Higher Visit Rates Research Articles

Floral phenology, secondary pollen presentation and pollination mechanism in Inula racemosa (Angiosperms: Asteraceae)

Inula racemosa Hook. f. is protandrous, discharges pollen grains inside the anther tube and presents pollen secondarily onto the sweeping hairs of the style. The style and stigmatic branches present the yellow clumped pollen grains for pollination. This study describes floral functional morphology and phenology, anther dehiscence and pollen presentation, growth and behaviour of style during anthesis and pollination mechanism of I. racemosa. The species is entomophilous and is characterized by a highly asynchronous sexual phase. A large degree of asynchrony from floret to floret in a capitulum, and capitulum to capitulum in a plant, keeps the pollen dispersed for a longer duration. Two insect families were represented in the pollinator survey: Hymenoptera and Diptera. A significant correlation was observed between the number of capitula visited per bout and foraging time. We discuss morphological features of the ?owers which may enhance the pollen removal rate per bee visit and consequently cause a high visitation and pollination rate.

Prediction of members’ return visit rates using a time factor

The profit of portal companies in Taiwan is generated by online advertising and e-commerce. Effective advertising requires predicting how users respond to advertisements and then targeting (presenting advertisements) the users in ways that reflect their preferences. The behavioral targeting leverages historical users’ behaviors in order to select for display the ads which are most related to the users’ preferences. Although we may not want to provide advertisements that repeat the same concept, we can exploit predicted return visit rates for the registered members at the specific category of a portal site. However, customers’ preferences change over time. In order to capture the ‘concept drift’, we propose a novel and simple time function to increase/decrease the weight of the old data in evaluating various members’ past behaviors. Then, we construct a member’s Click Preference Index with a Time factor (CPIT) model in order to effectively distinguish the different kinds of member behaviors and predict return visit rates. The marketers of a portal site can thus target the members with high return visit rates and design corresponding marketing strategies. Experimental results with a real dataset have demonstrated that this CPIT model can be practically implemented and provide satisfactory results.

Evaluating pollen flow indicators for an insect-pollinated plant species

For insect-pollinated plant species, reproductive success and genetic exchange via the transfer of pollen between flowers depends (i.a.) on the efficiency, abundance and behaviour of floral visitors. These in turn are expected to respond to plant population size and flower density. High floral densities for example usually attract large numbers of pollinators that visit more flowers per plant or patch, which increases pollen deposition at short distances. Thus, population characteristics might serve as indicators for pollen dispersal patterns and help to identify suitable habitat size and quality for conservation measures. To test this hypothesis, we observed floral visitors of a generalist, entomophilous species, Comarum palustre, and compared their abundance and visitation rates in populations of different sizes and flower densities. At the same time, we mimicked pollen flow using fluorescent dye. In the large and dense populations, pollinator abundance and visitation rates were high and dye was dispersed to the edges of the populations (up to 200m). In the medium-sized population with high flower density, insect abundance and visitation rates were unexpectedly low and dye dispersal declined very quickly. On the contrary, in the smallest population with scattered flowers, especially bumble bee abundance was similar to the large populations and dye dispersal mirrored this high bumble bee activity. Thus, our results indicate that in smaller habitat fragments, the mere size of a population might be insufficient to suggest pollen flow for a plant species. Instead, the abundance of its major pollinators should be considered.

Species visitation at free‐choice quail feeders in west texas

AbstractProviding supplemental feed is a common practice for the management of northern bobwhite (Colinus virginianus) and scaled quail (Callipepla squamata). The ecological efficacy and economic efficiency of a feeding program for quail can be evaluated using numerous metrics, including visitation rates by target and non‐target species. We quantified species visitation rates seasonally at free‐choice quail feeders with motion‐sensing cameras at 4 sites in West Texas, USA. Feeders were monitored from autumn 2002 to summer 2003 using both an active‐infrared sensing camera system (TrailMaster 1500®; Goodson & Associates, Inc., Lenexa, KS) and a passive infrared video system (TrophyView®; Wildlife Surveillance Systems, Inc., Kerens, TX). Our camera systems recorded 14 mammal and 18 avian species among 6,558 events observed from 490 days of feeder surveillance. Collectively, northern bobwhite and scaled quail accounted for only 7.3% and 11.3% of all recorded species visitations for the TrophyView and TrailMaster camera systems, respectively. Raccoons (Procyon lotor, 43.2%) and nongame birds (32.5%) comprised the majority of all recorded visitations. Although feeder visitation rates do not necessarily equate to feed consumption, we conclude that the vast majority of the feed in this study was consumed by non‐target species and most notably raccoons. High visitation rates by raccoons at feeders suggest supplemental feeding programs for quail could facilitate targeted removal of a common feed competitor (and potential predator of quail nests) and perhaps improve efficacy of feeding efforts. Managers should consider both direct and indirect effects of providing supplemental feeding efforts. © 2012 The Wildlife Society.

Total Control – Pollen Presentation and Floral Longevity in Loasaceae (Blazing Star Family) Are Modulated by Light, Temperature and Pollinator Visitation Rates

Stamen movements can be understood as a mechanism influencing pollen presentation and increasing outbreeding success of hermaphroditic flowers via optimized male function. In this study we experimentally analyzed the factors regulating autonomous and thigmonastic (triggered by flower visitors) stamen movements in eight species of Loasaceae. Both types of stamen movements are positively influenced by light and temperature and come to a virtual standstill in the dark and at low temperatures (12°C). Pollen presentation is thus discontinued during periods where pollinators are not active. Overall stamen presentation increases with increasing flower age. Contrary to expectation, no geometrical correlation between the floral scale stimulated and the stamen fascicle reacting exists, indicating that the stimulus is transmitted over the receptacle and stamen maturation dictates which and how many stamens react. Thigmonastic stamen presentation is dramatically accelerated compared to autonomous movement (3–37 times), indicating that the rate of stamen maturation can be adjusted to different visitation schedules. Flowers can react relatively uniformly down to stimulation intervals of 10–15 min., consistently presenting comparable numbers of stamens in the flower c. 5 min. after the stimulus and can thus keep the amount of pollen presented relatively constant even under very high visitation frequencies of 4–6 visits/h. Thigmonastic pollen presentation dramatically reduces the overall duration of the staminate phase (to 1/3rd in Nasa macrothyrsa). Similarly, the carpellate phase is dramatically reduced after pollination, down to 1 d from 4 d. Overall flower longevity is reduced by more than 2/3rds under high visitation rates (<3 d versus 10 d under visitor exclusion) and depleted and pollinated flowers are rapidly removed from the pool. Complex floral behaviour in Loasaceae thus permits a near-total control over pollen dispensation schedules and floral longevity of the individual flower by an extraordinary fine-tuning to both biotic and abiotic factors.

Low Rates of Influenza Immunization in Young Children Under Ontario’s Universal Influenza Immunization Program

To determine physician-administered influenza vaccine coverage for children aged 6 to 23 months in a jurisdiction with a universal influenza immunization program during 2002-2009 and to describe predictors of vaccination. By using hospital records, we identified all infants born alive in Ontario hospitals from April 2002 through March 2008. Immunization status was ascertained by linkage to physician billing data. Children were categorized as fully, partially, or not immunized depending on the number and timing of vaccines administered. Generalized linear mixed models determined the association between immunization status and infant, physician, and maternal characteristics. Influenza immunization was low for the first influenza season of the study period (1% fully immunized during the 2002-2003 season), increased for the following 3 seasons (7% to 9%), but then declined (4% to 6% fully immunized during the 2006-2007 to 2008-2009 seasons). Children with chronic conditions or low birth weight were more likely to be immunized. Maternal influenza immunization (adjusted odds ratio 4.31; 95% confidence interval 4.21-4.40), having a pediatrician as the primary care practitioner (adjusted odds ratio 1.85; 95% confidence interval 1.68-2.04), high visit rates, and better continuity of care were all significantly associated with full immunization, whereas measures of social disadvantage were associated with nonimmunization. Low birth weight infants discharged from neonatal care in the winter were more likely to be immunized. Influenza vaccine coverage among children aged 6 to 23 months in Ontario is low, despite a universal vaccination program and high primary care visit rates. Interventions to improve coverage should target both physicians and families.

Factors Influencing Domestic Tourism for Urban and Semiurban Populations Around Nairobi National Park, Kenya

Tourism is a very important source for foreign revenue for Kenya. But most of this revenue is from international tourists. However, international tourists cannot always support the tourism industry, especially in years of economic, political, and social turmoil. A vibrant domestic tourism can cushion the industry from fluctuations of the international tourism market and bring stability and predictability in the industry. This study sought to address factors influencing urban and semiurban local population visitation to Nairobi National Park (NNP), and suggest ways of improving it in Kenya. The data for this study were gathered through semistructured interviews and discussions with communities surrounding the park. The results revealed that a significant (p &lt; 0.001) majority (66%) of the community had visited the park. About half of the people (59%) were interested in viewing wildlife as the main recreational opportunity provided by the park. However, only less than 50% of the community had visited the park more than three times in their lifetime. The level of education influenced the likelihood of the community to visit the park and appreciate its conservation contribution. Even though the lack of free time, lack of interest in wildlife, or the thinking that protected areas in Kenya were meant for foreign tourists, were not hindrances to local community visiting the parks, they noted that key constraints were lack of extra disposable income, high cost of food and hospitality services inside the park for local communities, and poor marketing of parks especially targeting local Kenyans hindered high visitation rates of local Kenyans to protected areas. A large number (81%) of community members mentioned poor marketing as the reason for low park visits. Indeed, 96% said no form of advertisement for NNP had influenced their decision to visit. Hence, there is a need for new domestic customer-oriented marketing and a more friendly hospitality services tailored to local tourists among government policy to improve the economy to release more disposable income for leisure targeting NNP and other protected areas in Kenya.

Fibromyalgia: development of symptoms and principles of therapy

Fibromyalgia is one of the most complex problems of clinical practice. Despite its high prevalence rates in the population and high medical visit rates, fibromyalgia is maldiagnosed. Its clinical symptom development, nosological independence, and the choice of priority treatments are debatable questions. By now the number of randomized trials dealing with the efficiency of treatment for fibromyalgia has substantially increased. This permits the identification of its treatment priorities.

Mangrove Eco-system and their Multifunctionalities: An Analysis of the Provision of Economic and Environmental Livelihoods to the Fishermen Communities in the South-East Coast of India

A study was conducted to analyze the direct and indirect benefits of Pitchavaram Mangrove Forests (PMF)in the south east coast region of Tamil Nadu, India, where the concentration of mangrove biosphere is substantial. For the study,30 numbers each of i. Fishermen and ii. Tourists were personally contacted. About 75% of the respondents depended mangrove area for fishing while coastal area was the source of fish catch for only 25% of sample respondents. Among the tourists respondents, only 3.3% were foreigners, 10% were from other states and the rest were domestic visitors. Most of tourists were young and middle aged and about 43% had a monthly income of Rs.15001 to 30000. It is understood that high income and educated people showed more interest in visiting places of natural origin. People who travelled by own vehicles had higher visitation rate of 50% than those travelling by hired vehicles owing to the high cost of hired vehicles. The principal products collected by local stakeholders were firewood, fodder and timber. The Individual Travel Cost Method (ITCM) was used to estimate the recreational value and the determinants of visitation rate. The marital status had a negative influence on visitation rate. It was found out that bachelors had made more frequent trips to PMF than the families. The monthly income was also significant and had the expected relationship. Travel cost had a significant influence on frequency of visits. The price elasticity of demand for recreational visit was estimated to be -0.1566. It indicated that the visitation rate was inelastic with respect to the travel cost i.e. one per cent increase in travel cost would result in only 0.1566% reduction in visitation rate. The option value of conserving the PMF was estimated using contingent valuation method using the bidding game technique. The fishermen were willingness to pay an amount of Rs.1763 towards internalizing externalities. The catchment area, monthly income and duration of fishing were positively related to Willingness To Pay (WTP) and were significant. It is implicit from the analysis that duration of fishing and fishing area (near mangrove) influenced the WTP significantly. Household expenditure of a fisherman had been positively related to the duration of fishing. The major findings of the regression results regarding the overall impact of PMF was that the people who entered into fishing and other mangrove dependent occupations had extensively improved their standard of living. The additional money generated from tourism by tourist dependents encouraged the households to incur more on luxurious goods. Positive externalities like shoreline protection, increased fish catch and enhanced income, utilization of non â-“timber forest products, control of soil erosion, water retention and purification of water by mangrove forests were the other environmental benefits. The study came out with the policy that the optimal exploitation of mangrove biosphere by the end users should be ensured by the enforcement authorities. Both the state and central institutions should protect the mangrove ecology and sea-shore through stringent adoption of regulatory mechanisms. The local institutions should also be empowered adequately to deal with the free-riders; so that the mangroves will be promoted on large scale since off-shore fishing has been the lifeline of the poor and marginalized fisher folk in coastal regions.

Estimating pollination success with novel artificial flowers: Effects of nectar concentration

We developed novel artificial flowers that dispense and receive powdered food dyes as pollen analogues while their nectar is replenished by capillary action. Dye receipt, which can be measured colourimetrically, is a direct surrogate for pollen receipt or female reproductive success, but can also serve to compare pollen donation (male reproductive success) from flowers with different colours of dye. By allowing captive bumble bee colonies to visit large arrays of such flowers, we investigated whether total dye receipt depended on the sugar concentration of a flower’s nectar. Estimating pollen transfer, rather than simply visitation rate, is appropriate for this question because flowers with more concentrated nectar might accrue more pollen not only through higher visitation rates but also through longer visits that transfer more pollen per visit. Flowers with richer nectar did receive more dye regardless of their spatial arrangement, but the effect was greatest when rich and poor flowers were segregated in large blocks, as opposed to being intermingled.

Carnivores in burned and adjacent unburned areas in a Mediterranean ecosystem

Wildfire is a major disturbance factor that affects wildlife both directly and indirectly. To better understand its influence, carnivore mammals were monitored using scent stations, inside and outside a burned area of a typical Mediterranean ecosystem of Northern Hellas, in the second and third summers post-fire. The main Carnivora species in the study area were red fox ( Vulpes vulpes ), stone marten ( Martes foina ), and free-ranging dogs and cats. Carnivore visitation rate was found higher in the intensely burned area. Unburned and intensely burned areas differ by the absence of stone marten from the burned areas and the high visitation rate of fox in the intensely burned area. At a micro-scale level, no relation was found between carnivore visits and fire influence on vegetation of the moderately burned area. Wildlife managers would be advised to monitor fox populations after forest fires as their increased abundance may influence other species.

Abstract P2: Medical Resource Utilization and Costs Following Hospitalization of Patients with Chronic Heart Failure in the United States

Background: The study objective was to determine medical resource utilization and direct and indirect costs following hospitalization with chronic heart failure (HF). Methods: Patients (Pts) with ≥1 hospitalization with a chronic HF claim (ICD-9 428.22, 428.32 or 428.42) were identified in a US commercial insurance claims database from 2004-2008. Pts were observed from beginning of first hospitalization (index hospitalization) for chronic HF until disenrollment or end of data availability. Inpatient, outpatient, and prescription drug data were used to estimate per patient per month (PPPM) utilization rates. Costs (2009 USD) were calculated per hospitalization and PPPM for patients ≤65 years, and included insurers’ reimbursement, patient out-of-pocket (OOP) and sick leave. Results: There were 7,814 pts (mean age 73.2 years, 55.7% (4,355/7,814) male) meeting inclusion criteria. Mean HF hospitalization length of stay increased from 6.7 days at index hospitalization to 8.2 days at fourth re-hospitalization. Rate of HF-related re-hospitalization remained over 0.045 PPPM throughout 24 months of follow-up, accounting for the majority of all-cause hospitalizations. Rate of all-cause and HF-related outpatient visits peaked at 4.0 and 0.59 visits PPPM, respectively, within the three months after index hospitalization. Index hospitalization was most expensive (Table). Patient OOP costs accounted for less than 10% of direct costs (Table) and sick leave costs were less than $1,800 at any hospitalization. During the study period, outpatient cardiovascular drugs accounted for a small proportion of total pharmacy costs; average PPPM cost varied from $88 to $124, less than 1% of the average cost of a HF-related hospitalization. Conclusions: Treating chronic HF pts is resource intensive. The greatest burden occurs within the three months after index hospitalization and pts continue to be burdened after hospitalization by high inpatient and outpatient visit rates. Index hospitalization HF-related re-hospitalization 1st 2nd 3rd 4th Total direct medical costs $31,998 $22,047 $23,946 $24,839 $24,517 Reimbursement by insurers $31,023 $21,521 $23,103 $23,781 $23,971 Patient out-of-pocket $975 $526 $843 $1,058 $546 Indirect costs (sick leave) $1,194 $1,194 $1,281 $1,703 $1,764 Total $33,192 $23,241 $25,227 $26,542 $26,281

Comparative study of the reproductive ecology of two co-occurring related plant species: the invasive Senecio inaequidens and the native Jacobaea vulgaris

Background and aims – A previous study showed that the visitation rate by pollinators and the seed set of the exotic invasive Senecio inaequidens (Asteraceae) were higher compared to the native relative, Jacobaea vulgaris. The first aim of the present study was to assess if these results could be explained by differences in self-fertility, nectar rewards or floral display between the two species. Moreover, in a second step, we examined if the higher visitation rate on S. inaequidens has a negative effect on the reproductive success of J. vulgaris. Methods – Self-fertility was estimated after self- and cross-hand pollinations. Nectar volume, total sugar concentration and sugar composition were analysed on plants cultivated under controlled conditions. In the field, in order to assess the effect of floral display and impact of the invasive on the pollination success of the native, insect behaviour was assessed by comparing visitation rates, number of visitors per 10 min observation and individual censuses. Floral display (density of capitula per unit area) was artificially modified by clipping or grouping inflorescences in both species.Key results – In terms of self-fertility, seed sets were similarly low after self-pollination (11–12%) for both species. S. inaequidens produced lower amounts of nectar with lower sugar concentration compared to J. vulgaris. No influence of floral display was detected on insect visitation rates. The presence of S. inaequidens did not alter pollinator visits and seed set of J. vulgaris. Conclusions – Other traits need to be investigated to explain the different visitation rates and reproductive success between the two species. The higher seed set of S. inaequidens could be due to a higher outcrossing rate, or more frequent pollinator movements between individuals.

Small-size bees reduce male fitness of the flowers of Ononis masquillierii (Fabaceae), a rare endemic plant in the northern Apennines

Most plant species are visited by a diverse array of visitors that may contribute differently to reproductive success. In particular, the size of visitors, relative to flower size, may have severe implications for plant fitness, as it can affect the mechanics of the pollination process. Ononis masquillierii, a rare endemic legume in northern Italy, is visited by numerous bee species of different families and sizes. To evaluate the effect of bee guilds on seed set, we compared the relative efficiency of four size classes of bees visiting flowers in eight plant populations occurring in the Apennines. Size classes were assorted by body weight. Reproductive success was positively related to plant population size and affected by the visitation frequency of the bee size guilds: higher visitation rates by larger bees (medium–large Andrenidae and large Apidae) increased seed set, whereas high visitation rates by smaller bees (small Halictidae and small−medium Megachilidae) reduced seed set. We conclude that the influence of bee size on seed set is related to the pollen foraging techniques of the different bee guilds. Larger bees paying short visits to flowers remove one ‘batch’ of pollen and transfer it to another flower. In contrast, smaller bees enter the flower entirely and activate the pump-like pollen dispensing mechanism several times, resulting in a higher degree of selfing. These behaviours may result in differential seed sets as the flowers are self-incompatible, i.e. seed set may be reduced after visitation by smaller bees. Such variations in pollinator quality among populations coupled with the ephemeral nature of the habitat of O. masquillierii may represent a risk for its persistence. Our results show that such a risk can be confronted only through the conservation of large plant populations and of large bees capable of flying long-distances. © 2011 The Linnean Society of London, Botanical Journal of the Linnean Society, 2011, 165, 267–277.

Pollination and Seed Dispersal in the Endangered SucculentEuphorbia brevitorta

The dwarf succulent euphorbia Euphorbia brevitorta (Euphorbiaceae) is a localized and potentially threatened endemic species with limited distributed across rocky grasslands in central and southern Kenya. The pollination ecology and seed dispersal of E. brevitorta was investigated by direct observation. Euphorbia brevitorta relies on pollinators for fruit-set as it bears separate male and female flowers on the same plant, but appears to be self-compatible. Euphorbia brevitorta was found to have a generalist pollination system, with insects being the main pollinators. Pollinators of E. brevitorta comprise a wide range of insects from three different orders: true flies (Diptera), ants, bees and wasps (Hymenoptera) and beetles (Coleoptera). Flies, wasps and honeybees were found to be the most efficient transporters of pollen between different individual plants and carried the highest volumes of pollen. Observations of pollinators revealed adequate pollination and high visitation rates by pollinators. Seed dispersal was found to occur in two stages: localized dispersal from explosive capsules up to∼2 metres from the plant, followed by limited secondary dispersal by ants further away. Euphorbia brevitorta relies on both pollinators and seed dispersal for adequate recruitment and survival in its natural habitat.

Health Care Disparities in Sickle Cell Disease : A Population-Based Study of Los Angeles County.

Abstract 2480Poster Board II-457 Introduction:As young adults with Sickle Cell Disease (SCD) age out of comprehensive pediatric coverage, they are left with suboptimal coverage for disease-appropriate comprehensive care, and rely on Emergency Departments (ED). This situation is implied to affect SCD outcome, as review of death certificates suggests that patients cared for outside comprehensive sickle cell centers (CSCC) die earlier on average than patients cared for within CSCCs. Los Angeles County (LAC) poses particular challenges, as even within the CSCC network patients die younger than the national average. There are no data describing LAC SCD patients outside of the tertiary care referral centers, nor are there population-based data describing the effect of access to health care on ED utilization in SCD. In order to eliminate these disparities in health care and health outcomes, the first step is to identify the population and where they receive care. This population-based study assesses the effect of where a patient lives, age, and insurance status on utilization of emergency departments (ED) and rates of inpatient admission. Methods:We conducted a retrospective cohort study using the 2007 LAC data from the California Office of Statewide Healthcare Planning and Development, with all hospital discharges from non-federal emergency departments (ED) and inpatient units. We selected patients based on ICD9 codes indicating SCD (282.60-282.69) or SB-thalassemia (282.41-282.42) as a primary or secondary diagnosis. Unique identifiers longitudinally link multiple visits. One of the 8 service planning areas (SPA) defined by LAC Department of Public Health has very poor health outcomes and access to care as compared to the others. Using Poisson regression, we evaluated the effect of living in this resource-poor SPA on the number of SCD-related ED visits per year. We controlled for age (adult ≥21 years old vs. child), gender (male vs. female), race (African American vs. not), ethnicity (Hispanic vs. not), and socioeconomic status (using insurance as a proxy). Finally, we evaluated the effect of living in the resource-poor SPA on disposition from the ED (admit vs. discharge) using binary logistic regression. Results:In LAC in 2007, 1088 identified individual patients with SCD visited the ED, leading to 4420 total ED visits. There were 298 children and 790 adults (>21yo). The mean number of visits per patient was 4.06 (SD = 10.84; range 1 to 180). The mean number of annual SCD-related ED visits per hospital was 35.93 (SD = 75.30; range 1 to 414). Children accounted for 18% of the visits and adults 82%. SCD adults had 2 times the rate of ED visits as compared to children. Patients living in the poor-resource SPA had 7% more ED visits than those living in the SPAs with better healthcare resources. Publicly insured SCD patients had a 33% higher rate of ED visits than privately insured patients and a 77% higher rate of visits than self-pay patients. Being male and African American were also significantly associated with an increased rate of ED visits. ED visits by patients from the resource-poor SPA were 13% less likely to result in an inpatient admission than were the ED visits by patients living in the other SPAs. Being female, African American, Hispanic, and having public insurance were also significantly associated with increased likelihood of the ED visit resulting in inpatient admission. Conclusions:Our data suggest that among SCD patients in LAC, adults ≥ 21 years of age, those living in a resource-poor area of LAC, and the publicly insured all have higher ED utilization rates. ED visits by patients from the resource-poor area of LAC are less likely to result in inpatient admissions whereas visits from publicly insured patients were more likely to result in an inpatient admission. The dramatically higher rate of ED visits by those 21 and over is consistent with the notion that adults with SCD have poor access to appropriate comprehensive care leading them to seek care in the ED. The results also support the premise that poor access to health care and public insurance are associated with suboptimal comprehensive care in SCD, leading to a higher rate of ED use. Considering LAC's population size and diversity, this population-based study substantiates findings from the tertiary care center cohorts. These findings beg further investigation into the outpatient utilization practices of patients with SCD as a means of developing measures of access to care in SCD. Disclosures:No relevant conflicts of interest to declare.

National study of medications associated with injury in elderly Medicare/Medicaid dual enrollees during 2003

ObjectivesTo address the association between inappropriate prescribing for the elderly and adverse outcomes and to identify the magnitude of the cost of medication-associated injury in this population. DesignCross sectional. SettingUnited States, 2003. Patients5,412,678 dually eligible Medicare/Medicaid enrollees aged 65 years or older. InterventionBeers and non-Beers medications with potential central nervous system adverse effects of dizziness/vertigo, drowsiness, and/or fainting were assessed. Emergency department (ED) visits with admitting diagnoses pertaining to injuries for elderly enrollees dually eligible for Medicare and Medicaid during the calendar year were linked to prescriptions filled during the 90 days preceding the visit. Main outcome measureFor each drug, the proportion of ED-related fills and the Medicare average revenue charge per injury-related ED visit were calculated. ResultsSeveral drugs not currently on the Beers list were found to be associated with high proportions of ED-related fills: methadone had the highest proportion of any of the drugs studied (12.3 per 1,000 fills), and bethanechol (7.8 per 1,000 fills) had the highest proportion among genitourinary products. Regarding narcotic analgesics, propoxyphene (7.7 per 1,000 fills) had a higher association with injury than morphine (6.6 per 1,000 fills) or tramadol (6.5 per 1,000 fills). For cardiovascular agents, clonidine (4.7 per 1,000 fills) and doxazosin (3.6 per 1,000 fills) had higher associations with injury than nifedipine (3.3 per 1,000 fills). Fentanyl, a non-Beers medication, was associated with the most expensive injury-related ED visits ($1,263 average revenue charge). ConclusionBeers medications are associated with high injury-related ED visit rates for the elderly, and a number of drugs not currently on the Beers list also pose an apparent risk for injury-related visits.

Is the magnitude of pollen limitation in a plant community affected by pollinator visitation and plant species specialisation levels?

Pollen limitation on a plant community level has received little attention, although it might show which pollination‐related traits may cause pollen limitation to vary among species. To address several central questions in plant reproductive biology, we investigated pollen limitation in 11 plant species, including visitation and specialisation levels of all species. The female reproductive success of most species within the studied plant community was not pollen limited, but a general tradeoff between seed production and seed weight occurred as a response to supplemental pollination. In contrast to general notion, we did not find that less visited species were most pollen limited. Instead, it appears that species with high visitation rates were most pollen limited. Our study provided conflicting evidence to whether specialisation levels may affect the degree of pollen limitation within the study community. We discuss these findings in the context of recent reviews on the occurrence, causes and consequences of pollen limitation in plants. In particular, we propose that, although pollen limitation is an important phenomenon, 1) the majority of species within a plant community may not experience pollen limitation at a given moment, 2) that common notions of which plant species should experience pollen limited reproductive success do not hold true in the studied plant community, and 3) that offspring quality is as likely affected by surplus pollen loads as is the number of offspring.

Role of native bees and natural habitats in eggplant ( Solanum melongena) pollination in Kenya

The pollination requirements of eggplant ( Solanum melongena) were investigated. One variety of eggplant exhibited a significantly reduced seed set in absence of pollinators, and two varieties significantly increased seed numbers when pollen deposition was enhanced. Two solitary bee species, Xylocopa caffra and Macronomia rufipes, were identified as effective pollinators of the crop. The visitation rates of these pollinators to eggplant flowers declined significantly with distance from the wild habitat. The importance of wild plants as alternative forage source for pollinators was assessed by a survey of the flowering plants in different habitats surrounding eggplant fields. While ruderal farm weeds provide much of these resources, the Acacia tortilis riverine forest experienced high visitation rates in one critical period of the dry season. The spatio-temporal foraging behaviour of eggplant pollinators highlights the role of the agricultural matrix in conserving ecosystem services. Interspersion of wild habitats with cultivated land promoted increased pollination services.

Managed Care: Effect of an Academic Detailing Intervention on the Utilization Rate of Cyclooxygenase-2 Inhibitors in the Elderly

Osteoarthritis is prevalent in the elderly. Nova Scotia general practitioners (GPs) identified the need for an academic detailing (AD) intervention aimed at optimizing the management of osteoarthritis. AD was provided by Dalhousie University Continuing Medical Education in a face-to-face encounter employing evidence-based information. GP participation was voluntary. To evaluate the effect of a GP-targeted osteoarthritis AD intervention on a reduction in the prescribing of cyclooxygenase-2 (COX-2) inhibitors, as well as examine the intervention effect on the utilization rates of gastroprotective agents and medical services. A retrospective cohort study design employing administrative data was used. Differences in utilization rates between intervention and control groups were evaluated using generalized estimating equations analysis for longitudinal data over four 90-day postintervention periods. Confounding was addressed using propensity scores to adjust for between-group bias on the measured covariates. The between-group difference for change in COX-2 utilization rates was 0.76 defined daily doses/patient (p = 0.040; 95% CI 0.037 to 1.48) for the 3-month period following the intervention, with lower COX-2 utilization in the AD intervention group than in the control group. The intervention group showed a significant decrease in the within-group utilization rate between the pre- and postintervention periods (z =-2.34; p = 0.019). The between-group difference for change in GP office visit rates was 0.40 visits/patient (p = 0.028; 95% CI 0.046 to 0.79) with the intervention group, showing higher visit rates compared with the control group. The osteoarthritis AD intervention was associated with a significant decrease (23%) in COX-2 utilization rates in the 3-month period immediately following the intervention. The only secondary outcome to show a significant between-group effect was the GP office visit rate, which was higher for the intervention group in the second 3-month postintervention period.