Emergency Department Utilization and Capacity

Synthesizes research on who utilizes emergency departments, how often for non-urgent or preventable conditions and why, how cost-sharing affects utilization, and how utilization patterns affect hospital finances, overcrowding, and cost implications

The Impact of State Dependent Coverage Expansions on Young Adult Insurance Status: Further Analysis

Outlines how state initiatives to expand dependent coverage affected young adults' rates of uninsurance and of employer-sponsored coverage. Considers differential time effects and implications for national reform provisions to expand coverage to age 26

Dependent Coverage Expansions: Estimating the Impact of Current State Policies

Presents preliminary findings on common provisions in state regulations of dependent health coverage and discusses the analytic approach to estimating the impact of state policy changes on young adults

Late Quaternary glaciation in the Hebrides sector of the continental shelf : cosmogenic nuclide dating of glacial events on the St Kilda archipelago

The authors thank NERC-CIAF for funding analysis of the 10Be and 36Cl exposure ages (Allocation 9116/0412), the Carnegie Trust for the Universities of Scotland for a grant towards travel expenses.The St Kilda archipelago lies ~65 km west of the Outer Hebrides and ~60 km east of the Atlantic shelf break, and represents a key site for testing the assertion that during the Last Local Glacial Maximum (LLGM; c. 27 ka) the British–Irish Ice Sheet (BIIS) extended to near the shelf edge in all sectors. Two consistent cosmogenic 36Cl exposure ages averaging (≥) 81.6±7.8 ka for perched boulders at 290 m altitude demonstrate that the last ice sheet failed to over-run high ground on the largest island, Hirta. 36Cl and 10Be exposure ages for glacially emplaced boulders on low ground indicate deposition by small, locally nourished glaciers that last occupied a north-facing valley (Gleann Mòr) at c. 30.9±3.2 ka, prior to extension of the last ice sheet to the outer shelf, and a south-facing valley (Village Bay) at c. 19.2±2.3 ka, several millennia after the LLGM. Our dating evidence is consistent with previous interpretations of lithostratigraphical, seismostratigraphical and geomorphological evidence and confirms that the last ice sheet failed to encroach on St Kilda. A simple ice-flow model demonstrates that even if thin, low-gradient ice lobes encircled the archipelago during the LLGM, the ice margin can only have reached the outermost moraine banks, ~40 km west of St Kilda, under extremely low (<2 kPa) driving stresses, implying either surge-like transient streaming behaviour at the ice-sheet margin or that the moraine banks relate to an earlier, more extensive ice sheet. The final glaciation of the Village Bay area at c. 19.2±2.3 ka was out of phase with the behaviour of the BIIS, which was undergoing net retreat during this period.PostprintPeer reviewe

Kenyan milk consumers’ behaviour and perceptions of aflatoxin

Aflatoxin contamination in food is a human health threat in many developing countries. This study examines Kenyan milk consumers’ behaviour related to, and perception of, aflatoxin contamination. The study considered two groups of respondents: raw milk consumers mainly located in peri-urban areas of Nairobi, and processed milk consumers located in urban areas. Results indicate that practically all raw milk consumers and the majority of processed milk consumers boil the milk before its consumption believing that the product is completely safe after boiling. Aflatoxin awareness is very high for the urban milk consumers and relatively high for the peri-urban ones. In both groups, almost half of the respondents who had heard about aflatoxin believe, or know, that it can be transferred into milk. Most respondents, however, did not know how to avoid aflatoxin-contaminated milk. Given the credence characteristic of aflatoxin consumer education and awareness raising programs alone will not be able to solve the problem. Efforts along the whole value chain and at the level of government are needed to reduce the use of aflatoxin spoiled feed and secure aflatoxin safe milk at the consumer level

Kenyan milk consumers’ behaviour and perceptions of aflatoxin

Aflatoxin contamination in food is a human health threat in many developing countries. This study examines Kenyan milk consumers’ behaviour related to, and perception of, aflatoxin contamination. The study considered two groups of respondents: raw milk consumers mainly located in peri-urban areas of Nairobi, and processed milk consumers located in urban areas. Results indicate that practically all raw milk consumers and the majority of processed milk consumers boil the milk before its consumption believing that the product is completely safe after boiling. Aflatoxin awareness is very high for the urban milk consumers and relatively high for the peri-urban ones. In both groups, almost half of the respondents who had heard about aflatoxin believe, or know, that it can be transferred into milk. Most respondents, however, did not know how to avoid aflatoxin-contaminated milk. Given the credence characteristic of aflatoxin consumer education and awareness raising programs alone will not be able to solve the problem. Efforts along the whole value chain and at the level of government are needed to reduce the use of aflatoxin spoiled feed and secure aflatoxin safe milk at the consumer level

A glacial chronology for sub-Antarctic Marion Island from MIS 2 and MIS 3

It is increasingly apparent that local and regional factors, including geographic location, topography and climatic variability, strongly influence the timing and extent of glaciations across the Southern Hemisphere. Glacial chronologies of sub-Antarctic islands can provide valuable insights into the nature of regional climatic variability and the localised response(s) of glacial systems during periods of climatic change. With new cosmogenic 36Cl exposure ages from Marion Island in the southern Indian Ocean, we provide the oldest dated terrestrial moraine sequences for the sub-Antarctic islands. Results confirm that a local Last Glacial Maximum was reached prior to ∼56 ka when ice retreated with localised stand still events at ∼43 ka and between ∼38 and 33 ka. Evidence of ice re-advances throughout MIS 2 are limited and particularly absent for the cooling periods at ∼32 and ∼21 ka, and retreat continued until ∼17 ka ago. Any MIS 1 readvances on the island would be confined to altitudes above 900 m a.s.l. but the Holocene exposure ages remains to be documented. We compare Marion Island's glacial chronology with other sub-Antarctic islands (e.g., the Kerguelen archipelago, Auckland and Campbell islands and South Georgia) and review the evidence for a Southern Hemisphere glacial maximum in late MIS 3 (∼41 ka). At a regional scale we recognize sea surface temperatures, sea ice extent and the latitudinal position of the Southern Westerly Wind belt as key controls on equilibrium-line altitudes and ice accumulation due to their influence on air temperature and precipitation regimes. At an island scale, geomorphological mapping shows that deglaciation of individual glacier lobes was a-synchronous due to local physiographical and topographical factors controlling the island's micro-climate. We suggest that variability in deglaciation chronologies at smaller scales (particularly at the sub-Antarctic Islands) are important to consider when untangling climatic drivers across the Southern Ocean