Pesticides in Ground Water: Will the EPA's New Regulation Decrease Health Risks?

The EPA's new regulation to protect ground water, the Pesticides and Ground Water Management Plan rule, will not significantly decrease health risks. Existing evidence suggests that the risk from ground water contamination is low and states have effective ground water protection programs. It is therefore unlikely that extensive federal involvement is necessary to protect ground water. The EPA has indicated it will use the new regulation to require states to expand their programs. The EPA did not, however, estimate the benefits of expanding ground water protection in the proposed rule, consider the risk of alternative pesticides, or show that the actual level of risk is potentially greater than existing data suggest. In this paper, I illustrate an approach for estimating the benefits and costs of ground water protection based on a case study of ground water contamination in California's San Joaquin Valley. The study shows that the health risk from ground water contamination is low, the costs of reducing contamination are high, and California is effectively protecting ground water. The study also shows that better analysis of the benefits and costs of ground water protection in each state can help the EPA determine the appropriate level of federal involvement in state ground water protection activities.

Developing a Framework for Sensible Regulation: Lessons from OSHA's Proposed Ergonomics Rule

Injuries caused by workplace activities that involve repetitive motion, known as musculoskeletal disorders (MSDs), increasingly concern workers, employers, and regulators because of their frequency and high treatment costs. The Occupational Safety and Health Administration (OSHA) recently proposed a national rule designed to reduce the workplace risk of MSDs. OSHA estimates there were about 626,000 MSDs in 1997, representing about one-third of all serious nonfatal workplace injuries and illnesses. OSHA estimates the proposed rule will cost $4 billion per year and generate$9 billion per year in benefits. Yet, OSHA does not provide sufficient evidence that private markets are failing to reduce MSD risk without government intervention and does not convincingly demonstrate that the rule will result in more good than harm. Unless OSHA effectively addresses some of the more serious flaws in the proposed rule, OSHA should not proceed with the final regulation. OSHA should more carefully evaluate the nature and extent of MSDs in the workplace than it did in the proposed rule and use improved economic analysis to target serious MSDs that employers can reduce at low cost. Furthermore, OSHA should include new provisions to improve employer access to information about reducing workplace risk of MSDs. The rule's ergonomics program requirements should apply only to those MSDs which employers do not have sufficient incentive to reduce without government intervention.

The impact of social networks on male student motivation in UAE tertiary education

This paper presents data obtained from focus groups conducted to investigate male students’ experience of higher education in the United Arab Emirates (UAE). Among the issues discussed by students was the impact of social networks addiction on student motivation and this paper focuses on that issue. Thirteen focus groups were conducted with 83 EFL male students at four government campuses including United Arab Emirates University (UAEU) at Al Ain Campus, Higher College of Technology (HCT) at Ras Al-Khaima Campus), and two campuses (Abu Dhabi and Dubai) of Zayed University (ZU). Students access social networks (SN) site for both educational and non-educational aspects. Students spoke about their experiences and how SN addiction influenced their academic motivation to study. The resulting themes from the focus groups show SN addiction has had an impact on student class performance and in some cases led to class failure. Recommendation for better class management and intervention programs are suggested to policy makers and instructors to foster a better student learning experience

Assessing Regulatory Impact Analyses: The Failure of Agencies to Comply With Executive Order 12,866

None.Environment, Health and Safety, Regulatory Reform

Assessing the Quality of Regulatory Impact Analyses

This study provides the most comprehensive evaluation of the quality of recent economic analyses that agencies conduct before finalizing major regulations. We construct a new dataset that includes analyses of forty-eight major health, safety, and environmental regulations from mid-1996 to mid-1999. This dataset provides detailed information on a variety of issues, including an agency's treatment of benefits, costs, net benefits, discounting, and uncertainty. We use this dataset to assess the quality of recent economic analyses and to determine the extent to which they are consistent with President Clinton's Executive Order 12866 and the benefit-cost guidelines issued by the Office of Management and Budget (OMB). We find that economic analyses prepared by regulatory agencies typically do not provide enough information to make decisions that will maximize the efficiency or effectiveness of a rule. Agencies quantified net benefits for only 29 percent of the rules. Agencies failed to discuss alternatives in 27 percent of the rules and quantified costs and benefits of alternatives in only 31 percent of the rules. Our findings strongly suggest that agencies generally failed to comply with the executive order and adhere to the OMB guidelines. We offer specific suggestions for improving the quality of analysis and the transparency of the regulatory process, including writing clear executive summaries, making analyses available on the Internet, providing more careful consideration of alternatives to a regulation, and estimating net benefits of a regulation when data on costs and benefits are provided.

Major hepatic resections – the progress of a new HBP surgical-centre

Spitalul Clinic “Dr. Ion Cantacuzino”, București, România, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: In mod istoric, rezecțiile hepatice au fost insoțite de morbitate si morbitate majore, reprezentând un tip prohibitiv de chirurgie până în ultimii ani. Odata cu evoluția tehnologiei și imbunătățirea tehnicilor imagistice, cât și a dezvoltării unui management perioperator specific ficatului, rezectiile hepatice au ajuns sa fie efectuate în centre de volum mare cu o rată a mortalitații de < 5%. Material si metode: În ultimii 5 ani, Spitalul Clinic “Dr. Ion Cantacuzino” s-a dezvoltat ca un nou centru de chirurgie hepato-biliopancreatică, o varietate largă de rezecții hepatice fiind practicate de rutină. Rezultate: Experiența acestei clinici în ceea ce privește rezecțiile hepatice majore a progresat până la 15 cazuri, la ora actuală, cu un singur deces postoperator. Concluzii: Din perspectiva unui centru în creștere a devenit aparent faptul ca se pot realiza rezecții hepatice majore în siguranță și cu rezultate postoperatorii bune, atât timp cât se aplica o selecție riguroasă a pacienților și sunt urmarite protocoale standardizate.Background: Historically major hepatic resections have been associated with high morbidity and mortality, being a prohibitive type surgery until recent years. With the advancement of technology and better imaging techniques, as well as liver-specific perioperative care, hepatic resections are performed in high-volume centres with a mortality of less than 5 %. Method and materials: The “Dr. Ion Cantacuzino” Hospital in Bucharest has developed as a new hepato-biliary-pancreatic surgical centre in the past 5 years, with a wide variety of hepatic resections performed on a regular basis. Results: The experience of this clinic, as far as major hepatic resections is concerned, has progressed, to date, to 15 such cases, with just one postoperative death. Conclusion: From the perspective of a growing centre it has become apparent that major hepatic resections can be safely performed and with good postoperative outcomes, with a thorough selection of patients and if standardised protocols are followed

Manifestations of Cognitive Presence in Blended Learning Classes of the Philippine K–12 System

Through an exploratory case study, this research sought to determine the applicability of the Community of Inquiry in the K–12 setting. There are research gaps to leverage support for blended learning and flexible learning options to benefit Filipino youth and school-leavers under the Alternative Delivery Mode of the Philippine K–12 system. This study was driven by the following research questions: How is cognitive presence manifested in the blended learning interactions? In what ways do the interactions of cognitive presence with the other presences characterize learning community building? Three blended learning classes were examined based on data collected through surveys, student focus group discussions, teacher interviews, class observations and archived data. Through constant comparison analysis and descriptive statistics, evidence revealed cognitive presence across its categories in the form of connectedness, collaborative work, trust and reciprocation, and shared views on technology by K–12 teachers and learners. The analysis affirmed 'regulating learning' as the intersection of cognitive presence and teaching presence. Implications for practice and recommendations for further research are discussed through the study's proposed modifications on the cognitive presence categories, indicators, and the survey instrument for the K–12 setting where teacher-directed pedagogies or collaborative inquiry processes have not been thoroughly co-opted

The iPad schizophrenia: UAE male students’ reflection on the paradoxes of using iPads in college EFL classrooms

This paper presents data obtained from focus groups conducted to investigate male students’ experience of higher education in the United Arab Emirates (UAE). Among the issues discussed by students was the impact of using iPads in replacement of printed books and this paper focuses on that issue. Thirteen focus groups were conducted with 83 EFL male students at four government campuses including United Arab Emirates University (UAEU) at Al Ain Campus, Higher College of Technology (HCT) at Ras Al-Khaima Campus), and two campuses (Abu Dhabi and Dubai) of Zayed University (ZU). Students acknowledged the paradoxes of using iPads in learning, citing learning and technical issues that influenced their academic motivation to study. The resulting themes from the focus groups show that ineffective iPad use has had an impact on student class performance and in some cases led to class failure. Recommendation for better iPad implementation is suggested to policy makers and instructors to foster a better student-iPad learning experience

hernia repair – is there a place for one-day surgery?

Spitalul Clinic “Dr. Ion Cantacuzino”, București, România, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Tratamentul chirurgical al herniilor inghinale este una dintre cele mai frecvente intervenții chirurgicale care se practică pe plan mondial, în ciuda faptului că persistă o lipsă de conses în ceea ce privește “cel mai bun” procedeu; unii autori susținând avantajele procedeelor deschise, în principiu operația Lichtenstein, în timp ce alții beneficiile abordarilor laparoscopice, TAPP sau TEP. Material și metode: Am realizat un studiu retrospectiv în cadrul Spitalului Clinic “Dr. Ion Cantacuzino”, pe o perioadă de 5 ani, pe 517 pacienți la care s-au practicat diferite intervenții chirurgicale pentru tratamentul herniilor inghinale. Pacienții au fost imparțiți în 2 grupuri, unii beneficiind de un procedeu deschis, în timp ce alții de laparoscopie. Variabile introduse în studiu au fost vârsta, sexul, perioada medie de spitalizare, media zilelor de spitalizare postoperatorie, timpul operatorie si costurile aferente spitalizării. Rezultate: Procedee laparoscopice s-au efectuat la 304/517 (59,37%), cu o mică prevalență TEP vs TAPP. Perioada de spitalizare, cheltuielile și timpii operatori au fost semnificativ mai mici pentru grupul TEP, majoritatea pacientilor fiind externați în prima zi postoperator. Concluzii: Rezultatele studiului nostru sprijină ideea ca procedeul TEP se poate practica într-un regim de “one-day surgery” într-un spital public astfel crescând confortul pacientului și scazând cheltuielile de spitalizare.Background: Hernia surgery is one of the most frequent operation performed world-wide, although there still seems to be a lack of consensus as to “the best” technique, with some authors still advocating for open, mainly Lichtenstein repair, while others supporting laparoscopic techniques, TAPP or TEP. Methods and materials: A retrospective study was performed in a public county hospital, over a period of 5 years, on 517 patients who benefitted from a surgical procedure for inguinal hernia treatment. Patients were divided into 2 groups, one with open surgical repair and, the other, laparoscopic. Variables taken into account were age, sex, mean hospital stay, mean postoperative hospital stay, hospital expenses, and operative time. Results: Laparoscopic repair was performed for 304/517 (59,37%), with a slight prevalence of TEP over TAPP; Hospital stay, expenses and operative time were significantly lower for the TEP group, most of the patients being discharged the following day. Conclusion: The results of our study seems to support the idea that TEP hernia repair could be performed on a “one-day surgery” basis in a public hospital, thus increasing patient comfort and decreasing hospital expenses

Multivisceral resections in invasive colorectal tumors – indication and postoperative outcome

Spitalul ,,Dr.I.Cantacuzino”, Clinica chirurgie II, București, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Rezecțiile colorectale pentru neoplaziile de colon și rect reprezintă intervenții chirurgicale bine codificate. Cu toate acestea, neoplaziile avansate, cu invazie locoregională, care necesită îndepărtarea tuturor țesuturilor și organelor interesate, pot ridica probleme de tactică și tehnică operatorie, precum și îngrijiri postoperatorii deosebite. Scopul: Prezentarea experienței unei echipe chirurgicale în abordarea leziunilor pluriviscerale în cancerele colorectale invazive. Material și metode: Au fost urmărite retrospectiv, în intervalul ianuarie 2013 - iunie 2015, cancerele colorectale invazive, primitive sau recurente, operabile, care au necesitat rezecții complexe multiorgan. Nu au fost luate în calcul tumorile colorectale cu metastaze hepatice la care s-a făcut, pe lîngă rezecția segmentului digestiv, îndepărtarea metastazelor hepatice. Rezultate: Au fost 24 de cazuri de rezecții multiorgan care au asociat rezecții colorectale. Cele mai multe situații au fost reprezentate de invaziile tumorilor de rect sau sigmoid în ansele ileale, dar au fost și situații de invazii de colon drept sau unghi splenic în pancreas, stomac, rinichi, suprarenale, necesitînd îndepărtarea organelor respective. În 9 cazuri au fost interesate organele pelvine, uter și/sau vezica urinară, ceea ce a impus rezecții rectosigmoidiene tip Dixon sau Hartman asociate histerectomiilor și pelvectomiilor. Concluzii: Considerate pînă nu demult ca inoperabile, cazurile de neoplazii colonice și rectale care au depășit limita organului invadînd organele vecine, cavitare sau parenchimatoase, beneficiază actualmente de rezecțiile multiorganice. Diversitatea organelor interesate nu permite standardizarea intervențiilor chirurgicale, dar se pot stabili unele principii de tactică operatorie care să permită o rezecție chirurgicală cu tentă de radicalitate.Introduction: Colorectal resections in colonic and rectal neoplasms are now well coded. However, advanced neoplasms with regional/local invasion can challenge the operative strategy and require special postoperative care. Aim: To present experience of a single surgical team in multi-visceral resections for invasive tumors (T4) with colorectal origin.Material and methods: We analyzed retrospectively between January 2013 and June 2015 all patients admitted with invasive but resectable colorectal tumors that required multivisceral resections. From analysis were excluded colorectal tumors with metastasis in the liver. Results: There were 24 colorectal tumors that required multivisceral resections; most of them were with rectal origin involving urinary bladder or internal genital organs and required beside rectal procedure hysterectomies or pelvectomies; other cases were invasive: colon tumors affecting stomach, pancreas, kidney or spleen and necessitating “en-bloc” multivisceral resections. Conclusions: Considered until recently as unresectable, cases of colorectal cancers that have invaded multiple neighboring organs currently benefit from multivisceral resections with promising results in terms of survival and morbidity. Diversity of involved organs allows only for general surgical strategy aiming for oncological cure