A NEW APPROACH FOR ASSESSING THE COSTS OF LIVING WITH WILDLIFE IN DEVELOPING COUNTRIES

The costs of living with wildlife are assessed using Namibian subsistence farmers willingness to pay (WTP) for deterrents to attacks on crops and livestock as a measure of damage costs. A utility-theoretic approach jointly estimates household WTP for deterrent programs in two currencies, maize and cash. This has a double payoff. Use of a noncash staple increases respondent comprehension and provides more information about preferences, improving the accuracy of results. The household shadow value of maize is also identified. Significant costs from living with elephants and other types of wildlife are demonstrated. Compensation for farmers may be warranted on equity and efficiency grounds. Uncontrolled domestic cattle generate even higher costs to farmers than wildlife, highlighting the need to clarify property rights among these farmers.Resource /Energy Economics and Policy,

Feasibility of National Surveillance of Health-Care-Associated Infections in Home-Care Settings

This article examines the rationale and strategies for surveillance of health-care-associated infections in home-care settings, the challenges of nonhospital-based surveillance, and the feasibility of developing a national surveillance system

Proficiency of clinical laboratories in and near Monterrey, Mexico, to detect vancomycin-resistant enterococci.

Early detection of vancomycin-resistant enterococci is important for preventing its spread among hospitalized patients. We surveyed the ability of eight hospital laboratories in and near Monterrey, Mexico, to detect vancomycin resistance in Enterococcus spp. and found that although laboratories can reliably detect high-level vancomycin resistance, many have difficulty detecting low-level resistance

Research on atmospheric volcanic emissions: An overview

The project Research on Atmospheric Volcanic Emissions is a unique effort by NASA and university scientists to investigate the detailed chemical nature of plumes from volcanic eruptions. The major goals of the project are to: 1) understand the impact major eruptions will have on atmospheric chemistry processes, 2) understand the importance of volcanic emissions in the atmospheric geochemical cycles of selected species, 3) use knowledge of the plume chemical composition to diagnose and predict magmatic processes. Project RAVE\u27S first mission used the NASA Lockheed Orion P-3 outfitted with equipment to measure concentrations of the gases SO2, OCS, H2S, CS2, NO, O3and trace elements in particles in Mt. St. Helens\u27 plume on September 22, 1980. Measurements of SO2 column densities in the plume permitted calculations of SO2 fluxes. This article is an overview of the first experimental design factors and performance of the initial RAVE experiment

Control of Vancomycin-Resistant Enterococcus in Health Care Facilities in a Region

Background In late 1996, vancomycin-resistant enterococci were first detected in the Siouxland region of Iowa, Nebraska, and South Dakota. A task force was created, and in 1997 the assistance of the Centers for Disease Control and Prevention was sought in assessing the prevalence of vancomycin-resistant enterococci in the region’s facilities and implementing recommendations for screening, infection control, and education at all 32 health care facilities in the region. Methods The infection-control intervention was evaluated in October 1998 and October 1999. We performed point-prevalence surveys, conducted a case– control study of gastrointestinal colonization with vancomycin-resistant enterococci, and compared infection-control practices and screening policies for vancomycin-resistant enterococci at the acute care and long-term care facilities in the Siouxland region. Results Perianal-swab samples were obtained from 1954 of 2196 eligible patients (89 percent) in 1998 and 1820 of 2049 eligible patients (89 percent) in 1999. The overall prevalence of vancomycin-resistant enterococci at 30 facilities that participated in all three years of the study decreased from 2.2 percent in 1997 to 1.4 percent in 1998 and to 0.5 percent in 1999 (P Conclusions An active infection-control intervention, which includes the obtaining of surveillance cultures and the isolation of infected patients, can reduce or eliminate the transmission of vancomycinresistant enterococci in the health care facilities of a region. (N Engl J Med 2001;344:1427-33.

Serratia marcescens bacteremia traced to an infused narcotic

BACKGROUND From June 30, 1998, through March 21, 1999, several patients in the surgical intensive care unit of a hospital acquired Serratia marcescens bacteremia. We investigated this outbreak. METHODS A case was defined as the occurrence of S. marcescens bacteremia in any patient in the surgical intensive care unit during the period of the epidemic. To identify risk factors, we compared patients with S. marcescens bacteremia with randomly selected controls. Isolates from patients and from medications were evaluated by pulsed-field gel electrophoresis. The hair of one employee was tested for fentanyl. RESULTS Twenty-six patients with S. marcescens bacteremia were identified; eight (31 percent) had polymicrobial bacteremia, and seven of these had Enterobacter cloacae and S. marcescens in the same culture. According to univariate analysis, patients with S. marcescensbacteremia stayed in the surgical intensive care unit longer than controls (13.5 vs. 4.0 days, PS. marcescens and E. cloacae. The isolates from the case patients and from the fentanyl infusions had similar patterns on pulsed-field gel electrophoresis. After removal of the implicated respiratory therapist, no further cases occurred. Full Text of Results... CONCLUSIONS An outbreak of S. marcescens and E. cloacae bacteremia in a surgical intensive care unit was traced to extrinsic contamination of the parenteral narcotic fentanyl by a health care worker. Our findings underscore the risk of complications in patients that is associated with illicit narcotic use by health care workers

Proposals on Kaplan-Meier plots in medical research and a survey of stakeholder views: KMunicate.

OBJECTIVES: To examine reactions to the proposed improvements to standard Kaplan-Meier plots, the standard way to present time-to-event data, and to understand which (if any) facilitated better depiction of (1) the state of patients over time, and (2) uncertainty over time in the estimates of survival. DESIGN: A survey of stakeholders' opinions on the proposals. SETTING: A web-based survey, open to international participation, for those with an interest in visualisation of time-to-event data. PARTICIPANTS: 1174 people participated in the survey over a 6-week period. Participation was global (although primarily Europe and North America) and represented a wide range of researchers (primarily statisticians and clinicians). MAIN OUTCOME MEASURES: Two outcome measures were of principal importance: (1) participants' opinions of each proposal compared with a 'standard' Kaplan-Meier plot; and (2) participants' overall ranking of the proposals (including the standard). RESULTS: Most proposals were more popular than the standard Kaplan-Meier plot. The most popular proposals in the two categories, respectively, were an extended table beneath the plot depicting the numbers at risk, censored and having experienced an event at periodic timepoints, and CIs around each Kaplan-Meier curve. CONCLUSIONS: This study produced a high response number, reflecting the importance of graphics for time-to-event data. Those producing and publishing Kaplan-Meier plots-both authors and journals-should, as a starting point, consider using the combination of the two favoured proposals

Are There Regional Variations in the Diagnosis, Surveillance, and Control of Methicillin-Resistant Staphylococcus aureus?

Abstract Objective: To assess the way healthcare facilities (HCFs) diagnose, survey, and control methicillin-resistant Staphylococcus aureus (MRSA). Design: Questionnaire. Setting: Ninety HCFs in 30 countries. Results: Evaluation of susceptibility testing methods showed that 8 laboratories (9%) used oxacillin disks with antimicrobial content different from the one recommended, 12 (13%) did not determine MRSA susceptibility to vancomycin, and 4 (4.5%) reported instances of isolation of vancomycin-resistant S. aureus but neither confirmed this resistance nor alerted public health authorities. A MRSA control program was reported by 55 (61.1%) of the HCFs. The following isolation precautions were routinely used: hospitalization in a private room (34.4%), wearing of gloves (62.2%), wearing of gowns (44.4%), hand washing by healthcare workers (53.3%), use of an isolation sign on the patient's door (43%), or all four. When the characteristics of HCFs with low incidence rates (< 0.4 per 1,000 patient-days) were compared with those of HCFs with high incidence rates (P = 0.4 per 1,000 patient-days), having a higher mean number of beds per infection control nurse was the only factor significantly associated with HCFs with high incidence rates (834 vs 318 beds; P = .02). Conclusion: Our results emphasize the urgent need to strengthen the microbiologic and epidemiologic capacities of HCFs worldwide to prevent MRSA transmission and to prepare them to address the possible emergence of vancomycin-resistant S. aureu