Platte River Endangered Species Partnership: Collaboration or Coercion in Disguise

9 pages

Platte River Endangered Species Partnership: Collaboration or Coercion in Disguise

9 pages

Production of mast by selected species of oak (Quercus sp.) and its use by wildlife on the Tellico Wildlife Management Area, Monroe County, Tennessee

This study dealt with the production of mast by white oak (Quercus alba, L.) and northern red oak (Q. rubra, L.) on the North River watershed of the Tellico Wildlife Management Area, and the relation of mast production and wildlife utilization of acorns to forest regeneration. Mast production was highly variable between trees within a species and between the two species. Sound acorn production per acre by white oak ranged from a trace by trees 23 and 24 inches dbh to 0.04 pounds (oven dry weight) per acre by trees 11 inches dbh with a total of .17 pounds per acre produced by all diameter classes. Northern red oak production of sound acorns ranged from 0.81 pounds (oven dry weight) per acre by trees 15 and 30 inches dbh to 7.54 pounds per acre by trees 11 inches dbh. Total production of sound northern red oak acorns was 62.9 pounds per acre. Poor mast production by white oak in 1971 and a general mast failure in 1968 were attributed to temperature trends and late frosts in spring. The amount of acorns needed by wildlife on the study area was estimated to be 27.1 pounds (air dry weight) per acre for 90 days, 54.3 pounds per acre for 180 days, and 90.5 pounds per acre for 300 days. There was sufficient white oak and northern red oak mast produced in 1971 to support these wildlife populations on the study area for 90 and 180 days but not for 300 days. The European wild hog appeared to prefer coves to ridges (X2 = 7.27,* 1 df). However, movement patterns in summer and autumn, I97I were random and it was concluded that increased use of the ridges was due to an abundance of food, especially acorns, on these sites. Only 10 mature and germinated white oak acorns remained per acre in spring, 1972. However, there were 1,083 mature northern red oak acorns per acre weighing 6.19 pounds still on the ground in spring. This included 563 sound and germinated, 368 damaged and germinated, and 152 sound, non-germinated acorns

A Patient-Centered Medical Home Model For Improvement Of Healthcare For The Homeless Population: An Integrative Review

The homeless population is surrounded by many obstacles while trying to obtain the essentials of life including food, water, shelter, clothes, medical care, and safety. In many areas of the United States and other countries homelessness is becoming an increasing problem. Compared to standard healthcare, the Patient-Centered Medical Home Model is offering a better experience for homeless patients. This integrated review provides a selection of published studies and information on the homeless population and the beginning of the Patient-Centered Medical Home Model to improve access and healthcare to many homeless patients. As the model is accepted by more medical professionals, coordination of healthcare for the homeless may improve

Postoffer Pre-Placement Screening for Carpal Tunnel Syndrome in Newly Hired Manufacturing Workers

OBJECTIVE: We determined the predictive validity of a post-offer pre-placement (POPP) screen using nerve conduction velocity studies (NCV) to identify future cases of carpal tunnel syndrome (CTS). METHODS: A cohort of 1648 newly hired manufacturing production workers underwent baseline NCS, and were followed for 5 years. RESULTS: There was no association between abnormal POPP NCV results and incident CTS. Varying NCV diagnostic cut-offs did not improve predictive validity. Workers in jobs with high hand/wrist exposure showed greater risk of CTS than those in low exposed jobs (Relative Risk 2.82; 95% CI 1.52, 5.22). CONCLUSIONS: POPP screening seems ineffective as a preventive strategy for CTS

Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

PURPOSE: Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. METHODS: A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. RESULTS: All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. CONCLUSIONS: Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work

Reliability of hand diagrams for the epidemiologic case definition of carpal tunnel syndrome

INTRODUCTION: The purpose of this study was to evaluate the inter-rater reliability of hand diagrams, which are commonly used in research case definitions of carpal tunnel syndrome (CTS). To evaluate the potential of non-random misclassification of cases, we also studied predictors of rater disagreement as a function of personal and work factors, and of hand symptoms not classic for CTS. METHODS: Participants in a longitudinal study investigating the development of CTS completed repeated self-administered questionnaires. Three experienced clinicians, blind to subjects’ work or personal history, independently rated all hand diagrams on an ordinal scale from 0 to 3. Disagreements between ratings were resolved by consensus. Reliability was measured by the weighted kappa statistic. Logistic regression models evaluated predictors of disagreement. RESULTS: Three hundred and thirty-three subjects completed 494 hand diagrams. Eighty-five percent were completed by self-administered questionnaire and 15% by telephone interview. Weighted kappa values representing agreement among the three raters, were 0.83 (95% CI: 0.78, 0.87) for right hand diagrams and 0.88 (95% CI: 0.83, 0.91) for left hand diagrams. Ratings from hand diagrams obtained by telephone interview produced better agreement. Agreement among raters was not affected by subjects’ personal or work factors. Disagreement among raters was associated with the presence of hand/wrist symptoms other than classic CTS symptoms. CONCLUSIONS: Overall, high levels of agreement were attained by independent raters of hand diagrams. Personal factors did not affect agreement among raters, but presence of non-CTS symptoms seemed to affect results and should be considered in studies focused on diverse populations with heterogeneity of upper extremity symptoms

Assessing agreement of self-reported and observed physical exposures of the upper extremity

Assessment of workplace physical exposures by self-reported questionnaires has logistical advantages in population studies but is subject to exposure misclassification. This study measured agreement between eight self-reported and observer-rated physical exposures to the hands and wrists, and evaluated predictors of inter-method agreement. Workers (n=341) from three occupational categories (clerical/technical, construction, and service) completed self-administered questionnaires and worksite assessments. Analyses compared self-reported and observed ratings using a weighted kappa coefficient. Personal and psychosocial factors, presence of upper extremity symptoms and job type were evaluated as predictors of agreement. Weighted kappa values were substantial for lifting (0.67) and holding vibrating tools (0.61), moderate for forceful grip (0.58) and fair to poor for all other exposures. Upper extremity symptoms did not predict greater disagreement between self-reported and observed exposures. Occupational category was the only significant predictor of inter-method agreement. Self-reported exposures may provide a useful estimate of some work exposures for population studies

Responsiveness of a 1-year recall modified DASH Work module in active workers with upper extremity musculoskeletal symptoms

OBJECTIVES: To evaluate the responsiveness to change of a modified version of the Work module of the Disabilities of the Arm, Shoulder, and Hand (DASH-W) in a prospective, longitudinal cohort study of active workers. METHODS: We compared change on a 1-year recall modified DASH-W to change on work ability, work productivity, and symptom severity, according to predetermined hypotheses following the Consensus-based standards for the selection of health measurement instruments (COSMIN). We evaluated concordance in the direction of change, and magnitude of change using Spearman rank correlations, effect sizes (ES), standardized response means (SRM), and area under the receiver operating characteristic curves (AUC). RESULTS: In a sample of 551 workers, change in 1-year recall modified DASH-W scores showed moderate correlations with changes in work ability, work productivity, and symptom severity (r=0.47, 0.44, and 0.36, respectively). ES and SRM were moderate for 1-year recall modified DASH-W scores in workers whose work ability (ES=−0.58, SRM=−0.52) and work productivity improved (ES=−0.59, SRM=−0.56), and larger for workers whose work ability (ES=1.24, SRM=0.68) and work productivity worsened (ES=1.02, SRM=0.61). ES and SRM were small for 1-year recall modified DASH-W scores of workers whose symptom severity improved (−0.32 and −0.29, respectively). Responsiveness of the 1-year recall modified DASH-W was moderate for those whose symptom severity worsened (ES=0.77, SRM=0.50). AUC met responsiveness criteria for work ability and work productivity. CONCLUSIONS: The 1-year recall modified DASH-W is responsive to changes in work ability and work productivity in active workers with upper extremity symptoms