GIS, GPS, and Remote Sensing Technologies in Extension Services: Where to Start, What to Know

The rapid development and integration of spatial technologies such as Geographic Information Systems, the Global Positioning System, and remote sensing, have created many new tools for Extension professionals, but have also widened the digital divide, leaving many with little understanding of the technology and potential applications. This article presents examples of Extension-related applications of GIS-GPS-RS technologies and discusses how to go about learning more and determining if these technologies would be useful. Examples and recommendations are taken from the literature and from the authors\u27 own experience

Reducing Outpatient Antibiotic Resistance: A Quasi-Experimental Study

Approved May 2017 by the faculty of UMKC in partial fulfillment of the requirements for the degree of Doctor of Nursing PracticeApproximately 50% of antibiotics prescribed are not necessary, nevertheless in the United States among the many outpatient prescriptions, few are more widely prescribed than antibiotics. The inappropriate use of antibiotics to treat non-bacterial infections has been largely responsible for the emergence of antibiotic resistance. The purpose of this DNP project was to evaluate the effect of an antibiotic stewardship program on urgent care providers’ antibiotic prescribing for acute respiratory infections and to analyze providers’ awareness and beliefs regarding antibiotic use and resistance. A quasi-experimental study was conducted among a convenience sample of eight urgent care providers who received a one hour theory-based intervention program on antibiotic prescribing. Outcomes measured included provider antibiotic prescribing rates pre- and post-intervention, differences in antibiotic prescribing among the providers, and provider attitude and knowledge regarding antibiotic prescribing and resistance. The antibiotic prescribing rate decreased from 30% to 20% post-intervention, p =. 078. The odds ratio of nurse practitioners preferring not to prescribe antibiotics pre-intervention was 3.273 (p = .001) and post-intervention 4.155 (p = < .0005) times more than physicians. Within their setting, 84.43% believed antibiotics are overused, and 92.25% believed antibiotic resistance is a problem. Implementation of an outpatient antibiotic stewardship program is necessary to decrease inappropriate antibiotic prescribing, slow progression of antibiotic resistance, and decrease healthcare costs associated with this world-wide public health problem

Genetic determinants of cerebral edema in severe traumatic brain injury: A pilot study of the role of CACNA1 and AQP4 gene mutations

Cerebral edema is the one of the most significant predictors of poor outcome after traumatic brain injury. It is still unclear what the pathophysiological and cellular mechanisms and predictors of post-traumatic edema are. The exponential growth in genetic information has opened an avenue for investigation in traumatic brain injury and implicated specific genes in the pathophysiology of post-traumatic injury edema. Two examples are the Aquaporin-4 and CACNA1 genes, which respectively encode water and calcium channels. The Aquaporin-4 gene on chromosome 18q11.2-12.1 encodes the Aquaporin-4 protein (AQP4) water channel. AQP4 is one of the bidirectional high capacity water channels that is primarily expressed in astrocytic foot processes in the central nervous system at the blood-brain barrier and is thought to be critical for brain water homeostasis. Experimental studies showed that AQP4 deficient mice had significantly reduced cerebral edema and better survival in a water intoxication model. The CACNA1 gene on chromosome 19p13 encodes the a1A subunit of a neuronal calcium channel. Patients with Familial Hemiplegic Migraine and delayed fatal cerebral edema and seizuresfrom minor trauma have been found to have mutations in CACNA1, which are hypothesized to enhance development of cytotoxic edema. A missense mutation is reported to enhance risk of delayed fatal cerebral edema. Hypothesis: The CACNA1 gene missense mutation S218L and AQP4 polymorphisms will be over-represented in patients with post-traumatic cerebral edema. Our Specific Aim is to perform full exon sequence analysis of these two genes in 20 well-defined cases of excessive cerebral edema. Our long term goal is to systematically investigate genetic variants as determinants of risk of excessive cerebral edema. It is hoped that this will further elucidate secondary mechanisms of injury specifically in the formation of post-traumatic edema and lead to targeted therapies in the future

California Drought: Hydrological and Regulatory Water Supply Issues

This report provides a summary of California's 2012-2015 drought including: comparisons, where applicable, to previous droughts; a summary of the key regulatory requirements that at certain times limit water deliveries (or exports) from the San Joaquin and Sacramento Rivers' Delta; and a brief discussion of California water rights with their relation to different types of federal contracts and their associated water allocations