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11.
    
Objectives: The Alcohol Use Disorders Identification Test (AUDIT) is used to assess the level of alcohol use/misuse and to inform the intensity of intervention delivered within screening, brief intervention, and referral to treatment (SBIRT) programs. Policy initiatives are recommending delivery of SBIRT within health care settings to reduce alcohol misuse and prevent alcohol-impaired driving. Recent reports are considering extending delivery of SBIRT to criminal justice settings. One consideration in implementing SBIRT delivery is the question of resource utilization; the amount of effort required in delivering the 4 different intensities of intervention in SBIRT: Alcohol education, simple advice, brief counseling and continued monitoring, and brief counseling and referral to specialist (from least to most intense in terms of delivery time, the skill level of the provider, and personnel resources).

Methods: In order to inform expectations about intervention intensity, this article describes the AUDIT scores from 982 adults recently arrested for alcohol-impaired driving. The distribution of scores is extrapolated to state rates for individuals arrested for alcohol-impaired driving by intervention level.

Results: Though alcohol education was the most common intervention category, about one quarter of the sample scored in a range corresponding with the more intensive interventions using the brief counseling, continued monitoring for ongoing alcohol use, and/or referral to specialist for diagnostic evaluation and treatment.

Conclusions: This article provides local distribution of AUDIT scores and state estimates for the number of individuals scoring in each level of risk (AUDIT risk zone) and corresponding intervention type. Routine criminal justice practice is well positioned to deliver alcohol screening, education, simple advice, and continued alcohol monitoring, making delivery of SBIRT feasible for the majority of alcohol-impaired drivers. Challenges to implementing the full range of SBIRT services include resource demands of brief counseling, identifying the appropriate providers within a criminal justice context, and availability of community providers for referral to diagnostic and specialty care. Solutions may vary by state due to differences in population density and incidence rates of alcohol-impaired driving.  相似文献   

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13.
A survey was conducted of the results of mid-trimester diagnostic amniocenteses in the Oxford Region from 1974 to 1981. The survey used data relating to all 4357 singleton pregnancies in which an amniocentesis was performed during this period. Follow-up information on outcome was obtained in respect of 4284 (98 per cent) pregnancies. A cell culture to determine karyotype and an alpha-fetoprotein determination was carried out in all cases. From 1974 to 1981 amniocenteses became increasingly common, rising from 2 to 32 per 1000 births. The most common indication for amniocentesis was a high risk of a chromosome abnormality–56 per cent of all amniocenteses. Within this group advanced maternal age was responsible for 89 per cent of the cases. The next most common indication was a high risk of a neural tube defect (37 per cent of all amniocenteses)–in 1974 a raised maternal serum alpha-fetoprotein level accounted for only 4 per cent of these; by 1981 this had risen to 67 per cent. There were seven false-positive and 132 true-positive diagnoses of neural tube defect; since 1981, with the introduction of amniotic fluid acetylocholinesterase determination as a secondary diagnostic test for neural tube defects, there have been no further false-positive diagnoses. In 1981 76 per cent of women aged 35 years or more did not have an amniocentesis. It is not known to what extent this was due to not offering women in this age group amniocentesis or to women not accepting such an offer.  相似文献   
14.
Training programs and warning labels have been advocated as a means of convincing consumers to follow safety precautions when using all-terrain vehicles (ATVs), and are emphasized in the recent consent decree signed between the Consumer Product Safety Commission and ATV manufacturers. An alternative approach is to mandate safe behavior through regulations and law. This field study of ATV operator behavior conducted in six states in 1988 and 1989 provides initial insight into the effectiveness of these approaches. Logit analysis revealed that helmet use was significantly higher when required by law or when riders had 3 or more years of riding experience. Helmet use was significantly lower when riders rode frequently, when helmets were perceived as uncomfortable or not used on motorcycles, and when subjects had been moderately or seriously injured in ATV accidents. The presence of warning labels, reading of a manual, and participation in a training course were not significantly related to helmet use.  相似文献   
15.
This 2-year longitudinal study of 302 high school students in the state of Indiana examined attitudes toward the use of alcohol in 25 potentially hazardous settings, varying from riding in a car, to swimming, to simply drinking at home. Student ratings indicated that they were capable of rationally evaluating alcohol-related risks. Principal components factor analysis identified three factors underlying student responses: propensity/desirability of the behavior, choice/control of the risk, and fear/consequences/likelihood of the risk. Each of these factors was comparable to factors found to be important in past studies of adult risk perception. The finding that self-reported behavioral propensity and desirability were weakly correlated with the measures of perceived risk is of particular interest. Attempts to reduce the use of alcohol by adolescents have traditionally focused on risk awareness. The implication of this study is that intervention programs might be more successful if they focused on modifying perceived value.  相似文献   
16.
Dissolved organic carbon (DOC) concentrations have increased in many sites in Europe and North America in recent decades. High DOC concentrations can damage the structure and functions of aquatic ecosystems by influencing water chemistry. This study investigated the spatial and seasonal variation of DOC concentrations in Irish streams across 55 sites at seven time occasions over 1 year (2006/2007). The DOC concentrations ranged from 0.9 to 25.9 mg/L with a mean value of 6.8 and a median value of 5.7 mg/L and varied significantly over the course of the year. The DOC concentrations from late winter (February: 5.2 ± 3.0 mg/L across 55 sites) and early spring (April: 4.5 ± 3.5 mg/L) had significantly lower DOC concentrations than autumn (October: mean 8.3 ± 5.6 mg/L) and early winter (December: 8.3 ± 5.1 mg/L). The DOC production sources (e.g., litterfall) or the accumulation of DOC over dry periods might be the driving factor of seasonal change in Irish stream DOC concentrations. Analysis of data using stepwise multiple linear regression techniques identified the topographic index (TI, an indication of saturation-excess runoff potential) and soil conditions (organic carbon content and soil drainage characteristics) as key factors in controlling DOC spatial variation in different seasons. The TI and soil carbon content (e.g., soil organic carbon; peat occurrence) are positively related to DOC concentrations, while well-drained soils are negatively related to DOC concentrations. The knowledge of spatial and seasonal variation of DOC concentrations in streams and their drivers are essential for optimum riverine water resources management.  相似文献   
17.
The authors present short- and long-term supply schedules for the primary US copper industry. These schedules are based on the economic theory of supply, and are derived from site- and input-specific cost data. Cost figures are arrived at by a combination of engineering process analysis and statistical cost estimation. The supply functions can be used to evaluate the effects of changes in market, policy, or other variables on US copper supply.  相似文献   
18.

Improved agricultural practices that increase yields and preserve soils are critical to addressing food insecurity and undernutrition among smallholder farmer families. Urine-enriched biochar has been shown to be an accessible and effective fertilization option in various subtropical countries; however, it is new to Bangladesh. To better understand attitudes and experiences preparing and using urine-enriched biochar fertilizer, mixed-methods research was undertaken among smallholder farmers in northeastern Bangladesh in 2016/2017. In-depth interviews were conducted with 25 respondents who had compared the production of crops grown with biochar-based fertilizer to usual practice. In addition, in areas where trainings on biochar-based fertilization had been offered, 845 farmers were asked about their experience through a quantitative survey. Interview results indicated that cow urine-enriched biochar was favored over human urine because cow urine was perceived as clean and socially acceptable, whereas human urine was considered impure and disgusting. Respondents praised biochar-based fertilizer because it increased yields, cost little, was convenient to prepare with readily available natural materials, produced tastier crops, and allowed families to share their larger yields which in turn enhanced social and financial capital. Comparative field trials indicated a 60% yield benefit in both cabbage and kohlrabi crops. Challenges included uneven access to ingredients, with some respondents having difficulty procuring cow urine and biomass feedstock. The low social, health, and financial risk of adoption and the perceived benefits motivated farmers to produce and apply biochar-based fertilizer in their gardens, demonstrating strong potential for scale-up of this technology in Bangladesh.

  相似文献   
19.
    
We carried out a one year (2002) study of phosphorus (P) loss from soil to water in three nested grassland catchments with known P input in chemical fertilizer and animal liquid slurry applications. Chemical fertilizer was applied to the grasslands between March and September and animal slurry was applied over the twelve months. The annual chemical P fertilizer applications for the 17 and 211 ha catchments were 16.4 and 23.7 kg P/ha respectively and the annual slurry applications were 10.7 and 14.0 kg P/ha, respectively. The annual total phosphorus (TP) export in stream-flow was 2.61, 2.48 and 1.61 kg P/ha for the 17, 211 and 1524 ha catchments, respectively, compared with a maximum permissible (by regulation) annual export of ca. 0.35 kg P/ha. The export rate (ratio of P export to P in land applications) was 9.6% and 6.6% from the 17 and 211 ha catchments, respectively. On average, 70% of stream flow and 85% of the P export occurred during the five wet months (October to February) indicating that when precipitation is much greater than evaporation, the hydrological conditions are most favourable for P export. However the soil quality and land use history may vary the results. Particulate P made up 22%, 43% and 37% of the TP export at the 17, 211 and 1524 ha catchment areas, respectively. As the chemical fertilizer was spread during the grass growth months (March to September), it has less immediate impact on stream water quality than the slurry applications. We also show that as the catchment scale increases, the P concentrations and P export decrease, confirming dilution due to increasing rural catchment size. In the longer term, the excess P from fertilizer maintains high soil P levels, an antecedent condition favourable to P loss from soil to water. This study confirms the significant negative water quality impact of excess P applications, particularly liquid animal slurry applications in wet winter months. The findings suggest that restricted P application in wet months can largely reduce the P losses from soil to water.  相似文献   
20.
Managers of small populations often need to estimate the expected time to extinction Te of their charges. Useful models for extinction times must be ecologically realistic and depend on measurable parameters. Many populations become extinct due to environmental stochasticity, even when the carrying capacity K is stable and the expected growth rate is positive. A model is proposed that gives Te by diffusion analysis of the log population size nt (= loge Nt). The model population grows according to the equation Nt+1 = RtNt, with K as a ceiling. Application of the model requires estimation of the parameters k = logK, rd = the expected change in n, vr = Variance(log R), and ϱ the autocorrelation of the rt. These are readily calculable from annual census data (rd is trickiest to estimate). General formulas for Te are derived. As a special case, when environmental fluctuations overwhelm expected growth (that is rd 0), Te = 2no(k - no/2)/vr. If the rt are autocorrelated, then the effective variance is vre vr (1 + ϱ)/(1 - ϱ). The theory is applied to populations of checkerspot butterfly, grizzly bear, wolf, and mountain lion.  相似文献   
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