Evaluation of Kentucky\u27s Graduated Driver Licensing System

Kentucky\u27s current GDL program, which applies to drivers up to age 18, was enacted in 1996. The program includes a six-month instruction permit for drivers under age 18 (minimum age 16), a restriction on driving between midnight and 6am and a requirement for adult-supervised driving for permit drivers. In addition, there is a six-point limit on traffic violations with a penalty of license suspension for drivers under age 18, a requirement for a four-hour driving safety education class (or driver education course) and a 0.02 ml/dl limit on blood alcohol concentration (continues up to age 21 ). Objectives: The objectives of this program evaluation were: (a) to examine teen driver motor vehicle crashes, crash-related injuries, and crash-related costs before and after the implementation of the GDL program; (b) to examine the implementation of the program at the local level ; and (c) to recommend actions to enhance the program\u27s effectiveness in addressing the teen crash problem. Methods: Crash and licensing data before ( 1993-1995) and after GDL ( 1997-2000) were analyzed. Data on miles driven were obtained from driving logs of over I ,000 high school students. Estimation of the cost of crashes was derived from analysis of crash data using the Crash Cost computer software program. Information on local implementation of GDL was obtained through interviews and through a questionnaire survey of 700 law enforcement officers and over 40 district judges. Results: Results indicate a 31 percent reduction in crashes for 16 year-old drivers after the GDL program, and a similar reduction in fatal crashes (31 percent) and injury crashes (33 percent), crashes between midnight and 6am (36 percent), and alcohol-related crashes (32 percent). Cost analysis indicates an estimated reduction of $36 million per year in 16 year-old teen driver crash-related expenses. Results indicate that this is due to the 83% reduction in the number of 16 to 16 1/2 year-old drivers involved in crashes. However, the number of crashes has not been reduced for drivers over age 16 1/2, i.e. drivers who may be past the permit level. In addition, the six-point limit on traffic violations and the non-cumulative penalties on 0.02 blood alcohol limit violations have not reduced the number of traffic violations or alcohol-related crashes for teen drivers over age 16 1/2. Recommendations: The six-month permit level has been successful in substantially reducing crash-related injuries and fatalities and should be retained. Additional measures, such as upgrading to an expanded GDL program, are needed to reduce crash-related injuries and fatalities for 16 1/2 to 18 year-old drivers. Specific recommendation are made to increase parental awareness and enforcement of program provisions

Opioid Treatment Is Associated with Recurrent Healthcare Visits, Increased Side Effects, and Pain

Introduction: Pain is a major driver of visits to the emergency department (ED). Clinicians must consider not only the efficacy of treatment options but also subsequent healthcare utilization and patient-centered outcomes such as side effects from prescribed medications. Our goal in this study was to determine whether there was an association between acute pain treatment regimen (opioids, intranasal non-steroidal anti-inflammatory drugs [NSAIDs], or both) and unscheduled healthcare visits following ED discharge. Methods: This study was a secondary analysis of the Acute Management of Pain from the Emergency Department (AMPED) prospective, observational cohort study. We used Cox proportional hazards analysis to assess the relationship between treatment regimen and time to first unscheduled healthcare visit. Repeated measures logistic regression analyses were used to determine the relationship between treatment regimen and any unscheduled visits, and to evaluate whether this relationship was mediated by pain severity and/or medication side effects. Results: Of 831 total enrolled participants, 141 (16.9%) experienced an unplanned healthcare visit within five days of ED discharge. A majority of these visits happened one day after the ED visit. Those who were treated with intranasal NSAIDs only were less likely to have an unscheduled healthcare visit compared to those who received opioids only, with an adjusted odds ratio (AOR) of 0.63. The higher odds of unscheduled healthcare visits with opioids were mediated by both the presence of side effects and higher pain levels, with AORs of 2.24 and 1.33, respectively. Conclusion: Opioid treatment for acute pain is associated with increased unscheduled healthcare visits compared to those treated with intranasal ketorolac. This difference can be explained by higher levels of ongoing pain and greater medication side effects

Global patterns of freshwater species diversity, threat and cross-taxon congruence

Aim Global-scale studies are required to identify broad-scale patterns in the distributions of species, to evaluate the processes that determine diversity and to determine how similar or different these patterns and processes are among different groups of freshwater species. Broad-scale patterns of spatial variation in species distribution are central to many fundamental questions in macroecology and conservation biology. We aimed to evaluate how congruent three commonly used metrics of diversity were among taxa for six groups of freshwater species. Location Global. Methods We compiled geographical range data on 7083 freshwater species of mammals, amphibians, reptiles, fishes, crabs and crayfish to evaluate how species richness, richness of threatened species and endemism are distributed across freshwater ecosystems. We evaluated how congruent these measures of diversity were among taxa at a global level for a grid cell size of just under 1°. Results We showed that although the risk of extinction faced by freshwater decapods is quite similar to that of freshwater vertebrates, there is a distinct lack of spatial congruence in geographical range between different taxonomic groups at this spatial scale, and a lack of congruence among three commonly used metrics of biodiversity. The risk of extinction for freshwater species was consistently higher than for their terrestrial counterparts. Main conclusions We demonstrate that broad-scale patterns of species richness, threatened-species richness and endemism lack congruence among the six freshwater taxonomic groups examined. Invertebrate species are seldom taken into account in conservation planning. Our study suggests that both the metric of biodiversity and the identity of the taxa on which conservation decisions are based require careful consideration.As geographical range information becomes available for further sets of species, further testing will be warranted into the extent to which geographical variation in the richness of these six freshwater groups reflects broader patterns of biodiversity in fresh water

Numerical simulations of type I planetary migration in nonturbulent magnetized discs

Using 2D MHD numerical simulations performed with two different finite difference Eulerian codes, we analyze the effect that a toroidal magnetic field has on low mass planet migration in nonturbulent protoplanetary discs. The presence of the magnetic field modifies the waves that can propagate in the disc. In agreement with a recent linear analysis (Terquem 2003), we find that two magnetic resonances develop on both sides of the planet orbit, which contribute to a significant global torque. In order to measure the torque exerted by the disc on the planet, we perform simulations in which the latter is either fixed on a circular orbit or allowed to migrate. For a 5 earth mass planet, when the ratio \beta between the square of the sound speed and that of the Alfven speed at the location of the planet is equal to 2, we find inward migration when the magnetic field B_{\phi} is uniform in the disc, reduced migration when B_{\phi} decreases as r^{-1} and outward migration when B_{\phi} decreases as r^{-2}. These results are in agreement with predictions from the linear analysis. Taken as a whole, our results confirm that even a subthermal stable field can stop inward migration of an earth--like planet.Comment: 17 pages, 12 figures, accepted in MNRAS. A version with full resolution, colour figures is available at http://www.maths.qmul.ac.uk/~rpn/preprints

Protoplanets with core masses below the critical mass fill in their Roche lobe

We study the evolution of a protoplanet of a few earth masses embedded in a protoplanetary disc. If we assume that the atmosphere of the protoplanet, i.e. the volume of gas in hydrostatic equilibrium bound to the core, has a surface radius smaller than the Roche lobe radius, we show that it expands as it accretes both planetesimals and gas at a fixed rate from the nebula until it fills in the Roche lobe. The evolution occurs on a timescale shorter than the formation or migration timescales. Therefore, we conclude that protoplanets of a few earth masses have an atmosphere that extends to the Roche lobe surface, where it matches to the nebula. This is true even when the Bondi radius is smaller than the Roche lobe radius. This is in contrast to the commonly used models in which the static atmosphere extends up to the Bondi radius and is surrounded by a cold accretion flow. As a result, any calculation of the tidal torque exerted by the disc onto the protoplanet should exclude the material present in the Roche lobe, since it is bound to the protoplanet.Comment: 17 pages, 1 figure, accepted by MNRA

Systematic Identification of Balanced Transposition Polymorphisms in Saccharomyces cerevisiae

High-throughput techniques for detecting DNA polymorphisms generally do not identify changes in which the genomic position of a sequence, but not its copy number, varies among individuals. To explore such balanced structural polymorphisms, we used array-based Comparative Genomic Hybridization (aCGH) to conduct a genome-wide screen for single-copy genomic segments that occupy different genomic positions in the standard laboratory strain of Saccharomyces cerevisiae (S90) and a polymorphic wild isolate (Y101) through analysis of six tetrads from a cross of these two strains. Paired-end high-throughput sequencing of Y101 validated four of the predicted rearrangements. The transposed segments contained one to four annotated genes each, yet crosses between S90 and Y101 yielded mostly viable tetrads. The longest segment comprised 13.5 kb near the telomere of chromosome XV in the S288C reference strain and Southern blotting confirmed its predicted location on chromosome IX in Y101. Interestingly, inter-locus crossover events between copies of this segment occurred at a detectable rate. The presence of low-copy repetitive sequences at the junctions of this segment suggests that it may have arisen through ectopic recombination. Our methodology and findings provide a starting point for exploring the origins, phenotypic consequences, and evolutionary fate of this largely unexplored form of genomic polymorphism

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Search for stop and higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top-quark (stop) and the Higgs boson (higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7 inverse femtobarns of proton-proton collision data at sqrt(s) = 8 TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the stop mass below 360 to 410 GeV, depending on the higgsino mass