The Practitioner\u27s Corner: An exploration of municipal active living charter development and advocacy

Background: Numerous municipal active living-­‐related charters have been adopted to promote physical activity in Canada throughout the past decade. Despite this trend, there are few published critical examinations of the process through which charters are developed and used. Purpose: Thus, the purpose of this study was to establish greater understanding of active living charter development and advocacy. Methods: Semi-­‐structured interviews were conducted with eight primary contributors to different active living-­‐related charters across Ontario, Canada. Interview questions explored participants’ experiences developing and advocating for an active living charter. Interviews were analyzed using open, axial, and selective coding. Results and Conclusions: Participants consistently described a process whereby an impetus triggered the development of a charter, which was subsequently adopted by regional or municipal council. Continued advocacy to develop awareness of the charter and to promote desired outcomes in the community was valued and the capacity of the working group as well as the local political context played pivotal roles in determining how the charter was implemented. Outcomes were, however, only objectively evaluated in one case that was described – evaluation being a process that many participants thought was omitted in regard to their own charter. This work provides practical guidance for health professionals developing regional active living charters as a component of broader advocacy efforts

Examining the Potential for Bundling the Attractions Along the Grand Strand

The Grand Strand area offers a broad assortment of entertainment and amusement options for its 14 million annual visitors. This paper examines the possibility of price bundling of area attractions. Two options are advanced: Targeted Selections and Broader Selections. Market-specific factors (such as seasonal demand for some attractions) may limit the effectiveness of such programs. As such, possible solutions to these market-specific factors are advanced

Agri-Tainment: Combining Agriculture and Entertainment Along the Grand Strand

This paper provides an overview of the benefits sought by consumers from Agri-tainment venues and the challenges of establishing such venues. The paper begins by defining Agri-tainment, and providing examples of established Agri-tainment venues across the United States and within the Grand Strand area of South Carolina. It then provides a series of Supporting Statements regarding likely benefits and Cautionary Statements associated with Agri-tainment, and concludes with potential resources for expanding the offering of Agri-tainment venues along the Grand Strand

Using population surfaces and spatial metrics to track the development of deprivation landscapes in Glasgow, Liverpool, and Manchester between 1971 and 2011

Measuring change in the spatial arrangement of deprivation over time, and making international, inter-city comparisons, is technically challenging. Meeting these challenges offers a means of furthering understanding and providing new insights into the geography of urban poverty and deprivation. In this paper, we introduce a novel approach to mapping and analysing spatio-temporal patterns of household deprivation, assessing the distribution at the landscape level. The approach we develop has advantages over existing techniques because it is applicable in situations where i) conventional approaches based on choropleth mapping are not feasible due to boundary change and/or ii) where spatial relationships at a landscape level are of interest. Through the application of surface mapping techniques to disaggregate census count data, and by applying spatial metrics commonly used in ecology, we were able to compare the development of the spatial arrangement of deprivation between 1971 and 2011 in three UK cities of particular interest: Glasgow, Manchester and Liverpool. Applying three spatial metrics – spatial extent, patch density, and mean patch size – revealed that over the 40 year period household deprivation has been more spatially dispersed in Glasgow. This novel approach has enabled an analysis of deprivation distributions over time which is less affected by boundary change and which accurately assesses and quantifies the spatial relationships between those living with differing levels of deprivation. It thereby offers a new approach for researchers working in this area

Cleaning Process Development for Metallic Additively Manufactured Parts

Additive Manufacturing of metallic components for aerospace applications offers many advantages over traditional manufacturing techniques. As a new technology, many aspects of its widespread utilization remain open to investigation. Among these are the cleaning processes that can be used for post finishing of parts and measurements to verify effectiveness of the cleaning processes. Many cleaning and drying processes and measurement methods that have been used for parts manufactured using conventional techniques are candidates that may be considered for cleaning and verification of additively manufactured parts. Among these are vapor degreasing, ultrasonic immersion and spray cleaning, followed by hot air drying, vacuum baking and solvent displacement drying. Differences in porosity, density, and surface finish of additively manufactured versus conventionally manufactured parts may introduce new considerations in the selection of cleaning and drying processes or the method used to verify their effectiveness. This presentation will review the relative strengths and weaknesses of different candidate cleaning and drying processes as they may apply to additively manufactured metal parts for aerospace applications. An ultrasonic cleaning technique for exploring the cleanability of parts will be presented along with an example using additively manufactured Inconel 718 test specimens to illustrate its use. The data analysis shows that this ultrasonic cleaning approach results in a well-behaved ultrasonic cleaning/extraction behavior. That is, it does not show signs of accelerated cavitation erosion of the base material, which was later confirmed by neutron imaging. In addition, the analysis indicated that complete cleaning would be achieved by ultrasonic immersion cleaning at approximately 5 minutes, which was verified by subsequent cleaning of additional parts

A Prospective Evaluation of Opioid Utilization After Upper-Extremity Surgical Procedures: Identifying Consumption Patterns and Determining Prescribing Guidelines.

BACKGROUND: Although adequate management of postoperative pain with oral analgesics is an important aspect of surgical procedures, inadvertent overprescribing can lead to excess availability of opioids in the community for potential diversion. The purpose of our study was to prospectively evaluate opioid consumption following outpatient upper-extremity surgical procedures to determine opioid utilization patterns and to develop prescribing guidelines. METHODS: All patients undergoing outpatient upper-extremity surgical procedures over a consecutive 6-month period had the following prospective data collected: patient demographic characteristics, surgical details, anesthesia type, and opioid prescription and consumption patterns. Analysis of variance and post hoc comparisons were performed using t tests, with the p value for multiple pairwise tests adjusted by the Bonferroni correction. RESULTS: A total of 1,416 patients with a mean age of 56 years (range, 18 to 93 years) were included in the study. Surgeons prescribed a mean total of 24 pills, and patients reported consuming a mean total of 8.1 pills, resulting in a utilization rate of 34%. Patients undergoing soft-tissue procedures reported requiring fewer opioids (5.1 pills for 2.2 days) compared with fracture surgical procedures (13.0 pills for 4.5 days) or joint procedures (14.5 pills for 5.0 days) (p \u3c 0.001). Patients who underwent wrist surgical procedures required a mean number of 7.5 pills for 3.1 days and those who underwent hand surgical procedures required a mean number of 7.7 pills for 2.9 days, compared with patients who underwent forearm or elbow surgical procedures (11.1 pills) and those who underwent upper arm or shoulder surgical procedures (22.0 pills) (p \u3c 0.01). Procedure type, anatomic location, anesthesia type, age, and type of insurance were also all significantly associated with reported opioid consumption (p \u3c 0.001). CONCLUSIONS: In this large, prospective evaluation of postoperative opioid consumption, we found that patients are being prescribed approximately 3 times greater opioid medications than needed following upper-extremity surgical procedures. We have provided general prescribing guidelines, and we recommend that surgeons carefully examine their patients\u27 opioid utilization and consider customizing their opioid prescriptions on the basis of anatomic location and procedure type to prescribe the optimal amount of opioids while avoiding dissemination of excess opioids