Follow-up care after a health fair screening in three Houston neighborhoods in 2008

Background. Each year thousands of people participate in mass health screenings for diabetes and hypertension, but little is known about whether or not those who receive higher than normal screening results obtain the recommended follow-up medical care, or what barriers they perceive to doing so. ^ Methods. Study participants were recruited from attendees at three health fairs in low-income neighborhoods in Houston, Texas Potential participants had higher than normal blood pressure (> 90/140 mgHg) or blood glucose readings (100 mm/dL fasting or 140 mm/dL random). Study participants were called at one, two, and three months and asked if they had obtained follow-up medical care; those who had not yet obtained follow-up care were asked to identify barriers. Using a modified Aday-Andersen model of health service access, the independent variables were individual and community characteristics and self-perceived need. The dependent variable was obtaining follow-up care, with barriers to care a secondary outcome. ^ Results. Eighty-two study participants completed the initial questionnaire and 59 participants completed the study protocol. Forty-eight participants (59% under an intent to treat analysis, 81% of those completing the study protocol) obtained follow-up care. Those who completed the initial questionnaire and who reported a regular source of care were significantly more likely to obtain follow-up care. For those who completed the study protocol the relationship between having a regular source of care and obtaining follow-up care approached but did not reach significance. For those who completed the initial questionnaire, self-described health status, when examined as a binary variable (good, very good, excellent, or poor, fair, not sure) was associated with obtaining follow-up care for those who rated their health as poor, fair, or not sure. While the group who completed the study protocol did not reach statistical significance, the same relationship between self-described health status of poor, fair, or not sure and obtaining follow-up care was present. The participants who completed the study protocol and described their blood pressure as OK or a little high were statistically more likely to get follow-up care than those who described it as high or very high. All those on oral medications for hypertension (12/12) and diabetes (4/4) who were told to obtain follow-up care did so; however, the small sample size allows this correlation to be of statistical significance only for those treating hypertension. ^ The variables significantly associated with obtaining follow-up care were having a regular source of care, self-described health status of poor, fair, or not sure, self-described blood pressure of OK or a little high, and taking medication for blood pressure. ^ At the follow-up telephone calls, 34 participants identified barriers to care; cost was a significant barrier reported by 16 participants, and 10 reported that they didn’t have time because they were working long hours after Hurricane Ike. ^ The study included the offer of access assistance: information about nearby safety-net providers, a visit to or information from the Health Information Center at their Neighborhood Center location, or information from Project Safety Net (a searchable web site for safety net providers). Access assistance was offered at the health fairs and then again at follow-up telephone calls to those who had not yet obtained follow-up care. Of the 48 participants who reported obtaining follow-up care, 26 said they had made use of the access assistance to do so. The use of access assistance was associated with being Hispanic, not having health insurance or a regular source of care, and speaking Spanish. It was also associated with being worried about blood glucose. ^ Conclusion. Access assistance, as a community enabling characteristic, may be useful in aiding low-income people in obtaining medical care. ^

Profiles of diatoms, pollen, XRD, XRF and organic composition of two sediment cores (PG2022 and PG2023) from Lake Kyutyunda in Yakutia, NE Siberia, Russia

Although the climate development over the Holocene in the Northern Hemisphere is well known, palaeolimnological climate reconstructions reveal spatiotemporal variability in northern Eurasia. Here we present a multi-proxy study from north-eastern Siberia combining sediment geochemistry, and diatom and pollen data from lake-sediment cores covering the last 38,000 cal. years. Our results show major changes in pyrite content and fragilarioid diatom species distributions, indicating prolonged seasonal lake-ice cover between ~13,500 and ~8,900 cal. years BP and possibly during the 8,200 cal. years BP cold event. A pollen-based climate reconstruction generated a mean July temperature of 17.8°C during the Holocene Thermal Maximum (HTM) between ~8,900 and ~4,500 cal. years BP. Naviculoid diatoms appear in the late Holocene indicating a shortening of the seasonal ice cover that continues today. Our results reveal a strong correlation between the applied terrestrial and aquatic indicators and natural seasonal climate dynamics in the Holocene. Planktonic diatoms show a strong response to changes in the lake ecosystem due to recent climate warming in the Anthropocene. We assess other palaeolimnological studies to infer the spatiotemporal pattern of the HTM and affirm that the timing of its onset, a difference of up to 3,000 years from north to south, can be well explained by climatic teleconnections. The westerlies brought cold air to this part of Siberia until the Laurentide ice-sheet vanished 7,000 years ago. The apparent delayed ending of the HTM in the central Siberian record can be ascribed to the exceedance of ecological thresholds trailing behind increases in winter temperatures and decreases in contrast in insolation between seasons during the mid to late Holocene as well as lacking differentiation between summer and winter trends in paleolimnological reconstructions.

Landings of European lobster (Homarus gammarus) and edible crab (Cancer pagurus) from 1615 to 2009, Helgoland, North Sea

From 2000 to 2005 about 5400 one-year-old hatchery-reared lobsters (Homarus gammarus) were tagged and released at the rocky island of Helgoland, North Sea. To date, 1-8% of the different release cohorts were recaptured in the field and 8-19% of these lobsters were recaptured from the semi-open area of the outer harbour. The recaptured lobsters indicated good development and growth conditions. The smallest berried females caught were 83 mm carapace length and 4 years old. The proportion of cultured lobsters to all measured lobsters captured around the island was 3-8% in the years 2007-2009. The population size of two cohorts was assessed using the Lincoln-Peterson method and the estimated survival rate averaged 30% and 40%. Minimum landing size of cultured lobsters was reached after 4-7 years. Cultured lobsters showed strong fidelity to their release sites, and thus remained around the island of Helgoland. A basis has been laid to enhance this endangered lobster population by means of a large scale restocking programme.

(Table 2) Weight percent organic carbon from ODP Site 138-847

As the length of marine cores increases and sampling intervals decrease, the need for rapid and inexpensive means of determining sediment composition has become apparent. In this study we examine one potentially useful technique for assessing compositional changes in marine cores, diffuse reflectance spectrophotometry. We examined near-ultraviolet, visible, and near-infrared reflectance spectra from five data sets. Each data set consists of calibration samples and test samples. The calibration samples' spectra were related to a sediment component using multiple linear regression. The resulting regression or calibration equations were then evaluated using the test samples. Calibration equations were written relating spectra to several sediment components incduding carbonate (Atlantic and east Pacific Rise ODP Site 847), organic carbon content (Atlantic and east Pacific Rise), and opal content (east Pacific Rise). The correlation coefficients for the regression equations ranged from a high of 0.99 for carbonate and opal at ODP Site 847 to a low of 0.97 for Atlantic carbonate indicating that spectral variations are highly correlated to sediment composition. All of the equations include a substantial number of variables from shorter visible and longer near ultraviolet wavelengths suggesting that these wavelengths are especially important for devices designed specifically to scan marine cores. Although equations for estimating organic and carbonate content appear independent of other sediment components, the opal equation is strongly dependent on carbonate content indicating that opal concentration is correlated to carbonate content. Tests of the calibration equations indicated that all our equations reasonably estimate the pattern of changes, either down core or in surface sediments. Where our spectral estimates have difficulty is with absolute values, frequently over or underestimating observed values by a substantial amount. Within these limitations diffuse reflectance spectrophotometry can be a useful tool for characterizing marine cores and as our understanding of the relationship between spectra and mineralogy improves so will estimates of absolute values.

Late Miocene palaeoflora and palaeoclimate of Lincang (China)

The Miocene Lincang leaf assemblage is used in this paper as proxy data to reconstruct the palaeoclimate of southwestern Yunnan (SW China) and the evolution of monsoon intensity. Three quantitative methods were chosen for this reconstruction, i.e. Leaf Margin Analysis (LMA), Climate Leaf Analysis Multivariate Program (CLAMP), and the Coexistence Approach (CA). These methods, however, yield inconsistent results, particularly for the precipitation, as also shown in European and other East Asian Cenozoic floras. The wide range of the reconstructed climatic parameters includes the Mean Annual Temperature (MAT) of 18.5-24.7 °C and the Mean Annual Precipitation (MAP) of 1213-3711 mm. Compared with the modern Lincang climate (MAT, 17.3 °C; MAP, 1178.7 mm), the Miocene climate is slightly warmer, wetter and has a higher temperature seasonality. A detailed comparison on the palaeoclimatic variables with the coeval Late Miocene Xiaolongtan flora from the eastern part of Yunnan allows us to investigate the development and interactions of both South Asian and East Asian monsoons during the Late Miocene in southwest China, now under strong influence of these monsoon systems. Our results suggest that the monsoon climate has already been established in southwest Yunnan during the Late Miocene. Furthermore, our results support that both Southeast Asian and East Asian monsoons co-occurred in Yunnan during the Late Miocene.

Geochemistry of sediments from the Cretaceous-Tertiary boundary

Siderophilic element concentrations are high in sediments from the Cretaceous-Tertiary boundary. An extraterrestrial source is indicated. Concentrations are too high to be understood in terms of the impact of a chondritic asteroid. Either the projectile was a metal-sulphide core or the infalling material (probably weak cometary matter) was slowed down during atmospheric passage.