AN EXAMINATION OF A DEVELOPMENT RIGHTS PURCHASE PROGRAM FOR ALASKA AGRICULTURAL LANDS

A report submitted to the Department of Natural Resources, State of Alaska, in accordance with terms of research contract OCTO 1142.Many Alaskans are concerned about the conversion of highly productive agricultural lands to nonagricultural uses now occurring in the state. Land on the urban fringes of Anchorage and Fairbanks that once produced vegetables and grains or supported dairy farms appears most vulnerable to this conversion. As major population centers grow, residential, shopping center and industrial land uses displace agriculture because they render greater returns. This displacement is viewed by some as not being in society's best interest. Those concerned about the loss of agricultural lands argue that these lands are some of the best agricultural lands in the state and are vital to maintaining the agricultural economy of the state. In addition, it is suggested that their preservation will help to maintain a much desired way of life and to provide needed open space. The state and municipal governments in Alaska have made attempts to intervene in the land market to slow down or stop agricultural land conversion. Methods employed to date include tax incentives and the sale of only the agricultural rights on state or municipal lands. This report discusses the feasibility of an alternative means of preserving agricultural lands, namely, the public purchase of development rights from private landowners. Under this voluntary arrangement, private agricultural landowners would be compensated for giving up their option to develop their land for nonagricultural purposes.Introduction: Overview, Plan of Report -- Market Failure and the Allocation of Agricultural Land Resources -- Agricultural Land Conversion in Alaska -- Present and Potential Agricultural Development in Alaska: Introduction, Present Agricultural Situation, Agricultural Lands for Future Development, Future Agricultural Development in Alaska -- Purchase of Development Rights: Suffolk County: History, Maryland, New Jersey, Massachusetts and Connecticut, Definition of Development Rights, Strengths and Weaknesses of Development Rights Purchases -- Applicability of a Development Rights Program in Alaska: Introduction, Development Rights Survey in Alaska: Response, Farm Size of Respondents, Interest in Selling Development Rights, Market Values of Cleared and Uncleared Agricultural Lands, Value of Development Rights, Distance from a Population Center, Interest in Selling Development Rights, and Perceived Value of Development Rights -- Economic Size Agricultural Operations -- Potential Costs of a Purchase of Development Rights Program: Other Costs -- Benefits of Development Rights Acquisition: Maintenance of the Local Agricultural Economy, Locally Produced Food, Open Space and Other Public Good Amenities, Removal of Uncertainty -- Other Agricultural Land Control Tools: Comparison of Agricultural Land Preservation Tools -- Summary and Conclusions -- References -- Appendix A: Operation of of Purchase of Development Rights Programs -- Appendix B: Alaska Agricultural Lands Survey -- Appendix C: Additional Comments from Respondents -- Appendix D: Alternative Agricultural Land Control Technique

Superficial femoral artery catheterisation with two parallel guidewires after femoris profunda artery cannulation in antegrade percutaneous femoral access

No abstract availabl

Coil embolization as an alternative endovascular approach for ruptured superficial femoral artery aneurysms

Purpose: True aneurysms of the superficial femoral artery (SFAA) are rare and, the endovascular approach using covered stents has gained more popularity. We report an endovascular alternative using embolization coils for treatment of a ruptured SFAA. Case description: An 88-old male admitted for a ruptured true SFAA (67×52mm in diameter and 70mm in length) presenting with painful mass pulsating in the proximal third of the left thigh. His surgical history consisted of an infrarenal abdominal aneurysm treated by open surgery and an ipsilateral popliteal aneurysm treated with prosthetic bypass by a medial approach; this was revealed to be occluded at the CT scan evaluation. The patient was asymptomatic for limb ischaemia, therefore we decided to perform embolization of the SFA with coils (MReye®Embolization Coil, Cook Medical, Bloomington,USA). Under local anaesthesia, via a 5-Fr sheath and an antegrade approach, coils were deployed first at the distal neck of the SFAA and then to its proximal neck. On the angiogram, complete aneurysm sac thrombosis with no leaks was achieved. At 6-month follow-up, the SFAA remained occluded, and the patient had not developed any sign of limb ischaemia. Conclusion: Coil embolization of SFAA in selected cases represents a feasible and safe endovascular alternative

Sepsis and nosocomial infections: The role of medico-legal experts in Italy

Sepsis is a leading cause of morbidity and mortality worldwide. It is defined as the presence of a Systemic Inflammatory Response Syndrome, and it represents a significant burden for the healthcare system. This is particularly true when it is diagnosed in the setting of nosocomial infections, which are usually a matter of concern with regard to medical liability being correlated with increasing economic costs and people’s loss of trust in healthcare. Hence, the Italian governance promotes the clinical risk management with the aim of improving the quality and safety of healthcare services. In this context, the role of medico-legal experts working in a hospital setting is fundamental for performing autopsy to diagnose sepsis and link it with possible nosocomial infections. On the other hand, medico-legal experts are party to the clinical risk management assessment, and deal with malpractice cases and therefore contribute to formulating clinical guidelines and procedures for improving patient safety and healthcare providers’ work practices. Due to this scenario, the authors here discuss the role of medico-legal experts in Italy, focusing on sepsis and nosocomial infections

Sepsis and nosocomial infections: The role of medico-legal experts in Italy

Sepsis is a leading cause of morbidity and mortality worldwide. It is defined as the presence of a Systemic Inflammatory Response Syndrome, and it represents a significant burden for the healthcare system. This is particularly true when it is diagnosed in the setting of nosocomial infections, which are usually a matter of concern with regard to medical liability being correlated with increasing economic costs and people’s loss of trust in healthcare. Hence, the Italian governance promotes the clinical risk management with the aim of improving the quality and safety of healthcare services. In this context, the role of medico-legal experts working in a hospital setting is fundamental for performing autopsy to diagnose sepsis and link it with possible nosocomial infections. On the other hand, medico-legal experts are party to the clinical risk management assessment, and deal with malpractice cases and therefore contribute to formulating clinical guidelines and procedures for improving patient safety and healthcare providers’ work practices. Due to this scenario, the authors here discuss the role of medico-legal experts in Italy, focusing on sepsis and nosocomial infections

SARS-COV-2 Pandemic for Patients with Chronic Obstructive Peripheral Arterial Disease: Impact of Interruption to Access According to Gender in a Single Center Experience

Background: This retrospective study aims to evaluate the impact of interrupted services for peripheral arterial disease (PAD) patients and especially women in a single north-eastern Italian center over a period of 3 months prior to the pandemic, during the first (2020) and the second (2021) wave of contagion in northern Italy. Methods: Patients with PAD at Rutherford stages 3 to 6 that required revascularization between March 2019 and March 2021 were classified into 3 groups, according to the period of treatment: the prepandemic period, the pandemic-20 period, and the pandemic-21 period. Results: Twenty-eight patients were treated in the prepandemic period, 21 in the pandemic-20 period, and 39 in the pandemic-21 period. It was observed that in the both pandemic periods patients presented with more severe stages of limb ischemia, Rutherford 5 and 6 stages. During pandemic-20, patients underwent mostly open surgery, followed by hybrid procedures. No differences were observed between the 3 groups in major amputations, length of hospital stay, type of discharge, limb salvage and mortality. During long-term follow-up, limb salvage appeared to be significantly better in the pandemic-21 group. The gender analysis revealed a significantly reduced female proportion of overall treated patients in 2020 and 2021 compared to the prepandemic period. In the pandemic-20 this difference appears even more evident since treatments on females represented 19% of the total while in the same period of the previous year the male/female percentage was comparable (54% vs. 46%). The women admitted presented higher stages of disease and tended to have a longer hospital stay than men. At 12-month follow-up, limb salvage was similar between the 2 genders but was slightly worse in women. Conclusions: An efficient reorganization of the vascular surgery services during the pandemic period guaranteed the quality and standard of treatment offered in the preceding periods. Among patients suffering from PAD the impact of the pandemic was greater for the female gender. It is therefore important that in addition to a reorganization of hospital services to provide adequate care for patients with ACOP in the pandemic period, greater information and awareness of women

Implementing a Multi-Component School-based Obesity Prevention Intervention: A Qualitative Study

Objective: To explore barriers and facilitators to implementing and sustaining Healthy Choices, a three-year multi-component obesity prevention intervention implemented in middle schools in Massachusetts. Methods: Using purposive sampling, 56 in-depth interviews were conducted with middleschool employees representing different positions (administrators, teachers, food service personnel, and employees serving as intervention coordinators). Interviews were recorded and transcribed. Emergent themes were identified using thematic analyses. Results: State-mandated testing, budget limitations, and time constraints were viewed as implementation barriers while staff buy-in and technical assistance were seen as facilitating implementation. Respondents felt that intervention sustainability was dependent on external funding and expert assistance. Conclusions and Implications: Results confirm the importance of gaining faculty and staff support. Schools implementing large scale interventions should consider developing sustainable partnerships with organizations that can provide resources and ongoing training. Sustainability of complex interventions may depend on state-level strategies that provide resources for implementation and technical assistance