Place Attachment and Willingness to Pay: How Do Visitors Value State Parks?

Abstract State parks provide benefits for members of the public who may not have access to natural environments. In this context, it is critical to understand how minority groups value and depend on state parks. To better understand these issues research was conducted during the summers of 2009 and 2010 at three state parks in north Georgia. Intercept surveys were administered to 929 state park visitors. Data pertaining to whether or not visitors perceived themselves as being dependent on state parks and were willing to pay for parks were collected. Results of an exploratory factor analysis suggested that place dependency varied by race/ethnicity, education and income. Results revealed a positive relationship between willingness to pay and place dependency. Results of this study may provide Georgia state park managers with a better understanding of how visitors, in particular minorities, value state parks

Burden of disease, healthcare pathways and costs of cardiovascular high-risk patients with type 2 diabetes: a real world analysis:

Objective: To estimate the burden of disease and to describe healthcare pathways and costs of type-2diabetes (DMT2) patients at high cardiovascular risk (HRCV). Methods: A real-world analysis was performed by using a subset of the AR-CO database, containing administrative health data of >4.3 million of inhabitants. A cohort of adult patients with DMT2 and HRCV was selected in 2013, and followed for 1 year. Through this period, information on antidiabetic and cardiovascular therapies, other co-treatments, hospitalisations, and outpatient services, was collected and analysed. The costs associated with each variable were assessed to estimate the integrated health care expenditure. Results: Overall, 7,167 patients with DMT2 and HRCV were identified, corresponding to 3.1% of all diabetic patients and 0.2% of adult population. During the 1-year follow-up, 90.1% of the cohort received at least a prescription of an antidiabetic drug, 98.0% of a cardiovascular medication and 95.9% used at least an outpatient service. 44.5% had an admission during the follow-up period, especially for cardiovascular events. The integrated cost analysis showed that the overall average cost for each subject was € 13,567. Hospitalisations generated 86.8% of this expenditure, followed by drugs (7.7%) and by outpatient services (5.5%). Conclusions: Although patients with DMT2 and HRCV represent a small percentage of the overall population with diabetes, they generate very high costs for National Healthcare System. These costs are mainly due to the hospitalisations, especially for cardiovascular events. New therapeutic strategies involving these patients should allow reduction of hospital admission, resulting in savings for National Healthcare System

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA

Primary care management of diabetes in a low/middle income country: A multi-method, qualitative study of barriers and facilitators to care

<p>Abstract</p> <p>Background</p> <p>The management of patients with diabetes mellitus is complex. Some research has been done in developed countries to attempt to determine the factors that influence quality of care of patients with diabetes: Factors thus far postulated are usually categorised into patient, clinician and organisational factors. Our study sought to discover the main barriers and facilitators to care in the management of diabetes in primary care in a low/middle income country.</p> <p>Methods</p> <p>A qualitative study, based on reflexive ethnography using participant observation, semi-structured interviews of clinicians (10) and group interviews with paramedical staff (4) and patients (12) in three purposively sampled health centres, along with informal observation and discussions at over 50 other health centres throughout Tunisia. A content analysis of the data was performed.</p> <p>Results</p> <p>Over 400 potential barriers or facilitators to care of patients with diabetes in primary care in Tunisia emerged. Overall, the most common cited factor was the availability of medication at the health centre. Other frequently observed organisational factors were the existence of chronic disease clinics and clinicians workload. The most commonly mentioned health professional factor was doctor motivation. Frequently cited patient factors were financial issues, patient education and compliance and attendance issues. There were notable differences in the priority given to the various factors by the researcher, physicians, paramedical staff and the patients.</p> <p>Conclusion</p> <p>We have discovered a large number of potential barriers and facilitators to care that may potentially be influencing the care of patients with diabetes within primary care in Tunisia, a low/middle income country. An appreciation and understanding of these factors is essential in order to develop culturally appropriate interventions to improve the care of people with diabetes.</p

Tandem fluorescence and Raman (fluoRaman) characterisation of a novel photosensitiser in colorectal cancer cell line SW480

The development of new imaging tools, molecules and modalities is crucial to understanding biological processes and the localised cellular impact of bioactive compounds. A small molecule photosensitiser, DC473, has been designed to be both highly fluorescent and to exhibit a strong Raman signal in the cell-silent region of the Raman spectrum due to a diphenylacetylene structure. DC473 has been utilised to perform a range of novel tandem fluorescence and Raman (fluoRaman) imaging probe experiments, enabling a thorough examination of the compound’s cellular localisation, exemplified in colorectal cancer cells (SW480). This multifunctional fluoRaman imaging modality has revealed the presence of the compound in lipid droplets and only weak signal in the cytosol, where both Raman and fluorescence results show the presence of the fluoRaman imaging probe. In addition, Raman microscopy detected the compound in a cell compartment we labelled as the nucleolus, where fluorescence microscopy did not detect the fluoRaman probe due to solvatochromatic effects in a local polar environment. This last finding was only possible with the use of tandem confocal Raman and fluorescence methods. By following the approach detailed herein, incorporation of strong Raman functional groups into fluorophores can enable a plethora of fluoRaman experiments, shedding further light on an imaging probe or potential drug compound’s cellular behaviour and biological activity