Low correlation between self-report and medical record documentation of urinary tract infection symptoms.

BACKGROUND Correlations between symptom documentation in medical records and patient self-report (SR) vary depending on the condition studied. Patient symptoms are particularly important in urinary tract infection (UTI) diagnosis, and this correlation for UTI symptoms is currently unknown. METHODS This is a cross-sectional survey study in hospitalized patients with Escherichia coli bacteriuria. Patients were interviewed within 24 hours of diagnosis for the SR of UTI symptoms. We reviewed medical records for UTI symptoms documented by admitting or treating inpatient physicians (IPs), nurses (RNs), and emergency physicians (EPs). The level of agreement between groups was assessed using Cohen κ coefficient. RESULTS Out of 43 patients, 34 (79%) self-reported at least 1 of 6 primary symptoms. The most common self-reported symptoms were urinary frequency (53.5%); retention (41.9%); flank pain, suprapubic pain, and fatigue (37.2% each); and dysuria (30.2%). Correlation between SR and medical record documentation was slight to fair (κ, 0.06-0.4 between SR and IPs and 0.09-0.5 between SR and EDs). Positive agreement was highest for dysuria and frequency. CONCLUSION Correlation between self-reported UTI symptoms and health care providers' documentation was low to fair. Because medical records are a vital source of information for clinicians and researchers and symptom assessment and documentation are vital in distinguishing UTI from asymptomatic bacteriuria, efforts must be made to improve documentation.

Bentgrass response to K fertilization and K release rates from eight sand rootzone sources used in putting green construction.

There is a lack of plant response to fertilizer K in some sandy soils even though routine soil tests for soil available K are shown to be low. This lack of plant response to K fertilizer application may be explained by K release from nonexchangeable forms. Greenhouse and laboratory experiments were conducted to evaluate (a) response of bentgrass (Agrostis palustris [Agrostis stolonifera var. palustris]) cv. Pencross grown in rootzones with different sand sources to K fertilizer application and (b) K release from nonexchangeable forms from the different sand sources as an index to K availability. Experimental variables in the greenhouse were 2 K levels (0 and 250 mg K/kg soil) and 8 sand rootzone sources. Rootzone soils were sub-irrigated to ensure no K loss from leaching. Two laboratory methods (boiling 1 M HNO3 extraction and continuous leaching with 0.01 M HCl) and total K uptake by the bentgrass were employed to index K release from nonexchangeable forms for each rootzone source. K fertilizer application significantly increased bentgrass yield growing in one rootzone source and root weight in 3 rootzone sources. K uptake by bentgrass and the 2 laboratory methods showed important differences in K release from the sand rootzones. The K removed by the 2 laboratory methods was closely related to leaf tissue K and K uptake, with the 1 M HNO3 extraction method providing the closest fit. The release of K from primary minerals in some rootzones with high sand content is proceeding at rates to satisfy bentgrass requirements for K. The 1 M HNO3 extraction method may provide an alternative to the routine laboratory procedures presently being used to measure the extractable K in sand-based constructed putting greens by measuring K contributed by nonexchangeable forms.

Some Law and Economics of Historic Shipwrecks

This paper examines how US and proposed international law relate to the recovery of archaeological data from historic shipwrecks. It argues that US federal admiralty law of salvage gives far less protection to historic submerged sites than do US laws protecting archaeological sites on US federal and Indian lands. The paper offers a simple model in which the net present value of the salvage and archaeological investigation of an historic shipwreck is maximized. It is suggested that salvage law gives insufficient protection to archaeological data, but that UNESCO's Convention on the Protection of the Underwater Cultural Heritage goes too far in the other direction. It is also suggested that a move towards maximizing the net present value of a wreck would be promoted if the US admiralty courts explicitly tied the size of salvage awards to the quality of the archaeology performed.

Murky Waters: The Law and Economics of Salvaging Historic Shipwrecks

The salvage of historic shipwrecks involves a debate between salvors, who wish to maximize profit, and archeologists, who wish to preserve historical value. Traditionally, salvage of shipwrecks has been governed by admiralty law, but the Abandoned Shipwreck Act of 1987 transferred title of historically important wrecks in U.S. waters to the state in whose waters the wreck is found, thereby abrogating admiralty law. This paper examines incentives to locate and salvage historic wrecks under traditional admiralty law and proposes an efficient reward scheme. It then re-considers current U.S. and international law in light of the results.

Statistical and methodological challenges for disaster preparedness and medical needs assessment in Rio Grande Valley of Texas

In recent years, disaster preparedness through assessment of medical and special needs persons (MSNP) has taken a center place in public eye in effect of frequent natural disasters such as hurricanes, storm surge or tsunami due to climate change and increased human activity on our planet. Statistical methods complex survey design and analysis have equally gained significance as a consequence. However, there exist many challenges still, to infer such assessments over the target population for policy level advocacy and implementation. ^ Objective. This study discusses the use of some of the statistical methods for disaster preparedness and medical needs assessment to facilitate local and state governments for its policy level decision making and logistic support to avoid any loss of life and property in future calamities. ^ Methods. In order to obtain precise and unbiased estimates for Medical Special Needs Persons (MSNP) and disaster preparedness for evacuation in Rio Grande Valley (RGV) of Texas, a stratified and cluster-randomized multi-stage sampling design was implemented. US School of Public Health, Brownsville surveyed 3088 households in three counties namely Cameron, Hidalgo, and Willacy. Multiple statistical methods were implemented and estimates were obtained taking into count probability of selection and clustering effects. Statistical methods for data analysis discussed were Multivariate Linear Regression (MLR), Survey Linear Regression (Svy-Reg), Generalized Estimation Equation (GEE) and Multilevel Mixed Models (MLM) all with and without sampling weights. ^ Results. Estimated population for RGV was 1,146,796. There were 51.5% female, 90% Hispanic, 73% married, 56% unemployed and 37% with their personal transport. 40% people attained education up to elementary school, another 42% reaching high school and only 18% went to college. Median household income is less than $15,000/year. MSNP estimated to be 44,196 (3.98%) [95% CI: 39,029; 51,123]. All statistical models are in concordance with MSNP estimates ranging from 44,000 to 48,000. MSNP estimates for statistical methods are: MLR (47,707; 95% CI: 42,462; 52,999), MLR with weights (45,882; 95% CI: 39,792; 51,972), Bootstrap Regression (47,730; 95% CI: 41,629; 53,785), GEE (47,649; 95% CI: 41,629; 53,670), GEE with weights (45,076; 95% CI: 39,029; 51,123), Svy-Reg (44,196; 95% CI: 40,004; 48,390) and MLM (46,513; 95% CI: 39,869; 53,157). ^ Conclusion. RGV is a flood zone, most susceptible to hurricanes and other natural disasters. People in the region are mostly Hispanic, under-educated with least income levels in the U.S. In case of any disaster people in large are incapacitated with only 37% have their personal transport to take care of MSNP. Local and state government’s intervention in terms of planning, preparation and support for evacuation is necessary in any such disaster to avoid loss of precious human life. ^ Key words: Complex Surveys, statistical methods, multilevel models, cluster randomized, sampling weights, raking, survey regression, generalized estimation equations (GEE), random effects, Intracluster correlation coefficient (ICC).^

OUT-OF-HOSPITAL CHILDBEARING CENTERS IN THE UNITED STATES: A DESCRIPTIVE STUDY OF THE DEMOGRAPHIC AND MEDICAL-OBSTETRIC CHARACTERISTICS OF WOMEN BEGINNING LABOR THEREIN 1972-1979

There is currently much interest in the appropriate use of obstetrical technology, cost containment and meeting consumers' needs for safe and satisfying maternity care. At the same time, there has been an increase in professionally unattended home births. In response, a new type of service, the out-of-hospital childbearing center (CBC) has been developed which is administratively and structurally separate from the hospital. In the CBC, maternity care is provided by certified nurse-midwives to carefully screened low risk childbearing families in conjunction with physician and hospital back-up.^ It was the purpose of this study to accomplish the following objectives: (1) To describe in a historical prospective study the demographic and medical-obstetric characteristics of patients laboring in eleven selected out-of-hospital childbearing centers in the United States from May 1, 1972, to December 15, 1979. Labor is defined as the onset of regular contractions as determined by the patient. (2) To describe any differences between those patients who require transfer to a back-up hospital and those who do not. (3) To describe administrative and service characteristics of eleven selected out-of-hospital childbearing centers in the United States. (4) To compare the demographic and medical-obstetric characteristics of women laboring in eleven selected out-of-hospital childbearing centers with a national sample of women of similar obstetric risk who according to birth certificates delivered legitimate infants in a hospital setting in the United States in 1972.^ Research concerning CBCs and supportive to the development of CBCs including studies which identified factors associated with fetal and perinatal morbidity and mortality, obstetrical risk screening, and the progress of technological development in obstetrics were reviewed. Information concerning the organization and delivery of care at each selected CBC was also collected and analyzed.^ A stratified, systematic sample of 1938 low risk women who began labor in a selected CBC were included in the study. These women were not unlike those described previously in small single center studies reported in the literature. The mean age was 25 years. Sixty-three per cent were white, 34 per cent Hispanic, 88 per cent married, 45 per cent had completed at least two years of college, nearly one-third were professionals and over a third were housewives. . . . (Author's abstract exceeds stipulated maximum length. Discontinued here with permission of school.) UMI ^

Climatic impact on Al, K, Sc and Ti in marine sediments: Evidence from ODP Site 1144, South China Sea

Al, K, Sc and Ti concentrations of the terrestrial material-dominant sediments from ODP site 1144 were reported. Comparison between the bulk and the acid-leached sediments indicates that about 20~30% of the Al, K and Sc in the bulk sediments are not hosted in terrestrial detritus, rather they are of authigenic origin. However, authigenic Ti is negligible. The results indicate that Ti rather than Al is the best proxy for terrestrial materials. Significant climate controls are displayed in the Al/Ti, K/Ti and Sc/Ti variation patterns both for the bulk and the acid leached sediments. Such variation patterns can be mainly accounted for in terms of climate change in their provenance areas in South China. Elevated Al/Ti, K/Ti and Sc/Ti ratios during interglacial periods indicate that chemical weathering then was stronger than during glacial periods, which might be related to a more humid climate in interglacial periods.

Harris, E. M; Leão, D. F. and Rhodes, P. J. , Law and Drama in Ancient Greece, Duckworth, London, 2010, vii + 200 pp.

Fil: Fernández Deagustini, María del Pilar. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación. Instituto de Investigaciones en Humanidades y Ciencias Sociales (UNLP-CONICET); Argentina.

Harris, E. M; Leão, D. F. and Rhodes, P. J. , Law and Drama in Ancient Greece, Duckworth, London, 2010, vii + 200 pp.

Fil: Fernández Deagustini, María del Pilar. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación. Instituto de Investigaciones en Humanidades y Ciencias Sociales (UNLP-CONICET); Argentina.

Harris, E. M; Leão, D. F. and Rhodes, P. J. , Law and Drama in Ancient Greece, Duckworth, London, 2010, vii + 200 pp.

Fil: Fernández Deagustini, María del Pilar. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación. Instituto de Investigaciones en Humanidades y Ciencias Sociales (UNLP-CONICET); Argentina.

(Table 2) Geochemistry of K-feldspars and associated plagioclase phenocrysts and rims at DSDP Legs 69, 52, 51 and 19

Basalts from some holes of the Deep Sea Drilling Project contain secondary K-feldspar which forms pseudomorphs after calcic (>76% An) Plagioclase cores, whereas Plagioclase of rims and microlites (68-74% An) remains unaltered. In basalts of Hole 504B two such grains with relics of Plagioclase in the central parts of phenocysts were recovered. The composition of the Plagioclase rims and of non-replaced phenocrysts is An79-81; the composition of relics is An83. The An and Ab contents of the K-feldspar is higher than in K-feldspar from altered basalt in Hole 418A in the Atlantic Ocean near the Bermuda Rise. Replacement of plagioclases by K-feldspar evidently is caused by oxygen-rich nearbottom sea water penetrating into basalts. The temperature interval of K-feldspathization is probably in the range 30 to 80°C, more-calcic Plagioclase being replaced by K-feldspar at higher temperatures.