880 research outputs found

    Driver Knowledge, Beliefs, and Attitudes About Deer–Vehicle Collisions in Southern Michigan

    Get PDF
    Deer–vehicle collisions (DVCs) are one of the most frequent and costly human– wildlife conflict throughout the range of white-tailed deer (Odocoileus virginianus). We conducted a self-administered, mail-back survey of Michigan drivers to determine: (1) driver attitudes and knowledge about DVCs; (2) reporting rates of DVCs; and (3) effects of being in a DVC on attitudes toward desired deer population levels. From a sample of 3,600 randomly selected licensed drivers \u3e18 years of age in southeast Michigan, we obtained 1,653 completed questionnaires (48% response rate). Although 18% of respondents reported experiencing \u3e1 DVC within 5 years of the survey and 81% of them perceived DVCs to be a serious problem, drivers stated a willingness to make only modest changes in their driving behavior to minimize risk of a DVC. Most respondents (79%) believed DVCs were unavoidable. Only 46% of drivers involved in \u3e1 DVCs indicated that they reported it to police, and 52% reported the DVC to their insurance company. Drivers involved in DVCs were more likely than other drivers to be male, drive more, be more knowledgeable about DVCs, and be more likely to desire a decrease in the deer population. If reporting rates revealed in this study are an indication of rates elsewhere, DVCs are a much greater hazard than previously estimated

    Impact of a Community Association on Integrated Suburban Housing Patterns

    Get PDF
    Community associations-neighbors who join together in recognition of common interests and sometimes in pursuit of greater political influence-appear and disappear with the ebb and flow of local issues. Home community organizations have concerned themselves with installation of improvements, such as sidewalks and sewers; others, with the quality of municipal services, property maintenance, and compliance with building and zoning laws. More recently, however, such community organizations have sprung into life for the purpose of dealing with the emotionally-charged issue of racial integration in their neighborhoods. This paper will explore the development of The Lomond Association, a community organization committed to a belief in racial integration, and will trace its impact on housing patterns within its jurisdictio

    L'hydrologie urbaine: nouvelles problématiques, nouvelles approches de solutions

    Get PDF
    La pratique de l'hydrologie, appliquée au milieu urbain, a beaucoup évolué depuis les années 1960. De nouveaux outils scientifiques, méthodologiques et technologiques ont été mis au point. En ce qui concerne les eaux pluviales urbaines, un changement de philosophie complet s'est produit. Aujourd'hui, des développements rapides continuent à se produire pour faire face de la meilleure manière possible aux graves problèmes qui se posent en zone urbaine : inondation et pollution du milieu naturel. Deux approches récentes illustrent ces développements : la gestion des risques et l'approche globale sur le bassin versant. Une évaluation de plus en plus précise de l'aléa et de la vulnérabilité s'avère nécessaire ainsi qu'une planification hydrologique bassin versant par bassin versant. Celle-ci devrait conduire à définir et à hiérarchiser les principaux objectifs que l'on se fixe dans les domaines du contrôle des inondations, du contrôle de l'érosion, de l'amélioration du milieu naturel et de la protection de l'environnement. Les actions à mener doivent utiliser les outils de modélisation des phénomènes hydrologiques sur les bassins versants. L'efficacité de ces approches est illustrée par un exemple pris sur le bassin versant de la rivière Beauport au Québec.Urban hydrology practice has evolved a great deal, keeping up with the evolution of urban problems. Thus, professional engineers have had to keep up with this evolution, in order to understand the effects of urbanization on the hydrological behavior of the systems for which they have to recommend best solutions. Engineers have also had to evolve from the traditional approach of a limited vision of the problem, of its extent and of its impacts on the system. A global vision of the entire system, grouping every watershed element, such as forestry, agriculture or urbanization, is necessary if one is to circumscribe the problem, to analyze it and to reach to the best long-lasting solution. This article represents a synthesis of the hydrological disturbance phenomenon caused by uncontrolled urbanization, not properly planned, which is often characterized by numerous short-term solutions, often ineffective in the context of a long-lasting approach.Examples of natural disasters caused by meteorological events are more and more frequent. Take the case of Vaison-la-Romaine, in September 1992, where the Groseau devastated the Vaison community. More recently, the 1996 summer floods in the Saguenay region, in Québec, demonstrate once more that water always tends to return to its original bed, now occupied by artificial structures. When these types of events are analyzed in detail, we notice that meteorological phenomena are not always the main cause of the disaster cause and that often part of the responsibility lies with the occurrence of human activity in the catchment. This observation shows the importance of using wisdom and humility towards these natural forces and of anticipating, during design, a "secure" passage for the inevitable flows that one day will exceed the structure capacity. Knowing all the interactions that exist in the heart of the stormwater management problems, it is risky to intervene in isolation without analyzing the impact of the action. The approach must then be global and coherent; the tool necessary for success is the stormwater master plan made on a watershed basis. The master plan allows us to properly describe the problematical elements, to identify the real causes and to optimize the location of the control solutions. It also allows us to manage the increase in stormwater due to urbanization, with the "flow set point" concept of each watercourse tributary.This article presents an application example where the global analysis approach is used and where the solution involves different interventions and developments, which, when combined, effectively treat backwater effects, flooding and erosion in the presented area. The master plan of the watershed containing this sector had already been conceived and the specific flows of each of its tributaries had been identified; the global approach method therefore allowed us to settle the local problems in the studied area while respecting the flow granted by the master plan. Finally, a floodable plain, containing marshes, completes the intervention plan by combining the restoration of certain watercourse ecological characteristics with the need for flood control. This example demonstrates the necessity and the advantages of approaching urban drainage problems at the watershed level. However, watershed management concepts lead planners and designers to deal with antagonisms: urbanization or renaturalization? Obviously, in urban areas, the return to natural conditions is impossible and the disturbances to watercourses generated by urbanization cannot all be compensated for. Rather, we must aspire to the establishment of a balanced environment by controlling inflows produced by the watershed and by supporting the system to receive them. The notion of feasibility must always occupy the thoughts of the master plan designers and planners. The credibility and the continuity of the master plan depend on all these considerations; any unrealistic flow order, on an implementation level, can compromise the balance of the management plan and its applicability, which in turn can lead to a confused plan, possibly having disastrous consequences. The ultimate consequence of the management plan is the protection of the watercourse, the development of which can be designed to meet different criteria, such as flood control, erosion control, ecological potential enhancement, etc. It is at this stage that management becomes most complex: flood control, for example, does not apply to the same type of events as erosion control. The former requires management of major hydrological events, whereas the second needs implies control of frequent flows, which are at the origin of bank undermining caused by differential volume excesses. The management scheme must then handle multiple events and multiple criteria; consequently, it becomes more complex but also grows in value and justifies itself more adequately. Furthermore, the whole question of watercourse quality, in the broad sense of the term, must be managed from a frequent-event point of view, as this yields the best physical, ecological and aesthetic image of the aquatic environment. To this effect, present efforts in the control of combined sewage network overflows can be seen as a predecessor of what will later be extended to the entire stormwater network. This whole aspect of management has not been treated in this paper, as many others are dedicated to doing so. The evolution of the situation is similar in France and in Québec; coherent watershed management must rest on clear political goals regarding environmental use, risk protection and urban development. The stormwater master plan must, permanently, become part of the water resource master plan for the whole watershed, with its objectives of flood control, erosion control and maintenance of acceptable physical-chemical and biochemical water quality, as well as assured resource use (drinking water--, hydroelectricity, agriculture, industrial waters, etc.). This water resource master plan will have to be integrated in the same way as the French Water Agencies do today, and as Québec is preparing to do so

    Cost and Utilization of Behavioral Health Medications Associated with Rescission of an Exemption for Prior Authorization for Severe and Persistent Mental Illness in the Vermont Medicaid Program

    Get PDF
    BACKGROUND: In recent years, many state Medicaid programs have implemented preferred drug lists (PDL) to control pharmaceutical costs by generating supplemental rebate revenues and directing providers to the most cost-effective treatments. Two states, Michigan and Vermont, sought approval from the Centers for Medicare and Medicaid Services for supplemental rebates for their Medicaid fee-for-service programs in 2002. Behavioral health medications were largely excluded from PDLs and other managed care initiatives implemented by state Medicaid programs because of significant opposition to any impact on this vulnerable population. In November 2001, the Vermont Medicaid program implemented the Vermont Health Access Pharmacy Benefit Management Program, a PDL designed to promote cost-effective use of medications. Despite the potential cost savings resulting from implementation of a PDL, behavioral health providers and advocates in the state of Vermont opposed the implementation of the managed care initiative for beneficiaries with severe mental illness, and after January of 2002, Vermont\u27s program was changed to exempt beneficiaries meeting the severe and persistent mental illness (SPMI) criteria from prior authorization (PA) for behavioral health medications not on the Medicaid PDL. The SPMI exemption was phased out by June 30, 2006. OBJECTIVES: To determine the effects of the rescission of the PA exemption on utilization and costs of 3 classes of behavioral health medications (antidepressants, antipsychotics, and anxiolytics/sedatives). Secondary analyses were conducted to assess the association between rescission of the PA exemption and 2 quality measures that might be associated with pharmacy management policy: (a) behavioral health hospitalizations and (b) high-dose prescribing of antipsychotics, defined as dosing that exceeded the manufacturer-recommended maximum dose by 25%. METHODS: This was a retrospective analysis of pharmacy claims for beneficiaries of the Office of Vermont Health Access Medicaid Program for dates of service from July 1, 2005, through December 31, 2007. The 12-month PA exemption period for 3 categories of drugs (antidepressants, antipsychotics, and anxiolytics/sedatives) was July 1, 2005, through June 30, 2006; and the post-PA exemption period was the 12 months from January 1, 2007, through December 31, 2007, following rescission of the SPMI exemption. Costs in this analysis were defined as the amount paid by Medicaid, excluding federal drug rebates paid by drug manufacturers and supplemental rebates associated with the PDL program. Costs were adjusted for inflation using the Consumer Price Index for medical costs. Frequencies were used to identify trends between medication classes and time periods. Medical claims from the 2 time periods were used to assess inpatient hospitalization trends. Descriptive statistics, Pearson chi-square tests (for categorical data), and t-tests (for continuous data) were used to assess the 2 study cohorts. RESULTS: 17.8% (n=22,130) of 124,169 eligible beneficiaries in the PA exemption period had 1 or more pharmacy claims in the 3 classes of medications exempt from PA versus 19.2% (n=23,717) of 123,499 eligible beneficiaries in the post-PA exemption period. Utilization of behavioral medications per member per month (PMPM) increased by 14.3% from 0.14 claims PMPM in the PA exemption period to 0.16 claims PMPM in the post-PA exemption period, similar to the 14.1% increase in the utilization of nonbehavioral medications (from 0.64 to 0.73 claims PMPM). Utilization changed little between the PA exemption period and the post-PA exemption period for the 3 individual classes of behavioral health drugs, 0.08 claims PMPM versus 0.09 claims PMPM for antidepressants and 0.03 for both study periods for both antipsychotics and anxiolytics/sedative hypnotics. PMPM costs for the 3 drug classes exempt from PA increased by 2.1% from 12.76to12.76 to 13.03, compared with a 12.2% increase from 42.58PMPMto42.58 PMPM to 47.79 PMPM for nonbehavioral health medications. The small 2.1% increase in PMPM costs for the 3 formerly PA-exempt drug classes was attributable in part to a 12.9% reduction in average cost per pharmacy claim, from 94.05to94.05 to 81.92, including a 24.8% reduction in the average cost per antidepressant claim, from 65.59to65.59 to 49.33. For the subgroup of beneficiaries taking atypical antipsychotic medications, the percentage with high-dose prescriptions decreased from 3.1% to 2.2%. Mental health inpatient hospitalizations also decreased from 0.6% of beneficiaries in the PA exemption period to 0.4% in the post-PA exemption period. CONCLUSIONS: In a Medicaid population excluding Medicare dual-eligible beneficiaries, the rescission of a PA exemption for 3 major classes of behavioral health medications in a PDL was not associated with decreased utilization of formerly PA-exempt behavioral health medications. The increase in PMPM spending for the formerly PA-exempt behavioral health medications was small compared with the increase in PMPM cost for nonbehavioral health medications, and there were fewer beneficiaries with hospitalization for mental health reasons in the period after rescission of the PA exemption

    L'agressivité et l'anxiété chez les enfants maltraités

    Get PDF

    Characterization of Major Surface Protease Homologues of Trypanosoma congolense

    Get PDF
    Trypanosomes encode a family of proteins known as Major Surface Metalloproteases (MSPs). We have identified six putative MSPs encoded within the partially sequenced T. congolense genome. Phylogenic analysis indicates that T. congolense MSPs belong to five subfamilies that are conserved among African trypanosome species. Molecular modeling, based on the known structure of Leishmania Major GP63, reveals subfamily-specific structural variations around the putative active site despite conservation of overall structure, suggesting that each MSP subfamily has evolved to recognize distinct substrates. We have cloned and purified a protein encoding the amino-terminal domain of the T. congolense homologue TcoMSP-D (most closely related to Leishmania GP63). We detect TcoMSP-D in the serum of T. congolense-infected mice. Mice immunized with the amino-terminal domain of TcoMSP-D generate a persisting IgG1 antibody response. Surprisingly, a low-dose challenge of immunized mice with T. congolense significantly increases susceptibility to infection, indicating that immunity to TcoMSP-D is a factor affecting virulence

    Large-Scale Integration of Nanoelectromechanical Systems for Gas Sensing Applications

    Get PDF
    We have developed arrays of nanomechanical systems (NEMS) by large-scale integration, comprising thousands of individual nanoresonators with densities of up to 6 million NEMS per square centimeter. The individual NEMS devices are electrically coupled using a combined series-parallel configuration that is extremely robust with respect to lithographical defects and mechanical or electrostatic-discharge damage. Given the large number of connected nanoresonators, the arrays are able to handle extremely high input powers (>1 W per array, corresponding to <1 mW per nanoresonator) without excessive heating or deterioration of resonance response. We demonstrate the utility of integrated NEMS arrays as high-performance chemical vapor sensors, detecting a part-per-billion concentration of a chemical warfare simulant within only a 2 s exposure period
    corecore