Ethanol: Implications for Rural Communities

This paper presents an overview of the U.S. ethanol industry, its location, and the public policy umbrella that supports its growth. Then the paper analyzes what happens when a county adds an ethanol plant, demonstrates what must be done to modify input-output models to capture those effects realistically, and applies the approach to proposed plants in three counties.Resource /Energy Economics and Policy,

Perceptions of emergency department crowding in the commonwealth of Pennsylvania

Introduction: The state of emergency department (ED) crowding in Pennsylvania has not previously been reported. Methods: We assessed perceptions of ED crowding by surveying medical directors/chairs from Pennsylvania EDs in the spring of 2008. Results: A total of 106 completed the questionnaire (68% response rate). A total of 83% (86/104) agreed that ED crowding was a problem; 26% (27/105) reported that at least half of admitted patients boarded for more than 4 hours. Ninety-eight percent (102/104) agreed that patient satisfaction suffers during crowding and 79% (84/106) stated that quality suffers. Sixty-five percent (68/105) reported that crowding had worsened during the past 2 years. Several hospital interventions were used to alleviate crowding: expediting discharges, 81% (86/106); prioritizing ED patients for inpatient beds, 79% (84/ 106); and ambulance diversion, 55% (57/105). Almost all respondents who had improved ED operations reported that it had reduced crowding. Conclusion: ED crowding is a common problem in Pennsylvania and is worsening in the majority of hospitals, despite the implementation of a variety of interventions. [West J EmergMed. 2013;14(1):1–10.

Monitoring international migration flows in Europe. Towards a statistical data base combining data from different sources

The paper reviews techniques developed in demography, geography and statistics that are useful for bridging the gap between available data on international migration flows and the information required for policy making and research. The basic idea of the paper is as follows: to establish a coherent and consistent data base that contains sufficiently detailed, up-to-date and accurate information, data from several sources should be combined. That raises issues of definition and measurement, and of how to combine data from different origins properly. The issues may be tackled more easily if the statistics that are being compiled are viewed as different outcomes or manifestations of underlying stochastic processes governing migration. The link between the processes and their outcomes is described by models, the parameters of which must be estimated from the available data. That may be done within the context of socio-demographic accounting. The paper discusses the experience of the U.S. Bureau of the Census in combining migration data from several sources. It also summarizes the many efforts in Europe to establish a coherent and consistent data base on international migration. The paper was written at IIASA. It is part of the Migration Estimation Study, which is a collaborative IIASA-University of Groningen project, funded by the Netherlands Organization for Scientific Research (NWO). The project aims at developing techniques to obtain improved estimates of international migration flows by country of origin and country of destination

Opportunities and restrictions for the local-endogenous development in metropolitan areas of high industrial concentration: the case of Thriasio Pedio in Attica

This paper investigates the development pattern of the urban area of Thriasio Pedio in the metropolitan region of Attica, which is characterised by a high concentration of industrial activities. The local-endogenous development model is discussed in the theoretical review of the paper, in the sense of the local socioeconomic system’s capacity to transform, react to external challenges, promote awareness and import specific forms of social regulation at the local level.On this ground, the main question of the paper concerns the nature of the area’s development and more specifically, whether or not this is defined by endogenous factors (i.e. the operation of locally embedded production systems) along with predetermined exogenous factors (i.e. the allocation of central/metropolitan activities in Thriasio Pedio). The study is supported by the results of a sampling research in representative economic units of the Thriasio Pedio area. The analysis helped us to see whether the various applications of the local-endogenous development pattern, as defined in the paper, are incorporated into the overall productive system of the area. The prerequisites for the reinforcement of the local endogenous capacity were also identified in this analysis

A cross-sectional study of US rural adults’ consumption of fruits and vegetables: do they consume at least five servings daily?

<p>Abstract</p> <p>Background</p> <p>Rural residents are increasingly identified as being at greater risk for health disparities. These inequities may be related to health behaviors such as adequate fruits and vegetable consumption. There is little national-level population-based research about the prevalence of fruit and vegetable consumption by US rural population adults. The objective of this study was to examine the prevalence differences between US rural and non-rural adults in consuming at least five daily servings of combined fruits and vegetables.</p> <p>Methods</p> <p>Cross-sectional analysis of weighted 2009 Behavioral Risk Factor Surveillance Survey (BRFSS) data using bivariate and multivariate techniques. 52,259,789 US adults were identified as consuming at least five daily servings of fruits and vegetables of which 8,983,840 were identified as living in rural locales.</p> <p>Results</p> <p>Bivariate analysis revealed that in comparison to non-rural US adults, rural adults were less likely to consume five or more daily servings of fruits and vegetables (OR = 1.161, 95% CI 1.160-1.162). Logistic regression analysis revealed that US rural adults consuming at least five daily servings of fruits and vegetables were more likely to be female, non-Caucasian, married or living with a partner, living in a household without children, living in a household whose annual income was > $35,000, and getting at least moderate physical activity. They were also more likely to have a BMI of <30, have a personal physician, have had a routine medical exam in the past 12 months, self-defined their health as good to excellent and to have deferred medical care because of cost. When comparing the prevalence differences between rural and non-rural US adults within a state, 37 States had a lower prevalence of rural adults consuming at least five daily servings of fruits and vegetables and 11 States a higher prevalence of the same.</p> <p>Conclusions</p> <p>This enhanced understanding of fruit and vegetable consumption should prove useful to those seeking to lessen the disparity or inequity between rural and non-rural adults. Additionally, those responsible for health-related planning could benefit from the knowledge of how their state ranks in comparison to others vis-à-vis the consumption of fruits and vegetables by rural adults---a population increasingly being identified as one at risk for health disparities.</p

Comparative empirical evaluations of internal migration models in subnational population projections

While population forecasters place considerable emphasis on the selection of appropriate migration assumptions, surprisingly little attention has been given to the effects on projection outcomes of the way internal migration is handled within population projection models. This paper compares population projections for Australia's states and territories prepared using ten different internal migration models but with identical assumptions for fertility, mortality and international migration and with the internal migration model parameters held constant. It is shown that the choice of migration model generates large differences in total population, geographical distribution and age--sex composition. It is argued that model choice should be guided by balancing model reality with practical utility and model performance is examined against these criteria. Of the ten models evaluated the authors argue that the migration pool, biregional, and biregional with net constraints models offer a good compromise between conceptual rigour and practicality. If the projected origin-destination flows are required then one of the versions of the standard multiregional model with reduced data inputs is preferred. The large variation in projection outputs points to the need for a better understanding of the spatio-temporal structure of migration in Australia

Doing the plastic fantastic: ‘artificial’ adventure and older adult climbers

The aim of this article is to determine the perceptions and experiences of climbing at artificial climbing walls (ACWs) as undertaken by a cohort of ‘young-old’ people (approximately 65–75 years). The engagement of older people in outdoor activities and adventure is an evolving topic; however, as part of this development, little has been written on the use of ACWs. Methodologically, the research employed in-depth semi-structured focus groups and interviews with a purposive convenience sample of six recreational climbers, subsequently expanded to ten through snowball technique. Both sexes were equally represented. Manual thematic analysis identified two key motifs: ACWs and the notion of adventure, and ACWs and the potential for learning. The findings point at what constitutes ‘real’ adventure for this group of older adults; the shifting nature of ‘old age’; the significance of self-awareness; and the role of reflexivity and physical activity in the construction of a ‘successful’ old age

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701