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PubMed2003

Potential impacts of global warming on water resources in southern California.

Global warming will have a significant impact on water resources within the 20 to 90-year planning period of many water projects. Arid and semi-arid regions such as Southern California are especially vulnerable to anticipated negative impacts of global warming on water resources. Long-range water facility planning must consider global climate change in the recommended mix of new facilities needed to meet future water requirements. The generally accepted impacts of global warming include temperature, rising sea levels, more frequent and severe floods and droughts, and a shift from snowfall to rain. Precipitation changes are more difficult to predict. For Southern California, these impacts will be especially severe on surface water supplies. Additionally, rising sea levels will exacerbate salt-water intrusion into freshwater and impact the quality of surface water supplies. Integrated water resources planning is emerging as a tool to develop water supplies and demand management strategies that are less vulnerable to the impacts of global warming. These tools include water conservation, conjunctive use of surface and groundwater and desalination of brackish water and possibly seawater. Additionally, planning for future water needs should include explicit consideration of the potential range of global warming impacts through techniques such as scenario planning.

California↗

PubMed2003

From waste treatment to integrated resource management.

Wastewater treatment was primarily implemented to enhance urban hygiene. Treatment methods were improved to ensure environmental protection by nutrient removal processes. In this way, energy is consumed and resources like potentially useful minerals and drinking water are disposed of. An integrated management of assets, including drinking water, surface water, energy and nutrients would be required to make wastewater management more sustainable. Exergy analysis provides a good method to quantify different resources, e.g. utilisable energy and nutrients. Dilution is never a solution for pollution. Waste streams should best be managed to prevent dilution of resources. Wastewater and sanitation are not intrinsically linked. Source separation technology seems to be the most promising concept to realise a major breakthrough in wastewater treatment. Research on unit processes, such as struvite recovery and treatment of ammonium rich streams, also shows promising results. In many cases, nutrient removal and recovery can be combined, with possibilities for a gradual change from one system to another.

Conservation of Energy Resources↗

PubMed2003

Cardiovascular disease prevention in low resource settings: lessons from the Heartfile experience in Pakistan.

This paper outlines activities of the Heartfile Program in Pakistan (http://heartfile.org). The program focuses on cardiovascular disease prevention and health promotion, and includes several initiatives that encompass building policy, reorienting health services, and developing community interventions that utilize the print and electronic media and outreach at the grass-root level to incorporate social marketing approaches. Initiated by the nonprofit private sector, the program now links with major public sector primary healthcare programs, and is currently spearheading formulation of the National Action Plan on Noncommunicable Disease Prevention and Control in Pakistan. In addition, the program is being refined, validated, and packaged as a replicable model for other developing countries and in low resource settings, utilizing appropriate principles of franchising with inbuilt components sensitive to cultural and social adaptations. A review of the planning process, implementation strategy, and fund-raising experience is presented. Strategies unique to low resource settings, such as the development of cost- and time-efficient strategic alliances and partnerships, have also been highlighted. In addition, specific caveats are identified as being helpful to private sector development of chronic disease prevention programs in resource-constrained settings, and a road map to a sustainable public-private sector partnership is provided.

Cardiovascular Diseases↗

PubMed2003

Utilization of health care resources by HIV-infected white, African-American, and Hispanic men in the era before highly active antiretroviral therapy.

In the highly active antiretroviral therapy (HAART) era, U.S. African-American and Hispanic patients with HIV use HAART less, but emergency and inpatient services more, than white patients. We evaluated whether these patterns existed in the pre-HAART era. Data from prospective cohort studies of 462 male Veterans Affairs patients and 1,309 male patients from the AIDS Costs and Services Utilization Survey were combined. Resource utilization of white, African-American, and Hispanic men was compared. Compared to whites, African Americans were more likely to visit the emergency department and less likely to have mental health, home health, and dental visits; had fewer outpatient and substance abuse treatment visits; and had more inpatient nights. Hispanics were less likely to have mental health and home health visits, and had more inpatient nights. Whites used prescription drugs more than African Americans or Hispanics, but antiretrovirals were equally used. Lower access to HAART for African-American and Hispanic patients is a new phenomenon, not a continuation of pre-HAART patterns, while the undesirable patterns of emergency and outpatient provider resource utilization in the HAART era are a continuation of pre-HAART patterns. Undesirable resource utilization patterns by African-American and Hispanic populations need urgent attention.

Adult↗

PubMed2003

Development of resource-use and expenditure questionnaires for use in rheumatology research.

OBJECTIVE: To develop a self-completion and postal resource-use and expenditure questionnaire for use in economic studies of early inflammatory polyarthritis (IP). METHODS: Identification of cost-generating events associated with early IP through a literature review and focus groups of IP patients and their partners. The information obtained was used to inform the development of self-completion postal resource-use and expenditure data collection instruments/questionnaires in terms of structure and content. Finally, the developed questionnaire was pilot-tested and validated in populations in 2 geographically different areas. RESULTS: The main cost categories identified through the focus groups, and used in the development of the questionnaires, included forgone leisure time and activities, reliance on other people, life events, emotions, help with everyday chores, travel, and over-the-counter medication. Pilot-testing the questionnaires resulted in high unit and item response rates, and high acceptability and ease of completion by respondents, as well as generalizability to different geographical settings. Where possible, collected data were validated against alternative data sources, and agreement was good. CONCLUSION: Overall, resource-use and expenditure questionnaires developed in this study were shown to be highly acceptable to respondents, easy to complete, and generalizable to different geographical settings within the UK.

Arthritis↗

PubMed2003

Developing a methodology to improve the allocation of specialized health resources for acutely injured persons.

Inappropriate triage following acute injury may result in misallocation of specialized health resources, increased health care costs, reduced or delayed access to care, and increased death and disability. Although triage criteria have been developed, they vary widely, and inappropriate triage rates are high (50% - 85%). The purpose of this project was to evaluate the ability of decision tree induction to predict need for specialized trauma resources in acutely injured persons. We considered any person who was admitted to the trauma center's ICU or died prior to being admitted to the ICU as needing specialized trauma resources.

Acute Disease↗

PubMed2003

[Evaluation on sustainability of forest resources in Bailong River forest region, Gansu Province].

Based on the theories of sustainable development of forest resources, this paper constructed an index system for the integrative evaluation on the sustainability of forest resources in Bailon River forest region of Gansu Province. After calculated the index values of five strategic levels and twenty measure levels, the degree of harmony (DH) was obtained, with which, the sustainability of test forest resources could be evaluated. The DH value was 0.5320 in 1996 and 0.6100 in 2000, which was smaller than the theoretic value of 0.7000, and hence, this forest region belonged to non-sustainable development, but made some progress for its sustainability.

Conservation of Natural Resources↗

PubMed2003

[Establishment of the national macro-management system on Chinese medicinal resource--base of the modernization for Chinese medicine].

OBJECTIVE: To establish a national management system on the utilization and protection, reserves and wastes of Chinese medicinal resources, and provide a scientific basis for the national administering authorities for the macro-management. METHOD: Many modern high technologies of community ecology, statistics, 3S technologies (remote sensing RS, geographic information system GIS, global positioning system GPS) and computer information system were based upon, and a national monitoring and protection system for the Chinese medicinal resources was set up. RESULT AND CONCLUSION: The national Chinese medicinal macro-management system will integrate modern high technologies with administrative supervision, so as to protect Chinese medicinal resources and economy towards a sustainable utilization and development, and finally make our country and people more prosperous and powerful.

China↗

PubMed2003

[Study on licorice resources and their sustainable utilization in center and western area of China].

OBJECTIVE: To investigate the latest wild and cultivated licorice resource status; bring forward the licorice resource protection and sustainable utilization countermeasures in the center and western area of China. METHOD: With study both in interview survey and field survey. RESULT: All samples investigated were the species of Glycyrrhiza uralensis. Human actions is concerned with the community status, reserves per unit and quality. Excessive exploitation made the licorice quality lower and reserves decrease. CONCLUSION: Enforcing the wild licorice resource protection and improving licorice cultivated technique are brought forward to act as the sustaining countermeasures.

China↗

PubMed1992

Exploration of home care resources for rural families with cancer.

The purpose of this qualitative study was to explore the availability and perceived adequacy of formal resources to assist family caregivers of rural persons with cancer. Ten participants who had provided home care for a family member with cancer throughout their illness and death were interviewed in two focus groups. An important finding was that the more rural the family, the more limited and inadequate the formal resources available to assist the family. A second major finding was that the longer the dying trajectory and the greater the deterioration of the person with cancer, the more resources became inadequate and the greater the caregiver burden.

Caregivers↗

PubMedDate not supplied

[The present state of paediatric neurology in the Autonomous Community of Madrid: variability in the distribution of resources].

INTRODUCTION: Paediatric neurology (PN) lies halfway between neurology and paediatrics, with no official acknowledgment. It is therefore difficult to determine exactly how resources are shared out. AIMS: The aim of this study is to analyse the public resources devoted to PN in the different health care areas within the Autonomous Community of Madrid (ACM). MATERIALS AND METHODS: In May 2002 we carried out a survey among child neurologists (CN) from the 9 independent health care districts within the ACM. RESULTS: A total of 28 CN work for the public health service in the ACM, eight of whom are employed on a part time basis. Only 53% are owners. The ratio of CN per 100000 inhabitants (inhab.) is 0.55 (0.45 after correction for part time work). The figure varies from one area to another from 0.07 to 1 CN/100000 inhab. (1/12000 1/220000 children). Part time neurologists work in the outer districts of the ACM. In most areas it is difficult to carry out diagnostic tests and these become even complicated when the child is small and requires some anaesthetic procedure. Neuropsychological assessment is one of the basic evaluations performed in PN and this is not easily performed in most centres. CONCLUSIONS: The CN/100000 inhab. ratio in the ACM is lower than that commonly recommended. The distribution of resources varies greatly and does not match demographic criteria. Temporary and part time jobs are commonplace in the peripheral areas. It is difficult for most centres to perform diagnostic tests.

Data Collection↗

PubMed2004

[Allocation of resources and restrictive standards in hospitals in the face of economic and personnel shortages].

The allocation of financial resources between both hospitals and the departments within a single hospital follows historically grown structures. Concepts on the basis of well-established factors for the systematic allocation of resources are rarely if ever used. Systematic approaches are needed, especially in times of decreasing resources, but they have to be grounded in a detailed understanding of both the customers and the products offered. The application of standards is a vital factor in order to simultaneously enhance operational efficiency and strategic effectiveness.

Costs and Cost Analysis↗

PubMed2004

Rationalizing historical successes of malaria control in Africa in terms of mosquito resource availability management.

Environmental management of mosquito resources is a promising approach with which to control malaria, but it has seen little application in Africa for more than half a century. Here we present a kinetic model of mosquito foraging for aquatic habitats and vertebrate hosts that allows estimation of malaria transmission intensity by defining the availability of these resources as the rate at which individual mosquitoes encounter and use them. The model captures historically observed responses of malaria transmission to environmental change, highlights important gaps in current understanding of vector ecology, and suggests convenient solutions. Resource availability is an intuitive concept that provides an adaptable framework for models of mosquito population dynamics, gene flow, and pathogen transmission that can be conveniently parameterized with direct field measurements. Furthermore, the model presented predicts that drastic reductions of malaria transmission are possible with environmental management and elucidates an ecologic basis for previous successes of integrated malaria control in Africa before the advent of DDT or chloroquine. Environmental management for malaria control requires specialist skills that are currently lacking in sub-Saharan Africa where they are needed most. Infrastructure and human capacity building in clinical, public health, and environmental disciplines should therefore be prioritized so that growing financial support for tackling malaria can be translated into truly integrated control programs.

Animals↗

PubMed1992

Inpatient resource use: a comparison of family medicine and internal medicine physicians.

BACKGROUND: It is not known whether differences exist between the use of inpatient resources by family medicine and internal medicine physicians when patient demographic and complexity variables are statistically controlled. METHODS: The study population was all patients in 13 higher volume diagnosis-related groups (DRGs) discharged from the family medicine (n = 306) and internal medicine services (n = 2374) of the University of Cincinnati Hospital during 1985 and 1986. The dependent variables were length of stay and inpatient readmission within 2 weeks. Stratification by DRGs was used to control for the effects of age and case mix on these variables. RESULTS: With the exception of findings regarding one DRG, the results do not indicate that differences exist in average length of stay between patients of family medicine and internal medicine physicians after adjustment for other variables. Furthermore, almost all of the explained variance in length of stay was attributed to patient complexity and not to physician specialty or patient race or sex. For all discharges, the proportion of patients readmitted within 2 weeks was about 4% higher for the internal medicine service. However, multivariate analysis did not support the importance of physician specialty (family medicine or internal medicine) as a predictor of whether readmission occurred within 2 weeks. CONCLUSIONS: General indicators of resource use (such as length of stay or readmission occurrence) without adjustment for patient case mix, demographics, and complexity are inadequate for comparison of health care providers. Further research regarding interspecialty differences should use longitudinal data from large populations, which would permit more detailed examination of resource utilization.

Family Practice↗

PubMed2004

[Ecological research on resources of Chinese herbal medicine].

OBJECTIVE: To explore the status and development of the ecological research on resources of Chinese herbal medicine. METHOD: The ecological domain related to the resources of Chinese Herbal Medicine was Analyzed. RESULT: It was found that the weakness of the theoretical study and application were the main problems constrained the development of ecological research of Chinese Herbal Medicine. CONCLUSION: A new subject, ecology of resources of Chinese herbal medicine, will come into being with the development of the theoretical and practical study and application of new technology and method.

China↗

PubMed2004

[Impact of groundwater resource temporal-spatial change in Minqin oasis on ecological security of irrigation region landscape].

By the GIS technology, this paper studied the impact of groundwater resource temporal-spatial change in the lake area of Minqin Oasis on the ecological security of irrigation region landscape. The results showed that the depth of groundwater was descending continuously, the velocity of groundwater line change in the center of irrigation region was faster than that in the edge region, and consequently, the area of the descending funnel of groundwater line was enlarged. From 1987 to 2001, the area with a groundwater depth deeper than 3 m was increased from 81.2% to 97.4%. The descending of groundwater line due to soil water reducing was the main reason that resulted in the destruction and deadness of forests. When the depth of groundwater was deeper than 8 m and soil water content was less than 12%, the die-back rate of tree was morn than 90%, and that of shrub was more than 50%. Impacted by the descend of groundwater depth, the area of forest land, shrub land and open-canopy land was decreased by 67%, 54% and 31%, and the number of their patches was decreased by 35, 42 and 50, respectively. The mineralization degree of groundwater in northern irrigation region increased obviously, and changed the safe pattern of crop growth. The benefit of agriculture decreased, and the adjustment of planting construction was restricted seriously, which became the main impact factor on the ecological security of irrigation region. Reasonably distributing water resource between upper and lower river basin, reducing unreasonable land use, decreasing farmland area, and constructing safety landscape pattern could lead to the balance between the exploitation and replenishment of groundwater resource, prevent the descend of groundwater depth and the increase of groundwater mineralization, and improve the ecological security of the irrigation region.

China↗

PubMed2004

[Resource and pharmacognostical study on Aralia echinocaulis].

OBJECTIVE: To provide fundamental information for its exploiting. Aralia echinocaulis by the resource and identification study on. METHOD: Resource survey and various identification were carried out. RESULT: The county level distribution and ecological environment of A. echinocaulis were initially observed. It mainly distributed in the mountainous areas of the Yangtze River basin and the south, and was usually used as folk drug. This study also displayed its morphological, microscopic and chemophysical identification features. CONCLUSION: The morphological features of original plant and crude drug, and the anatomical and chemophysical characteristics of A. echinocaulis are of identification value, and the species are also of greater development and utilization potentiality, but the resource does not support the sustainable utilization. Therefore, artificial propagation is apparently crucial to its exploitation.

Aralia↗

PubMed2005

Vulnerability to global environmental changes in Argentina: opportunities for upgrading regional water resources management strategies.

There is evidence of the increasing economic losses from extreme natural events during the last decades. These facts, thought to be triggered by environmental changes coupled with inefficient management and policies, highlight particularly exposed and vulnerable regions worldwide. Argentina faces several challenges associated with global environmental change and climate variability, especially related to water resources management including extreme floods and droughts. At the same time, the country's production capacity (i.e. natural resource-based commodities) and future development opportunities are closely tied to the sustainable development of its natural resource endowments. Given that vulnerability is registered not only by exposure to hazards (perturbations and stresses), but also resides in the sensitivity and resilience of the system experiencing such hazards, Argentina will need to improve its water management capacities to reduce its vulnerability to climate variability and change. This paper presents the basic components of the vulnerability analysis and suggests how it can be used to define efficient water management options.

Argentina↗