98 research outputs found
Targeting the Premium Market: Organic Crops for Iowa
According to the USDA Economic Research Service, statistics on organic production in the U.S. lag far behind those complied for conventional agriculture. In the last USDA census in 1995, there were 4,050 organic farmers reporting 1.5 million acres of production (Greene 1999). The Organic Farming Research Foundation estimates that there were 10,000 U.S. organic farmers in 1998. In Iowa, 120,000 acres of organic production were reported to the Iowa Department of Agriculture and Land Stewardship (IDALS 1999). This figure reflects only acreage reported by those farmers who returned their survey; thus, more acres are believed to go unreported. This increase in organic acreage represents a doubling from the previous year, and a four-fold increase since 1993. The organic industry has been experiencing a 20% annual growth rate, with U.S. sales listed at $4.5 billion in 1998 (OT A 1998). The organic industry is a consumer-driven market based on consumers\u27 belief that organic products are safer for human consumption and beneficial to the environment (Bourne 1999). Many consumers affirm the superior health benefits and taste of organic products (Sylvander 1993), although scientific studies are limited, except in the area of pesticide content (C.U. 1999). Researchers found 52% more of the conventional produce on U.S. supermarket shelves contained pesticide residues compared with the organic produce
PCV34 FINANCIAL ASSESSMENT OF A COMPREHENSIVE CARDIAC CARE PROGRAM FOR PATIENTS WITH OCCULSIVE CORONARY ARTERY DISEASE
The Effect of Natural Mulches on Crop Performance, Weed Suppression and Biochemical Constituents of Catnip and St. John\u27s Wort
Because of expanding markets for high-value niche crops, opportunities have increased for the production of medicinal herbs in the USA. An experiment was conducted in 2001 and 2002 near Gilbert, IA, to study crop performance, weed suppression, and environmental conditions associated with the use of several organic mulches in the production of two herbs, catnip (Nepeta cataria L.) and St. John\u27s wort (Hypericum perforatum L. ‘Helos’). Treatments were arranged in a completely randomized design and included a positive (hand-weeded) control, a negative (nonweeded) control, oat straw, a flax straw mat, and a nonwoven wool mat. Catnip plant height was significantly greater in the oat straw than the other treatments at 4 wk through 6 wk in 2001; at 4 to 8 wk in 2002, catnip plant height and width was significantly lower in the negative control compared with the other treatments. Catnip yield was significantly higher in the flax straw mat than all other treatments in 2001. In 2002, St. John\u27s wort yields were not statistically different in any treatments. All weed management treatments had significantly fewer weeds than the non-weeded rows in 2002. Total weed density comparisons in each crop from 2 yr showed fewer weeds present in the flax straw and wool mat treatments compared with positive control plots. There was no significant weed management treatment effect on the concentration of the target compounds, nepetalactone in catnip and pseudohypericin–hypericin in St. John\u27s wort, although there was a trend toward higher concentrations in the flax straw treatment
Informing the development of an online self-management program for men living with HIV: a needs assessment
Background: The aim of this mixed methods study was to conduct a multifaceted needs assessment to inform the development of an online self-management program for men living with HIV. The objectives were to describe the health-related quality of life for men living with HIV, the impact of living with HIV, and the perceived problem areas and service and support needs of these men. The needs assessment was conducted in accordance with the PRECEDE model for health promotion program planning.Methods: A survey assessing the quality of life of men living with HIV (n = 72) was conducted and results were compared to Australian normative data. Focus groups were also undertaken with men living with HIV (n = 11) and a multidisciplinary team of service providers working in the area of HIV (n = 11). Focus groups enabled an in-depth description of the impact of HIV on quality of life and perceived problem areas in daily life.Results: HIV-positive men experience significantly lower quality of life when compared with Australian normative data, particularly in those domains concerned with social and emotional aspects of quality of life. Qualitative focus groups yielded an overarching theme ‘The psychosocial impact of HIV’ which contained three sub-themes; (1) Life before and after HIV – a changed identity and its repercussions; (2) Resilience and the importance of social support; (3) Negotiating the practicalities – intimate relationships and disclosure.Conclusions: The findings from this needs assessment highlight the need to target socio-emotional contexts of HIV positive men’s daily lives to improve quality of life and well-being. Intervention priorities for the proposed online self-management program include: (1) managing the emotional impact of HIV; (2) disclosing HIV status to family and friends; (3) maintaining social connectedness; (4) managing HIV within intimate relationships; and (5) disclosure of HIV status to intimate partners
Green and animal manure use in organic field crop systems
Dual-use cover/green manure (CGM) crops and animal manure are used to supply nitrogen (N) and phosphorus (P) to organically grown field crops. A comprehensive review of previous research was conducted to identify how CGM crops and animal manure have been used to meet N and P needs of organic field crops, and to identify knowledge gaps to direct future research efforts. Results indicate that: (a) CGM crops are used to provide N to subsequent cash crops in rotations; (b) CGM-supplied N generally can meet field crop needs in warm, humid regions but is insufficient for organic grain crops grown in cool and sub-humid regions; (c) adoption of conservation tillage practices can create or exacerbate N deficiencies; (d) excess N and P can result where animal manures are accessible if application rates are not carefully managed; and (e) integrating animal grazing into organic field crop systems has potential benefits but is generally not practiced. Work is needed to better understand the mechanisms governing the release of N by CGM crops to subsequent cash crops, and the legacy effects of animal manure applications in cool and sub-humid regions. The benefits and synergies that can occur by combining targeted animal grazing and CGMs on soil N, P, and other nutrients should be investigated. Improved communication and networking among researchers can aid efforts to solve soil fertility challenges faced by organic farmers when growing field crops in North America and elsewhere
The positive outlook study- a randomised controlled trial evaluating the effectiveness of an online self-management program targeting psychosocial issues for men living with HIV: a study protocol
Background: The emergence of HIV as a chronic condition means that people living with HIV are required to takemore responsibility for the self-management of their condition, including making physical, emotional and socialadjustments. This paper describes the design and evaluation of Positive Outlook, an online program aiming toenhance the self-management skills of gay men living with HIV.Methods/design: This study is designed as a randomised controlled trial in which men living with HIV in Australiawill be assigned to either an intervention group or usual care control group. The intervention group willparticipate in the online group program ‘Positive Outlook’. The program is based on self-efficacy theory and uses aself-management approach to enhance skills, confidence and abilities to manage the psychosocial issues associatedwith HIV in daily life. Participants will access the program for a minimum of 90 minutes per week over seven weeks.Primary outcomes are domain specific self-efficacy, HIV related quality of life, and outcomes of health education.Secondary outcomes include: depression, anxiety and stress; general health and quality of life; adjustment to HIV;and social support. Data collection will take place at baseline, completion of the intervention (or eight weeks postrandomisation) and at 12 week follow-up.Discussion: Results of the Positive Outlook study will provide information regarding the effectiveness of onlinegroup programs improving health related outcomes for men living with HIV
Understanding the agreements and controversies surrounding childhood psychopharmacology
The number of children in the US taking prescription drugs for emotional and behavioral disturbances is growing dramatically. This growth in the use of psychotropic drugs in pediatric populations has given rise to multiple controversies, ranging from concerns over off-label use and long-term safety to debates about the societal value and cultural meaning of pharmacological treatment of childhood behavioral and emotional disorders. This commentary summarizes the authors' eight main findings from the first of five workshops that seek to understand and produce descriptions of these controversies. The workshop series is convened by The Hastings Center, a bioethics research institute located in Garrison, New York, U.S.A
Interventions designed to improve the quality and efficiency of medication use in managed care: A critical review of the literature – 2001–2007
<p>Abstract</p> <p>Background</p> <p>Managed care organizations use a variety of strategies to reduce the cost and improve the quality of medication use. The effectiveness of such policies is not well understood. The objective of this research was to update a previous systematic review of interventions, published between 1966 and 2001, to improve the quality and efficiency of medication use in the US managed care setting.</p> <p>Methods</p> <p>We searched MEDLINE and EMBASE for publications from July 2001 to January 2007 describing interventions targeting drug use conducted in the US managed care setting. We categorized studies by intervention type and adequacy of research design using commonly accepted criteria. We summarized the outcomes of well-controlled strategies and documented the significance and magnitude of effects for key study outcomes.</p> <p>Results</p> <p>We identified 164 papers published during the six-year period. Predominant strategies were: educational interventions (n = 20, including dissemination of educational materials, and group or one-to-one educational outreach); monitoring and feedback (n = 22, including audit/feedback and computerized monitoring); formulary interventions (n = 66, including tiered formulary and patient copayment); collaborative care involving pharmacists (n = 15); and disease management with pharmacotherapy as a primary focus (n = 41, including care for depression, asthma, and peptic ulcer disease). Overall, 51 studies met minimum criteria for methodological adequacy. Effective interventions included one-to-one academic detailing, computerized alerts and reminders, pharmacist-led collaborative care, and multifaceted disease management. Further, changes in formulary tier-design and related increases in copayments were associated with reductions in medication use and increased out-of-pocket spending by patients. The dissemination of educational materials alone had little or no impact, while the impact of group education was inconclusive.</p> <p>Conclusion</p> <p>There is good evidence for the effectiveness of several strategies in changing drug use in the managed care environment. However, little is known about the cost-effectiveness of these interventions. Computerized alerts showed promise in improving short-term outcomes but little is known about longer-term outcomes. Few well-designed, published studies have assessed the potential negative clinical effects of formulary-related interventions despite their widespread use. However, some evidence suggests increases in cost sharing reduce access to essential medicines for chronic illness.</p
Physical and emotional health outcomes after 12 months of public-sector antiretroviral treatment in the Free State Province of South Africa: a longitudinal study using structural equation modelling
<p>Abstract</p> <p>Background</p> <p>African and Asian cohort studies have demonstrated the clinical efficacy of antiretroviral treatment (ART) in resource-limited settings. However, reports of the long-term changes in the physical and emotional quality of life (QoL) of patients on ART in these settings are still scarce. In this study, we assessed the physical and emotional QoL after six and 12 months of ART of a sample of 268 patients enrolled in South Africa's public-sector ART programme. The study also tested the impact of the adverse effects of medication on patients' physical and emotional QoL.</p> <p>Methods</p> <p>A stratified random sample of 268 patients undergoing ART was interviewed at baseline (< 6 months ART) and follow-up (< 12 months ART). A model of the relationships between the duration of ART, the adverse effects of medication, and physical and emotional QoL (measured using EUROQOL-5D) was tested using structural equation modelling.</p> <p>Results</p> <p>The improved physical and emotional QoL shown at baseline was sustained over the 12-month study period, because treatment duration was not significantly associated with changes in the patients' QoL. Physical QoL significantly and positively influenced the patients' emotional QoL (subjective well-being [SWB]) (β = 0.33, <it>P </it>< 0.01). Longitudinal data showed that patients reported significantly fewer adverse effects at follow-up than at baseline (β = -0.38, <it>P </it>< 0.001) and that these adverse effects negatively influenced physical (β = -0.27, <it>P </it>< 0.01) and emotional QoL (β = -0.15, <it>P </it>< 0.05).</p> <p>Conclusion</p> <p>This study provides evidence that the South African public-sector ART programme is effective in delivering sustained improvement in patient well-being. However, the results should encourage clinicians and lay health workers to be vigilant regarding the adverse effects of treatment, because they can seriously affect physical and emotional QoL.</p
Factors affecting residents transition from long term care facilities to the community: a scoping review
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