662 research outputs found
UNESCO, URI, and Archaeology in the Deep Blue Sea: Archaeological Ethics and Archaeological Oceanography
Multiple groups have interests that intersect within the new field of deep submergence (beyond the 50 meter range of SCUBA) archaeology. These groups‟ differing priorities present challenges for interdisciplinary collaboration, particularly as there are no established guidelines for best practices in such scenarios. Associating the term \u27archaeology\u27 with projects directed at underwater cultural heritage that are are not guided by archaeologists poses a real risk to that heritage. Recognizing that the relevant professional organizations, local laws, and conventions currently have little ability to protect pieces of cultural heritage across disciplines and international boundaries, the authors propose institution-specific mechanisms, called Archaeology Review Boards (ARBs), guided by local and international laws and conventions concerning cultural heritage, as the best means to provide oversight for academically centered archaeological activities at the local level
1862-07-02 William Buxton recommends Henry P. Herrick for a commission
https://digitalmaine.com/cw_me_16th_regiment_corr/1041/thumbnail.jp
Utilization Rates of Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death: A 2012 Calculation for a Midwestern Health Referral Region
Background
Utilization rates (URs) for implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden cardiac death (PPSCD) are lacking in the community.
Objective
To establish the ICD UR in central Indiana.
Methods
A query run on two hospitals in a health information exchange database in Indianapolis identified patients between 2011 and 2012 with left ventricular ejection fraction (EF) ≤0.35. ICD-eligibility and utilization were determined from chart review.
Results
We identified 1,863 patients with at least one low-EF study. Two cohorts were analyzed: 1,672 patients without, and 191 patients with, ICD-9-CM procedure code 37.94 for ICD placement. We manually reviewed a stratified (by hospital) random sample of 300 patients from the no-ICD procedure code cohort and found that 48 (16%) had no ICD but had class I indications for ICD. Eight of 300 (2.7%) actually had ICD implantation for PPSCD. Review of all 191 patients in the ICD procedure code cohort identified 70 with ICD implantation for PPSCD. The ICD UR (ratio between patients with ICD for PPSCD and all with indication) was 38% overall (95% CI 28–49%). URs were 48% for males (95% CI 34–61%), 21% for females (95% CI 16–26%, p=0.0002 vs males), 40% for whites (95% CI 27–53%), and 37% for blacks (95% CI 28–46%, p=0.66 vs whites).
Conclusions
The ICD UR is 38% among patients meeting Class I indications, suggesting further opportunities to improve guideline compliance. Furthermore, this study illustrates limitations in calculating ICD UR using large electronic repositories without hands-on chart review
Sustainable tree-shrub-grass buffer strips along waterways
The midwestern landscape, which formerly consisted of prairies, wetlands, and forests, is now primarily devoted to agricultural purposes. Unfortunately, the resulting large-scale agricultural production has also produced nonpoint source (NPS) pollution of water, alteration of waterways, and disruption of wildlife habitat. NPS pollution, whether by sediment, fertilizers, or pesticides, is a problem nationwide. The agricultural community has addressed this problem by increasing soil conservation efforts and improving chemical application practices. One Best Management Practice (BMP) is the use of riparian (streamside) vegetative filter strips on watersheds prone to such pollution. Most such filter strips to date consist primarily of cool-season grasses
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Values for preventing influenza-related morbidity and vaccine adverse events in children
BACKGROUND: Influenza vaccination recently has been recommended for children 6–23 months old, but is not currently recommended for routine use in non-high-risk older children. Information on disease impact, costs, benefits, risks, and community preferences could help guide decisions about which age and risk groups should be vaccinated and strategies for improving coverage. The objective of this study was to measure preferences and willingness-to-pay for changes in health-related quality of life associated with uncomplicated influenza and two rarely-occurring vaccination-related adverse events (anaphylaxis and Guillain-Barré syndrome) in children. METHODS: We conducted telephone interviews with adult members selected at random from a large New England HMO (n = 112). Respondents were given descriptions of four health outcomes: uncomplicated influenza in a hypothetical 1-year-old child of their own, uncomplicated influenza in a hypothetical 14-year-old child of their own, anaphylaxis following vaccination, and Guillain-Barré syndrome. "Uncomplicated influenza" did not require a physician's visit or hospitalization. Preferences (values) for these health outcomes were measured using time-tradeoff and willingness-to-pay questions. Time-tradeoff questions asked the adult to assume they had a child and to consider how much time from the end of their own life they would be willing to surrender to avoid the health outcome in the child. RESULTS: Respondents said they would give a median of zero days of their lives to prevent an episode of uncomplicated influenza in either their (hypothetical) 1-year-old or 14-year-old, 30 days to prevent an episode of vaccination-related anaphylaxis, and 3 years to prevent a vaccination-related case of Guillain-Barré syndrome. Median willingness-to-pay to prevent uncomplicated influenza in a 1-year-old was 100, anaphylaxis 4000. The median willingness-to-pay for an influenza vaccination for their children with no risk of anaphylaxis or Guillain-Barré syndrome was 100, respectively. CONCLUSION: Most respondents said they would not be willing to trade any time from their own lives to prevent uncomplicated influenza in a child of their own, and the time traded did not vary by the age of the hypothetical affected child. However, adults did indicate a willingness-to-pay to prevent uncomplicated influenza in children, and that they would give more money to prevent the illness in a 1-year-old than in a 14-year-old. Respondents also indicated a willingness to pay a premium for a vaccine without any risk of severe complications
Health Benefits, Risks, and Cost-Effectiveness of Influenza Vaccination of Children
Vaccinating children aged 6–23 months, plus all other children at high-risk, will likely be more effective than vaccinating all children against influenza
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