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The evaluation of agricultural practices through monitoring and modeling is necessary for the development of more effective conservation programs and policies. No-till and reduced-till are both agricultural conservation practices widely promoted for their proven ability to conserve water and reduce soil erosion. These conservation practices were used to evaluate the APEX (Agricultural Policy/Environmental Extender) model. Data from two tile-drained corn-soybean rotation fields located within the St. Joseph River watershed in northeast Indiana were collected and compared. Observed daily surface and subsurface tile flow, sediment load, and nutrient transport values were described and analyzed using a Wilcoxon signed-rank test. Among the nutrient variables examined, we compared soluble phosphorus (SP), total phosphorus (TP), soluble nitrogen (SN), and soluble nitrogen in tile (SN-tile). The results agree with previous findings identifying lower sediment and nutrient transport values in no-till compared to reduced-till (except for SP during the corn year). However, significantly lower values were only observed for sediment and SN-tile losses in the no-till system. The monitored variables were also used for calibration and validation of the APEX model. APEX calibration/validation evaluation scores were satisfactory for surface runoff for both tillage management simulations (R² = 0.87/0.76 and NSE = 0.65/0.76 for no-till, and R²= 0.76/0.74 and NSE = 0.74/0.74 for reduced-till, in addition to other statistical analyses). Model performances in simulating sediment load, nutrient variables, and tile flow were relatively lower, yet satisfactory overall. APEX was an efficient tool for simulating most of the variables examined. However, the model presents limitations in simulating tile flow, and consequently nitrogen loss, from tile-drained systems. [ABSTRACT FROM AUTHOR]

The article describes the case of a Tennessee Walking Horse gelding that was presented to the University of Georgia's Veterinary Teaching Hospital for evaluation of episodic fever and acute bilateral blindness of approximately 7 days' duration. Abnormalities on initial ophthalmic examination entailed absent menace responses with intact palpebral reflexes ocular uterque (OU). Initial treatment of the horse included systemic antifungal treatment with fluconazole.

Background: Emergency department health care workers frequently provide care to patients who are in unstable condition, bleeding, or in a crisis situation. To identify the variables described in the Health Belief Model affecting health care workers' compliance with practices and devices believed to reduce exposure to patients' blood, the staff of a level II trauma center were surveyed for knowledge, compliance, and training regarding universal precautions., Methods: Fifty-three health care workers responded to an anonymous, self-report, 50-item questionnaire. Significant differences in mean scores were determined by use of a two-tailed t test., Results: Health care workers estimated they were most likely to perform handwashing after contact with body fluids and to wear gloves if contact with blood was anticipated. The most common obstacles to compliance with universal precautions were lack of time, patients perceived to be at lower risk for HIV or hepatitis B infections, and interference with technical skills. Health care workers with more than three perceived obstacles to universal precautions were less likely to use gloves (p < 0.05) if contact with blood was anticipated. Health care workers with a higher number of training experiences in universal precautions were more likely to use gloves if contact with blood was anticipated (p < 0.05) and less likely to recap a needle after giving an intravascular injection (p < 0.05), drawing a blood gas sample (p < 0.05), or injecting medication into an intravenous line (p < 0.05)., Conclusions: The application of the Health Belief Model to this problem suggests that an integrated approach is appropriate. Such an approach should incorporate engineering controls, cognitive approaches, behavior modification strategies, and training experiences to improve skills and dexterity.

Background: To describe rates of needle disposal and barrier use within the emergency departments at two privately owned community hospitals in two suburbs of Minneapolis, a study was conducted. This study consisted of direct observation of a cohort of emergency department personnel providing patient care followed by a self-administered survey of the same personnel., Methods: From June through August 1990, seven specially trained registered nurses observed emergency department personnel for a total of 400 hours. The observers documented the appropriate rates of use of gowns, goggles, masks, and gloves. Observers also noted methods of needle disposal and frequency of needle recapping. After observation, surveys that included items requesting estimates of rates of use for each barrier, as well as estimates of the rates and methods of needle recapping and disposal, were distributed. For each observed and corresponding self-reported behavior, 95% confidence intervals were calculated and compared., Results: A total of 1,822 procedures were recorded. Gloves were observed to be used when appropriate 67.2% of the time, followed by goggles (50.7%), masks (16.0%), and gowns (15.3%). Self-reported barrier rates were slightly higher in all cases except for goggle use. About one third (34.4%) of the needles were recapped; 78.1% of these were recapped two-handed., Conclusions: Previous studies have documented low universal precautions compliance rates at urban teaching hospitals. Our data indicate less than optimal levels of compliance also at community hospitals, and show that personnel are less than fully aware of their own noncompliance.

Background: As a result of the HIV epidemic, the role of the ICP has changed; acute care settings have developed a variety of policies regarding patient and health care worker (HCW) HIV testing and issues related to the HIV-infected HCW. APIC conducted a survey to determine the extent to which ICPs were involved in HCW and patient HIV testing and counseling, the prevalence of routine HIV testing for patients, institutional policies on HIV testing of patients and HCWs, and the management of HIV infected HCWs., Methods: In 1990, a questionnaire was sent to ICPs in a simple random sample of 1300 acute care hospitals (approximately 20%) in the United States., Results: Response rate was 52.8%. Of the 686 respondents, 54.8% provided counseling to the HCW after an exposure incident. ICPs were involved not only in HIV testing and counseling for patients and HCWs but also in institutional policy development for HIV-related issues. Most facilities (73.8%) obtained written consent for testing from the patient after an employee exposure. When a direct care giver was known to be HIV positive, 61.5% of the respondents evaluated each case individually., Conclusions: The ICP has a significant role in the development and implementation of institutional policies on HIV testing and counseling and on the management of HIV-infected workers. These findings affirm the need for APIC to provide educational opportunities on the issues related to HIV testing and counseling.

1. Methicillin-resistant Staphylococcus aureus (MRSA) are gram-positive cocci, differing from methicillin-resistant species of S epidermidis because they produce coagulase. MRSA is distinguished from methicillin-sensitive S aureus by its resistance to methicillin and other antibiotics. MRSA has not been found to be an organism of greater virulence than methicillin-sensitive strains of S aureus, but infections caused by MRSA are sometimes of greater concern because of the limited antibiotic treatment options. 2. In the past 25 years there has been an increase in the number of reported infections in patients caused by MRSA. As infections with MRSA have become more prevalent in community hospitals throughout the country, the difficulty in controlling the spread within the community hospitals has mirrored the experiences of the tertiary care centers. 3. Education regarding the transmission of microorganisms and the caregiver's role in prevention is essential for every nursing facility. Interfacility communication is essential for hospital and nursing home staff to plan and manage the care of infected or colonized residents. 4. A facility-specific MRSA policy should optimize the opportunity for infected persons to receive nursing home care--without jeopardizing other residents.

Careful room design can prevent "headaches" and "heartaches" or both to patients and staff who will use the "extended facility" involved with high-technology imaging. Principles and pitfalls of room design are discussed as they apply to these modalities.

A prospective study of 98 patients with portal hypertension who hemorrhaged revealed that certain hemodynamic parameters were valuable in confirming the cause of cirrhosis, aiding in the selection of patients best suited for a selective distal splenorenal shunt, and in providing an estimate of prognosis. The presence of a pressure gradient of 4 mmHg or more between the right atrium and inferior vena cava was observed only in patients with alcoholic cirrhosis. The shape of the "pull-back" tracing between the wedge and free hepatic vein positions was "smooth" in postnecrotic disease and "lumpy" in alcoholic disease. The ratio of the aortic diastolic pressure divided by the hepatic (vein) wedge pressure segregated patients by cause and direction of portal blood flow.

Lower extremity arteriography is customarily performed in the anteroposterior projection with the feet in forced plantar flexion. A case is reported showing "pseudoobstruction" of the anterior tibial artery at the ankle in this projection, which was not present with the foot in the neutral position for a lateral view. To confirm the positional nature of this phenomenon in younger patients, pulse tracings of five volunteers were obtained. These showed that pulsatile flow could be repeatedly abolished in the anterior tibial artery by plantar flexion of the foot. The anatomic causes for this phenomenon are discussed.

Deoxyribonucleic acid base compositions were determined for 25 Mycoplasma strains and 6 L-phase variant strains. Values obtained correlated well with the results of other investigators.