Business Development and Entrepreneurship on the Navajo Reservation

In this paper, I explore the underdevelopment of the business sector on the Navajo reservation. I investigate why the Navajo reservation continues to be economically depressed and find that institutions unique to the reservation create barriers that disincentivize formal business development. I first conducted a literature review on general barriers to entrepreneurship. Second, I reviewed the institutional analysis of the Navajo reservation to understand how institutions affect potential entrepreneurs. Next, I summarized a three-phased entrepreneurship training program on the reservation. Finally, I assessed the results of the program and how it was effected by barriers to business development. I conclude that there are three main barriers that discourage entrepreneurship. First, red tape and a complicated business license application process disincentivize new business development in the formal economy. Second, a lack of private property rights limit how entrepreneurs can access and develop land. Third, the Navajo reservation lacks access to lending opportunities, restricting the capital that is necessary to start a business. These barriers combine to create a vicious cycle of underdevelopment and poverty

Heparin versus 0.9% sodium chloride intermittent flushing for prevention of occlusion in central venous catheters in adults

Background Heparin intermittent flushing is a standard practice in the maintenance of patency in central venous catheters. However, we could find no systematic review examining its effectiveness and safety. Objectives To assess the effectiveness of intermittent flushing with heparin versus 0.9% sodium chloride (normal saline) solution in adults with central venous catheters in terms of prevention of occlusion and overall benefits versus harms. Search methods The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched December 2013) and the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 11). Searches were also carried out in MEDLINE, EMBASE, CINAHL and clinical trials databases (December 2013). Selection criteria Randomised controlled trials (RCTs) in adults 18 years of age and older with a central venous catheter (CVC) in which intermittent flushing with heparin (any dose with or without other drugs) was compared with 0.9% normal saline were included. No restriction on language was applied. Data collection and analysis Two review authors independently selected trials, assessed trial quality and extracted data. Trial authors were contacted to retrieve additional information, when necessary. Main results Six eligible studies with a total of 1433 participants were included. The heparin concentrations used in these studies were very different (10-5000 IU/mL), and follow-up varied from 20 days to 180 days. The overall risk of bias in the studies was low. The quality of the evidence ranged from very low to moderate for the main outcomes (occlusion of CVC, duration of catheter patency, CVC-related sepsis, mortality and haemorrhage at any site). Combined findings from three trials in which the unit of analysis was the catheter suggest that heparin was associated with reduced CVC occlusion rates (risk ratio (RR) 0.53, 95% confidence interval (CI) 0.29 to 0.94). However, no clear evidence of a similar effect was found when the results of two studies in which the unit of analysis was the participant were combined (RR 0.21, 95% CI 0.03 to 1.70), nor when findings were derived from one study, which considered total line accesses (RR 1.08, 95% CI 0.84 to 1.40). Furthermore, results for other estimated effects were found to be imprecise and compatible with benefit and harm: catheter duration in days (mean difference (MD) 0.41, 95% CI -1.29 to 2.12), CVC-related thrombosis (RR 1.22, 95% CI 0.74 to 1.99), CVC-related sepsis (RR 1.02, 95% CI 0.34 to 3.03), mortality (RR 0.77, 95% CI 0.45 to 1.32) and haemorrhage at any site (RR 1.37, 95% CI 0.49 to 3.85). Authors' conclusions We found no conclusive evidence of important differences when heparin intermittent flushing was compared with 0.9% normal saline flushing for central venous catheter maintenance in terms of efficacy or safety. As heparin is more expensive than normal saline, our findings challenge its continued use in CVC flushing outside the context of clinical trials

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Impediments to Business Development in the Navajo Nation

Since its foundation, the Navajo Nation has had little economic development and faces unemployment rates of nearly fifty percent. This raises a question: What are the impediments to business development within the Navajo Nation? We hypothesize that this lack of business development has been hindered by: increased red tape, as there are more than the normal number of processes for entrepreneurs to obtain a business license as a result of the dual nature of the tribal and federal governments; lack of property rights caused by communal land laws; and the local culture of dependency of federal assistance programs. We analyze the relationship between the time it takes to acquire a business license and the number of overall applicants, how the absence of property rights creates barriers to securing capital for use as collateral when applying for loans, and the inverse relationship between government dependency and starting a business. Using these variables, we compare Kayenta, a township within the Navajo Nation that has been granted municipality and political autonomy, with a small community within the reservation known as Monetezuma Creek. A case study of business owners in Kayenta compared to Montezuma Creek further illustrates conditions that hinder business development within the reservation