The HELP System as a Tool for Monitoring Physician Prescribing Patterns

Conference PaperBiomedical Informatic

\u27Dare to be Different\u27: How Religious Groups Frame and Enact Appropriate Sexuality and Gender Norms among Young Adults

Purpose The sexual lives of religious youth and young adults have been an increasing topic of interest since the rise of abstinence-only education and attendant programs in many religious institutions. But while we know a lot about individual-level rates of sexual behavior, far less is known about how religious organizations shape and mediate sexuality. We draw on data from observations with youth and young adult ministries and interviews with religious young adults and adult leaders from Muslim, Hindu, and Protestant Christian groups in order to examine how religious adults in positions of organizational authority work to manage the gender and sexual developments in the transition to adulthood among their youth. We find three distinct organizational styles across the various religious traditions: avoidance through gender segregation, self-restraint supplemented with peer surveillance, and a classed disengagement. In each of these organizational responses, gender and sexuality represent something that must be explained and controlled in the process of cultivating the proper adult religious disposition. The paper examines how religious congregations and other religious organizations oriented toward youth, work to manage the gender and sexual developments in their youth’s transitions to adulthood. The paper draws from a larger project that is studying the lived processes of religious transmission between generations. Methodology/approach Data were extracted from (a) ethnographic observations of youth programming at religious organizations; (b) ethnographicobservations with families during their religious observances; (c) interviews with adult leaders of youth ministry programs. The sample includes Protestant Christian, Muslim, and Hindu organizations and families

Evaporation Reduction Potential in an Undisturbed Soil Irrigated with Surface Drip and Sand Tube Irrigation

The efficiency of drip irrigation is highly dependent on evaporation losses occurring from the constantly saturated soil beneath emitters. Advent of subsurface drip irrigation is in part an approach to curb this inefficiency. An irrigation method, Sand Tube Irrigation (STI), is proposed to increase the efficiency of “Normal” surface applied drip Irrigation (NI method) on permanent tree crops without the need for burying the irrigation tubing. The sand tube consists of removing a soil core beneath the emitter and filling the void with coarse sand. A weighing lysimeter was constructed in the laboratory and instrumented to directly measure temporal evaporation from large, undisturbed soil columns, 0.7 m in diameter and 0.8 m in height. Experiments were performed on six replicated soil monoliths to compare the two methods. The results indicated that, for four consecutive days after irrigation, there was a significant difference at the 95% confidence level between evaporation occurring from the NI and STI methods. After four days of evaporation, comparison of water contents indicated that a higher amount of water existed between the depths of 0.2 to 0.55 m in the STI versus the NI method. Although drainage occurred from the macropore structure of the undisturbed soil monoliths, the STI method showed potential in retaining more water in the micropore structure of the lower depths, that would be available for plant use rather than potential evaporation

Comparison of Water and Temperature Distribution Profiles Under Sand Tube Irrigation

Drip irrigation is one of the most efficient systems in delivering water to the plant root zone. Research has shown that the saturated, or nearly saturated, surface beneath the emitter may increase evaporation thereby reducing the irrigation efficiency. To increase the efficiency of surface applied drip irrigation on permanent tree crops a sand tube irrigation (STI) method was developed and tested. The sand tube method consists of removing a soil core beneath the emitter and filling the void with coarse sand. A weighing lysimeter was designed and instrumented to directly measure temporal evaporation during irrigation and for a period of three days after irrigation ceased. Thermocouples were used throughout the soil profile to detect the temperature variation and also to determine temporal movement of the wetting front. The results indicated that for the surface applied drip irrigation method, approximately 30% of the applied water evaporated during the four-day period after irrigation. The STI method resulted in approximately 4% of the applied water being evaporated. The STI method allowed more water to remain in the soil profile thereby increasing the irrigation efficiency

) a swarm at Strandline Lake, which continued for several years (1996-1999); and (5) deformation of Mt. Peulik (inflation begins after October

Abstract In the fall of 1996 the Alaska Volcano Observatory recorded an unprecedented level of seismic and volcanic activity. The following were observed: (1) a swarm at Iliamna Volcano (August 1996 to mid-1997); (2) an eruption at Pavlof Volcano (September 1996 to December 1996; (3) a swarm at Martin/Mageik volcanoes (October 1996); (4) a swarm at Strandline Lake, which continued for several years (1996)(1997)(1998)(1999); and (5) deformation of Mt. Peulik (inflation begins after October 1996 and ends in fall 1998), based on interpretation of interferometric synthetic aperture radar data. The number of monitored volcanic areas in 1996 was thirteen. We conducted two formal statistical tests to determine the likelihood of four of these events occurring randomly in the same time interval. The tests are based on different conceptual probabilistic models (classical and Bayesian) that embrace a wide range of realistic tectonic models. The first test considered only the areas in which swarms or eruptions occurred (7 of 13 if Strandline Lake is included; 6 of 12 otherwise), by comparing the real catalog with 10,000 synthetic catalogs under the assumption that the sites are independent. The second method is a hierarchical Bayesian model in which the probability of a swarm at each of the 13 (or 12) areas is different but the parent population is the same. We found that the likelihood of the swarms and eruption occurring nearly simultaneously by chance alone is small for a wide range of probabilistic schemes and, consequently, for different tectonic scenarios. Therefore, we conclude that the events may be related to a single process. We speculate that a widespread deformation pulse or strain transient occurred, mainly in the east half of the arc, and may be the most likely candidate for causing such nearly simultaneous events

Modeling Surface and Subsurface Pesticide Transport Under Three Field Conditions Using PRZM-3 and GLEAMS

Contaminant transport models should be evaluated over a wide range of conditions to determine their limitations. The models PRZM and GLEAMS have been evaluated many times, but few studies are available in which predicted movement in runoff and percolate were simultaneously evaluated against field data. Studies of this type are essential because pesticide leaching and runoff are mutually dependent processes. For this reason, PRZM-3 and GLEAMS were evaluated for their ability to predict metribuzin concentrations in runoff, sediment, subsurface soil, and pan lysimeters under three field conditions (yard waste compost amended, no-till, and conventional-till) on a Lowell silt loam soil. Sensitive input parameters were either site specific (climatic, soil, and chemical) or calibrated (K-factor, C-factor, curve number). In general, both models under-predicted metribuzin concentration in runoff water, runoff sediment, subplow layer soil (15-75 cm), and pan lysimeter water (75 cm). Contrary to field data, both models predicted that a large percentage (\u3e 50%) of metribuzin would move below the “mixing zone” (top 1 cm) during the first rainfall event after application. Relatively little metribuzin was predicted to move beyond the plow layer (top 15 cm) into the pan lysimeters or subsurface soil throughout the simulation period, possibly due to the lack of a macropore component in the models. High metribuzin concentrations in sediment (field data) indicated that relatively little metribuzin moved below the “mixing zone”, possibly because of hysteresis but much of the metribuzin that did move was quickly transported into the pan lysimeters, probably due to macropore flow. GLEAMS more accurately predicted pesticide concentration in sediment and PRZM predicted subsurface soil concentration somewhat more accurately than GLEAMS. Little difference in accuracy was detected between models on metribuzin concentration in runoff or metribuzin concentration in percolate. Although both models generally under-predicted metribuzin concentration in runoff, runoff transport (mass of metribuzin in runoff) for the study period was over-predicted by both models which emphasizes the importance of accurately predicting herbicide concentration and runoff volume soon after application when the surface pesticide concentrations are highest

A warped disk model for M33 and the 21-cm line width in spiral galaxies

To determine the actual HI distribution and the velocity field in the outermost disk of the spiral galaxy M33, a tilted-ring model is fitted to 21-cm line data taken with the Arecibo Telescope. Since M33 is one of the main calibrators for the extragalactic distance scale derived through the Tully-Fisher relation, the outer disk warping is of interest for a correct determination and deprojection of the galaxy's line width. Even though our best model predicts small effects on the observed line width of M33, we show that similar outer disk warping in galaxies oriented differently along our line of sight could affect the widths considerably. Therefore there may be systematic effects in the determination of the rotation velocities and dynamic masses of spiral galaxies, whose exact value depends also on which method is used for measuring the galaxy's total line width.Comment: 27 pages, ps files only, ApJ in pres

Group versus individual academic detailing to improve the use of antihypertensive medications in primary care: a cluster-randomized controlled trial

Purpose To compare group versus individual academic detailing to increase diuretic or β-blocker use in hypertension. Methods We conducted a cluster-randomized controlled trial in a large health maintenance organization. Subjects (N=9820) were patients with newly treated hypertension in the year preceding the intervention (N=3692), the 9 months following the intervention (N=3556), and the second year following intervention (N=2572). We randomly allocated 3 practice sites to group detailing (N=227 prescribers), 3 to individual detailing (N=235 prescribers), and 3 to usual care (N=319 prescribers). Individual detailing entailed a physician-educator meeting individually with clinicians to address barriers to prescribing guideline-recommended medications. The group detailing intervention incorporated the same social marketing principles in small groups of clinicians. Results In the first year following the intervention, the rates of diuretic or β-blocker use increased by 13.2% in the group detailing practices, 12.5% in the individual detailing practices, and 6.2% in the usual care practices. As compared with usual care practices, diuretic or β-blocker use was more likely in group detailing practices (adjusted odds ratio (OR), 1.40; 95% confidence interval (CI), 1.11 – 1.76) and individual detailing practices (adjusted OR, 1.30; 95% CI, 0.95 – 1.79). Neither intervention affected blood pressure control. Two years following this single-visit intervention, there was still a trend suggesting a persistent effect of individual (OR, 1.22; 95% CI, 0.92 – 1.62), but not group, detailing (OR, 1.06; 95% CI, 0.80 – 1.39), as compared with usual care. Conclusion Both group and individual academic detailing improved antihypertensive prescribing over and above usual care but may require reinforcement to sustain improvements

Initiation of Psychotropic Medication after Partner Bereavement: A Matched Cohort Study

Background Recent changes to diagnostic criteria for depression in DSM-5 remove the bereavement exclusion, allowing earlier diagnosis following bereavement. Evaluation of the potential effect of this change requires an understanding of existing psychotropic medication prescribing by non-specialists after bereavement. Aims To describe initiation of psychotropic medication in the first year after partner bereavement. Methods In a UK primary care database, we identified 21,122 individuals aged 60 and over with partner bereavement and no psychotropic drug use in the previous year. Prescribing (anxiolytic/hypnotic, antidepressant, antipsychotic) after bereavement was compared to age, sex and practice matched controls. Results The risks of receiving a new psychotropic prescription within two and twelve months of bereavement were 9.5% (95% CI 9.1 to 9.9%) and 17.9% (17.3 to 18.4%) respectively; an excess risk of initiation in the first year of 12.4% compared to non-bereaved controls. Anxiolytic/hypnotic and antidepressant initiation rates were highest in the first two months. In this period, the hazard ratio for initiation of anxiolytics/hypnotics was 16.7 (95% CI 14.7 to 18.9) and for antidepressants was 5.6 (4.7 to 6.7) compared to non-bereaved controls. 13.3% of those started on anxiolytics/hypnotics within two months continued to receive this drug class at one year. The marked variation in background family practice prescribing of anxiolytics/hypnotics was the strongest determinant of their initiation in the first two months after bereavement. Conclusion Almost one in five older people received a new psychotropic drug prescription in the year after bereavement. The early increase and trend in antidepressant use after bereavement suggests some clinicians did not adhere to the bereavement exclusion, with implications for its recent removal in DSM-5. Family practice variation in use of anxiolytics/hypnotics suggests uncertainty over their role in bereavement with the potential for inappropriate long term use