117 research outputs found

    Improving nitrogen management for corn in southern Idaho and southwest Oregon

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    Funding is being sought from multiple sources to update nitrogen fertilizer recommendations for irrigated corn in southern Idaho and southwest Oregon. This paper summarizes the justifications and main objectives of this proposed research. Nitrogen needs to be correctly managed in corn production systems to optimize economic returns and to protect the environment. The fertilizer nitrogen recommendations for irrigated field corn in Idaho and other parts of the Pacific need to be re-evaluated because: (1) University of Idaho (U of I) and PNW region recommendations are based on sparse research data; (2) Recommendation are based on research data that is over 25 years old; (3) Corn production area and yield have increased dramatically in concentrated areas due to the growing dairy industry; (4) There is evidence of variation in optimal nitrogen rates and management between the U of I recommendations and growers, and between U of I and other corn growing regions; (5) In southern Idaho nitrate concentrations have been increasing in groundwater and springs along the Snake River. Agriculture has been implicated by the Idaho Department of Environmental Quality as a major source of the nitrate. This document elaborates on the above justifications

    Formation and Evolution of Planetary Systems: Placing Our Solar System in Context with Spitzer

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    We summarize the progress to date of our Legacy Science Program entitled "The Formation and Evolution of Planetary Systems" (FEPS) based on observations obtained with the Spitzer Space Telescope during its first year of operation. In addition to results obtained from our ground-based preparatory program and our early validation program, we describe new results from a survey for near-infrared excess emission from the youngest stars in our sample as well as a search for cold debris disks around sun-like stars. We discuss the implications of our findings with respect to current understanding of the formation and evolution of our own solar system.Comment: 8 postscript pages including 3 figures. To appear in "Spitzer New Views of the Cosmos" ASP Conference Series, eds. L. Armus et al. FEPS website at http://feps.as.arizona.ed

    Phosphorus Removal by Silage Corn in Southern Idaho

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    Corn silage is the predominant crop in Idaho used for recovering phosphorus (P) that has accumulated in soils from dairy manure applications. However, little is known about how much P and other nutrients are being recov- ered under Idaho conditions. The objective of the study is to estimate P removal by irrigated corn silage crops cultivated throughout southern Idaho with variable soil test P concentrations, and to identify effects of increasing soil test P on tissue concentrations of P and on plant P uptake. Forty-two different corn silage fields in 2008 and 2009 were selected throughout southern Idaho for soil and whole plant sampling at harvest. Soils were ana- lyzed for Olsen P, plant tissue was measured for total P content, and dry and wet yields were calculated based on field weights and drying of plant tissue

    Soil–Plant Nutrient Interactions on Manure-Enriched Calcareous Soils

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    Growers working with manured soils o? en rely on soil test information when developing nutrient management for their crop, especially when manure application information is unavailable. Nutrient-enriched soils, like manured soils, can trigger nutrient de? ciencies and toxicities due to plant–soil nutrient interactions. ? e goal of the study was to determine correlations between soil test and plant tissue nutrient concentrations for irrigated corn silage crops (Zea mays L. subsp. mays) with varying nutrient concentrations unique to dairy manure-enriched calcareous soils. Whole plant and soil samples were collected from 39 cooperator corn silage ? elds at harvest over a 2-yr period throughout the Snake River Plain region of southern Idaho. Soils were sampled to a depth of 30.5 cm and analyzed for plant available forms of P, K, Ca, Mg, Na, S, Zn, Fe, Mn, Cu, and B; whole plant tops were analyzed for total N, P, K, Ca, Mg, Na, S, Zn, Fe, Mn, and Cu. Signi? cant positive correlations were detected between soil test K and tissue K (Spearman’s rho correlation coe? cient = 0.63), soil test K and tissue N (rho = 0.59), and soil test B and tissue N (rho = 0.53). A significant negative correlation was detected between soil test Fe and tissue Mn (rho = –0.59). Controlled studies are needed to corroborate the relationships observed in this survey study

    Centralisation of specialist cancer surgery services in two areas of England: the RESPECT-21 mixed-methods evaluation

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    Background: Centralising specialist cancer surgical services is an example of major system change. High-volume centres are recommended to improve specialist cancer surgery care and outcomes. Objective: Our aim was to use a mixed-methods approach to evaluate the centralisation of specialist surgery for prostate, bladder, renal and oesophago-gastric cancers in two areas of England [i.e. London Cancer (London, UK), which covers north-central London, north-east London and west Essex, and Greater Manchester Cancer (Manchester, UK), which covers Greater Manchester]. Design: Stakeholder preferences for centralising specialist cancer surgery were analysed using a discrete choice experiment, surveying cancer patients (n = 206), health-care professionals (n = 111) and the general public (n = 127). Quantitative analysis of impact on care, outcomes and cost-effectiveness used a controlled before-and-after design. Qualitative analysis of implementation and outcomes of change used a multisite case study design, analysing documents (n = 873), interviews (n = 212) and non-participant observations (n = 182). To understand how lessons apply in other contexts, we conducted an online workshop with stakeholders from a range of settings. A theory-based framework was used to synthesise these approaches. Results: Stakeholder preferences – patients, health-care professionals and the public had similar preferences, prioritising reduced risk of complications and death, and better access to specialist teams. Travel time was considered least important. Quantitative analysis (impact of change) – only London Cancer’s centralisations happened soon enough for analysis. These changes were associated with fewer surgeons doing more operations and reduced length of stay [prostate –0.44 (95% confidence interval –0.55 to –0.34) days; bladder –0.563 (95% confidence interval –4.30 to –0.83) days; renal –1.20 (95% confidence interval –1.57 to –0.82) days]. The centralisation meant that renal patients had an increased probability of receiving non-invasive surgery (0.05, 95% confidence interval 0.02 to 0.08). We found no evidence of impact on mortality or re-admissions, possibly because risk was already low pre-centralisation. London Cancer’s prostate, oesophago-gastric and bladder centralisations had medium probabilities (79%, 62% and 49%, respectively) of being cost-effective, and centralising renal services was not cost-effective (12% probability), at the £30,000/quality-adjusted life-year threshold. Qualitative analysis, implementation and outcomes – London Cancer’s provider-led network overcame local resistance by distributing leadership throughout the system. Important facilitators included consistent clinical leadership and transparent governance processes. Greater Manchester Cancer’s change leaders learned from history to deliver the oesophago-gastric centralisation. Greater Manchester Cancer’s urology centralisations were not implemented because of local concerns about the service model and local clinician disengagement. London Cancer’s network continued to develop post implementation. Consistent clinical leadership helped to build shared priorities and collaboration. Information technology difficulties had implications for interorganisational communication and how reliably data follow the patient. London Cancer’s bidding processes and hierarchical service model meant that staff reported feelings of loss and a perceived ‘us and them’ culture. Workshop – our findings resonated with workshop attendees, highlighting issues about change leadership, stakeholder collaboration and implications for future change and evaluation. Limitations: The discrete choice experiment used a convenience sample, limiting generalisability. Greater Manchester Cancer implementation delays meant that we could study the impact of only London Cancer changes. We could not analyse patient experience, quality of life or functional outcomes that were important to patients (e.g. continence). Future research: Future research may focus on impact of change on care options offered, patient experience, functional outcomes and long-term sustainability. Studying other approaches to achieving high-volume services would be valuable. Study registration: ational Institute for Health and Care Research (NIHR) Clinical Research Network Portfolio reference 19761

    How to Cost the Implementation of Major System Change for Economic Evaluations: Case Study Using Reconfigurations of Specialist Cancer Surgery in Part of London, England.

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    BACKGROUND: Studies have been published regarding the impact of major system change (MSC) on care quality and outcomes, but few evaluate implementation costs or include them in cost-effectiveness analysis (CEA). This is despite large potential costs of MSC: change planning, purchasing or repurposing assets, and staff time. Implementation costs can influence implementation decisions. We describe our framework and principles for costing MSC implementation and illustrate them using a case study. METHODS: We outlined MSC implementation stages and identified components, using a framework conceived during our work on MSC in stroke services. We present a case study of MSC of specialist surgery services for prostate, bladder, renal and oesophagogastric cancers, focusing on North Central and North East London and West Essex. Health economists collaborated with qualitative researchers, clinicians and managers, identifying key reconfiguration stages and expenditures. Data sources (n = approximately 100) included meeting minutes, interviews, and business cases. National Health Service (NHS) finance and service managers and clinicians were consulted. Using bottom-up costing, items were identified, and unit costs based on salaries, asset costs and consultancy fees assigned. Itemised costs were adjusted and summed. RESULTS: Cost components included options appraisal, bidding process, external review; stakeholder engagement events; planning/monitoring boards/meetings; and making the change: new assets, facilities, posts. Other considerations included hospital tariff changes; costs to patients; patient population; and lifetime of changes. Using the framework facilitated data identification and collection. The total adjusted implementation cost was estimated at £7.2 million, broken down as replacing robots (£4.0 million), consultancy fees (£1.9 million), staff time costs (£1.1 million) and other costs (£0.2 million). CONCLUSIONS: These principles can be used by funders, service providers and commissioners planning MSC and researchers evaluating MSC. Health economists should be involved early, alongside qualitative and health-service colleagues, as retrospective capture risks information loss. These analyses are challenging; many cost factors are difficult to identify, access and measure, and assumptions regarding lifetime of the changes are important. Including implementation costs in CEA might make MSC appear less cost effective, influencing future decisions. Future work will incorporate this implementation cost into the full CEAs of the London Cancer MSC. TRIAL REGISTRATION: Not applicable
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