Factors Influencing Successful Small-Farm Operations in North Carolina

The overall goal of this research project is to identify and refine factors influencing successful small farm operations in North Carolina. Small farms account for 91 percent of all farms. Given the importance of small farm viability, this research project focuses on identifying ways to further enhance successful small farming in North Carolina. In an effort to further explain the factors that affect successful small-scale farming, researchers have identified factors that have underpinnings in 1) small-farm educational programming; 2) small-scale agricultural enterprises and production practices; 3) alternative marketing; and 4) risk management. Although this research project includes several surveys, for this phase of the project the survey instrument solicited production and financial data, attitudes and beliefs about farming, as well as demographic questions. The research instrument was distributed to a sampling frame that also included small farmers not identified as being successful. Outcomes of this project yielded possible ways to further enhance the success of small farms in North Carolina. Based on case study and questionnaire results, income was not found to be as important as believed and the overall, “love of farming,” seemed to be the driving force behind the farmer’s view of success and not profit. The small farm may represent an individual business enterprise but in reality represents a family business whose success is often measured in qualifiers indicators rather than business quantifiers.Small Farm, Agribusiness, Successful, Agribusiness,

Validation of Factors Influencing Successful Small Scale Farming in North Carolina

This phase of the research project involves developing a survey instrument to test the validity and predictive value of the variables identified in previous case studies. Given the importance of small farm viability, this research project focuses on identifying ways to further enhance successful small farming in North Carolina. The survey instrument was designed to solicit production and financial data, attitudes and beliefs about farming, as well as demographic questions. The results demonstrated that successful farmers indicators were the “love of farming” and “manageable debt”. Other strong indicators of successful farmers included a combination of marketing strategies that utilize technology such as websites as well as local farmers markets and educational level. Knowledge about the successful small farm is likely to provide valuable information about how to evaluate the “successfulness” of small farm operations and produce best practices models for small scale farm operations.Small Farmers, Agribusiness, Agribusiness, Farm Management,

Case Studies of Successful Small Scale Farming in North Carolina

The goal of this study focuses on determining factors that contribute to a successful small farm in North Carolina and on identifying ways to further enhance successful small farming. North Carolina farms vary extensively in size and other characteristics, ranging from very small retirement and residential farms to establishments with millions of dollars in sales. Farming continues to be a distinctive industry in part because most production, even among very large farms, is carried out on family-operated farms whose operators often balance farm and off-farm employment and investment decisions. The case studies of successful small farmers conducted in November 2007 were the primary sources of data. The North Carolina Cooperative Extension Program identified three “successful” farmers from its sampling frame to participate in the case studies. Researchers identified sets of variables associated with small farm success through various literature, published and unpublished reports and recommendations from experts in the field. After the variables were operationalized, a questionnaire was developed as a guide for conducting the case studies interview protocols. Each case study consisted of a one-visit protocol with electronic follow-up. Researchers conducted on-site interviews, and then toured the individual farms. The case study farmers used a diverse mix of enterprises including specialty crops and a combination of marketing strategies. The educational level ranged from post high school to Ph.D. although all farmers attended several workshops. All farmers minimized risk through diversity, contractual sales and insurance. Only one farmer used computers for record keeping and finance. The overall “love of farming” seemed to be the biggest driving force behind the farmer’s view of success.Small Farmer, Agribusiness, Agricultural Finance, Teaching/Communication/Extension/Profession,

Spacelab system analysis: A study of the Marshall Avionics System Testbed (MAST)

An analysis of the Marshall Avionics Systems Testbed (MAST) communications requirements is presented. The average offered load for typical nodes is estimated. Suitable local area networks are determined

Spacelab system analysis: A study of communications systems for advanced launch systems

An analysis of the required performance of internal avionics data bases for future launch vehicles is presented. Suitable local area networks that can service these requirements are determined

Screening for Asymptomatic Bacteriuria in Adults: US Preventive Services Task Force Recommendation Statement

Importance: Among the general adult population, women (across all ages) have the highest prevalence of asymptomatic bacteriuria, although rates increase with age among both men and women. Asymptomatic bacteriuria is present in an estimated 1% to 6% of premenopausal women and an estimated 2% to 10% of pregnant women and is associated with pyelonephritis, one of the most common nonobstetric reasons for hospitalization in pregnant women. Among pregnant persons, pyelonephritis is associated with perinatal complications including septicemia, respiratory distress, low birth weight, and spontaneous preterm birth. Objective: To update its 2008 recommendation, the USPSTF commissioned a review of the evidence on potential benefits and harms of screening for and treatment of asymptomatic bacteriuria in adults, including pregnant persons. Population: This recommendation applies to community-dwelling adults 18 years and older and pregnant persons of any age without signs and symptoms of a urinary tract infection. Evidence Assessment: Based on a review of the evidence, the USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in pregnant persons has moderate net benefit in reducing perinatal complications. There is adequate evidence that pyelonephritis in pregnancy is associated with negative maternal outcomes and that treatment of screen-detected asymptomatic bacteriuria can reduce the incidence of pyelonephritis in pregnant persons. The USPSTF found adequate evidence of harms associated with treatment of asymptomatic bacteriuria (including adverse effects of antibiotic treatment and changes in the microbiome) to be at least small in magnitude. The USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in nonpregnant adults has no net benefit. The known harms associated with treatment include adverse effects of antibiotic use and changes to the microbiome. Based on these known harms, the USPSTF determined the overall harms to be at least small in this group. Recommendations: The USPSTF recommends screening pregnant persons for asymptomatic bacteriuria using urine culture. (B recommendation) The USPSTF recommends against screening for asymptomatic bacteriuria in nonpregnant adults. (D recommendation)

Evaluating Detection of an Inhalational Anthrax Outbreak

One-sentence summary for table of contents: When syndromic surveillance detected a substantial proportion of outbreaks before clinical case finding, false-positive results occurred

Medication Use to Reduce Risk of Breast Cancer: US Preventive Services Task Force Recommendation Statement

Importance: Breast cancer is the most common nonskin cancer among women in the United States and the second leading cause of cancer death. The median age at diagnosis is 62 years, and an estimated 1 in 8 women will develop breast cancer at some point in their lifetime. African American women are more likely to die of breast cancer compared with women of other races. Objective: To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on medications for risk reduction of primary breast cancer. Evidence Review: The USPSTF reviewed evidence on the accuracy of risk assessment methods to identify women who could benefit from risk-reducing medications for breast cancer, as well as evidence on the effectiveness, adverse effects, and subgroup variations of these medications. The USPSTF reviewed evidence from randomized trials, observational studies, and diagnostic accuracy studies of risk stratification models in women without preexisting breast cancer or ductal carcinoma in situ. Findings: The USPSTF found convincing evidence that risk assessment tools can predict the number of cases of breast cancer expected to develop in a population. However, these risk assessment tools perform modestly at best in discriminating between individual women who will or will not develop breast cancer. The USPSTF found convincing evidence that risk-reducing medications (tamoxifen, raloxifene, or aromatase inhibitors) provide at least a moderate benefit in reducing risk for invasive estrogen receptor-positive breast cancer in postmenopausal women at increased risk for breast cancer. The USPSTF found that the benefits of taking tamoxifen, raloxifene, and aromatase inhibitors to reduce risk for breast cancer are no greater than small in women not at increased risk for the disease. The USPSTF found convincing evidence that tamoxifen and raloxifene and adequate evidence that aromatase inhibitors are associated with small to moderate harms. Overall, the USPSTF determined that the net benefit of taking medications to reduce risk of breast cancer is larger in women who have a greater risk for developing breast cancer. Conclusions and Recommendation: The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects. (B recommendation) The USPSTF recommends against the routine use of risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, in women who are not at increased risk for breast cancer. (D recommendation) This recommendation applies to asymptomatic women 35 years and older, including women with previous benign breast lesions on biopsy (such as atypical ductal or lobular hyperplasia and lobular carcinoma in situ). This recommendation does not apply to women who have a current or previous diagnosis of breast cancer or ductal carcinoma in situ

The Effect of Preoperative Weight Loss before Gastric Bypass: A Systematic Review

Background. Many insurance companies require obese patients to lose weight prior to gastric bypass. From a previous study by the same authors, preoperative weight at surgery is strongly predictive of weight loss up to one year after surgery. This review aims to determine whether preoperative weight loss is also correlated with weight loss up to one year after surgery. Methods. Of the 186 results screened using PubMed, 12 studies were identified. A meta-analysis was performed to further classify studies (A class, B class, regression, and rejected). Results. Of all 12 studies, one met the criteria for A class, six were B class, four were regression, and one was rejected. Six studies supported our hypothesis, five were inconclusive, and no study refuted. Conclusions. Preoperative weight loss is additive to postsurgery weight loss as predicted from the weight at the time of surgery

Screening for HIV Infection: US Preventive Services Task Force Recommendation Statement

Importance: Approximately 1.1 million persons in the United States are currently living with HIV, and more than 700000 persons have died of AIDS since the first cases were reported in 1981. There were approximately 38300 new diagnoses of HIV infection in 2017. The estimated prevalence of HIV infection among persons 13 years and older in the United States is 0.4%, and data from the Centers for Disease Control and Prevention show a significant increase in HIV diagnoses starting at age 15 years. An estimated 8700 women living with HIV give birth each year in the United States. HIV can be transmitted from mother to child during pregnancy, labor, delivery, and breastfeeding. The incidence of perinatal HIV infection in the United States peaked in 1992 and has declined significantly following the implementation of routine prenatal HIV screening and the use of effective therapies and precautions to prevent mother-to-child transmission. Objective: To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on screening for HIV infection in adolescents, adults, and pregnant women. Evidence Review: The USPSTF reviewed the evidence on the benefits and harms of screening for HIV infection in nonpregnant adolescents and adults, the yield of screening for HIV infection at different intervals, the effects of initiating antiretroviral therapy (ART) at a higher vs lower CD4 cell count, and the longer-term harms associated with currently recommended ART regimens. The USPSTF also reviewed the evidence on the benefits (specifically, reduced risk of mother-to-child transmission of HIV infection) and harms of screening for HIV infection in pregnant persons, the yield of repeat screening for HIV at different intervals during pregnancy, the effectiveness of currently recommended ART regimens for reducing mother-to-child transmission of HIV infection, and the harms of ART during pregnancy to the mother and infant. Findings: The USPSTF found convincing evidence that currently recommended HIV tests are highly accurate in diagnosing HIV infection. The USPSTF found convincing evidence that identification and early treatment of HIV infection is of substantial benefit in reducing the risk of AIDS-related events or death. The USPSTF found convincing evidence that the use of ART is of substantial benefit in decreasing the risk of HIV transmission to uninfected sex partners. The USPSTF also found convincing evidence that identification and treatment of pregnant women living with HIV infection is of substantial benefit in reducing the rate of mother-to-child transmission. The USPSTF found adequate evidence that ART is associated with some harms, including neuropsychiatric, renal, and hepatic harms, and an increased risk of preterm birth in pregnant women. The USPSTF concludes with high certainty that the net benefit of screening for HIV infection in adolescents, adults, and pregnant women is substantial. Conclusions and Recommendation: The USPSTF recommends screening for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk of infection should also be screened. (A recommendation) The USPSTF recommends screening for HIV infection in all pregnant persons, including those who present in labor or at delivery whose HIV status is unknown. (A recommendation)