No evidence of suitability of prophylactic fluids for wildfire prevention at landscape scales

Yu et al. propose a viscoelastic fluid as a prophylactic fire-retardant treatment in landscapes at high risk of wildfires. We argue that, while the idea is worth exploring further, their data do not support its suitability for real landscape-scale applications.Peer reviewe

Beliefs about Development Versus Environmental Tradeoffs in the Puget Sound Region

Policymakers face difficult decisions as they attempt to balance competing calls for increased developmentand environmental protection. In the Puget Sound region of Washington State, population growth and the needfor housing and energy have brought these types of tradeoffs to the forefront. Using data from a phone survey of 1,980 residents, researchers from the Carsey Institute and the National Oceanic and Atmospheric Administration (NOAA) Fisheries investigated public perceptions of environmental concerns across Puget Sound. This fact sheet outlines residents' views about the importance of environmental protection as well as their opinions about energy development, protection of wild salmon, and land use regulation

The species diversity × fire severity relationship is hump-shaped in semiarid yellow pine and mixed conifer forests

The combination of direct human influences and the effects of climate change are resulting in altered ecological disturbance regimes, and this is especially the case for wildfires. Many regions that historically experienced low–moderate severity fire regimes are seeing increased area burned at high severity as a result of interactions between high fuel loads and climate warming with a number of negative ecological effects. While ecosystem impacts of altered fire regimes have been examined in the literature, little is known of the effects of changing fire regimes on forest understory plant diversity even though understory taxa comprise the vast majority of forest plant species and play vital roles in overall ecosystem function. We examined understory plant diversity across gradients of wildfire severity in eight large wildfires in yellow pine and mixed conifer temperate forests of the Sierra Nevada, California, USA. We found a generally unimodal hump-shaped relationship between local (alpha) plant diversity and fire severity. High-severity burning resulted in lower local diversity as well as some homogenization of the flora at the regional scale. Fire severity class, post-fire litter cover, and annual precipitation were the best predictors of understory species diversity. Our research suggests that increases in fire severity in systems historically characterized by low and moderate severity fire may lead to plant diversity losses. These findings indicate that global patterns of increasing fire size and severity may have important implications for biodiversity

Flood realities, perceptions, and the depth of divisions on climate

Research has led to broad agreement among scientists that anthropogenic climate change is happening now and likely to worsen. In contrast to scientific agreement, US public views remain deeply divided, largely along ideological lines. Science communication has been neutralised in some arenas by intense counter-messaging, but as adverse climate impacts become manifest they might intervene more persuasively in local perceptions. We look for evidence of this occurring with regard to realities and perceptions of flooding in the northeastern US state of New Hampshire. Although precipitation and flood damage have increased, with ample news coverage, most residents do not see a trend. Nor do perceptions about past and future local flooding correlate with regional impacts or vulnerability. Instead, such perceptions follow ideological patterns resembling those of global climate change. That information about the physical world can be substantially filtered by ideology is a common finding from sociological environment/society research

Referral management and the care of patients with diabetes: the Translating Research Into Action for Diabetes (TRIAD) study.

OBJECTIVE: To examine the effect of referral management on diabetes care. STUDY DESIGN: Cross-sectional analysis. PATIENTS AND METHODS: Translating Research Into Action for Diabetes (TRIAD) is a multicenter study of managed care enrollees with diabetes. Prospective referral management was defined as "gatekeeping" and mandatory preauthorization from a utilization management office, and retrospective referral management as referral profiling and appropriateness reviews. Outcomes included dilated eye exam; self-reported visit to specialists; and perception of difficulty in getting referrals. Hierarchical models adjusted for clustering and patient age, gender, race, ethnicity, type and duration of diabetes treatment, education, income, health status, and comorbidity. RESULTS: Referral management was commonly used by health plans (55%) and provider groups (52%). In adjusted analyses, we found no association between any referral management strategies and any of the outcome measures. CONCLUSIONS: Referral management does not appear to have an impact on referrals or perception of referrals related to diabetes care

Blood Pressure Control in Diabetes: Temporal progress yet persistent racial disparities: national results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

OBJECTIVE Despite widespread dissemination of target values, achieving a blood pressure of <130/80 mmHg is challenging for many individuals with diabetes. The purpose of the present study was to examine temporal trends in blood pressure control in hypertensive individuals with diabetes as well as the potential for race, sex, and geographic disparities. RESEARCH DESIGN AND METHODS We analyzed baseline data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national, population-based, longitudinal cohort study of 30,228 adults (58% European American and 42% African American), examining the causes of excess stroke mortality in the southeastern U.S. We calculated mean blood pressure and blood pressure control rates (proportion with blood pressure <130/80 mmHg) for 5,217 hypertensive diabetic participants by year of enrollment (2003–2007) using multivariable logistic regression models. RESULTS Only 43 and 30% of European American and African American diabetic hypertensive participants, respectively, demonstrated a target blood pressure of <130/80 mmHg (P < 0.001). However, a temporal trend of improved control was evident; the odds of having a blood pressure <130/80 mmHg among diabetic hypertensive participants of both races enrolled in 2007 (as compared with those enrolled in 2003) were ∼50% greater (P < 0.001) in multivariate models. CONCLUSIONS These data suggest temporal improvements in blood pressure control in diabetes that may reflect broad dissemination of tighter blood pressure control targets and improving medication access. However, control rates remain low, and significant racial disparities persist among African Americans that may contribute to an increased risk for premature cardiovascular disease

Assessment of the efficacy and toxicity of 131I-metaiodobenzylguanidine therapy for metastatic neuroendocrine tumours

131I-metaiodobenzylguanidine (131I-MIBG) is a licensed palliative treatment for patients with metastatic neuroendocrine tumours. We have retrospectively assessed the consequences of 131I-MIBG therapy in 48 patients (30 gastroenteropancreatic, 6 pulmonary, 12 unknown primary site) with metastatic neuroendocrine tumours attending Royal Liverpool University Hospital between 1996 and 2006. Mean age at diagnosis was 57.6 years (range 34–81). 131I-MIBG was administered on 88 occasions (mean 1.8 treatments, range 1–4). Twenty-nine patients had biochemical markers measured before and after 131I-MIBG, of whom 11 (36.7%) showed >50% reduction in levels post-therapy. Forty patients had radiological investigations performed after 131I-MIBG, of whom 11(27.5%) showed reduction in tumour size post-therapy. Twenty-seven (56.3%) patients reported improved symptoms after 131I-MIBG therapy. Kaplan–Meier analysis showed significantly increased survival (P=0.01) from the date of first 131I-MIBG in patients who reported symptomatic benefit from therapy. Patients with biochemical and radiological responses did not show any statistically significant alteration in survival compared to non-responders. Eleven (22.9%) patients required hospitalisation as a consequence of complications, mostly due to mild bone marrow suppression. 131I-MIBG therefore improved symptoms in more than half of the patients with metastatic neuroendocrine tumours and survival was increased in those patients who reported a symptomatic response to therapy

The Prevalence of Cognitive Impairment Among Adults With Incident Heart Failure: The “Reasons for Geographic and Racial Differences in Stroke” (REGARDS) Study

Background Cognitive impairment (CI) is estimated to be present in 25%–80% of heart failure (HF) patients, but its prevalence at diagnosis is unclear. To improve our understanding of cognition in HF, we determined the prevalence of CI among adults with incident HF in the REGARDS study. Methods and Results REGARDS is a longitudinal cohort study of adults ≥45 years of age recruited in the years 2003–2007. Incident HF was expert adjudicated. Cognitive function was assessed with the Six-Item Screener. The prevalence of CI among those with incident HF was compared with the prevalence of CI among an age-, sex-, and race-matched cohort without HF. The 436 participants with incident HF had a mean age of 70.3 years (SD 8.9), 47% were female, and 39% were black. Old age, black race, female sex, less education, and anticoagulation use were associated with CI. The prevalence of CI among participants with incident HF (14.9% [95% CI 11.7%–18.6%]) was similar to the non-HF matched cohort (13.4% [11.6%–15.4%]; P < .43). Conclusions A total of 14.9% of the adults with incident HF had CI, suggesting that the majority of cognitive decline occurs after HF diagnosis. Increased awareness of CI among newly diagnosed patients and ways to mitigate it in the context of HF management are warranted