Island Residents Research Articles

Chronic Obesity in Deinstitutionalized Mentally Ill Adults Receiving Rehabilitative Services in Rhode Island

There is little published literature regarding the nutritional status of the mentally ill, except for limited data on the institutionalized mentally ill. The rate of deinstitutionalization in Rhode Island is over 98%, the highest in the nation. For every 100 Rhode Island residents in public mental health hospitals in 1955, fewer than 2 are there today. A pilot study was conducted to determine the nutrititional status of a population of mentally ill adults in Rhode Island residing in both community based group homes and independent settings receiving rehabilitative services. Fifteen males and 15 females (n = 30) were included in the study. Ages ranged from 35 to 73 years (mean = 50 years). Body mass index (BMI) ranged from 15 to 41kg/m2 (mean=31kg/m2). The prevalence of obesity was determined to be §7% which is more than double that of the general population. Review of past medical history revealed that the obesity was chronic as the obesity and the trend for increasing weight was documented for a minimum of two years. The severity of obesity was found to be variable from 33% with mild obesity, BMI = 27–29kg/m2; 43% with moderate obesity, BMI = 30–39kg/m2; to 13% with severe obesity, BMI ≥ 40kg/m2. Activity was sedentary to mildly active without evidence of physical limitation. Medication review revealed extensive polypharmacy with nutritional implications for altered appetite (n=28), weight (n=28), gastrointestinal function (n=30), and dental health (n=30). Poor motivational and cognitive functioning in this population present a challenge for obesity management, however close association between the members and case workers present a unique opportunity for dietitians to increase fitness and nutrition knowledge to accomplish a modest weight reduction.

RHIC Physicists Go to Media School

PHYSICSLast month, the Sunday Times of London ran a story speculating that the atom-scale collisions within the Relativistic Heavy Ion Collider at Brookhaven National Laboratory could create clumps of strange matter that might catastrophically transform normal matter into something, well, strange--or make black holes that would suck up the planet. Already unsettled by reports of chemical and radioactive leaks from Brookhaven facilities, Long Island residents feared the worst. Brookhaven officials, stung by past PR debacles, did not dismiss the public fears lightly.

Estimation of target hazard quotients and potential health risks for metals by consumption of seafood in Taiwan.

The purpose of this paper is to describe the impact of metal pollution on the main seafood and assess the potential health risk from consuming the contaminated seafood in Taiwan. The results of geometric mean (GM) metal concentrations in various seafood showed that the copper, zinc, and arsenic concentrations in oysters were significantly (p < 0.001) higher than those in the other seafood by about 1,057, 74.3, and 56.2 times, respectively. The green color found in the oysters was due to high GM copper and zinc concentrations of 909 (ranging from 113-2,805) and 1,293 (ranging from 303-3,593) microg/g dry wt, respectively. In addition, using a maximum consumption rate of 139 g/day of oysters for individuals, calculations yield target hazard quotients (daily intake/reference dose) of below 1 for cadmium and mercury and high values of 1.61, 9. 33, and 1.77 for inorganic arsenic, copper, and zinc in adults, respectively. The various lifetime cancer risks for inorganic arsenic (maximum exposed individuals risk ranging from 9.93 x 10(-6) to 3.11 x 10(-4)) might be caused by consuming different seafood in Taiwan. The highest risk estimate for inorganic arsenic was 5.10 x 10(-4) for consumption of oysters by Machu Islands residents. The long-term exposure of metals through consumption of oysters, especially for some high-risk groups, could be dangerous. Taking inorganic arsenic for example, a 10(-6) upper limit on lifetime risk as the health protection standard would require maximum oyster residue levels of approximately 0.0076-0.056 microg/g wet wt, for consumption rates of 139-18.6 g/d. In the light of known risks to public health, the government should issue an immediate warning to the public to refrain from eating all seafood harvested from the Taiwan coastal areas, especially the Hsiangshan area and the Machu Islands.

Public Preferences regarding the Goals of Farmland Preservation Programs: Comment

In a recent article in this journal, Kline and Wichelns (1996) (hereafter KW) argued that public (government) farmland preservation programs would be more efficient if broadened to include not only agricultural productive and lifestyle criteria, but also open space criteria as preservation objectives. While the public may prefer the open space benefits more than the agrarian benefits, much of the enabling legislation of public preservation programs relegate open space objectives as secondary to the agrarian ones. Therefore, by broadening the legislative scope of these public programs to include the multiple objectives of agricultural productive, lifestyle, aesthetics, environment, and open space, targeted land for preservation would be more efficient (and effective) in meeting the public's multiple objectives. Often, the nonagrarian objectives are highlighted by program proponents to gain public support. As evidence on the ranking of land preservation preferences, KW collected qualitative data from Rhode Island residents on reasons

Competing conceptions of Taiwan's identity: The irresolvable conflict in cross‐strait relations

Supporters of unification and Taiwan independence advocates view Taiwan's status through radically different logical frameworks. Unification supporters are guided by historical determinism. They believe that because Taiwan was part of China in the past, and because the island's residents have ancestral ties to mainland China, Taiwan is therefore an unalienable part of Chinese territory that must be brought under the control of the mainland Chinese state. In contrast, advocates of Taiwan independence are guided by the logic of pragmatism. In their view, cultural identity does not dictate political identity, and decisions about Taiwan's status should be guided by the will of the island's people, rather than by an abstract notion of historic destiny. Both of these approaches are rooted in long‐standing concepts of Chinese identity. Chinese ethnicity has long included both a hereditary and a cultural component. In the past, the cultural component allowed China to absorb populations on its periphery. Today, it serves as an outlet for Taiwan independence supporters seeking to redefine Taiwan as a political entity separate from the mainland Chinese state.

Public Preferences Regarding the Goals of Farmland Preservation Programs

Farmland preservation programs exist in all states. Most programs pursue agricultural objectives, such as preserving productive soils and viable farms. However, in some states the public may believe that programs should pursue broader goals often associated with preserving open space. Focus groups and a survey of Rhode Island residents provide information and data for factor analysis of preferences regarding farmland preservation goals. A system of structural equations (LISREL model) is used to examine differences in preferences among residents across socioeconomic categories. Results suggest that broadening the scope of farmland preservation programs to address environmental goals may increase public benefits.

Screening for peripheral arterial disease.

Peripheral arterial disease (PAD) is an age-dependent condition that limits ambulation and compromises quality of life in an estimated two million Americans. Early detection and treatment is essential for minimizing the signs and symptoms of PAD. Using a methodology developed by the National Council on the Aging, a noninvasive screening program was conducted for this disease in a population of 1,092 elderly ambulatory Rhode Island residents. Possible PAD was detected in 17.7% of the subjects, while 42% were identified as being at high risk for the disease.

Friedrich Ratzel's Discourse on Japan

Friedrich Ratzel wrote several papers (1878, 1879, 1895b, and 1895c) and book reviews (1881, 1887, 1894, 1895a, and 1897) relating to Japan, and during 1889-1902 at Reipzig University, he gave four lectures on the world outside Europe, including Japan (Fig. 1.). His notes (manuscripts and materials) for those lectures, which are listed in Tab. 1. A and B, have been preserved in the Archives of Geography, Institute of Regional Studies (Geographische Zentralbibliothek/Archiv für Geographie, Institüt für Länderkunde), Leipzig.The examination of his writings revealed Ratzel's discourse on Japan, which has never been investigated by geographers, in connection with his extensive geographical work. This paper makes it clear that:A) Ratzel was interested in Japan and maintained study and a material collection throughout his academic career (Tab. 2).B) At the watershed of 1895 when Japan won the Sino-Japanese War, his negative evaluation of Japan turned to a positive one. Parallel with this change, his research-focus in Japan itself was transferred, that is, his ethnographical and anthropological study shifted to the political geography of Japan as an island empire.C) In his writings before 1895, he pointed out that 1) the physical and mental features of the residents of the Japanese Islands were inferior to those of Europeans, 2)the strange social class system, which, essentially, the Meiji Restoration did not alter at all, and 3) the mysterious pluralistic jurisdiction among East Asian countries, which could easily cause a political dispute. Ratzel's sense of values with reference to European culture and his contempt for an uncivilized race in East Asia were obvious.D) With Japan's defeat of China, Ratzel realized the characteristics of a land of islands and a marine nation, which were common to England. After revisions and rearrangement (Tab. 3.), his discussion of the political geography of islands (1895c) was publishedas the chapter of ‘Islands (Inseln)’ in “Politische Geographie” (1897). Ratzel expected that Japan would follow the achievements of England in the near future. The most important reason why he changed his evaluation was that Japanese could master Western culture, technology, and social and political systems within a short term.E) According to Ratzel, because the Japanese were a marine nation with high learning-ability and followed Europe, they succeeded in the reexpansion of marine transport over the ocean, and exceeded thier neighbors China and Korea-China used to be accompanied by Japan and Korea respectively, in culture as well as politics.F) Ratzel's continuing study of Japan could be a synthetic chorography, which describes and explains a peculiar combination between a land of islands in the Pacific Ocean and a marine nation with high learning-ability. The possiblity that he preparedthe publication of “Japan” can not be denied.

Measuring public preferences for the environmental amenities provided by farmland

As farmland amenities have become relatively more scarce than food and fibre in developed countries, public concern has shifted away from increasing agricultural production, towards protecting rural environmental quality. Choosing appropriate policies requires accurate information describing public preferences for different amenities. This paper uses qualitative information provided by focus groups and survey data from a sample of Rhode Island (USA) residents, to identify and compare socially valued environmental amenities associated with farmland and open space. Public preferences for preserving farmland compare favourably with preferences for preserving other types of open space. Lands that include endangered species habitats and important groundwater resources are preferred. Copyright 1996 by Oxford University Press.

Marketing paradise, making nation

An analysis of themes and images used to market the British Virgin Islands to tourists focuses on assumptions about sexual desire, nature, and sexual difference underlying references to its untouched and natural beauty. A comparison with themes and images used by British Virgin Islands residents in conceptualizing their connections to the islands reveals important differences and similarities. While the themes and images of the British Virgin Islands draw upon notions of difference, and difference is stabilized by positing it to be a fact of nature, what tourism marketing campaigns represent as the exotic object of sexual desire is constituted by the British Virgin Islanders as motherland and nation.

Singing and Shouting in Moving Star Hall

I (Guy) first came to Johns Island, South Carolina, in the winter of 1959. Johns Island is one of a cluster of islands nestled along the coast adjacent to Charleston and including Wadmalaw, James Island, Edisto, and Yonges Island. I did not come as a traditional academic researcher but rather to work with a literacy and citizenship program developed by the Highlander Folk School in Tennessee. Working with Esau Jenkins, an important community leader, the Highlander staff intended to give basic literacy training to island residents so they could register to vote. Mrs. Septima Clark, a former teacher from Charleston, was the director of the program, and I was to be her driver. I had met both Esau and Septima at Highlander a few months before, and I was excited about working with them. I knew from my study of folklore that a rich layer of older folk expression was still alive in the Sea Islands. My mother was originally from Charleston, so I had personal roots there as well, though I had grown in southern California. Around midnight on Christmas Eve of 1959, Esau Jenkins took me to Moving Star Hall on Johns Island, where they were having an all-night Christmas Watch meeting. That experience really changed my life. Beginning just before midnight and lasting until dawn, or day clean, this service was the most moving and democratic form of worship I had ever encountered. Every person in the hall took a turn praying, giving a testimony, or preaching a short sermon. Each segment was supported by vigorous bearing up from the congregation and followed by an a cappella song-an old hymn, a spiritual, or a more moder gospel song-

Epidemiologic investigation of nonmelanoma skin cancer mortality: the Rhode Island Follow-Back Study.

The Rhode Island Follow-Back Study was initiated to elucidate the magnitude and characteristics of nonmelanoma skin cancer mortality. All deaths reported among Rhode Island residents during 1979 through 1987 and attributed to nonmelanoma skin cancer were investigated and medical records sought. Most were misclassified, primarily due to squamous cell carcinoma of mucosal surfaces in the head and neck. In Rhode Island and nationally, this source of misclassification is increasingly frequent. Appropriate adjustment of national statistics for misclassification reveals a consistent decline in nonmelanoma skin cancer mortality rates from 1969 through 1988, although the actual numbers of deaths are increasing due to growth and aging of the population. Examination of the records of those Rhode Island residents who did die from nonmelanoma skin cancer demonstrated that most had squamous cell carcinoma, and many of those arose from the ear. These analyses suggest that particular emphasis should be placed on the ear in public health campaigns geared toward the prevention and early detection of nonmelanoma skin cancer.

Norway Rats as Reservoir Hosts for Lyme Disease Spirochetes on Monhegan Island, Maine

To determine whether the agent of Lyme disease, Borrelia burgdorferi, may be maintained in the absence of its usual white-footed mouse reservoir host, Ixodes dammini ticks from an island where mice are absent were examined. Prevalence of spirochetal infection was described for ticks removed from mammals, birds, and vegetation on Monhegan Island, Maine. Forty percent of adult I. dammini removed from vegetation were infected. Norway rats were heavily infested with ticks, and > 60% of such ticks contained spirochetes. Other hosts were less frequently infested by ticks, and few such ticks were infected by spirochetes. The prevalence of antibody to B. burgdorferi was 23% in dogs and cats; 4% of island residents had Lyme disease. Thus, rats maintain Lyme disease spirochetes on Monhegan Island, and there may be transmission of this agent by I. dammini to island residents and their pets.

A Landfill Site Evaluation Model That Includes Public Preferences Regarding Natural Resources And Nearby Communities

This paper develops a model that provides an objective framework for evaluating the concerns often cited by members of nearby communities and other state residents when potential sites for solid waste landfills are evaluated. An empirical version of the model is estimated using preference data collected in a paired comparison survey of Rhode Island residents, in which participants identify a preferred site and location for a landfill among two alternatives. The estimated model is used to assign scores to each characteristic describing the natural resources present at a site and the characteristics of the nearby community. The model estimates the proportion of voters who would choose each candidate site in a referendum that includes the complete set of alternatives. This simulated voting mechanism can be used to reduce a long list of technically desirable sites to a shorter list of sites that rank highly according to public preferences regarding natural resources and local community impacts.

A Landfill Site Evaluation Model That Includes Public Preferences Regarding Natural Resources and Nearby Communities

This paper develops a model that provides an objective framework for evaluating the concerns often cited by members of nearby communities and other state residents when potential sites for solid waste landfills are evaluated. An empirical version of the model is estimated using preference data collected in a paired comparison survey of Rhode Island residents, in which participants identify a preferred site and location for a landfill among two alternatives. The estimated model is used to assign scores to each characteristic describing the natural resources present at a site and the characteristics of the nearby community. The model estimates the proportion of voters who would choose each candidate site in a referendum that includes the complete set of alternatives. This simulated voting mechanism can be used to reduce a long list of technically desirable sites to a shorter list of sites that rank highly according to public preferences regarding natural resources and local community impacts.

Optimal Pricing of the Toll Rate of a Large Scale Bridge Over Time

We derive the dynamic Nash equilibrium path of the toll rate of the bridge which connects the mainland and the island. The game is played between the bridge authority and the firm in the island.The firm in the island is assumed to be owned by individuals of the island, that is, the behavior of the firm is given as the optimal behavior of the island residents. The island exports their product to the mainland and import goods from the mainland. The island and the mainland trade goods of their products by using the bridge. The time path of the export and the import, i.e., the island's consumptions of the imported goods and the domestic goods, are determined so as to maximize the discounted sum of the future utilities of the individuals of the island, given the time path of the toll rates determined by the bridge authourity. At the same time, the optimal time path of the investment of the flrm in the island is determined.The bridge authority determines the optimal time path of the toll rate of the bridge so as to maximize the discounted sum of the future utilities of the island residents. The constraint of the authority is that the construction cost of the bridge should be refund by the toll revenue of the bridg in finite periods. Also, the authority takes the time path of the investment of the island as given.We derive that when the utility function of the island is strictly concave CES type, the equilibrium path of the toll rate is decreasing in time.

The External Debt Situation in Indonesia: Performance and Prospects

In interviews with bankers, government economists and academic observers, most of them attributed the absence of an Indonesian debt crisis during 1982–84 to the fact that a significant portion of external public debt, an average of 37 percent, was long‐term concessionary loans from foreign governments and international agencies. Our analysis challenges this conventional explanation. We show that if Indonesia (1) had paid the same effective interest rate as Mexico, (2) had the same maturity structure as Mexican debt, and (3) had the same export‐GNP ratio as Mexico, then its average 1980–82 total debt service‐export ratio would have been 84.4% instead of the actual 30.1%. Our decomposition shows that concessional interest rates account for 5.8 percentage points of the gap, maturity structure for 17.7 percentage points and export orientation for 30.8 percentage points.We have concluded that the major cause for the favorable 1982–84 outcome is competent management of the exchange rate. The absence of protracted exchange rate overvaluation from 1979 onward was fundamental in maintaining a strong nonoil tradeable sector. The nonoil tradeable sector was able to earn enough foreign exchange to service Indonesian debts when the external shock of high interest rates increased debt service payments and the recession in industrialized countries lowered the price of oil. The absence of extended exchange rate overvaluation also kept the external debt down and the maturity structure on the long side by not encouraging capital flight. We ascribe this use of the exchange rate to protect the tradeable sector as much to the existence of an influential political constituency consisting of neoclassical economists, Javanese peasants and Outer Island residents as to balance‐of‐payments considerations.We recommend an aggressive exchange rate policy and two sets of supplementary measures to reduce the probability of a debt crisis in the medium run.

Relationship of polyps to cancer of the large intestine.

Pathologic and epidemiologic evidence indicates that patients with sporadic (nonfamilial) adenomatous polyps of the large intestine are at high risk of developing colorectal cancer. Our primary goal in this study was to evaluate the colorectal cancer mortality rate among persons who have had a histologically confirmed benign colorectal polyp. We used the retrospective follow-up method to evaluate the risk of death from colorectal cancer in 2872 Rhode Island men and women who were 24 through 79 years of age at the time of surgery for benign polyps in the years 1959 through 1975. Among 2872 subjects, the mortality from colorectal cancer, standardized for age, sex, and calendar time, was estimated as 1.74 (95% confidence interval = 1.44-2.09) times the rate in the general population of Rhode Island residents. Colorectal cancer mortality was higher in the first 5 years of follow-up than it was later. There was little relationship between the numbers of polyps and colorectal cancer mortality, and there was only a modest association between the size of polyps and mortality. Colorectal cancer mortality was more than twice as high in subjects whose polyps were proximal to the sigmoid compared with those with sigmoid or rectal polyps. The observed elevation of risk of colorectal cancer was almost entirely confined to subjects who had an adenomatous polyp. The risk increased strongly with the percentage of villous features in the polyp and was about twice as high in subjects with villous adenoma than in those with other adenomatous polyps. Our results support the suspected relationship between colorectal polyps and cancer incidence and extend the association to colorectal cancer mortality.

Teens in poor community `milk' local school clinic

FAR ROCKAWAY, N.Y. -- Poverty, street violence and severely limited health services are just a few of the problems this isolated, innercity community is attempting to shed. Far Rockaway, a spit of land connected to mainland Queens by just two bridges, once was a popular weekend resort for Long Island and Manhattan residents.

Estimating the Benefits of Water Quality Improvements in the Upper Narragansett Bay

An EPA-sponsored study of the benefits to Rhode Island residents of the water quality improvement in the Upper Narragansett Bay showed that the estimated annual costs ($2.9 million) exceeded the expected annual benefits ($2.0 million). That analysis evaluated only user benefits which were measured via expenditures; nonuser (intrinsic) benefits were not included. This study estimated the benefits to Rhode Island residents using the Contingent Valuation approach and reponses from 435 residents to a 1985 survey about swimming and shellfishing. Aggregate annual benefits were estimated to be in the range of $30-60 million for swimmable and $30-70 million for shellfishable water quality, depending on the type of measure (mean or median) and survey format. Secondary objectives of the study were to test different versions of willingness to pay questions and compare mean and median values for measurement. Aside from payment vehicle bias, we found no evidence of serious bias.