Improving the Delivery of Recommended Pediatric Preventive Health Services

Background: Pediatric preventive health services, including screening, counseling, chemoprophylaxis, and immunization, are an essential part of health care for children; these services prevent disease and injury and promote the health of children. However, despite the widely recognized importance of pediatric preventive health services, the rate of delivery of many of these services remains low. Objectives: To examine the magnitude and extent of the problem oflow delivery rates of recommended pediatric preventive health services and to evaluate policy alternatives to address this problem. Methods: I examined the extent to which all U.S. children 0-5 years old receive preventive health services recommended by the AAP, Bright Futures, AAFP, USPSTF, and CDC. I focused on the following policy alternatives to increase delivery rates of recommended pediatric preventive health services: increased Medicaid and/or SCHIP coverage of uninsured children, patient reminder and recall systems, increased provider reimbursement for preventive health services, provider assessment and feedback, and provider reminder systems. I evaluated each of these policy alternatives using the following criteria: effectiveness, efficiency, equity, timeliness, patient-centeredness, ease of implementation, and political acceptability. I gathered data for the evaluation through a literature review of the MEDLINE database and the Cochrane Library. Results: Increased Medicaid and/or SCHIP coverage was highly equitable and moderately politically acceptable but had low effectiveness. Increased provider reimbursement for preventive health services was moderately effective and highly efficient but had low political acceptability. Patient reminder and recall systems, provider assessment and feedback, and provider reminder systems were highly effective, efficient, and politically acceptable. Conclusions: A synthesis of patient reminder and recall systems, provider assessment and feedback, and provider reminder systems is recommended to increase the delivery of preventive health services for U.S. children 0-5 years old.Master of Public Healt

The Relationship of Violence to the Ability, Achievement, and Adjustment of Sixth-Grade Children

The purpose of this research was to compare the scores on the variables of ability, achievement, and adjustment in an effort to locate areas wherein the children who perceive and project verbally a high amount of violence are significantly different from children who perceive and project a low amount of violence

Nitrogen to phosphorus ratio of plant biomass versus soil solution in a tropical pioneer tree, «Ficus insipida»

It is commonly assumed that the N:P ratio of a terrestrial plant reflects the relative availability of N and P in the soil in which the plant grows. Here it was assessed for a tropical pioneer tree, Ficus insipida. Seedlings were grown in sand and irrigated with nutrient solutions containing N:P ratios ranging from < 1 to > 100. The experimental design further allowed investigation of physiological responses to N and P availability. Homeostatic control over N:P ratios was stronger in leaves than in stems or roots, suggesting that N:P ratios of stems and roots are more sensitive indicators of the relative availability of N and P at a site than N:P ratios of leaves. The leaf N:P ratio at which the greatest plant dry mass and highest photosynthetic rates were achieved was about 11, whereas the corresponding whole-plant N:P ratio was about 6. Plant P concentration varied as a function of the transpiration rate at constant nutrient solution P concentration, possibly due to transpiration-induced variation in the mass flow of P to root surfaces. Transpiration rate varied in response to nutrient solution N concentration, but not to nutrient solution P concentration, demonstrating nutritional control over transpiration by N but not P. Water-use efficiency varied as a function of N availability, but not as a function of P availability.Il est couramment admis que le rapport N:P pour les plantes terrestres reflète la disponibilité relative d'azote et de phosphore dans sol où croît la plante. Ici, le rapport N:P a été évalué pour un arbre tropical pionnier, le Ficus insipida. Les semis ont été plantés dans le sable et irrigués avec des solutions nutritives contenant des rapports N:P allant de 1 a 100. Ce concept expérimental a permis une évaluation des réponses physiologiques à la disponibilité d'azote et de phosphore. Le contrôle homéostatique sur le rapport N:P était plus élevé dans les feuilles que dans les tiges ou les racines, ce qui peut signifier que le rapport N:P des tiges et des racines est un indicateur plus sensible à la disponibilité relative d'azote et de phosphore dans un site donné que celui des feuilles. Le rapport N:P de feuilles auquel les taux les plus élevés de masse sèche et de photosynthèse ont été obtenus était d'environ 11 alors que le rapport N:P pour l'ensemble de la plante était d'environ 6. La concentration de phosphore dans les plantes variait en fonction du taux de transpiration à des niveaux constants de concentration de phosphore dans la solution nutritive, ce qui est possiblement dû à des variations dans le débit de phosphore à la surface des racines provoquées par la transpiration. Le taux de transpiration variait en fonction du niveau de concentration de l'azote dans la solution nutritive, mais pas à celui du phosphore, indiquant un contrôle nutritionnel sur la transpiration par l'azote mais pas par le phosphore. L'efficacité de l'utilisation de l'eau variait en fonction de la disponibilité de l'azote mais pas en fonction de celle du phosphore

Research Articles in Simplified HTML: a Web-first format for HTML-based scholarly articles

Purpose. This paper introduces the Research Articles in Simplified HTML (or RASH), which is a Web-first format for writing HTML-based scholarly papers; it is accompanied by the RASH Framework, a set of tools for interacting with RASH-based articles. The paper also presents an evaluation that involved authors and reviewers of RASH articles submitted to the SAVE-SD 2015 and SAVE-SD 2016 workshops. Design. RASH has been developed aiming to: be easy to learn and use; share scholarly documents (and embedded semantic annotations) through the Web; support its adoption within the existing publishing workflow. Findings. The evaluation study confirmed that RASH is ready to be adopted in workshops, conferences, and journals and can be quickly learnt by researchers who are familiar with HTML. Research Limitations. The evaluation study also highlighted some issues in the adoption of RASH, and in general of HTML formats, especially by less technically savvy users. Moreover, additional tools are needed, e.g., for enabling additional conversions from/to existing formats such as OpenXML. Practical Implications. RASH (and its Framework) is another step towards enabling the definition of formal representations of the meaning of the content of an article, facilitating its automatic discovery, enabling its linking to semantically related articles, providing access to data within the article in actionable form, and allowing integration of data between papers. Social Implications. RASH addresses the intrinsic needs related to the various users of a scholarly article: researchers (focussing on its content), readers (experiencing new ways for browsing it), citizen scientists (reusing available data formally defined within it through semantic annotations), publishers (using the advantages of new technologies as envisioned by the Semantic Publishing movement). Value. RASH helps authors to focus on the organisation of their texts, supports them in the task of semantically enriching the content of articles, and leaves all the issues about validation, visualisation, conversion, and semantic data extraction to the various tools developed within its Framework

Ground-Based Measurements and Validation Protocols for Flex

The upcoming ESA Fluorescence Explorer (FLEX) mission will incorporate ground-based validations for fluorescence parameters and reflectance indices, drawing on an international network of sensors located at eddy covariance tower sites. A program has been initiated by the OPTIMISE program to develop methods and protocols for this network. A sensor system suite under evaluation by OPTIMISE includes the FLoX hyperspectral spectroradiometers. The NASA team at GSFC is participating in this experiment and we report first results from the 2017 summer measurements made above the canopy at the USDA/ARS Beltsville cornfield using the DFLoX and two other leaf-level measurement systems, the MONI-PAM and the FluoWat

Nitrogen to phosphorus ratio of plant biomass versus soil solution in a tropical pioneer tree, Ficus insipida

It is commonly assumed that the nitrogen to phosphorus (N:P) ratio of a terrestrial plant reflects the relative availability of N and P in the soil in which the plant grows. Here, this was assessed for a tropical pioneer tree, Ficus insipida. Seedlings were grown in sand and irrigated with nutrient solutions containing N:P ratios ranging from <1 to >100. The experimental design further allowed investigation of physiological responses to N and P availability. Homeostatic control over N:P ratios was stronger in leaves than in stems or roots, suggesting that N:P ratios of stems and roots are more sensitive indicators of the relative availability of N and P at a site than N:P ratios of leaves. The leaf N:P ratio at which the largest plant dry mass and highest photosynthetic rates were achieved was ∼11, whereas the corresponding whole-plant N:P ratio was ∼6. Plant P concentration varied as a function of transpiration rate at constant nutrient solution P concentration, possibly due to transpiration-induced variation in the mass flow of P to root surfaces. The transpiration rate varied in response to nutrient solution N concentration, but not to nutrient solution P concentration, demonstrating nutritional control over transpiration by N but not P. Water-use efficiency varied as a function of N availability, but not as a function of P availability

Nut production in Bertholletia excelsa across a logged forest mosaic: implications for multiple forest use

Although many examples of multiple-use forest management may be found in tropical smallholder systems, few studies provide empirical support for the integration of selective timber harvesting with non-timber forest product (NTFP) extraction. Brazil nut (Bertholletia excelsa, Lecythidaceae) is one of the world’s most economically-important NTFP species extracted almost entirely from natural forests across the Amazon Basin. An obligate out-crosser, Brazil nut flowers are pollinated by large-bodied bees, a process resulting in a hard round fruit that takes up to 14 months to mature. As many smallholders turn to the financial security provided by timber, Brazil nut fruits are increasingly being harvested in logged forests. We tested the influence of tree and stand-level covariates (distance to nearest cut stump and local logging intensity) on total nut production at the individual tree level in five recently logged Brazil nut concessions covering about 4000 ha of forest in Madre de Dios, Peru. Our field team accompanied Brazil nut harvesters during the traditional harvest period (January-April 2012 and January-April 2013) in order to collect data on fruit production. Three hundred and ninety-nine (approximately 80%) of the 499 trees included in this study were at least 100 m from the nearest cut stump, suggesting that concessionaires avoid logging near adult Brazil nut trees. Yet even for those trees on the edge of logging gaps, distance to nearest cut stump and local logging intensity did not have a statistically significant influence on Brazil nut production at the applied logging intensities (typically 1–2 timber trees removed per ha). In one concession where at least 4 trees ha-1 were removed, however, the logging intensity covariate resulted in a marginally significant (0.09) P value, highlighting a potential risk for a drop in nut production at higher intensities. While we do not suggest that logging activities should be completely avoided in Brazil nut rich forests, when a buffer zone cannot be observed, low logging intensities should be implemented. The sustainability of this integrated management system will ultimately depend on a complex series of socioeconomic and ecological interactions. Yet we submit that our study provides an important initial step in understanding the compatibility of timber harvesting with a high value NTFP, potentially allowing for diversification of forest use strategies in Amazonian Perù

Molecular Characterization of Podoviral Bacteriophages Virulent for Clostridium perfringens and Their Comparison with Members of the Picovirinae

Clostridium perfringens is a Gram-positive, spore-forming anaerobic bacterium responsible for human food-borne disease as well as non-food-borne human, animal and poultry diseases. Because bacteriophages or their gene products could be applied to control bacterial diseases in a species-specific manner, they are potential important alternatives to antibiotics. Consequently, poultry intestinal material, soil, sewage and poultry processing drainage water were screened for virulent bacteriophages that lysed C. perfringens. Two bacteriophages, designated ΦCPV4 and ΦZP2, were isolated in the Moscow Region of the Russian Federation while another closely related virus, named ΦCP7R, was isolated in the southeastern USA. The viruses were identified as members of the order Caudovirales in the family Podoviridae with short, non-contractile tails of the C1 morphotype. The genomes of the three bacteriophages were 17.972, 18.078 and 18.397 kbp respectively; encoding twenty-six to twenty-eight ORF's with inverted terminal repeats and an average GC content of 34.6%. Structural proteins identified by mass spectrometry in the purified ΦCP7R virion included a pre-neck/appendage with putative lyase activity, major head, tail, connector/upper collar, lower collar and a structural protein with putative lysozyme-peptidase activity. All three podoviral bacteriophage genomes encoded a predicted N-acetylmuramoyl-L-alanine amidase and a putative stage V sporulation protein. Each putative amidase contained a predicted bacterial SH3 domain at the C-terminal end of the protein, presumably involved with binding the C. perfringens cell wall. The predicted DNA polymerase type B protein sequences were closely related to other members of the Podoviridae including Bacillus phage Φ29. Whole-genome comparisons supported this relationship, but also indicated that the Russian and USA viruses may be unique members of the sub-family Picovirinae

The Relationship of Speech Defects with the Personality Development of Elementary School Children

The purpose of this study is to aid in the personal development of abnormal speech defective personalities by determining the effects of crippled speech upon certain individuals