Review of The Science, Impacts and Monitoring of Drought in Western Canada: Proceedings of the 2004 Prairie Drought Workshop Edited by Dave Sauchyn, Madhav Khandekar, and E. Ray Garnett

Drought is not an unusual phenomenon on the Canadian prairies or the U.S. Great Plains. There were many short-term droughts in the prairies during the 20th century that generally lasted one to two years (e.g., 1961, 1988). The Canadian prairies multi-year drought event (1999-2003+) has been considered similar in severity to the 1930s drought years. The 2004 Prairie Drought Workshop resulted in 76 scientists and resource managers gathering in Calgary, Alberta, to share information on drought science, impacts, and monitoring. Presenters examined the impacts on agriculture, stream flow, forests, and ground water, including potential impacts under a changed climate. Though focused on the Canadian prairies, the information presented could be applied to many parts of the U.S. Great Plains.

Using GIS to Locate Areas for Growing Quality Coffee in Honduras

Abstract Small-scale coffee producers worldwide remain vulnerable to price fluctuations after the 1999-2003 coffee crisis. One way to increase small-scale farmer economic resilience is to produce a more expensive product, such as quality coffee. There is growing demand in coffee-producing and coffee-importing countries for user-friendly tools that facilitate the marketing of quality coffee. The purpose of this study is to develop a prototypical quality coffee marketing tool in the form of a GIS model that identifies regions for producing quality coffee in a country not usually associated with quality coffee, Honduras. Maps of areas for growing quality coffee were produced with information on climate, soils, topography, areas vulnerable to environmental degradation, the location of current quality coffee farms, and infrastructure. The maps depict suitable coffee-growing land in portions of eight western Honduran departments.

Population-based epidemiology of rotavirus hospitalisations in Switzerland

BACKGROUND: Rotaviruses (RV) are the most common cause of dehydrating gastroenteritis requiring hospitalisation in children <5 years of age. A new generation of safe and effective RV vaccines is available. Accurate data describing the current burden of RV disease in the community are needed to devise appropriate strategies for vaccine usage. METHODS: Retrospective, population-based analysis of RV hospitalisations in children <5 years of age during a 5-year period (1999-2003) in a both urban and rural area inhabited by 12% of the Swiss population. RESULTS: Of 406 evaluable cases, 328 were community-acquired RV infections in children <5 years of age. RV accounted for 38% of all hospitalisations for gastroenteritis. The overall hospitalisation incidence in the <5-year-old was 1.5/1000 child-years (peak incidence, 2.6/1000 child-years in children aged 13-24 months). The incidence of community-acquired RV hospitalisations was significantly greater in children of non-Swiss origin (3.0 vs. 1.1/1000 child-years, relative risk 2.7; 95% CI 2.2-3.4), who were younger, but tended to be less severely dehydrated on admission than Swiss children. In comparison with children from urban areas, RV hospitalisation incidence was significantly lower among those residing in the remote mountain area (0.71 vs. 1.71/1000 child years, relative risk 2.2, 95% CI 1.6-3.1). CONCLUSION: Population-based RV hospitalisation incidence was low in comparison with other European countries. Significantly greater hospitalisation rates among children living in urban areas and those from non-Swiss families indicate that factors other than the severity of RV-induced dehydration are important driving forces of hospital admission.

Musikalische Globalisierungsprozesse als Begegnungsfeld ethnomusikologischer und musikhistorischer Forschung

Die moderne Globalisierungsdebatte war lange Zeit auf die verdichteten Prozesse (cf David Held et al. 1999/2003) der vergangenen Jahrzehnte ausgerichtet. Im Mittelpunkt der Diskurse stand dabei vor allem die westlich geprägte Dominanz globaler Netzwerke – sowohl auf kunstmusikalischer Ebene wie auch hinsichtlich des popularmusikalischen Mainstreams. Ein erweiterter Blick auf historische Globalisierungsprozesse enthüllt jedoch eine andere Musikgeschichte: Historisch-global betrachtet hat der Westen erst seit relativ kurzer Zeit (etwa seit dem 16./17. Jh.) eine zentrale Rolle in musikalisch-globalen Strömungen gespielt. Die stärksten musikalisch-globalen Bewegungen fanden beispielsweise zuvor eher im pazifischen und (süd-) asiatischen Raum statt. Dieser Perspektivenwechsel verlangt in der Auseinandersetzung mit den Quellen sowohl ein musikhistorisches als auch ein ethnomusikologisches Wissen. Wie kann eine mögliche Zusammenarbeit der beiden Fächer hier aussehen? Wie in diesem Vortrag argumentiert wird, liegt der fachliche Unterschied in der Gegenwart nicht so sehr in den gegensätzlichen Ausrichtungen auf nicht-westliche versus westliche Musiktraditionen oder etwa Kunstmusik versus Volks- oder Popularmusik. Vielmehr repräsentieren historische Musikwissenschaft und Ethnomusikologie vor allem unterschiedliche methodische Ansätze und ein jeweils anderes Quellenverständnis. Wie anhand von Beispielen aus der Berner Unterrichtspraxis erläutert werden soll, kann eine gemeinsame dialogische Auseinandersetzung über gemeinsame Forschungsgegenstände hier zu einem erweiterten Erkenntnisgewinn für beide Seiten führen.

No sports – no mental health? Analysis of longitudinal effects in SHP data.

Results from the Zurich study have shown lasting associations between sport practice and mental health. The effects are pronounced in people with pre-exising mental health problems. This analysis aims to replicate these results with the large Swiss Household Panel data set and to provide more differentiated results. The analysis covered the interviews 1999-2003 and included 3891 stayers, i.e., participants who were interviewed in all years. The outcome variables are depression / blues / anxiety, weakness / weariness, sleeping problems, energy / optimism. Confounding variables include sex, age, education level, citizenship. The analyses were carried out with mixed models (depression, optimism) and GEE models (weakness, sleep). About 60% of the SHP participants practise weekly or daily an individual or a team sport. A similar proportion enjoys a frequent physical activity (for half an hour minimum) which makes oneself slightly breathless. There are slight age-specific differences but also noteworthy regional differences. Practice of sport is clearly interrelated with self-reported depressive symptoms, optimism and weakness. This applies even though some relevant confounders – sex, educational level and citizenship – were introduced into the model. However, no relevant interaction effects with time could be shown. Moreover, direct interrelations commonly led to better fits than models with lagged variables, thus indicating that delayed effects of sport practice on the self-reported psychological complaints are less important. Model variants resulted for specific subgroups, for example, participants with a high vs. low initial activity level. Lack of sport practice is an interesting marker for serious psychological symptoms and mental disorders. The background of this association may differ in different subgroups, and should stimulate further investigations in this area.

Financial impact of the Medicare prospective payment system on long term acute care hospitals

Objective. Long Term Acute Care Hospitals (LTACs) are subject to Medicare rules because they accept Medicare and Medicaid patients. In October 2002, Medicare changed the LTAC reimbursement formulas, from a cost basis system to a Prospective Payment System (PPS). This study examines whether the PPS has negatively affected the financial performance of the LTAC hospitals in the period following the reimbursement change (2003-2006), as compared to the period prior to the change (1999-2003), and if so, to what extent. This study will also examine whether the PPS has resulted in a decreased average patient length of stay (LOS) in the LTAC hospitals for the period of 2003-2006 as compared to the prior period of 1999-2003, and if so, to what extent. ^ Methods. The study group consists of two large LTAC hospital systems, Kindred Healthcare Inc. and Select Specialty Hospitals of Select Medical Corporation. Financial data and operational indicators were reviewed, tabulated and dichotomized into two groups, covering the two periods: 1999-2002 and 2003-2006. The financial data included net annual revenues, net income, revenue per patient per day and profit margins. It was hypothesized that the profit margins for the LTAC hospitals were reduced because of the new PPS. Operational indicators, such as annual admissions, annual patient days, and average LOS were analyzed. It was hypothesized that LOS for the LTAC hospitals would have decreased. Case mix index, defined as the weighted average of patients’ DRGs for each hospital system, was not available to cast more light on the direction of LOS. ^ Results. This assessment found that the negative financial impacts did not materialize; instead, financial performance improved during the PPS period (2003-2006). The income margin percentage under the PPS increased for Kindred by 24%, and for Select by 77%. Thus, the study’s working hypothesis of reduced income margins for the LTACs under the PPS was contradicted. As to the average patient length of stay, LOS decreased from 34.7 days to 29.4 days for Kindred, and from 30.5 days to 25.3 days for Select. Thus, on the issue of LTAC shorter length of stay, the study’s working hypothesis was confirmed. ^ Conclusion. Overall, there was no negative financial effect on the LTAC hospitals during the period of 2003-2006 following Medicare implementation of the PPS in October 2002. On the contrary, the income margins improved significantly. ^ During the same period, LOS decreased following the implementation of the PPS. This was consistent with the LTAC hospitals’ pursuit of financial incentives.^

Financial impact of the Medicare prospective payment system on long term acute care hospitals

Objective. Long Term Acute Care Hospitals (LTACs) are subject to Medicare rules because they accept Medicare and Medicaid patients. In October 2002, Medicare changed the LTAC reimbursement formulas, from a cost basis system to a Prospective Payment System (PPS). This study examines whether the PPS has negatively affected the financial performance of the LTAC hospitals in the period following the reimbursement change (2003–2006), as compared to the period prior to the change (1999–2003), and if so, to what extent. This study will also examine whether the PPS has resulted in a decreased average patient length of stay (LOS) in the LTAC hospitals for the period of 2003–2006 as compared to the prior period of 1999-2003, and if so, to what extent. ^ Methods. The study group consists of two large LTAC hospital systems, Kindred Healthcare Inc. and Select Specialty Hospitals of Select Medical Corporation. Financial data and operational indicators were reviewed, tabulated and dichotomized into two groups, covering the two periods: 1999–2002 and 2003–2006. The financial data included net annual revenues, net income, revenue per patient per day and profit margins. It was hypothesized that the profit margins for the LTAC hospitals were reduced because of the new PPS. Operational indicators, such as annual admissions, annual patient days, and average LOS were analyzed. It was hypothesized that LOS for the LTAC hospitals would have decreased. Case mix index, defined as the weighted average of patients’ DRGs for each hospital system, was not available to cast more light on the direction of LOS. ^ Results. This assessment found that the negative financial impacts did not materialize; instead, financial performance improved during the PPS period (2003–2006). The income margin percentage under the PPS increased for Kindred by 24%, and for Select by 77%. Thus, the study’s working hypothesis of reduced income margins for the LTACs under the PPS was contradicted. As to the average patient length of stay, LOS decreased from 34.7 days to 29.4 days for Kindred, and from 30.5 days to 25.3 days for Select. Thus, on the issue of LTAC shorter length of stay, the study’s working hypothesis was confirmed. ^ Conclusion. Overall, there was no negative financial effect on the LTAC hospitals during the period of 2003–2006 following Medicare implementation of the PPS in October 2002. On the contrary, the income margins improved significantly. ^ During the same period, LOS decreased following the implementation of the PPS. This was consistent with the LTAC hospitals’ pursuit of financial incentives. ^

The prevalence, health risks, and consequences of asthma among adult residents in Texas

Based on asthma prevalence data collected from the 2000 BRFSS survey, approximately 14.7 million U.S. adults had current asthma, accounting for 7.2% of the total U.S. population. In Texas alone, state data extrapolated from the 1999-2003 Texas BRFSS suggested that approximately 1 million Texas adults were reporting current asthma and approximately 11% of the adult population has been diagnosed with the illness during their lifetime. From a public health perspective, the disease is manageable. Comprehensive state-specific asthma surveillance data are necessary to identify disparities in asthma prevalence and asthma-control characteristics among subpopulations and to develop targeted public health interventions. The purpose of this study was to determine the relative importance of various risk factors of asthma and to examine the impact of asthma on health-related quality of life among adult residents of Texas. ^ The study employed a cross-sectional study of respondents in Texas. The study extracted all the variables related to asthma along with their associated demographic, socioeconomic, and quality of life variables from the 2007 BRFSS data for 17,248 adult residents of Texas aged 18 and older. Chi-square test and logistic regression using SPSS were used in various data analyses on weighted data, adjusting for the complex sample design of the BRFSS data. All chi-square analyses were carried out using SPSS's CSTABULATE command. In addition, logistic regression models were fitted using SPSS's CSLOGISTIC command. ^ Risks factors significantly associated with reporting current asthma included BMI, race/ethnicity, gender, and income. Holding all other variables constant, obese adults were almost twice as likely to report current asthma as those adults who were normal weight (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.25 to 2.53). Other non-Hispanic adults were significantly more likely to report current asthma than non-Hispanic Whites (OR, 2.43; 95% CI, 1.38 to 4.25), while Hispanics were significantly less likely to report current asthma than non-Hispanic Whites (OR, 0.38; 95% CI, 0.25 to 0.60), after controlling for all other variables. After adjusting for all other variables, adult females were almost twice as likely to report current asthma as males (OR, 1.97; 95% CI, 1.49 to 2.60). Adults with household income of less than $15,000 were almost twice as likely to report current asthma as those persons with an annual household income of $50,000 or more (OR, 1.98; 95% CI, 1.33 to 2.94). In regards to the association between asthma and health-related quality of life, after adjusting for age, race/ethnicity, gender, tobacco use, body mass index (BMI), exercise, education, and income, adults with current asthma compared to those without asthma were more likely to report having more than 15 days of unhealthy physical health (OR, 1.84; 95% CI, 1.29 to 2.60). ^ Overall, the findings of this study provide insight and valuable information into the populations in Texas most adversely affected by asthma and health-related consequences of the disease condition. Further research could build on the findings of this study by replicating this study as closely as possible in other asthma settings, and look at the relationship for hospitalization rates, asthma severity, and mortality.^

Treatment discontinuation among breast, colorectal, and prostate cancer patients in Alabama

Introduction. Cancer registries provide information about treatment initiation but not the full course of treatment. In an effort to identify patient reported reasons for discontinuing cancer treatment, patients with prostate, breast, and colorectal cancer were identified from Alabama State Cancer Registry (ASCR) -Alabama Medicare linked database for interview. This study has two specific aims: (1) determine whether the ASCR-Medicare database accurately reflects patients’ treatment experiences in terms of whether they started and completed treatment when compared to patient self-report and (2) determine which patient demographic and health care system factors are related to treatment completion as defined by patient self-report. ^ Methods. The ASCR-Medicare claims dataset supplemented patient interview responses to identify treatment initiation and completion among prostate, breast, and colorectal cancer patients in Alabama from 1999-2003. Kappa statistic was used to test for concordance of treatment initiation and completion between patient self-report and Medicare claims data. Patients who reported not completing treatment were asked questions to ascertain reasons for treatment discontinuation. Logistic regression models were constructed to explore the association of patient and tumor characteristics with discontinuation of radiation and chemotherapy. ^ Results. Overall, there was a fair agreement across all cancer sites about whether one had surgery (Kappa=.382). There was fair agreement between self-report and Medicare claims data for starting radiation treatment (Kappa=.278). For starting chemotherapy there was moderate agreement (Kappa=.414). There was no agreement for completing treatment for radiation and chemotherapy between the self-report and claims data. Patients most often reported doctor’s recommendation (40% for radiation treatment and 21.4% for chemotherapy) and side effects (30% for radiation treatment and 42.8% for chemotherapy) for discontinuing treatment. Females were less likely to complete radiation than males (OR=.24, 95% CI=.11–.50). Stage I patients were more likely to drop radiation treatment than stage III patients (OR=3.34, 95% CI=1.12–9.95). Younger patients were more likely to discontinue chemotherapy than older patients (OR=2.84 95%, CI=1.08–7.69) and breast cancer patients were less likely to discontinue chemotherapy than colorectal patients (OR=.13, 95% CI=.04–.46). ^ Conclusion. This study reveals that patients recall starting treatment more accurately than completing treatment and that there are several demographic and tumor characteristics that influence treatment discontinuation. Providing patients with treatment summaries and survivorship plans can help patients their follow-up care when there are gaps in treatment recall and discontinuation of treatment.^

La vida cultural de las políticas públicas : un análisis de los conflictos por el uso del agua en el contexto neoliberal

La descentralización en el marco de las políticas neoliberales se concibió como una reforma política-administrativa para minimizar el rol del Estado postulando como bastión clave "La participación local". Sin embargo ésta sólo se queda en los ámbitos formales. El caso particular de las políticas de descentralización del riego en la provincia de Mendoza no es una excepción. Lo que nos lleva a analizar su microcosmos y las redes sociales informales que dan cuenca de la desigual participación de los distintos usuarios del agua de riego en las decisiones en torno a este recurso, según sus trayectorias y sus capitales sociales, económicos y culturales.

Making Abortion Services Accessible in the Wake of Legal Reforms: A Framework and Six Case Studies

Contiene Informe completo y resumen.

La regularización de migrantes argentinos en la España mediterránea (2005)¿Una solución o un nuevo problema?

El trabajo presenta la reforma política migratoria en España puesta en marcha durante los primeros meses del año 2005 y analiza a través de casos concretos los resultados de su aplicación. La ilusión primitiva de una solución a los casos de migrantes irregulares ha concluido con una realidad de aumento de la precariedad y la exclusión. Los cambios y reformas en la legislación de extranjería realizados, teóricamente, con el objetivo de lograr una disminución de indocumentados, han profundizado la segmentación laboral y la estratificación social. El resultado de la puesta en práctica de la nueva legislación lleva a un aumento de la desocupación y de la marginalidad. Las situaciones concretas de discriminación y marginación que padece gran parte de la población inmigrante son producidas y reforzadas por diversas prácticas políticas y legales. El colectivo argentino radicado en la región mediterránea que nos ocupa ha sentido el impacto de la aplicación de las nuevas disposiciones, generando situaciones de marginalidad de difícil solución. A través de historias de vida se presenta en forma práctica esta nueva problemática. La cuestión atraviesa como un gran sesgo al proyecto de investigación en marcha, generando cambios en el cronograma primitivo.

La regularización de migrantes argentinos en la España mediterránea (2005)¿Una solución o un nuevo problema?

El trabajo presenta la reforma política migratoria en España puesta en marcha durante los primeros meses del año 2005 y analiza a través de casos concretos los resultados de su aplicación. La ilusión primitiva de una solución a los casos de migrantes irregulares ha concluido con una realidad de aumento de la precariedad y la exclusión. Los cambios y reformas en la legislación de extranjería realizados, teóricamente, con el objetivo de lograr una disminución de indocumentados, han profundizado la segmentación laboral y la estratificación social. El resultado de la puesta en práctica de la nueva legislación lleva a un aumento de la desocupación y de la marginalidad. Las situaciones concretas de discriminación y marginación que padece gran parte de la población inmigrante son producidas y reforzadas por diversas prácticas políticas y legales. El colectivo argentino radicado en la región mediterránea que nos ocupa ha sentido el impacto de la aplicación de las nuevas disposiciones, generando situaciones de marginalidad de difícil solución. A través de historias de vida se presenta en forma práctica esta nueva problemática. La cuestión atraviesa como un gran sesgo al proyecto de investigación en marcha, generando cambios en el cronograma primitivo.

La regularización de migrantes argentinos en la España mediterránea (2005)¿Una solución o un nuevo problema?

El trabajo presenta la reforma política migratoria en España puesta en marcha durante los primeros meses del año 2005 y analiza a través de casos concretos los resultados de su aplicación. La ilusión primitiva de una solución a los casos de migrantes irregulares ha concluido con una realidad de aumento de la precariedad y la exclusión. Los cambios y reformas en la legislación de extranjería realizados, teóricamente, con el objetivo de lograr una disminución de indocumentados, han profundizado la segmentación laboral y la estratificación social. El resultado de la puesta en práctica de la nueva legislación lleva a un aumento de la desocupación y de la marginalidad. Las situaciones concretas de discriminación y marginación que padece gran parte de la población inmigrante son producidas y reforzadas por diversas prácticas políticas y legales. El colectivo argentino radicado en la región mediterránea que nos ocupa ha sentido el impacto de la aplicación de las nuevas disposiciones, generando situaciones de marginalidad de difícil solución. A través de historias de vida se presenta en forma práctica esta nueva problemática. La cuestión atraviesa como un gran sesgo al proyecto de investigación en marcha, generando cambios en el cronograma primitivo.

Sobre a representação dos estados na Câmara dos Deputados

Edição dedicada ao tema "Reforma Política" realizada em parceria com a Consultoria Legislativa do Senado Federal