Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Organic Farming in West Virginia: A Behavioral Approach

Although organic production continues to expand and remains the fastest growing segment of the U.S. agricultural economy, demand for organics continues to outpace supply, causing a lag in the supply chain. One of many important elements to remedying this issue is for more farmers to adopt organic practices and/or transition to organic certification. One state well positioned to tap into eastern U.S. metro markets is West Virginia. Our study sought to understand the factors affecting West Virginia farmers' decision to farm organically, as well as the barriers limiting pursuit of certification. Though West Virginia has the highest number of small farms in the U.S., only five farms were USDA organic–certified in 2012. We used a mixed-methods approach to explore the barriers to implementing organic practices and pursuing organic certification. The methods included interviews and mailed surveys, garnering responses from more than 230 farmers in West Virginia. We applied a social-ecological system lens for the development of a statistical model to parse out the major variables affecting transition to organic methods. Our results suggest that the decision to farm organically is largely an economic one, with a lack of perceived benefits being nearly as influential as perceived constraints as barriers. We also found that social ties to certified organic farmers reduced the likelihood of others implementing organic production practices. Finally, we propose that the choice to farm organically and pursue organic certification be studied in a holistic manner that assesses motives, constraints, and barriers to implementing organic practices in conjunction with relevant contextual attributes (farm characteristics and personal demographics) that affect the decision-making process

Missing ecology: integrating ecological perspectives with the social-ecological system framework

The social-ecological systems framework was designed to provide a common research tool for interdisciplinary investigations of social-ecological systems. However, its origin in institutional studies of the commons belies its interdisciplinary ambitions and highlights its relatively limited attention to ecology and natural scientific knowledge. This paper considers the biophysical components of the framework and its epistemological foundations as it relates to the incorporation of knowledge from the natural sciences. It finds that the mixture of inductive and deductive reasoning associated with socially-oriented investigations of these systems is lacking on the ecological side, which relies upon induction alone. As a result the paper proposes the addition of a seventh core sub-system to the social-ecological systems framework, ecological rules, which would allow scholars to explicitly incorporate knowledge from the natural sciences for deductive reasoning. The paper shows, through an instructive case study, how the addition of ecological rules can provide a more nuanced description of the factors that contribute to outcomes in social-ecological systems

Missing ecology: integrating ecological perspectives with the social-ecological system framework

The social-ecological systems framework was designed to provide a common research tool for interdisciplinary investigations of social-ecological systems. However, its origin in institutional studies of the commons belies its interdisciplinary ambitions and highlights its relatively limited attention to ecology and natural scientific knowledge. This paper considers the biophysical components of the framework and its epistemological foundations as it relates to the incorporation of knowledge from the natural sciences. It finds that the mixture of inductive and deductive reasoning associated with socially-oriented investigations of these systems is lacking on the ecological side, which relies upon induction alone. As a result the paper proposes the addition of a seventh core sub-system to the social-ecological systems framework, ecological rules, which would allow scholars to explicitly incorporate knowledge from the natural sciences for deductive reasoning. The paper shows, through an instructive case study, how the addition of ecological rules can provide a more nuanced description of the factors that contribute to outcomes in social-ecological systems

Putting the "E" in SES: unpacking the ecology in the Ostrom social-ecological system framework

The Ostrom social-ecological system (SES) framework offers an interdisciplinary tool for studies of linked human-natural systems. However, its origin in the social sciences belies the effectiveness of its interdisciplinary ambitions and undermines its ability to cope with ecological complexity. To narrow the gap between inherently dynamic ecological systems and the SES framework, we need to explicitly recognize that SES outcomes are coproduced by social systems in which choices are made, as well as an ecological system with a diverse assortment of dynamic natural processes that mediate the effect of those choices. We illustrate the need for more explicit incorporation of ecological attributes into the SES framework by presenting a case study of a community-managed forest in Indiana, USA. A preliminary set of ecological attributes are also proposed for inclusion in the SES framework with the aim of spurring interest in further development of a truly interdisciplinary framework for the study of SESs

Human and biophysical legacies shape contemporary urban forests: a literature synthesis

Understanding how urban forests developed their current patterns of tree canopy cover, species composition,and diversity requires an appreciation of historical legacy effects. However, analyses of current urban forestcharacteristics are often limited to contemporary socioeconomic factors, overlooking the role of history. Theinstitutions, human communities, and biophysical conditions of cities change over time, creating layers of legacieson the landscape, shifting urban forests through complex interactive processes and feedbacks. Urbangreen spaces and planted trees can persist long after their establishment, meaning that today’s mature canopyreflects conditions and decisions from many years prior. In this synthesis article, we discuss some of the majorhistorical human and biophysical drivers and associated legacy effects expressed in present urban forest patterns,highlighting examples in the United States and Canada. The bioregional context – native biome, climate, topography,initial vegetation, and pre-urbanization land use – represents the initial conditions in which a cityestablished and grew, and this context influences how legacy effects unfold. Human drivers of legacy effects canreflect specific historical periods: colonial histories related to the symbolism of certain species, and the urbanparks and civic beautification movements. Other human drivers include phenomena that cut across time periodssuch as neighborhood urban form and socioeconomic change. Biophysical legacy effects include the consequencesof past disturbances such as extreme weather events and pest and disease outbreaks. Urban treeprofessionals play a major role in many legacy effects by mediating the interactions and feedbacks betweenbiophysical and human drivers. We emphasize the importance of historical perspectives to understand past drivers that have produced current urban forest patterns, and call for interdisciplinary and mixed methodsresearch to unpack the mechanisms of long-term urban forest change at intra- and inter-city scales

Admission Temperature and Associated Mortality and Morbidity among Moderately and Extremely Preterm Infants

ObjectiveTo evaluate the temperature distribution among moderately preterm (MPT, 29-33 weeks) and extremely preterm (EPT, <29 weeks) infants upon neonatal intensive care unit (NICU) admission in 2012-2013, the change in admission temperature distribution for EPT infants between 2002-2003 and 2012-2013, and associations between admission temperature and mortality and morbidity for both MPT and EPT infants.Study designProspectively collected data from 18 centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were used to examine NICU admission temperature of inborn MPT and EPT infants. Associations between admission temperature and mortality and morbidity were determined by multivariable logistic regression. EPT infants from 2002-2003 and 2012-2013 were compared.ResultsMPT and EPT cohorts consisted of 5818 and 3213 infants, respectively. The distribution of admission temperatures differed between the MPT vs EPT (P < .01), including the percentage <36.5°C (38.6% vs 40.9%), 36.5°C-37.5°C (57.3% vs 52.9%), and >37.5°C (4.2% vs 6.2%). For EPT infants in 2012-2013 compared with 2002-2003, the percentage of temperatures between 36.5°C and 37.5°C more than doubled and the percentage of temperatures >37.5°C more than tripled. Admission temperature was inversely associated with in-hospital mortality.ConclusionsLow and high admission temperatures are more frequent among EPT than MPT infants. Compared with a decade earlier, fewer EPT infants experience low admission temperatures but more have elevated temperatures. In spite of a change in distribution of NICU admission temperature, an inverse association between temperature and mortality risk persists