent fully dense triangular atom nets and r/s and u/v are fractions used to describe partially filled triangular atom nets). We also develop complete crystallographic descriptions for the compounds in our oxidation sequence using trigonal space group R{bar 3}

Impacts of extreme 2013–2014 winter conditions on Lake Michigan's fall heat content, surface temperature, and evaporation

Since the late 1990s, the Laurentian Great Lakes have experienced persistent low water levels and above average over‐lake evaporation rates. During the winter of 2013–2014, the lakes endured the most persistent, lowest temperatures and highest ice cover in recent history, fostering speculation that over‐lake evaporation rates might decrease and that water levels might rise. To address this speculation, we examined interseasonal relationships in Lake Michigan's thermal regime. We find pronounced relationships between winter conditions and subsequent fall heat content, modest relationships with fall surface temperature, but essentially no correlation with fall evaporation rates. Our findings suggest that the extreme winter conditions of 2013–2014 may have induced a shift in Lake Michigan's thermal regime and that this shift coincides with a recent (and ongoing) rise in Great Lakes water levels. If the shift persists, it could (assuming precipitation rates remain relatively constant) represent a return to thermal and hydrologic conditions not observed on Lake Michigan in over 15 years.Key PointsLake Michigan has been in an altered thermal regime since the late 1990sThe 2013–2014 winter may return Lake Michigan to pre‐1998 thermal conditionsHydrological impacts of the 2013–2014 cold winter remain unclearPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112001/1/grl52850.pd

Conducting interactive experiments online

Online labor markets provide new opportunities for behavioral research, but conducting economic experiments online raises important methodological challenges. This particularly holds for interactive designs. In this paper, we provide a methodological discussion of the similarities and differences between interactive experiments conducted in the laboratory and online. To this end, we conduct a repeated public goods experiment with and without punishment using samples from the laboratory and the online platform Amazon Mechanical Turk. We chose to replicate this experiment because it is long and logistically complex. It therefore provides a good case study for discussing the methodological and practical challenges of online interactive experimentation. We find that basic behavioral patterns of cooperation and punishment in the laboratory are replicable online. The most important challenge of online interactive experiments is participant dropout. We discuss measures for reducing dropout and show that, for our case study, dropouts are exogenous to the experiment. We conclude that data quality for interactive experiments via the Internet is adequate and reliable, making online interactive experimentation a potentially valuable complement to laboratory studies

Is the onset of disabling chronic conditions in later childhood associated with exposure to social disadvantage in earlier childhood? a prospective cohort study using the ONS Longitudinal Study for England and Wales

Background: The aetiology of disabling chronic conditions in childhood in high income countries is not fully understood, particularly the association with socio-economic status (SES). Very few studies have used longitudinal datasets to examine whether exposure to social disadvantage in early childhood increases the risk of developing chronic conditions in later childhood. Here we examine this association, and its temporal ordering, with onset of all-cause disabling chronic later childhood in children reported as free from disability in early childhood. Methods: The study comprised a prospective cohort study, using data from the Office for National Statistics Longitudinal Study (ONSLS) for England and Wales. The study sample included 52,839 children with complete data born between 1981–1991 with no disabling chronic condition/s in 1991. Index cases were children with disability recorded in 2001. Comparison cases were children with no recorded disability in 1991. A socio-economic disadvantage index (SDI) was constructed from data on social class, housing tenure and car/van access. Associations were explored with logistic regression modelling controlling sequentially for potentially confounding factors; age, gender, ethnicity and lone parenthood. Results: By 2001, 2049 (4%) had at least one disability. Socio-economic disadvantage, age, gender and lone parenthood but not ethnicity were significantly associated with onset of disabling chronic conditions. The SDI showed a finely graded association with onset of disabling chronic conditions in the index group (most disadvantaged OR 2·11 [CI 1·76 to 2·53]; disadvantaged in two domains OR 1·45 [CI 1·20 to 1·75]; disadvantaged in one domain OR 1·14 [CI 0·93 to 1·39] that was unaffected by age, gender and ethnicity and slightly attenuated by lone parenthood. Conclusion: To our knowledge, this is the first study to identify socio-economic disadvantage in earlier childhood as a predisposing factor for onset of all-cause disabling chronic conditions in later childhood. Temporal ordering and gradation of the response indicate socio-economic disadvantage may play a causal role. This suggests that targeting preventative efforts to reduce socio-economic disadvantage in early childhood is likely to be an important public health strategy to decease health inequalities in later childhood and early adulthood

CONCEPTT: Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial: A multi-center, multi-national, randomized controlled trial - Study protocol.

BACKGROUND: Women with type 1 diabetes strive for optimal glycemic control before and during pregnancy to avoid adverse obstetric and perinatal outcomes. For most women, optimal glycemic control is challenging to achieve and maintain. The aim of this study is to determine whether the use of real-time continuous glucose monitoring (RT-CGM) will improve glycemic control in women with type 1 diabetes who are pregnant or planning pregnancy. METHODS/DESIGN: A multi-center, open label, randomized, controlled trial of women with type 1 diabetes who are either planning pregnancy with an HbA1c of 7.0 % to ≤10.0 % (53 to ≤ 86 mmol/mol) or are in early pregnancy (<13 weeks 6 days) with an HbA1c of 6.5 % to ≤10.0 % (48 to ≤ 86 mmol/mol). Participants will be randomized to either RT-CGM alongside conventional intermittent home glucose monitoring (HGM), or HGM alone. Eligible women will wear a CGM which does not display the glucose result for 6 days during the run-in phase. To be eligible for randomization, a minimum of 4 HGM measurements per day and a minimum of 96 hours total with 24 hours overnight (11 pm-7 am) of CGM glucose values are required. Those meeting these criteria are randomized to RT- CGM or HGM. A total of 324 women will be recruited (110 planning pregnancy, 214 pregnant). This takes into account 15 and 20 % attrition rates for the planning pregnancy and pregnant cohorts and will detect a clinically relevant 0.5 % difference between groups at 90 % power with 5 % significance. Randomization will stratify for type of insulin treatment (pump or multiple daily injections) and baseline HbA1c. Analyses will be performed according to intention to treat. The primary outcome is the change in glycemic control as measured by HbA1c from baseline to 24 weeks or conception in women planning pregnancy, and from baseline to 34 weeks gestation during pregnancy. Secondary outcomes include maternal hypoglycemia, CGM time in, above and below target (3.5-7.8 mmol/l), glucose variability measures, maternal and neonatal outcomes. DISCUSSION: This will be the first international multicenter randomized controlled trial to evaluate the impact of RT- CGM before and during pregnancy in women with type 1 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01788527 Registration Date: December 19, 2012