An evaluation of an adapted United States model of pharmaceutical care to improve psychoactive prescribing for nursing home residents in Northern Ireland (Fleetwood NI Study).

OBJECTIVES: To test the effect of an adapted U.S. model of pharmaceutical care on prescribing of inappropriate psychoactive (anxiolytic, hypnotic, and antipsychotic) medications and falls in nursing homes for older people in Northern Ireland (NI).

DESIGN: Cluster randomized controlled trial.

SETTING: Nursing homes randomized to intervention (receipt of the adapted model of care; n=11) or control (usual care continued; n=11).

PARTICIPANTS: Residents aged 65 and older who provided informed consent (N=334; 173 intervention, 161 control).

INTERVENTION: Specially trained pharmacists visited intervention homes monthly for 12 months and reviewed residents' clinical and prescribing information, applied an algorithm that guided them in assessing the appropriateness of psychoactive medication, and worked with prescribers (general practitioners) to improve the prescribing of these drugs. The control homes received usual care.

MEASUREMENTS: The primary end point was the proportion of residents prescribed one or more inappropriate psychoactive medicine according to standardized protocols; falls were evaluated using routinely collected falls data mandated by the regulatory body for nursing homes in NI.

RESULTS: The proportion of residents taking inappropriate psychoactive medications at 12 months in the intervention homes (25/128, 19.5%) was much lower than in the control homes (62/124, 50.0%) (odds ratio=0.26, 95% confidence interval=0.14–0.49) after adjustment for clustering within homes. No differences were observed at 12 months in the falls rate between the intervention and control groups.

CONCLUSION: Marked reductions in inappropriate psychoactive medication prescribing in residents resulted from pharmacist review of targeted medications, but there was no effect on falls.

Assessing the combined effect of land management and wildfire on runoff and soil erosion in north central Portugal

Strong and sometimes extreme responses in runoff and soil erosion following wildfires have been reported worldwide. However, in the case of North-Central Portugal, little research had been carried out regarding the hydrologic and erosive impacts of several land management activities in recently burnt areas (such as ground preparation, post-fire logging or post-fire mitigation treatments). This study aims to assess post-fire runoff and soil erosion response on Eucalypt and Maritime pine plantations during the first, second and third years following wildfires. The effect of several pre-fire ground preparation operations (ploughed down-slope, contour ploughed and inclined terraces), post-fire logging activities (on both the eucalypt and pine plantations), as well as the application of hydromulch (a post-fire emergency treatment) on overland flow and soil erosion were compared to burnt but undisturbed and untreated areas. The intensive monitoring of runoff, soil erosion and selected soil properties served to determine the main factors involved in post-fire runoff and soil erosion and their spatial and temporal variation. Soil water repellency deserved special attention, due to its supposed important role for overland flow generation. Repeated rainfall simulation experiments (RSE’s), micro-scale runoff plots and bounded sediment fences were carried out and/or installed immediately after the wildfire on seven burnt slopes. Micro-scale runoff plots results under natural rainfall conditions were also compared to the RSE’s results, which was useful for assessing the representativeness of the data obtained with artificial rainfall. The results showed comparable runoff coefficient (20-60%) but lower sediment losses (125-1000 g m-2) than prior studies in Portugal, but especially outside Portugal. Lower sediment losses were related with the historic intensive land use in the area. In evaluating these losses, however, the shallowness and stoniness of the soils, as well as the high organic matter fraction of the eroded sediments (50%) must not be overlooked. Sediment limited erosion was measured in all the ploughed sites, probably due to the time since ploughing (several years). The disturbance of the soil surface cover due to post-fire logging and wood extraction substantially increased sediment losses at both the pine and eucalypt sites. Hydromulch effectiveness in reducing the runoff (70%) and sediment losses (83%) was attributed to the protective high coverage provided by hydromulch. The hydromulch significantly affected the soil cover and other soil properties and these changes also reduced the soil erosion risk. The rainfall amount was the main factor explaining the variance in runoff. However, a shift from rainfall amount to rainfall intensity was detected when either the surface cover or the infiltration capacity (hydrophilic conditions) increased. Sediment losses were controlled by rainfall intensity and surface cover. The role of soil water repellency on runoff generation was not consistent; the overall repellency levels alone were not enough to assess its hydrological impact. Soil water repellency explained runoff generation in the specific-sites model better than in the overall model. Additionally, soil moisture content was a better predictor for soil water repellency than antecedent rainfall. The natural rainfall results confirmed that RSE’s were able to capture the specific sediment losses and its organic matter content as well as the differences between the ploughed and unploughed sites. Repeated RSE’s also captured the seasonal variations in runoff and sediment losses attributed to soil water repellency. These results have implications for post-fire soil erosion modelling and soil conservation practices in the region, or areas with the same land use, climate and soil characteristics. The measured sediment loss, as well as the increasing frequency of ploughing in recently burnt and unburnt eucalypt stands, suggests ploughing is not an effective as a soil conservation measure. Logging activities with less impact are recommended in order to maintain the forest litter protecting the soil surface. Due to its high effectiveness in reducing runoff and soil erosion, hydromulch is recommended for highly sensitive and vulnerable areas.

Message from the President of the United States, transmitting of a report of the Secretary of State, in relation to individuals selected from American prisoners of war, and sent to Great Britain for trial, and also in relation to any orders for retaliation, &c., &c.--

April 16, 1814. Printed by order of the Senate of the United States.

Vignettes and self-reported work disability in the United States: Correction of report heterogeneity

Subjective measures of health tend to suffer from bias given by reporting heterogeneity. however, some methodologies are used to correct the bias in order to compare self-assessed health for respondents with different sociodemographic characteristics. One of the methods to correct this is the hierarchical ordered probit (hopit), which includes rates of vignettes -hypothetical individuals with a fixed health state- and where two assumptions have to be fulfilled, vignette equivalence and response consistency. this methodology is used for the self-reported work disability for a sample of the united states for 2011. The results show that even though sociodemographic variables influence rating scales, adjusting for this does not change their effect on work disability, which is only influenced by income. the inclusion of variables related with ethnicity or place of birth does not influence the true work disability. however, when only one of them is excluded, it becomes significant and affects the true level of work disability as well as income.

Fragmentation or creative diversity? Options in the provision of land management advisory services

Rural land managers need access to sound advice and information to respond to pressures from environmental regulations, declining farm incomes, changing patterns in international trade and new institutional arrangements within the domestic food chain. Governments have cut back their provision of advisory services but need more than ever to influence land managers' decisions to achieve a growing array of policy objectives: The paper develops a conceptual framework for analysing advisory services and concludes, through a review of sixteen case studies, that the needs of both governments and land managers can be met by a diverse mixture of private and public sector provision. (C) 2003 Elsevier Ltd. All rights reserved.

Effects of land management on different forms of soil carbon in olive groves in Mediterranean areas

This study analyses soil organic carbon (SOC) and hot-water extractable carbon (HWC), both measures of soil quality, under different land management: (1) conventional tillage (CT); (2) CT plus the addition of oil mill waste alperujo (A); (3) CT plus the addition of oil mill waste olive leaves (L); (4) no tillage with chipped pruned branches (NT1); and (5) no tillage with chipped pruned branches and weeds (NT2); in a typical Mediterranean agricultural area; the olive groves of Andalucía, southern Spain. SOC values in CT, A, NT1 and NT2 decreased with depth, but in NT2 the surface horizon (0-5 cm) had higher values than the other treatments, 47% more than the average values in the other three soils. In L, SOC also decreased with depth, although there was an increase of 88.5% from the first (0-10 cm) to the second horizon (10-16 cm). Total SOC stock values were very similar under A (101.9 Mg ha−1), CT (101.7 Mg ha−1), NT1 (105.8 Mg ha−1) and NT2 (111.3 Mg ha−1, if we consider the same depth of the others). However, SOC under L was significantly higher (p < 0.05) at 250.2 Mg ha−1. HWC decreased with depth in A, CT and NT1. NT2 and L followed the same pattern as the other management types but with a higher value in the surface horizon (2.3 and 4.9 mg g−1 respectively). Overall, our results indicate that application of oil mill waste olive leaves under CT (L) is a good management practice to improve SOC and reduce waste.

Tendencias recientes en las importaciones de productos latinoamericanos en los Estados Unidos = Recent trends in United States imports of Latin American products

Incluye Bibliografía

Splitsville: A Study of Income Inequality and Political Polarization in the United States House of Representatives

The study compares a measure of income inequality with polarization scores of U.S. Representatives from the 104th to the 109th Congresses. It attempts to explain the link, on the abstract level, between high inequality and high polarization. The end findings indicate that inequality increases a Representative's likelihood to act liberally.

The Congo Slave State : a protest against the new African slavery ; and an appeal to the public of Great Britain, of the United States, and of the Continent of Europe

by Edmund D. Morel

Inventory of seeds and plants imported / U.S. Department of Agriculture, Bureau of Plant Industry.

48-61, 1921-1922

Inventory of seeds and plants imported / U.S. Department of Agriculture, Bureau of Plant Industry.

37-47

Circular / United States Department of Agriculture, Division of Agrostology.

no. 1-36