Tiered rates are an effective tool for conserving water in California, but they are subject to the courts' interpretation and consequent rulings; with guidance, water agencies can navigate this ...shifting legislative landscape as they assess and develop rate structures.
California is among the most progressive states regarding cost‐of‐service requirements for water rates. With the increasing need for water conservation, and increasing popularity of water budget rate ...structures, recent changes to California laws should be of interest to water utility managers. Water rates are regulated at the state level. The evolution of these regulations in California created a situation in which utility managers were not certain if conservation‐oriented rate structures would be upheld in court. The recent passage of Assembly Bill 2882 has lifted this uncertainty and set a precedent for other states. The growing popularity of water budget rate structures may accelerate even more now that they have been validated by California lawmakers. Allocation‐based inclining‐block rates were until recently infeasible because of the data management and lack of political will. The tide has changed in favor of such rates with the development of new information management tools, the public awareness of on‐going water resource issues, and the green light from lawmakers.
In meiosis, the segregation of chromosomes at the reductional division is accomplished by first linking homologs together. Genetic exchange generates the bivalents that direct regular chromosome ...segregation. We show that genetic exchange in mitosis also generates bivalents and that these bivalents direct mitotic chromosome segregation. After FLP-mediated homologous recombination in G2 of the cell cycle, recombinant chromatids consistently segregate away from each other (x segregation). This pattern of segregation also applies to exchange between heterologs. Most, or all, cases of non-x segregation are the result of exchange in G1. Cytological evidence is presented that confirms the existence of the bivalents that direct this pattern of segregation. Our results implicate sister chromatid cohesion in maintenance of the bivalent. The pattern of chromatid segregation can be altered by providing an additional FRT at a more proximal site on one chromosome. We propose that sister chromatid exchange occurs at the more proximal site, allowing the recombinant chromatids to segregate together. This also allowed the recovery of reciprocal translocations following FLP-mediated heterologous recombination. The observation that exchange can generate a bivalent in mitotic divisions provides support for a simple evolutionary relationship between mitosis and meiosis.
We've Got Mail Goodrich, Jim; Hildebrand, Mark; Gaur, Sanjay ...
Journal - American Water Works Association,
July 2009, 2009-07-00, 20090701, Letnik:
101, Številka:
7
Journal Article
Recenzirano
Setting water rates in California is a complex process because of the state's legal requirements, specifically Proposition 218. As explained in "Water Conservation Made Legal: Water Budgets and ...California Law" by Mark Hildebrand and co-authors (April 2009), adding conservation to the mix compounds the complexity of determining rate structures.
Background. The persistence of protection from meningococcal disease following immunization with serogroup C meningococcal (MenC) glycoconjugate vaccines in infancy is short-lived. The duration of ...protective immunity afforded by these vaccines in other at-risk age groups (i.e., adolescents and young adults) is not known. We evaluated the persistence of bactericidal antibodies following immunization with a MenC glycoconjugate vaccine (MenCV) in adolescents and the kinetics of immune response to a meningococcal AC plain polysaccharide vaccine (MenPS) challenge or a repeat dose of MenCV. Methods. We conducted a randomized comparative trial of 274 healthy 13–15-year-olds from whom a total of 4 blood samples were obtained (prior to administration of a dose of MenPS or MenCV, again on 2 further occasions at varying times from days 2–7 after vaccination, and finally on day 28 after vaccination. The correlate of protection was a serum bactericidal assay titer ⩾8 (with a serum bactericidal assay using human complement). Results. A serum bactericidal assay using human complement titer ⩾8 was observed in 75% of participants at baseline (mean age, 14.5 years; mean time since routine MenCV vaccination, 3.7 years). No increase in serum bactericidal assay geometric mean titers was detected until day 5 after administration of MenPS. Geometric mean titers following administration of MenCV were significantly higher than those observed following administration of MenPS, at days 5, 7, and 28. Conclusions. This study showed sustained levels of bactericidal antibodies for at least 3 years after immunization of adolescents with MenCV. After challenge of immunized adolescents with MenPS, there was no increase in serum bactericidal assay observed until day 5 after vaccination, indicating that immunological memory may be too slow to generate protection against this potentially rapidly invasive organism.
Care homes education: what can we learn? Armstrong, Sarah Frances; Gluck, Tim; Gorringe, Anna ...
BMJ open quality,
02/2021, Letnik:
10, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Medical care received by care home residents can be variable. Initiatives, such as matron-led community teams, ensure a timely response to alerts about unwell residents. But early recognition of ...deterioration is vital in accessing this help. The aim of this project was to design and deliver an education programme for carers. It was hypothesised that the implementation of a teaching programme may result in improved medical care for residents. By understanding the enablers and barriers to implementing teaching, we hoped to identify the components of a successful teaching programme. Four care homes in Enfield received training on topics such as deterioration recognition over a 1-year period. The project was evaluated at 3, 6 and 9 months. Each evaluation comprised: pre-and-post-teaching questionnaires, focus groups, analysis of percentages of staff trained, review of overall and potentially avoidable, hospital admission rates. A Plan–Do–Study–Act cycle structure was used. The programme was well-received by carers, who gave examples of application of learning. Modules about conditions frequently resulting in hospital admission, or concerning real cases, demonstrated the best pre-and-post lesson change scores. However, the reach of the programme was low, with attendance rates between 5% and 28%. Overall, the percentage of staff trained in deterioration recognition ranged from 35% (care home one) to 12% (care home three). Hospital admissions reduced from 37 hospital admissions to 20 over the duration of the project. Potentially avoidable admissions reduced from 16 to 5. Proving causality to the intervention was difficult. Factors facilitating delivery of training included a flexible approach, an activity-based curriculum, alignment of topics with real cases and embedding key messages in every tutorial. Barriers included: time pressures, shift work, low attendance rates, inequitable perception of the value of teaching and IT issues. Care home factors impacting on delivery included: stability of management and internal communication systems.please ensure space here
Surgical site infection (SSI) is the most common and costly complication of surgery. International guidelines recommend topical alcoholic chlorhexidine (CHX) before surgery. However, upper limb ...surgeons continue to use other antiseptics, citing a lack of applicable evidence, and concerns related to open wounds and tourniquets. This study aimed to evaluate the safety and effectiveness of different topical antiseptics before upper limb surgery.
This international multicentre prospective cohort study recruited consecutive adults and children who underwent surgery distal to the shoulder joint. The intervention was use of CHX or povidone-iodine (PVI) antiseptics in either aqueous or alcoholic form. The primary outcome was SSI within 90 days. Mixed-effects time-to-event models were used to estimate the risk (hazard ratio (HR)) of SSI for patients undergoing elective and emergency upper limb surgery.
A total of 2454 patients were included. The overall risk of SSI was 3.5 per cent. For elective upper limb surgery (1018 patients), alcoholic CHX appeared to be the most effective antiseptic, reducing the risk of SSI by 70 per cent (adjusted HR 0.30, 95 per cent c.i. 0.11 to 0.84), when compared with aqueous PVI. Concerning emergency upper limb surgery (1436 patients), aqueous PVI appeared to be the least effective antiseptic for preventing SSI; however, there was uncertainty in the estimates. No adverse events were reported.
The findings align with the global evidence base and international guidance, suggesting that alcoholic CHX should be used for skin antisepsis before clean (elective upper limb) surgery. For emergency (contaminated or dirty) upper limb surgery, the findings of this study were unclear and contradict the available evidence, concluding that further research is necessary.
Measuring international migration Zlotnik, Hania; Kritz, Mary M; Kraly, Ellen Percy ...
The International migration review,
01/1987, Letnik:
XXI, Številka:
4
Journal Article
PDF
