Elk in Nebraska: Opportunity or Another Private-Public Land Conundrum

We conducted a comprehensive research project on elk in the Pine Ridge region of northwestern Nebraska from 1995 to 2002 to determine ecological factors that could be used to improve management and reduce damage. The population ranged from 120 to 150 animals, with an average calf:cow ratio of 0.5:1 and bull:cow ratio of 0.4:1. We located 21 radio-collared female elk 6,311 times during 1995 to 1997. Seasonal home ranges of 2 herds were 10 and 44 km2, while average annual home ranges of the herds were much larger (483 and 440 km2, respectively). All wintering areas (n = 21) and 80% of the calving areas (n = 22) were located on privately-owned land. Active timber harvest temporarily displaced elk, most notably during the calving season. Elk shifted home ranges in association with the seasonal availability of agricultural crops, in particular, alfalfa, oats, and winter wheat. Population models indicated that static levels of hunting mortality would lead to a stable population of about 130 elk over 10 years. Most landowners in the Pine Ridge (57%) favored free-ranging elk, but 26% were concerned about damage to agricultural crops and competition with livestock. Habitat suitability models and estimates of social carrying capacity indicate that up to 600 elk could be sustained in the Pine Ridge without significant impacts to landowners. We recommended an integrated management program used to enhance elk habitat on publicly-owned land and redistribute elk from privately-owned land.

Survey of Staff and Organization of Private Secondary School Libraries in Ondo West Local Government Area of Ondo State

The teacher-librarian and organization of private secondary school libraries in Ondo West Local Government Area of Ondo State was the focus of the study. A structured questionnaire was the instrument used for data collection. Copies of questionnaires were administered to staff of six school libraries surveyed. The study revealed that none of the staff were professionally qualified, which resulted in poor and haphazard organization of the resources in all the schools surveyed. Recommendations were made to improve library services, including pr

Contesting Sphere Boundaries Online: Private/Technical/Public Discourses in Polycystic Ovarian Syndrome Discussion Groups

The internet is fast becoming a means for people to obtain information, creating a unique forum for the intersection of the public, technical, and private spheres. To ground my research theoretically, I used Jürgen Habermas’s sphere theory. Habermas (1987) explains that the technical sphere colonizes the private sphere, which decreases democratic potential. In particular, the internet is a place for altering technical colonization of the private and public spheres. My research focuses on women’s health because it is a particularly useful case study for examining sphere tensions. Historically, the biomedical health establishment has been a powerful agent of colonization, resulting in detrimental effects for women and their health. The purpose of this study is to examine how the internet encourages expert and female patient deliberation, which empowers women to challenge the experts and, thus, make conversations between the private/technical spheres more democratic. I used PCOS (Polycystic Ovarian Syndrome) as a case to observe the changing sphere boundaries by studying the discourse that took place on multiple patient and doctor websites over a four-year period. Through my research, I found that the PCOS women challenge the biomedical model by appropriating medical language. By understanding the medical talk, the women are able to feel confident when discussing their health conditions with the doctor and with each other. The PCOS women also become lay-experts who have personal and medical experience with PCOS, reducing private sphere colonization. This case study exemplifies how female empowerment can influence expert culture, challenging our conventional understanding of democracy.

Winning On for the Gipper: Diversity Strategies and Initiative at Notre Dame

One of the enduring images linked to the University of Notre Dame is that of injured football player George Gipp imploring Coach Knute Rockne to "Win One for the Gipper. " Similarly, people of color and conscience at Notre Dame struggle with formidable challenges in implementing diversity into areas of faculty retention, university initiatives and community outreach, all while remaining sane. The panelists will discuss innovative successes and continuing efforts that can be adapted by others seeking a game plan for diversity.

CHARACTERISTICS OF THE PRIVATE NUISANCE WILDLIFE CONTROL INDUSTRY IN NEW YORK

The nuisance wildlife control industry is rapidly expanding in New York State. To gain additional insight about this industry and the number of animals handled, we reviewed the 1989-90 annual logs submitted by Nuisance Wildlife Control Orators (NWC0s) to the New York State Department of Environmental Conservation (DEC). The specific objectives of this study were to determine: (1) the number and species of different wildlife responsible for damage incidents, (2) the cause of damage complaints, (3) the disposition of animals handled, (4) the location of damage events (i.e., urban, suburban, rural), and (5) an estimate of the economic impact of the nuisance wildlife industry in Upstate New York. The Nuisance Wildlife Logs (NWLs) were examined for 7 urban and 7 rural counties (25.5% of Upstate counties), and these data were used to estimate total NWCO activity in DEC Regions 3 through 9 (excludes Long Island). Approximately 75% of NWCOs licensed by DEC were active during 1989-90, and nearly 2,800 complaints were handled in the 14 counties sampled. More than 90% of complaints came from urban counties, and we estimated that NWC0s responded to more than 11,000 calls in Upstate New York. At a conservative estimate of $35/call, revenue generated by this industry exceeded $385,000 annually. Six wildlife species accounted for 85% of the nuisance complaints in urban and rural counties. During 1986 to 1993, the number of NWCOs licensed by DEC nearly quadrupled, and there is no indication that this trend will change in the near future.

The Brazilian National Health Agency and the Mental Health Policy in the Context of the Private Health System: developments and challenges

This work analyses the mental health policy-making activity of the Brazilian National Health Agency (ANS), responsible for controlling health insurance companies. Three points are discussed: a) the framework of an economic and private health assistance regulatory activity, b) the ANS and its regulation activity and c) the rules produced by ANS in the mental health care field. It was concluded that, despite advances like the legal obligation to ensure medical treatment to all the diseases listed in ICD-10, the inclusion of suicidal patient damage and self-inflicted damage care, care provided by a multiprofessional team, the increase in the number of sessions with a psychologist, with an occupational therapist and of psychotherapy sessions, and mental health day hospitals included as part of the services offered, the authors identified specific regulatory gaps in this area. Some issues that ANS has to solve so that it can really play its institutional role of defending the public interest in the private health system are: the regulation of co-participation and franchise mechanisms, the increasing co-participation as a limitation of psychiatric hospitalization, and the limited number of crisis intervention psychotherapy sessions.

CLINICAL CHARACTERISTICS AND SEVERITY OF PATIENTS ADMITTED TO PUBLIC AND PRIVATE ICUS

This study aimed to compare clinical characteristics, evolution and severity of adult patients admitted to public and private Intensive Care Units. It is a retrospective, longitudinal and quantitative analysis of 600 patients admitted to four Intensive Care Units of Sao Paulo, Brazil. Differences were found between patients admitted in private and public hospitals regarding the following variables: age, origin, length of stay and mortality in the critical unit, cardiologic, hematologic, neurologic and renal failures and some comorbidities. The results reveal the importance of analyzing in detail clinical characteristics and healthcare of patients admitted in public institutions, because of the high mortality found. The Intensive Care Nurse can contribute to change this scenario, because she/he plays a leading role in planning and providing resources for intensive care.

Private and Public Dental Care in the City of Sao Paulo in the First Decade of the XXI Century

Two concomitant movements occur in the first decade of the XXI century within the private and public dental services in Brazil: the entrance of oral health on the agenda of political priorities of the federal government and the vigorous growth of additional dental care. We analyzed the occurrence of these phenomena in the city of Sao Paulo, by seeking information in official documents and electronic databases in the Municipality of Sao Paulo, the Ministry of Health and National Health Agency (ANS), and also in scientific literature. During the studied period - January 2000 to December 2009 - and with basis on indicators such as coverage of First Consultation Program and Dental coverage Population Potential, percentages were found that characterize low public assistance and a situation far short of the constitutional principle of universal access to dental care. The growing number of beneficiaries of additional services through exclusively dental coverage insurance plans and other types of private insurance plans in the same period was significant, accounting for a major expansion of population coverage in this mode of care. It was found that, compared to the overall national framework, the city of Sao Paulo offers poor access to public dental care, with reduced supply of services to adults and aged people. Furthermore, considering the limitations of market additional services to provide dental care to all Brazilians, it reinforces the need for continuity and expansion of Brasil Sorridente, which is the programmatic expression of the National Oral Health Politics.

Evaluation of the identification protocol for newborns in a private hospital

This exploratory-descriptive quantitative study aimed to evaluate the protocol for identifying newborns admitted to the Neonatal Intensive and Semi-intensive Therapy Unit of a private hospital. The case series was made up of 540 observation opportunities, selected by simple random probability sampling. The data was collected between May and August 2010 according to a form and analyzed by descriptive statistic. The protocol's general performance had a conformity index of 82.2%. There were three stages to the protocol: identification components, the identification wristbands' condition and the number of identification wristbands. The highest percentage of conformity (93%) was attributed to the second stage and the lowest (89.3%) to the third, presenting a statistically significant difference of p=0.046. In the group of 'special' neonates, 88.5% conformity was achieved. These results will make it possible to restructure the protocol for identifying newborns and to establish care and managerial goals so as to improve the quality of care and the patients' safety.

Cost-effectiveness and budget impact of saxagliptine as additional therapy to metformin for the treatment of diabetes mellitus type 2 in the Brazilian private health system

Cost-effectiveness and budget impact of saxagliptine as additional therapy to metformin for the treatment of diabetes mellitus type 2 in the Brazilian private health system Objectives: To compare costs and clinical benefits of three additional therapies to metformin (MF) for patients with diabetes mellitus type 2 (DM2). Methods: A discrete event simulation model seas built to estimate the cost-utility ratio (cost per quality-adjusted life years [QALY)) of saxagliptine as an additional therapy to MF when compared to rosiglitazone or pioglitazone. A budget impact model (BIM) was built to simulate the economic impact of saxagliptine use in the context of the Brazilian private health system. Results: The acquiring medication costs for the hypothetical patient group analyzed in a time frame of three years, were R$ 10,850,185, R$ 14,836,265 and R$ 14,679,099 for saxagliptine, pioglitazone and rosiglitazone, respectively. Saxagliptine showed lower costs and greater effectiveness in both comparisons, with projected savings for the first three years of R$ 3,874 and R$ 3,996, respectively. The BIM estimated cumulative savings of R$ 417,958 with the repayment of saxagliptine in three years from the perspective of a health plan with 1,000,000 covered individuals. Conclusion: From the perspective of private paying source, the projection is that adding saxagliptine with MF save costs when compared with the addition of rosiglitazone or pioglitazone in patients with DM2 that have not reached the HbA1c goal with metformin monotherapy. The BIM of including saxagliptine in the reimbursement lists of health plans indicated significant savings on the three-year horizon.

Coping Style and Depressive Symptomatology during Pregnancy in a Private Setting Sample

Aim: to evaluate the association of antenatal depressive symptomatology (AD) with life events and coping styles, the hypothesis was that certain coping strategies are associated to depressive symptomatology. Methods: we performed a cross sectional study of 312 women attending a private clinic in the city of Osasco, Sao Paulo from 27/05/1998 to 13/05/2002. The following instruments were used: Beck Depression Inventory (BDI), Holmes and Rahe Schedule of Recent Events (SSRS), Folkman and Lazarus Ways of Coping Questionnaire and questionnaire with social-demographic and obstetric data. Inclusion criteria: women with 110 past history of depression, psychiatric treatment, alcohol or drug abuse and no clinical-obstetrical complications. Odds ratios and 95% CI were used to examine the association between AD (according to BDI) and exposures variables. Hypothesis testing was done with chi(2) tests and a p value < .05. Results: AD occurred in 21.1% of pregnant women. By the univariate analyses, education, number of pregnancies, previous abortion, husband income, situation of marriage and score of SSRS were associated with AD. All coping styles were associated with AD, except seeking support and positive reappraisal. By the multivariate analyses, four coping styles were kept in the final model: confront (p = .039), accepting responsibility (p < .001), escape-avoidance (p = .002), problem-solving (p = .005). Conclusions: AD was highly prevalent and was associated with maladaptive coping styles.

Guidelines for the Development of Comprehensive Care Centers for Congenital Adrenal Hyperplasia: Guidance from the CARES Foundation Initiative

Patients with rare and complex diseases such as congenital adrenal hyperplasia (CAH) often receive fragmented and inadequate care unless efforts are coordinated among providers. Translating the concepts of the medical home and comprehensive health care for individuals with CAH offers many benefits for the affected individuals and their families. This manuscript represents the recommendations of a 1.5 day meeting held in September 2009 to discuss the ideal goals for comprehensive care centers for newborns, infants, children, adolescents, and adults with CAH. Participants included pediatric endocrinologists, internal medicine and reproductive endocrinologists, pediatric urologists, pediatric surgeons, psychologists, and pediatric endocrine nurse educators. One unique aspect of this meeting was the active participation of individuals personally affected by CAH as patients or parents of patients. Representatives of Health Research and Services Administration (HRSA), New York-Mid-Atlantic Consortium for Genetics and Newborn Screening Services (NYMAC), and National Newborn Screening and Genetics Resource Center (NNSGRC) also participated. Thus, this document should serve as a "roadmap" for the development phases of comprehensive care centers (CCC) for individuals and families affected by CAH.

Do Academic and Private Entrepreneurs differ? An empirical analysis of the Micro-Foundation of Entrepreneurial Orientation

This Doctoral Thesis focuses on the study of individual behaviours as a result of organizational affiliation. The objective is to assess the Entrepreneurial Orientation of individuals proving the existence of a set of antecedents to that measure returning a structural model of its micro-foundation. Relying on the developed measurement model, I address the issue whether some Entrepreneurs experience different behaviours as a result of their academic affiliation, comparing a sample of ‘Academic Entrepreneurs’ to a control sample of ‘Private Entrepreneurs’ affiliated to a matched sample of Academic Spin-offs and Private Start-ups. Building on the Theory of the Planned Behaviour, proposed by Ajzen (1991), I present a model of causal antecedents of Entrepreneurial Orientation on constructs extensively used and validated, both from a theoretical and empirical perspective, in sociological and psychological studies. I focus my investigation on five major domains: (a) Situationally Specific Motivation, (b) Personal Traits and Characteristics, (c) Individual Skills, (d) Perception of the Business Environment and (e) Entrepreneurial Orientation Related Dimensions. I rely on a sample of 200 Entrepreneurs, affiliated to a matched sample of 72 Academic Spin-offs and Private Start-ups. Firms are matched by Industry, Year of Establishment and Localization and they are all located in the Emilia Romagna region, in northern Italy. I’ve gathered data by face to face interviews and used a Structural Equation Modeling technique (Lisrel 8.80, Joreskog, K., & Sorbom, D. 2006) to perform the empirical analysis. The results show that Entrepreneurial Orientation is a multi-dimensional micro-founded construct which can be better represented by a Second-Order Model. The t-tests on the latent means reveal that the Academic Entrepreneurs differ in terms of: Risk taking, Passion, Procedural and Organizational Skills, Perception of the Government, Context and University Supports. The Structural models also reveal that the main differences between the two groups lay in the predicting power of Technical Skills, Perceived Context Support and Perceived University Support in explaining the Entrepreneurial Orientation Related Dimensions.