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PubMed2005

Toward sustainable management of national parks in Japan: securing local community and stakeholder participation.

Japan's national park system constitutes a potentially viable mechanism for securing local community participation and building stakeholder consensus for sustainable park management, although the potential of this system is yet to be fully maximized. This article gives an overview of the system of protecting natural resources in Japan, focusing on the national park system. Parks are managed by zoning and regulation, which is unique in that land is not "set aside" for nature conservation, but designated as national park wherever the need to preserve "scenic beauty" has been recognized, regardless of land ownership or land use. Although resource conservation under this system has been problematic, it has advantages, especially in terms of community participation. This article demonstrates that in order to reach the system's potential, the park authority must act as coordinator of stakeholders and facilitator of bottom-up approaches to decision-making. In order to do this, steps that must be taken include the following: identifying the various stakeholders in park management and defining the "local community"; clarifying the roles and responsibilities of each stakeholder; and supporting consensus-building among stakeholders regarding the objectives and long-term vision of each park. By taking these steps, it would be possible to build a park management system that overrides government boundaries and involves local communities. This will enable the park authority to address the challenges facing Japan's complex system of conserving natural resources, and move towards sustainable management of natural resources in Japan.

Conservation of Natural Resources↗
PubMed2005

Assessing ecological integrity of Ozark rivers to determine suitability for protective status.

Preservation of extraordinary natural resources, protection of water quality, and restoration of impaired waters require a strategy to identify and protect least-disturbed streams and rivers. We applied two objective, quantitative methods to determine stream ecological integrity of headwater reaches of 10 Ozark rivers, 5 with Wild and Scenic River federal protective status. Thirty-four variables representing macroinvertebrate and fish assemblage characteristics, in-stream habitat, riparian vegetation, water quality, and watershed attributes were quantified for each river and analyzed using two multivariate approaches. The first approach, cluster and discriminant analyses, identified two groups of river with only one variable (% forested watershed) reliably distinguishing groups. Our second approach employed ordinal scaling to compare variables for each river to conceptually ideal conditions that were developed as a composite of optimal attributes among the 10 rivers. The composite distance of each river from ideal was then calculated using a unidimensional ranking technique. Two rivers without Wild and Scenic River designation ranked highest relative to ideal (highest ecological integrity), and two others, also without designation, ranked most distant from ideal (lowest ecological integrity). Fish density, number of intolerant fish species, and invertebrate density were influential biotic variables for scaling. Contributing physical variables included riparian forest cover, water nitrate concentration, water turbidity, percentage of forested watershed, percentage of private land ownership, and road density. These methods provide a framework for refinement and application in other regions to facilitate the process of establishing least-disturbed reference conditions and identifying rivers for protection and restoration.

Animals↗
PubMed2006

Socioeconomic factors affecting farmers' perceptions of land degradation and stonewall terraces in central Palestine.

Land degradation by soil erosion is a socioeconomic and environmental problem facing many developing countries. Application of stonewall terraces for soil moisture conservation is vital to reducing the environmental impacts of this phenomenon. To this end, a field plot experiment was conducted in the study area along with the use of a closed-ended questionnaire. The object of the experiment was to study the socioeconomic impacts of soil erosion on local farmers and their adoption of the stonewall terrace technique. The study showed a higher net profit in areas that had implemented terrace conservation practices than in areas that had not (i.e., 3.5 to 6 times higher net profit). Correlation analysis indicated that the farmers' perceptions, land ownership, and geomorphology were significantly related to the farmers' incentives and willingness to adopt terraces as soil conservation measures (P < 0.05), although the correlations were negative. Smallholder farmers (52% of the interviewed farmers) were involved in the sale of the agricultural land for urban uses, largely because of the high price and immediate returns offered. However, the associated land use changes warrant greater involvement of both the private and public sectors. This cooperation may be accomplished through the introduction of a long-term agricultural loan system and the development of proper legislation accompanied by a comprehensive and durable infrastructure and service system with the goal of reducing the negative impact of land use changes and encouraging sustainable use of resources.

Agriculture↗
PubMed2006

Onsite sewage system regulation along the Great Lakes and the US EPA "Homeowner Awareness" model.

According to the United States Environmental Protection Agency (US EPA), a significant percentage of residential onsite sewage systems (OSSs) are failing at any given time. The US EPA has therefore issued a set of recommended guidelines for OSS regulatory programs aimed at reducing overall failure rates. We conducted a survey of OSS regulatory program administrators with jurisdictions bordering a Great Lake. Our goal was to determine their programs' capacities to meet the US EPA's recommendations. We found that although some local programs meet the US EPA's recommendations, most do not. In this article, we present our findings and conclusions for one of the US EPA's models, the baseline "Homeowner Awareness" model. Most areas do not have recommended requirements that systems be inspected when properties transfer between owners. A majority do not track changes in ownership within the computerized databases they use to record information about systems. Although most provide at least "one-time" information to homeowners regarding proper OSS maintenance, most do not contact them periodically with reminders of needed maintenance. We include recommendations for resolving some of the issues that our research identified.

Equipment Failure↗
PubMed2005

[When is a clinical study non-commercial?].

A non-commercial study is a research project not aiming at the protection of a commercial institution's interests. The classification of a clinical study as non-commercial or commercial makes sense and is important especially for clinical research teams, ethics committees and hospital owners because of relevant differences in the image and cost fields. The support of non-commercial studies by commercial institutions like pharmaceutical companies is permissible, unless it is tied to conditions impairing impartiality in respect of design, publication of study results or ownership of the assessed data. Specific relationships between the investigator and a company of the health industry potentially profiting from the study results (e.g. major share holdings or financial dependences) favour the classification of a study as commercial. The reliable classification of a study as non-commercial is only possible if all aids and grants, all conflicts of interest and special agreements are disclosed.

Austria↗
PubMed1990

Monitoring physicians. A bargaining model of medical group practice.

This paper challenges the proposition that large physician-owned groups will be inefficient because of failures to control opportunism. A bargaining model implies that even large partnerships will make efficient resource and monitoring decisions. In addition, opportunism has much the same payoff for employees and partners. The data show that most large medical practice organizations are physician owned. Empirical analyses of nine forms of monitoring by large groups generally show no clear link between monitoring and ownership. There is one exception. Physician-owned firms tend to base compensation on productivity, which may help explain the continued dominance of professional partnerships.

Cohort Studies↗
PubMed1994

The role of national quality registers in the Swedish health service.

This article reports on a quality movement in Sweden that has gone largely unnoticed, namely the national quality control registers. These registers represent a potentially important primary data source for comparative studies and can play an important role in a national strategy for control and improvement of health care quality. First, we review the recent health care quality initiatives in Sweden and the background of national quality control registers. Secondly, we discuss our findings from a study on the purpose, content, value and problems associated with the registers. Our findings are based on (a) interviews with physician managers of the registers, (b) questionnaires to selected hospital departments participating in the registers and (c) questionnaires to elected officials and administrators representing the local health care providers. Finally, we discuss several crucial issues related to the registers. Although some have existed for several years, the registers are still defining their roles. Traditionally, this activity has been managed by the medical profession. However, interest in register information is increasing among health care policy makers and administrators at all levels in the system. Two key issues concern register ownership and finance, but the most sensitive issue concerns the right of policy makers and the public to access register information. The registers and the information they contain illustrate the ongoing conflict between openness and consumer sovereignty in health care on the one hand and professional autonomy on the other.

Cost-Benefit Analysis↗
PubMed1993

Property rights and payment to patients for cell lines derived from human tissues: an economic analysis.

The increasing potential for commercial applications in biotechnology has given rise to new legal and ethical questions with regard to ownership of human tissue. As the potential value of human cells and tissue has risen, so have donors' calls for a share in the profits. However, in a recent California ruling (John Moore vs the Regents of the University of California), the court once again held to its traditional position that individuals do not hold property rights in their own tissue and cells. We will show that, in the rare case where tissue value may be determined prospectively, a one-time payment (and, hence granting a property right) is efficient. Moore is such a case. In general, however, the transactions costs of granting full property rights to donors of tissue and cells outweigh the benefits of such a change in policy.

Biomedical Research↗
PubMedDate not supplied

The epidemic of penetrating trauma: a national dilemma.

Available literature on penetrating trauma in the USA was reviewed to determine the prevalence, etiological factors, and societal cost of penetrating trauma. Penetrating injuries accounted for 39,888 deaths in 1989 and was the eighth leading cause of death. Etiological factors include increasing ownership of firearms, alcohol consumption, recreational drug use and trafficking, occupational risks, and socioeconomic factors. These injuries account for the fourth leading cause of estimated years of potential life lost. Corrective strategies and research are severely limited by the disproportionately low research funding.

Alcohol Drinking↗
PubMed2005

Work-pattern differences between male and female orthodontists.

INTRODUCTION: Traditionally, most orthodontists have been men. In recent years, however, the number of women in dentistry and dental specialties, including orthodontics, has increased dramatically. Because practice patterns of male and female orthodontists might differ, they should be evaluated so that our schools can produce enough providers for the future. METHODS: Questionnaires were mailed to 798 orthodontists; the response rate was 68.8%. Questions about practice behavior and productivity were designed to assess sex difference with respect to age, marital status, and number of children. RESULTS: Number of children appeared to be a good predictor of days worked per week and length of leaves of absence for female orthodontists. Solo practitioners dominate the field of orthodontics, irrespective of age or sex. Although women were less likely than men to be practice owners, only 20% of the women responding were not in an ownership position. Women were slightly more likely to be involved in a group practice, they worked in fewer offices than men, and they employed fewer full-time and part-time people. Female nonowners were more likely to take longer leaves of absence. Overall, women worked slightly fewer days per week and spent fewer hours per week in direct patient care. Annually, they devoted 25 fewer days to practice than men, but, when adjusted for leaves of absence, men and women worked similar numbers of weeks in 1999. CONCLUSIONS: Among orthodontists, work patterns of men and women differ somewhat, but these differences might not be as significant as other factors; more study is required.

Adult↗
PubMed2005

Public health application comparing multilevel analysis with logistic regression: immunization coverage among long-term care facility residents.

PURPOSE: Public health studies often sample populations using nested sampling plans. When the variance of the residual errors is correlated between individual observations as a result of these nested structures, traditional logistic regression is inappropriate. We used nested nursing home patient data to show that one-level logistic regression and hierarchical multilevel regression can yield different results. METHODS: We performed logistic and multilevel regression to determine nursing home resident characteristics associated with receiving pneumococcal immunizations. Nursing home characteristics such as type of ownership, immunization program type, and certification were collected from a sample of 249 nursing homes in 14 selected states. Nursing home resident data including demographics, receipt of immunizations, cognitive patterns, and physical functioning were collected on 100 randomly selected residents from each facility. RESULTS: Factors associated with receipt of pneumococcal vaccination using logistic regression were similar to those found using multilevel regression model with some exceptions. Predictors using logistic regression that were not significant using multilevel regression included race, speech problems, infections, renal failure, legal responsibility for oneself, and affiliation with a chain. Unstable health conditions were significant only in the multilevel model. CONCLUSIONS: When correlation of resident outcomes within nursing home facilities was not considered, statistically significant associations were likely due to residual correlation effects. To control the probability of type I error, epidemiologists evaluating public health data on nested populations should use methods that account for correlation among observations.

Aged↗
PubMed2006

The influence of provider sex on neurologists' annual incomes.

OBJECTIVE: We sought to determine the influence of provider sex on neurologists' annual incomes after controlling for work effort, provider characteristics, and practice characteristics. METHODS: We used survey responses collected throughout the 1990s from 216 actively practicing neurologists and linear regression modeling to determine the independent influence of provider sex on neurologists' annual incomes. RESULTS: White female neurologists reported seeing 11% fewer visits and working 6% fewer annual hours than their white male counterparts. White female neurologists had practiced medicine for fewer years than white males (p = 0.01). In addition, females were less likely to be employees, as opposed to having an ownership interest in the practice, and were more likely to be board certified, though not statistically significantly so. After adjustment for work effort, provider characteristics, and practice characteristics, white female neurologists' mean annual income was 165,321 dollars, or 47,854 dollars (22%) lower than that for white males (95% CI: 82,710 dollars lower to 12,997 dollars lower, p = 0.007). CONCLUSION: During the 1990s, female sex was associated with lower annual incomes among neurologists. Just as policymakers are exploring sex differences in access to and outcomes health care, they should further explore these findings to ensure that income differences among physicians who provide that care are not unjustly driven by provider sex.

Certification↗
PubMed2006

Current trends in animal law and their implications for the veterinary profession.

In the last decade, the veterinary profession has experienced many changes, including the birth of a new area of law known as "animal law," and an increased scrutiny by the legal community and veterinary state boards. This article provides a sampling of some of the more challenging issues the profession is facing in the early part of the 21st century, namely, guardianship versus ownership, the awarding of non-economic damages in negligence lawsuits, and challenges in maintaining medical records.

Animal Rights↗
PubMed2006

Iowa nursing home characteristics associated with reported abuse.

OBJECTIVE: To evaluate the association of nursing home abuse reported by employees in Iowa licensed nursing homes with nursing home characteristics, inspection results, nursing staff hours, and census demographics. DESIGN: Mailed survey. SETTING: Iowa's 409 Medicare-certified stand-alone nursing homes. PARTICIPANTS: Administrators and directors of nursing. RESULTS: The annual rate of abusive events was 20.7 per 1000 nursing home residents, with a rate of 18.4 reported events and 5.2 substantiated events. A higher number of residents and a higher number of certified beds were significantly associated with higher incident, report, and substantiation rates. Higher incident and report rates were associated with nursing homes in metropolitan areas. Higher substantiation rates were associated with for-profit nursing homes. CONCLUSION: Recognized abuse in nursing homes is not uncommon. Approximately 90% of events are reported to the state authorities with 29% of those being substantiated. Differences associated with nursing facility abuse rates are metropolitan area, ownership, occupancy rate, and number of residents and certified beds.

Aged↗
PubMed2006

Aggregating high-priority landscape areas to the parcel level: an easement implementation tool.

Landscape characteristics and parcel ownership information are often collected on different spatial scales leading to difficulties in implementing land use plans at the parcel level. This study provides a method for aggregating highly resolute landscape planning information to the parcel level. Our parcel prioritization model directly incorporates a Land Trust's conservation goals in the form of a compromise programming model. We then demonstrate the use of our approach for implementation decisions, including parcel selection under a budget constraint and the estimation of a total conservation budget necessary to meet specific conservation goals. We found that these cost constraints significantly alter the composition of the 'best' parcels for conservation and can also provide guidance for implementation. The model's results were integral to a local Land Trust's ability to further define and achieve their goals.

Biodiversity↗
PubMed2004

To what extent are key services offered in treatment programs for special populations?

Many substance abuse treatment (SAT) facilities offer programs designed specifically for special populations such as women, adolescents, gays/lesbians and others. Previous research shows that there are specific services that are integral to the successful treatment of these populations (e.g., family therapy for adolescents, childcare and transportation assistance for women, and HIV testing and counseling for gays/lesbians). This study examines whether facilities that self-report having programs for special populations actually offer the recommended services. The data come from the 2000 National Survey of Substance Abuse Treatment Services, which contains information on service offerings, special programs and other characteristics for all SAT facilities in the USA. The results indicate that facilities with special programs are more likely to offer the recommended key services. However, often less than half of these facilities provide the key services. There are consistent differences by ownership status, with for-profit facilities less likely to offer many of the key services.

Adolescent↗
PubMed2006

Legal aspects of conserving native oysters in Scotland.

Native oysters (Ostrea edulis) historically supported valuable fisheries in Scotland, but are now absent from areas of former abundance on the east coast and occur mainly in isolated populations in west coast sea lochs. The main contemporary threat is from unauthorized gathering. In most places, the exclusive right to gather is retained by the Crown, as a remnant of the feudal system, but in some areas the right has been acquired by individuals or institutions. A temporary right to gather oysters may be obtained by permit from the proprietor, or through a Several or Regulating Order made under shellfish fisheries legislation. The right to gather oysters is separate from ownership of the foreshore or sea bed on which they are located. To receive the maximum legal protection, oyster beds must be marked out, or the rights to them otherwise adequately made known. Wild or formerly-cultivated oyster beds may not meet this criterion and, in any case, enforcement is difficult in remote locations. It has been proposed that there should be a statutory public right to gather oysters. Were this to be created, then strong conservation measures would need to be implemented to protect native oysters from eradication by uncontrolled gathering.

Animals↗
PubMed2005

Optimal design for sustainable development of a material recovery facility in a fast-growing urban setting.

Installing material recovery facilities (MRFs) in a solid waste management system could be a feasible alternative to achieve sustainable development goals in urban areas if current household and curbside recycling cannot prove successful in the long run. This paper addresses the optimal site selection and capacity planning for a MRF in conjunction with an optimal shipping strategy of solid waste streams in a multi-district urban region. Screening of material recovery and disposal capacity alternatives can be achieved in terms of economic feasibility, technology limitation, recycling potential, and site availability. The optimization objectives include economic impacts characterized by recycling income and cost components for waste management, while the constraint set consists of mass balance, capacity limitation, recycling limitation, scale economy, conditionality, and relevant screening constraints. A case study for the City of San Antonio, Texas (USA) presents a vivid example where scenario planning demonstrates the robustness and flexibility of this modeling analysis. It proves especially useful when determining MRF ownership structure. Each scenario experiences two case settings: (1) two MRF sites are proposed for selection and (2) a single MRF site is sought. Cost analysis confirms processing fees are not the driving force in the City's operation, but rather shipping cost. Sensitivity analysis solidifies the notion that significant public participation plays the most important role in minimizing solid waste management expenses.

Cities↗