PROJECTION OF HEALTH DEMAND IN TERMS OF HOSPITAL ADMISSIONS FOR SELECTED DIAGNOSES IN HEALTH SYSTEMS AGENCY SERVICE AREAS

The National Health Planning and Resources Development Act of 1974 (Public Law 93-641) requires that health systems agencies (HSAs) plan for their health service areas by the use of existing data to the maximum extent practicable. Health planning is based on the identificaton of health needs; however, HSAs are, at present, identifying health needs in their service areas in some approximate terms. This lack of specificity has greatly reduced the effectiveness of health planning. The intent of this study is, therefore, to explore the feasibility of predicting community levels of hospitalized morbidity by diagnosis by the use of existing data so as to allow health planners to plan for the services associated with specific diagnoses.^ The specific objectives of this study are (a) to obtain by means of multiple regression analysis a prediction equation for hospital admission by diagnosis, i.e., select the variables that are related to demand for hospital admissions; (b) to examine how pertinent the variables selected are; and (c) to see if each equation obtained predicts well for health service areas.^ The existing data on hospital admissions by diagnosis are those collected from the National Hospital Discharge Surveys, and are available in a form aggregated to the nine census divisions. When the equations established with such data are applied to local health service areas for prediction, the application is subject to the criticism of the theory of ecological fallacy. Since HSAs have to rely on the availability of existing data, it is imperative to examine whether or not the theory of ecological fallacy holds true in this case.^ The results of the study show that the equations established are highly significant and the independent variables in the equations explain the variation in the demand for hospital admission well. The predictability of these equations is good when they are applied to areas at the same ecological level but become poor, predominantly due to ecological fallacy, when they are applied to health service areas.^ It is concluded that HSAs can not predict hospital admissions by diagnosis without primary data collection as discouraged by Public Law 93-641. ^

THE CHLOREX TREATABILITY STUDY: ENVIRONMENTAL FATE IN FACULTATIVE ANAEROBIC AND AEROBIC WASTE STABILIZATION PONDS (BIODEGRADATION, VOLATILIZATION, SORPTION, PRIORITY POLLUTANTS)

The efficacy of waste stabilization lagoons for the treatment of five priority pollutants and two widely used commercial compounds was evaluated in laboratory model ponds. Three ponds were designed to simulate a primary anaerobic lagoon, a secondary facultative lagoon, and a tertiary aerobic lagoon. Biodegradation, volatilization, and sorption losses were quantified for bis(2-chloroethyl) ether, benzene, toluene, naphthalene, phenanthrene, ethylene glycol, and ethylene glycol monoethyl ether. A statistical model using a log normal transformation indicated biodegradation of bis(2-chloroethyl) ether followed first-order kinetics. Additionally, multiple regression analysis indicated biochemical oxygen demand was the water quality variable most highly correlated with bis(2-chloroethyl) ether effluent concentration. ^

Stable oxygen isotope record of Globigerinoides sacculifer and age determination of sediment cores from teh Somali Basin

This study documents the biological signatures impressed upon the sedimentary record underlying both the 5°N upwelling system of the Somali Current and the equatorial area of the Somali Basin out of the upwelling influence. The evolution of these two distinct hydrographic systems is compared for the last 160 kyr. Correspondence and cluster analyses are performed on combined radiolarian and planktonic foraminiferal quantitative data in order to study the changes of the planktonic assemblages through time and space. The Upwelling Radiolarian Index (URI) is used as a productivity proxy. The water temperature and hydrographic structure of the upper water masses appear to be the major factors controlling the distribution patterns of the fauna. The relative abundances of three groups of foraminifera, cold water form (dextral N. pachyderma), mixed layer dwellers (G. trilobus, G. ruber, G. sacculifer, G. conglobatus, and G. glutinata), and thermocline dwellers (G. menardii, G. tumida, N. dutertrei, G. crassaformis, and P. obliquiloculata), follow distinct evolutionary patterns at the two sites during the last 160 kyr. At the equatorial site (core MD 85668), downcore fluctuations in the relative abundances of the three groups are closely related to the glacial/interglacial cyclicity and provide some insights into the interpretation of hydrographic changes. The dominance of the mixed layer foraminifera at the transition intervals between isotope stages 6/5 and 2/1, combined with weak URI values, is thought to reflect the reorganization of the oceanographic circulation. These short-term events (with a duration of < 5000 year) could be related to the rapid inflow of oxygen-depleted water through the Indonesian straits as a result of sea level rise during deglaciation. Underneath the 5°N gyre (core MD 85674), the response to global climatic changes is overprinted by the regional effect of the Somalian upwelling, which has been persistent over the last 160 kyr.

Sea ice cover, and bottom water and sediment characteristics at stations in the Amundsen Gulf, Canada

Seasonal dynamics in the activity of Arctic shelf benthos have been the subject of few local studies, and the pronounced among-site variability characterizing their results makes it difficult to upscale and generalize their conclusions. In a regional study encompassing five sites at 100-595 m water depth in the southeastern Beaufort Sea, we found that total pigment concentrations in surficial sediments, used as proxies of general food supply to the benthos, rose significantly after the transition from ice-covered conditions in spring (March-June 2008) to open-water conditions in summer (June-August 2008), whereas sediment Chl a concentrations, typical markers of fresh food input, did not. Macrobenthic biomass (including agglutinated foraminifera >500 µm) varied significantly among sites (1.2-6.4 g C/m**2 in spring, 1.1-12.6 g C/m**2 in summer), whereas a general spring-to-summer increase was not detected. Benthic carbon remineralisation also ranged significantly among sites (11.9-33.2 mg C/m**2/day in spring, 11.6-44.4 mg C/m**2/day in summer) and did in addition exhibit a general significant increase from spring-to-summer. Multiple regression analysis suggests that in both spring and summer, sediment Chl a concentration is the prime determinant of benthic carbon remineralisation, but other factors have a significant secondary influence, such as foraminiferan biomass (negative in both seasons), water depth (in spring) and infaunal biomass (in summer). Our findings indicate the importance of the combined and dynamic effects of food supply and benthic community patterns on the carbon remineralisation of the polar shelf benthos in seasonally ice-covered seas.

(Table 1) Surface water chemistry of northern Victoria Land lakes

Concentrations of major ions, silicate and nutrients (total N and P) were measured in samples of surface water from 28 lakes in ice-free areas of northern Victoria Land (East Antarctica). Sixteen lakes were sampled during austral summers 2001/02, 2003/04, 2004/05 and 2005/06 to assess temporal variation in water chemistry. Although samples showed a wide range in ion concentrations, their composition mainly reflected that of seawater. In general, as the distance from the sea increased, the input of elements from the marine environment (through aerosols and seabirds) decreased and there was an increase in nitrate and sulfate concentrations. Antarctic lakes lack outflows and during the austral summer the melting and/or ablation of ice cover, water evaporation and leaching processes in dry soils determine a progressive increase in water ion concentrations. During the five-year monitoring survey, no statistically significant variation in the water chemistry were detected, except for a slight (hardly significant) increase in TN concentrations. However, Canonical Correspondence Analysis (CCA) indicated that other factors besides distance from the sea, the presence of nesting seabirds, the sampling time and percentage of ice cover affect the composition of water in Antarctic cold desert environments.

Relación precipitación-escorrentía y número de curva bajo diferentes condiciones de uso del suelo: : cuenca modal del sistema serrano de La Ventana, Argentina

La metodología del número de la curva (NC) es la más empleada para transformar la precipitación total en precipitación efectiva. De esta manera se constituye en una herramienta de gran valor para realizar estudios hidrológicos en cuencas hidrográficas, fundamentalmente cuando hay una deficiencia de registros extensos y confiables. Esta metodología requiere del conocimiento del tipo y uso de suelo de la cuenca en estudio y registros pluviográficos. En el presente trabajo se aplicó el procesamiento de imágenes LANDSAT para la zonificación de la vegetación y uso del suelo en la cuenca del Arroyo Pillahuinco Grande (38° LS y 61° 15' LW), ubicada sobre el sistema serrano de La Ventana, en el sudoeste de la provincia de Buenos Aires, Argentina. El análisis de su interrelación generó los valores de NC y coeficiente de escorrentía (CE). El procesamiento digital de la base de datos raster georreferenciada se realizó con aplicación de herramientas de sistema de información geográfica (Idrisi Kilimanjaro). El análisis de regresión múltiple efectuado a las variables generó un R2 que explica el 89,77 % de la variabilidad de CE (a < 0,01). Los resultados se exponen a nivel diagnóstico y zonificación del NC, donde la mayor influencia de la escorrentía se relaciona con las variables cobertura vegetal y uso del suelo.

Caracterización de poblaciones nativas de maíz mediante Análisis de Procrustes Generalizado y Análisis Factorial Múltiple

El establecimiento de relaciones entre taxones es un paso esencial en el proceso de catalogación y evaluación del material conservado en un Banco de Germoplasma. Existen distintos métodos de evaluación en función del tipo de caracteres estudiados. Cuando el registro de caracteres se repite en el tiempo y en distintos ambientes, se debe separar la variabilidad intrínsecamente genética entre los taxones de aquella que se debe al ambiente, y más aún, de la posible variabilidad debida a la interacción genotipo*ambiente para el posterior establecimiento de relaciones puramente filogenéticas. En el presente trabajo se estudia comparativamente la factibilidad de aplicación de dos estrategias de análisis estadístico para dar solución a este problema. La primera corresponde al análisis tradicional donde se realiza un Análisis de Componentes Principales sobre los caracteres promedios a lo largo de los diferentes ambientes; y la segunda son métodos más complejos en los cuales cada dato es originado por tres modos: individuos, variables y condiciones ambientales, tales como el Análisis Factorial Múltiple y el Análisis de Procrustes Generalizado. Si bien las configuraciones resultantes fueron todas equivalentes, los métodos de tres vías permiten la interpretación de la interacción genotipo*ambiente.

Tissue metal concentrations and metal transfer functions of Glaucous Gulls (Larus hyperboreus) from Bjørnøya and Jan Mayen

Heavy metals (Cd, Cu, Fe, Mn and Zn) concentrations were determined in different tissues (muscle, kidney, liver, brain, gonads, heart and feathers) of Glaucous Gulls (Larus hyperboreus) from Bjornoya and Jan Mayen. The age and spatial dependent variations in heavy metals were quantified and interpreted in view of the three chemometric techniques, i.e. non-parametric Mann-Whitney U test, redundancy gradient analysis and detrended correspondence analysis. The Glaucous Gulls from Bjornoya contained significantly higher (p < 0.05) levels of Cd, Cu and Zn than those inhabited Jan Mayen. Adult birds were characterized by greater (p < 0.01) concentration of muscle, hepatic and renal heavy metals in comparison to chicks. Insignificantly higher slope constant Zn/Cd for the liver than for the kidney may reflect insignificant Cd exposure. Estimate of transfer factor (TF) allows us to assess variations in heavy metal concentrations during the individual development of Glaucous Gulls. It may be stated that there is a distinct increase of bioaccumulation of all the studied metals during subsequent stages of the bird life.

Knowledge of medical abortion among Brazilian medical students

OBJECTIVE: To assess the knowledge of Brazilian medical students regarding medical abortion (MA) and the use of misoprostol for MA, and to investigate factors influencing their knowledge. METHODS: All students from 3 medical schools in São Paulo State were invited to complete a pretested structured questionnaire with precoded response categories. A set of 12 statements on the use and effects of misoprostol for MA assessed their level of knowledge. Of about 1260 students invited to participate in the study, 874 completed the questionnaire, yielding a response rate of 69%. The Ï (2) test was used for the bivariate analysis, which was followed by multiple regression analysis. RESULTS: Although all students in their final year of medical school had heard of misoprostol for termination of pregnancy, and 88% reported having heard how to use it, only 8% showed satisfactory knowledge of its use and effects. Academic level was the only factor associated with the indicators of knowledge investigated. CONCLUSION: The very poor knowledge of misoprostol use for MA demonstrated by the medical students surveyed at 3 medical schools makes the review and updating of the curriculum urgently necessary.

Environmental policy and knowledge. Copying with complexity through inclusive management

Scholars agree that governance of the public environment entails cooperation between science, policy and society. This requires the active role of public managers as catalysts of knowledge co-production, addressing participatory arenas in relation to knowledge integration and social learning. This paper deals with the question of whether public managers acknowledge and take on this task. A survey accessing Directors of Environmental Offices (EOs) of 64 municipalities was carried out in parallel for two regions - Tuscany (Italy) and Porto Alegre Metropolitan Region (Brazil). The survey data were analysed using the multiple correspondence method. Results showed that, regarding policy practices, EOs do not play the role of knowledge co-production catalysts, since when making environmental decisions they only use technical knowledge. We conclude that there is a gap between theory and practice, and identify some factors that may hinder local environmental managers in acting as catalyst of knowledge co-production, raising a further question for future research.

Diatom biostratigraphy and sea ice concentration reconstruction from core DA06-139G, Vaigat Strait in Disko Bugt, West Greenland

A diatom-based sea-ice concentration (SIC) transfer function is developed using 72 surface samples from west of Greenland and around Iceland, and through comparison with the associated modern SIC. Canonical correspondence analysis on surface sediment diatoms and monthly average of SIC reveals that April SIC is the most important environmental factor controlling the distribution of diatoms in the area, and permits the development of a diatom-based SIC transfer function. The consistency between reconstructed SIC based on diatoms from West Greenland and the instrumental and documentary data during the last ~75 years demonstrates that the diatom-based SIC reconstruction is reliable for studying the palaeoceanography off West Greenland. Relatively warm conditions with strong influence of the Irminger Current (IC) are indicated for the early part of the record (~5000-3860 cal. yr BP), corresponding in time to the latest part of the Holocene Thermal Maximum. The April SIC oscillated around the mean value between 3860 and 1510 cal. yr BP and was above mean afterwards, particularly during the time interval 1510-1120 cal. yr BP and after 650 cal. yr BP, indicating more extensive sea-ice cover in Disko Bugt. A high degree of consistency between the reconstructed April SIC and changes in the diatom species suggests that the sea-ice condition in Disko Bugt is strongly influenced by variations in the relative strength of two components of the West Greenland Current, i.e. the cold East Greenland Current and the relatively warm IC.

Zoobenthos and oceanographical parameters in the Kemskaya Guba (Bay) - estuary of the Kem' River entering the Onega Bay, White Sea

Data on distribution of zoobenthos in the Kemskaya Guba (or Kemskaya Bay - the estuary of the Kem' River entering the Onega Bay of the White Sea), which is strongly influenced by river runoff, are presented. The number of species at sampling stations varied from 4 to 65. Density of communities and zoobenthos biomass varied from 342±68 to 4293±96 #/m**2 and from 0.418±0.081 to 1975.22±494.36 g/m**2, respectively. Shannon index values varied between 1.19 to 4.7 bit/ind. At the upper part of the estuary, detritivores dominated, while in the central part and at outlets sestonophages prevailed. Changes in quantitative parameters of the zoobenthos along gradient of water salinity were traced, and relations of these parameters with seven other environmental factors were revealed. It was found that species composition, biodiversity, and trophic structure of the zoobenthos significantly correlated with some of parameters mentioned above. Multiple regression analysis was used to assess combined effect of factors, and it revealed which of them played a determining role in Kemskaya Guba: for species composition - depth, water color, and total concentration of suspended matter; for number of species - contents of <0.01 mm grain size (pelite) fraction and organic carbon in bottom sediments. Biomass depended on water salinity, water chromaticity, and organic carbon contents in bottom sediments and suspended matter. Values of the Shannon index of diversity are determined by water color, and contents of organic carbon and pelite fraction in bottom sediments. Calculations of ecological stress values revealed two zones with unstable state of the zoobenthos.

Distribution of deep-sea foraminifera in surface sediments east of New Zealand

Paleobathymetric assessments of fossil foraminiferal faunas play a significant role in the analysis of the paleogeographic, sedimentary, and tectonic histories of New Zealand's Neogene marine sedimentary basins. At depths >100 m, these assessments often have large uncertainties. This study, aimed at improving the precision of paleodepth assessments, documents the present-day distribution of deep-sea foraminifera (>63 µm) in 66 samples of seafloor sediment at 90-700 m water depth (outer shelf to mid-abyssal), east of New Zealand. One hundred and thirty-nine of the 465 recorded species of benthic foraminifera are new records for the New Zealand region. Characters of the foraminiferal faunas which appear to provide the most useful information for estimating paleobathymetry are, in decreasing order of reliability: relative abundance of common benthic species; benthic species associations; upper depth limits of key benthic species; and relative abundance of planktic foraminifera. R mode cluster analysis on the quantitative census data of the 58 most abundant species of benthic foraminifera produced six species associations within three higher level clusters: (1) calcareous species most abundant at mid-bathyal to outer shelf depths (<1000 m); (2) calcareous species most abundant at mid-bathyal and greater depths (>600 m); (3) agglutinated species mostly occurring at deep abyssal depths (>3000 m). A detrended correspondence analysis ordination plot exhibits a strong relationship between these species associations and bathymetry. This is manifest in the bathymetric ranges of the relative abundance peaks of many of the common benthic species (e.g., Abditodentrix pseudothalmanni 500-2800 m, Bolivina robusta 200-650 m, Bulimina marginata f. marginata 20-600 m, B. marginata f. aculeata 400-3000 m, Cassidulina norvangi 1000-4500 m, Epistominella exigua 1000-4700 m, and Trifarina angulosa 10-650 m), which should prove useful in paleobathymetric estimates. The upper depth limits of 28 benthic foraminiferal species (e.g., Fursenkoina complanata 200 m, Bulimina truncana 450 m, Melonis affinis 550 m, Eggerella bradyi 750 m, and Cassidulina norvangi 1000 m) have potential to improve the precision of paleobathymetric estimates based initially on the total faunal composition. The planktic percentage of foraminiferal tests increases from outer shelf to upper abyssal depths followed by a rapid decline within the foraminiferal lysocline (below c. 3600 m). A planktic percentage <50% is suggestive of shelf depths, and >50% is suggestive of bathyal or abyssal depths above the CCD. In the abyssal zone there is dramatic taphonomic loss of most agglutinated tests (except some textulariids) at burial depths of 0.1-0.2 m, which negates the potential usefulness of these taxa in paleobathymetric assessments.

Figures of dinoflagellate cysts (relative abundance, temperature, salinity and nutrients)

This Atlas summarises the global distribution of extant organic-walled dinoflagellate cysts in the form of 61 maps illustrated by the relative abundance of individual cyst taxa in recent marine sediments from the Atlantic Ocean and adjacent basins, the Antarctic region (South Atlantic, southwestern Pacific and southern Indian Ocean sections), the Arabian Sea and the northwestern Pacific. This synthesis is based on the integration of literature sources together with data from 835 marine surface sediments prepared on a comparable methodology and taxonomy. The relationships between distribution patterns of cyst species and the surface-water parameters (temperature, salinity, phosphate and nitrate concentrations) are documented with graphs depicting the relative abundance of species in relation to seasonal and annual values of the above mentioned parameters at the sample sites. Two ordination techniques (detrended correspondence analysis and canonical correspondence analysis) have been carried out to statistically illustrate the relationships between species distribution and sea-surface conditions. Results have been compared with previously published records and an overview of the ecological significance of each individual species is presented. Characterisations of selected environments as well as a discussion about how additional processes such as preservation and transport could have affected the present dataset are included.