Relative Resource Use Research Articles

Preface: Securing the Land and Resource Rights of Pastoral Peoples in East Africa

The land question in many African countries has geographical, political, economic, social and demographic nuances. These factors colour land and resource rights for pastoral and forest-dwelling communities. Land tenure--the nature and manner in which rights to and interests in various categories of land are created or determined, allocated and enjoyed--is pivotal to land as property, especially for resource-dependent communities for whom land and livestock comprise their only property and source of livelihood. The introduction of a modern tenure system through colonialism, continued by post-independence government policy and legislation, has made the rights of pastoralists and forest dwelling communities insecure. Pastoralism, a livestock-based land use that has flourished in arid and semi-arid lands, requires a supportive tenure system for both land and related resources. Tenure reform for the most part has come with subtle delegitimation of pastoralism, especially nomadic pastoralism, as boundaries and fixity are the norm. Pastoralism depends on flexible and negotiated cross-boundary access to land and resources, which has not been provided for in many land-reform processes. The boundaries demarcating different parcels of land have over time cut off pastoralists' access to vital water resources and pasture in individually and publicly owned land. It is therefore not surprising that the rights of pastoralists are a recurrent theme in policy discourses in East Africa. The rights of pastoralist communities to land have become very tenuous over time as land-holding and land-use patterns have changed. National law and policy have emphasized agrarian reform, even in areas more suited to pastoralism, with pastoral communities encouraged to settle and change their way of life. However, despite the efforts of governments to alter the lives of pastoralists and make them settle in one place, pastoralism as a land use has persisted. The failure of policy and law to recognize and provide for pastoralists' strategies of production has made the people living in arid and semi-arid lands of eastern Africa very vulnerable. Pertinent issues for these people include tenure security, political marginalization, citizenship for some groups whose existence is not recognized in national discourses, livelihood security, conflict and degradation of ecosystems. The relegation of pastoralism to a back seat has also impacted negatively on their governance systems regarding the allocation and use of land and related resources (Lenaola 1998: 253). These systems have been systematically replaced by state legal and social-ordering structures. Where these structures lack the force of the norms they seek to replace, the result is resource degradation and increased vulnerability for pastoralists. Indeed, the transfer of authority over common resources from the realm of communal rules to the individual or the state may lead to over-exploitation due to the sweeping aside of more widely accepted traditional structures that regulate use. Another factor that has affected pastoralists is climate change, which has resulted in reduced pasture and water. Pastoralists' ecosystems are threatened by desertification resulting from global climate change and conversion to agricultural land-uses. Within a context where national policies have put great emphasis on agriculture and neglected pastoralism, the contribution of grasslands and pastoral ecosystems to economies as habitats for wildlife and biodiversity is relegated to the back seat (AU and UNECA 2009). The pastoral communities' mistrust of government, rooted in both neglect and unpleasant encounters, has contributed to these communities' continuing with outmoded stock-management and environmental practices when governments have enacted laws and policies regarding sustainable natural resources at the national level. Not surprisingly, the quest for tenure security for pastoral communities has become a running theme in processes of national land-policy formulation in the region. …

FRI0440 Trends in rheumatoid arthritis related resource utilization in british columbia, canada: A population based cohort study

BackgroundRA related health resource use and direct costs may be influenced by prevalence, disease management, and available medications, and understanding trends is crucial for policy makers. Previous costing studies in...

Equivalency of Galápagos Giant Tortoises Used as Ecological Replacement Species to Restore Ecosystem Functions

Loss of key plant-animal interactions (e.g., disturbance, seed dispersal, and herbivory) due to extinctions of large herbivores has diminished ecosystem functioning nearly worldwide. Mitigating for the ecological consequences of large herbivore losses through the use of ecological replacements to fill extinct species' niches and thereby replicate missing ecological functions has been proposed. It is unknown how different morphologically and ecologically a replacement can be from the extinct species and still provide similar functions. We studied niche equivalency between 2 phenotypes of Galápagos giant tortoises (domed and saddlebacked) that were translocated to Pinta Island in the Galápagos Archipelago as ecological replacements for the extinct saddlebacked giant tortoise (Chelonoidis abingdonii). Thirty-nine adult, nonreproductive tortoises were introduced to Pinta Island in May 2010, and we observed tortoise resource use in relation to phenotype during the first year following release. Domed tortoises settled in higher, moister elevations than saddlebacked tortoises, which favored lower elevation arid zones. The areas where the tortoises settled are consistent with the ecological conditions each phenotype occupies in its native range. Saddlebacked tortoises selected areas with high densities of the arboreal prickly pear cactus (Opuntia galapageia) and mostly foraged on the cactus, which likely relied on the extinct saddlebacked Pinta tortoise for seed dispersal. In contrast, domed tortoises did not select areas with cactus and therefore would not provide the same seed-dispersal functions for the cactus as the introduced or the original, now extinct, saddlebacked tortoises. Interchangeability of extant megaherbivores as replacements for extinct forms therefore should be scrutinized given the lack of equivalency we observed in closely related forms of giant tortoises. Our results also demonstrate the value of trial introductions of sterilized individuals to test niche equivalency among candidate analog species.

An Improvement in Power Management in green Computing using Neural Networks

The green computing is the technology which is based on the environmental use of computer related resources. The computer related resources includes processing units, storage units etc. In such type of technology the energy consumption is the main concern. Green computing wills leads to reduce in resource consumption and electronic waste. The new technology of green computing will also include cloud computing services, grid computing services. In the past decades, many techniques have been proposed for the energy conservation in green computing. In this paper, we are proposing new technique for energy conservation in green computing. This novel technique is based on neural networks. The neural network is having capability of learning from the past experiences. The dynamic clustering approach is used with the neural networks for the energy conservation. The proposed technique is implemented in NS2 and simulation results are shown in the graphical form. The green computing is basically a technology which is based on the environmental responsible way to reduce power and environmental waste. In the present time, we are making efforts to make everything greener. This technology is related to reduce or managing impact of IT systems which basically includes materials and resources required for equipment, energy and also materials used in OS, potential health effects on humans from using equipment, and responsibility for the waste products that are created from IT systems. The green technology mainly focuses on super computers and cluster system which harm the green environment badly. The green computing is similar to green chemistry. In the approach of green computing we mainly focus on to design such systems which are having minimum effect to environment. The products supports reduce the use of hazardous materials, maximum energy efficient during the products lifetime and promote the recyclability of defunct products and factory waste. Artificial neural network is composed of interconnecting of artificial neurons. Artificial neural networks may either be used to gain understanding of biological neuron or to solve artificially intelligence problems without creating any model (8). Biological neural networks are made up of real biological neurons that are connected or functionally related in nervous system (wiki).neural network has been motivated from human brain. The brain is highly complex, parallel computer and nonlinear. It has capability to organize its constituent's structure known as neurons to perform complex computations. It is faster than digital computer exit in today's world (8). It is an adaptive in nature that changes its structure based on internal and external information that flows through the networks. Dynamic clustering is an energy efficient algorithm. Energy dissipation of the network can be reduced by using clustering algorithms. The energy consumption of nodes is depends upon the transmission distance, optimal routing protocols and amount of data to be transmitted. In cluster based networks, cluster heads (CH) meets these requirements 1) same adjacent sensors are grouped into a cluster. 2) High energy resources 3) Network should be distributed.

Emergy synthesis of a combined food and energy production system compared to a conventional wheat (Triticum aestivum) production system

It is a major challenge to produce food and energy sustainably for the ever increasing world population as today's conventional food production and energy needs are met by the fossil based resources, causing enormous environmental load. A novel, combined food and energy (CFE) agro-ecosystem, was designed for sustainable production of food, fodder and energy without chemical inputs (fertiliser, herbicide and fungicide). The objective was an emergy synthesis of the CFE system compared to a conventional wheat (Triticum aestivum) production system to assess resource use efficiency. The emergy indices, used to assess the environmental performance and sustainability, exhibited contrasting differences between the two production systems in terms of outputs (Y), total emergy use, solar transformity, relative use of local renewable resources, environmental loading ratio (ELR), emergy yield ratio (EYR) and emergy sustainability index (ESI). The Y in the CFE consisted of grain, straw, fodder and woodchip production of 4020, 3580, 6100 and 10,000kg/ha/yr respectively whereas Y in the conventional wheat consisted of 7250 and 3770kg grain and straw/ha/yr respectively. The Y in the CFE was 81% (2.80E+11J/ha/yr) higher with 13.5 times (6.40E+03seJ/J) lower solar transformity compared to the Y (1.54E+11J/ha/yr) and solar transformity (8.63E+04seJ/J) in the conventional wheat, exhibiting highly resource intensive production in conventional wheat. The local renewables constituted 19.2% and 2.6% of the total emergy input in the CFE and the conventional wheat respectively with a corresponding lower ELR (4.21) and 22.5% higher EYR (1.26) in CFE compared to conventional wheat. CFE was more reliant on local renewable emergy flows and compatible with the local environment with higher ESI (0.30) compared to conventional wheat (0.03), where 64.5% of the total emergy input constituted chemical inputs. The study demonstrated that the innovative agro-ecosystem, exemplified by CFE, is considerably less resource demanding and more amenable to sustainable production, whether defined in terms of outputs, solar transformity, relative use of local renewable resources, EYR, ELR or ESI.

Do differences in profiling criteria bias performance measurements? Economic profiling of medical clinics under the Korea National Health Insurance program: An observational study using claims data

BackgroundWith a greater emphasis on cost containment in many health care systems, it has become common to evaluate each physician's relative resource use. This study explored the major factors that influence the economic performance rankings of medical clinics in the Korea National Health Insurance (NHI) program by assessing the consistency between cost-efficiency indices constructed using different profiling criteria.MethodsData on medical care benefit costs for outpatient care at medical clinics nationwide were collected from the NHI claims database. We calculated eight types of cost-efficiency index with different profiling criteria for each medical clinic and investigated the agreement between the decile rankings of each index pair using the weighted kappa statistic.ResultsThe exclusion of pharmacy cost lowered agreement between rankings to the lowest level, and differences in case-mix classification also lowered agreement considerably.ConclusionsA medical clinic may be identified as either cost-efficient or cost-inefficient, even when using the same index, depending on the profiling criteria applied. Whether a country has a single insurance or a multiple-insurer system, it is very important to have standardized profiling criteria for the consolidated management of health care costs.

Health Care Resource Use and Costs in Opioid-Treated Patients with and without Constipation in Brazil

ObjectiveTo estimate the prevalence of constipation concomitant to opioid treatment and related resource use and costs from the private payer perspective. MethodsIn this retrospective database analysis, patients receiving opioid therapy were identified from a longitudinal insurance claims database. An algorithm was used to identify patients receiving opioid therapy with coincident constipation-related claims according to ICD-10 codes, targeted procedures, and opioid use criteria. Resource use and costs were determined for these individuals and compared with patients receiving opioid therapy without constipation, without opioid therapy with constipation, and without both conditions. Results were compared using analysis of variance with a significance level of 0.05. ResultsA total of 23,313 patients were classified as opioid-treated patients (2.2%) and 6678 of them had events related to constipation (29.0%). Compared with opioid-treated patients without constipation, incremental mean total costs per month per patient were 261.18 BRL (P < 0.001). The average cost per month for opioid-related constipation patients was 787.84 BRL, significantly higher than other patients (P < 0.001 for all comparisons). Among cancer patients, 24.4% was receiving opioids and 27.0% of those had constipation-related claims. As expected, the opioid therapy prevalence was significantly higher when compared to all patients (2.2% vs. 24.4%, P < 0.001). Cancer patients had, in average, higher costs than did noncancer patients in all four subgroups. ConclusionsPatients with constipation coincident with opioid treatment exhibited a significantly higher economic burden than did patients without the condition. These results indicate that reducing opioid-induced constipation could lead to potential cost savings for the health care system.

Prevalence of diabetic macular oedema and related health and social care resource use in England

AimsTo address the absence from the public health ophthalmology literature of age- and sex-specific prevalence and related resource use for diabetic macular oedema (DMO) in England, UK.MethodsCalculation of age- and...

Descriptive epidemiology of hereditary angioedema hospitalizations in the United States, 2004‐2007

Hereditary angioedema (HAE) is a rare inherited disorder of complement factor C1 inhibitor. There are ∼6000 HAE cases in the United States, nearly one-half of whom suffer a monthly exacerbation. Little is known about hospital use patterns by patients with HAE attacks in the United States. This study was designed to examine burden, epidemiology, and outcomes of hospitalizations among HAE patients. We evaluated epidemiology, resource use, and discharge destinations of HAE (ICD-9-CM code 277.6) hospitalizations within the NIS, part of Agency's for Healthcare Research and Quality Healthcare Costs and Utilization Project in 2004 through 2007. There were 10,125 hospitalizations with HAE, of which 3216 (31.8%) had HAE as the principal diagnosis (HAE-PD). Two-thirds of all HAE hospitalizations were among women, and 60% were white. Hypertension was the most common comorbidity (26.9%, all HAE, and 28.0%, HAE-PD). Mortality was 1.4% in HAE and 0.3% in the HAE-PD group. Mean hospital length of stay (3.7, 95% CI 3.0-4.4 days vs. 5.0, 95% CI 4.6-5.4 days) and costs ($4,760, 95% CI $3,612-$5,907 vs. $8,383, 95% CI $7,432-$9,334) were lower in HAE-PD than in the HAE cohort. Although >80% in each group were discharged home routinely, 15.9% of HAE and 4.9% of HAE-PD required either home health care or a transfer to another short-term hospital or a skilled nursing facility. HAE hospitalization volume is substantial. Because diagnostic uncertainty is likely, HAE and its related resource use may be underestimated. HAE prevention strategies need to be examined in the context of these outcomes.

Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study)

BackgroundStudies in bipolar disorder (BD) to date are limited in their ability to provide a whole-disease perspective - their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II) and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd) (NCT01062607) aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD.MethodsWAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices) in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales), adherence to treatment (DAI-10 scale and Medication Possession Ratio), quality of life (EQ-5D scale), healthcare resources, and caregiver burden (BAS scale) will be collected. Descriptive analysis with common statistics will be performed.DiscussionThis study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD.Trial registration noClinicalTrials.gov: NCT01062607

The burden of chronic lower back pain with neuropathic components: a healthcare resource perspective

The burden of chronic lower back pain with neuropathic components: a healthcare resource perspective

Editorial Comment

There is no doubt that percutaneous nephrolithotomy (PCNL) has revolutionized the management of renal pelvis stones. In this issue of the Journal, Akman et al performed a large, retrospective, cohort study, in which they identified those patient and surgical factors associated with shorter hospital stays after PCNL. The driving force behind their study was to improve the efficiency (ie, the relative resource use needed to achieve a specified quality level) of PCNL. Although most of the factors identified were not immediately modifiable, the authors demonstrated that, compared with tubeless PCNL, leaving a nephrostomy tube in place after the procedure was associated with a more than fourfold increased risk of a prolonged (ie, >2 days) hospital stay. Tubeless Procedure is Most Important Factor in Reducing Length of Hospitalization After Percutaneous Nephrolithotomy: Results of Univariable and Multivariable ModelsUrologyVol. 77Issue 2PreviewTo evaluate the effects of kidney stones and patient-related parameters on the length of hospitalization (LOH), which is one important factor affecting the cost effectiveness of percutaneous nephrolithotomy (PCNL). Recently, increases in healthcare costs have highlighted the importance of evaluating the cost effectiveness of a treatment as much as its efficacy. Full-Text PDF

Measuring use and cost of health sector and related care in a population of girls and young women with Rett syndrome

This study measured use and cost of health sector and related services in Rett syndrome and effects of socio-demographic, clinical severity and genetic factors on costs. The study population consisted of individuals with Rett syndrome registered with the Australian Rett Syndrome Database in 2004. Descriptive analysis was used to examine patterns of resource use and costs, and logistic regression to analyse factors associated with higher costs. We found the use of health sector and related resources varied by type of resource. Mean annual cost per case was $21,158 (range $238–$85,776). High cost items included long-term residential care, therapy services out of school and paid home and community care. Factors associated with increasing odds of being above the median cost were clinical severity and the p.R255X mutation. Compared with the youngest cases, cases in the 5–14 year age group and the 15–24 year age group were at lower odds of being above the median cost. Needs relating to health sector and related resources can result in considerable costs for individuals with Rett syndrome. Many households caring for dependents with Rett syndrome are like to be facing undue financial pressures from the additional costs of disability.

Assessing Health Related Resource use in Normal Elders and Subjects With Mild Cognitive Impairment

Assessing Health Related Resource use in Normal Elders and Subjects With Mild Cognitive Impairment

How does comorbidity affect cost of health care in patients with irritable bowel syndrome? A cohort study in general practice

BackgroundIrritable bowel syndrome (IBS) is associated with other disorders (comorbidity), reduced quality of life and increased use of health resources. We aimed to explore the impact of comorbidity on cost of health care in patients with IBS in general practice.MethodsIn this cohort study 208 consecutive patients with IBS (Rome II) were recruited. Sociodemographic data, IBS symptoms, and comorbidity (somatic symptoms, organic diseases and psychiatric disorders) were assessed at baseline. Based on a follow up interview after 6-9 months and use of medical records, IBS and non-IBS related health resource use were measured as consultations, hospitalisations, use of medications and alternative health care products and sick leave days. Costs were calculated by national tariffs and reported in Norwegian Kroner (NOK, 1 EURO equals 8 NOK). Multivariate analyses were performed to identify predictors of costs.ResultsA total of 164 patients (mean age 52 years, 69% female, median duration of IBS 17 years) were available at follow up, 143 patients (88%) had consulted their GP of whom 31 (19%) had consulted for IBS. Mean number of sick- leave days for IBS and comorbidity were 1.7 and 16.3 respectively (p < 0.01), costs related to IBS and comorbidity were 954 NOK and 14854 NOK respectively (p < 0.001). Age, organic diseases and somatic symptoms, but not IBS severity, were significant predictors for total costs.ConclusionCosts for health resource use among patients with IBS in general practice were largely explained by comorbidity, which generated ten times the costs for IBS.

Accounting for Ecosystem Services in Life Cycle Assessment, Part II: Toward an Ecologically Based LCA

Despite the essential role of ecosystem goods and services in sustaining all human activities, they are often ignored in engineering decision making, even in methods that are meant to encourage sustainability. For example, conventional Life Cycle Assessment focuses on the impact of emissions and consumption of some resources. While aggregation and interpretation methods are quite advanced for emissions, similar methods for resources have been lagging, and most ignore the role of nature. Such oversight may even result in perverse decisions that encourage reliance on deteriorating ecosystem services. This article presents a step toward including the direct and indirect role of ecosystems in LCA, and a hierarchical scheme to interpret their contribution. The resulting Ecologically Based LCA (Eco-LCA) includes a large number of provisioning, regulating, and supporting ecosystem services as inputs to a life cycle model at the process or economy scale. These resources are represented in diverse physical units and may be compared via their mass, fuel value, industrial cumulative exergy consumption, or ecological cumulative exergy consumption or by normalization with total consumption of each resource or their availability. Such results at a fine scale provide insight about relative resource use and the risk and vulnerability to the loss of specific resources. Aggregate indicators are also defined to obtain indices such as renewability, efficiency, and return on investment. An Eco-LCA model of the 1997 economy is developed and made available via the web (www.resilience.osu.edu/ecolca). An illustrative example comparing paper and plastic cups provides insight into the features of the proposed approach. The need for further work in bridging the gap between knowledge about ecosystem services and their direct and indirect role in supporting human activities is discussed as an important area for future work.

Conservation Heroes Versus Environmental Villains: Perceiving Elephants in Caprivi, Namibia

This article investigates the impact of transnational environmental organizations on rural people involved in conservation by exploring the impacts of the Convention of International Trade in Endangered Species of Flora and Fauna (CITES) ivory trade ban on Namibia’s elephant conservation policy. This case study examines how rural African people are put into categories of ‘conservation heroes’ or ‘environmental villains’ by local conservation practitioners, government officials in Namibia and transnational conservation actors. Findings indicate that the approach of state officials and conservation organizations (CO) results in incomplete representations of both rural African people and the cultural importance these people attach to elephants. The article concludes that current environmental narratives associated with rural African people have been used as powerful ‘tools of persuasion’ at the state and international level to support and legitimate conservation policy and resource use in relation to the concerns of transnational environmental actors to the exclusion of rural African people.

The book &lt;i&gt;‘Managing agrodiversity the traditional way lessons from West Africa in sustainable use of biodiversity and related natural resources’&lt;/i&gt;

The book &lt;i&gt;‘Managing agrodiversity the traditional way lessons from West Africa in sustainable use of biodiversity and related natural resources’&lt;/i&gt;

Perceptions and Competence in Evidence-Based Medicine: A Survey of the American Urological Association Membership

We investigated the attitudes and opinions of urologists toward evidence-based medicine to help guide future efforts of the American Urological Association and other organizations vested in the education and training of urologists. From August to November 2006 we performed a mail survey of a random sample of 2,000 members of the American Urological Association. Questions in the survey addressed the role of evidence-based medicine in urology, participants' self-assessed understanding of evidence-based medicine related terminology, their familiarity with and use of web based evidence-based medicine resources, as well as their evidence-based medicine competence based on their understanding of core concepts such as randomization and blinding. A total of 889 respondents completed the survey resulting in a response rate of 45%. There was widespread agreement that practicing evidence-based medicine improves patient care (median score 8; IQR 7, 10) and that every urologist should be familiar with critical appraisal techniques (median score 9; IQR 8, 10). The percentage of respondents who indicated that they "understand and could explain to others" the terms number needed to treat, power and level of evidence was 42%, 29% and 18%, respectively. The American Urological Association Guidelines were used regularly by 35% and on occasion by 51% of respondents. Of the participants 44% were unaware of the PubMed(R) search engine and only 14% used it regularly, while 76% were unaware of the Cochrane Database of Systematic Reviews and only 8% had ever used it. The mean evidence-based medicine competence score for all respondents was 67.2% +/- 17.0%. The findings of this survey confirm that urologists have a favorable attitude toward evidence-based medicine. However, understanding of evidence-based medicine terminology, concepts and use of related resources among American Urological Association members leaves room for improvement. Increased efforts to promote an understanding of evidence-based medicine through workshops, publications and web based resources specifically for a urological audience appear indicated.

Materials Use Across World Regions

discussed among the widerpublic. Pressure points in-cluding climate change,waterandfoodavailability,price surges for strategicraw materials, and peakingglobal oil supply are con-verging rapidly in an un-precedented manner. Thecurrent global patterns ofproduction and consump-tion are hitting the reallimitsofglobalecosystems.The global economy seems to be at a turningpoint where decisions are urgent while informa-tion is incomplete.The urgency of addressing issues of industrialmetabolism