An evaluation of the Chesapeake Bay management strategy to improve water quality in small agricultural watersheds.

Chesapeake Bay water quality has been a concern since 1970. In rural areas, agriculture is the dominant N and P source, and the voluntary application of best management practices (BMPs) is the primary management tool. Here we test the hypothesis that the current management approach of primarily voluntary, untargeted BMP implementation is insufficient to create detectable, widespread reductions in N, P, and total suspended solid (TSS) concentrations in agricultural watersheds of the Choptank basin, a tributary of Chesapeake Bay. To test this hypothesis, we assessed BMP implementation and sampled water quality on participating farms, at intermediate streams within each watershed, and at watershed outlets of four watersheds from 2013 to 2014. We also present water quality data from 2003 to 2014 at the outlets of 12 additional agricultural and one forested watershed and survey-directed interviews of farmers. By the end of 2014, large numbers of BMPs, both structural and cultural, had been implemented. Of the 16 agricultural watersheds, 50% showed significant decreases in baseflow N, 37.5% showed no changes, and 12.5% showed increasing TN. Baseflow P significantly decreased at just one watershed, increased at one, and remained stable at 14. Stormflow N was similar to baseflow, but stormflow P was 5 times higher than baseflow. These data partially support our hypothesis. Surveys suggested farmers considered themselves responsible for the quality of water leaving their farms, but out-of-pocket cost was the major impediment to further BMP adoption. We suggest that greater outreach and more financial support for farmers to implement BMPs is required to increase the types and densities of BMPs needed to achieve regional water quality goals.

An experimental test of psychic diagnosis of disease.

The authors, one a medical anthropologist and the other a medical doctor, investigated the claims of three acquaintances who include psychic diagnosis in the services they provide to clients. An experiment was designed that allowed each of the three psychics to diagnose five volunteers, patients of S. K. H. Aung, one at a time while hidden behind a screen. The results of the psychic diagnoses were then compared with the medical records of the patients. Results indicate some correspondence between the psychic diagnoses and the medical records, but the correspondence was not sufficiently impressive to warrant considering psychic diagnosis as a useful alternative method for diagnosing disease. It would appear that patients relying solely on psychic diagnosis as the basis for therapy are at risk of serious medical problems going undetected. Future research, with a larger sample of patients and psychic diagnosticians, is required to substantiate this conclusion.

Determining movement onsets from temporal series.

With the advent of recent measurement techniques, kinematic and kinetic measures commonly are used to describe events over time. Often, the central and peripheral nature of the control processes involved are derived from these temporal series. For example, movement onset often arbitrarily defines the end of the central and the beginning of the peripheral processes. Because of its critical temporal location, we examined whether response dynamics (average movement velocity) affects the determination of movement onset. Interactive graphics and numerical methods of determining movement onsets from temporal series were evaluated on various kinematic signals. Variations in the initial rate of change in a given signal significantly affected the determination of movement onset. Consequently, measurements of component latency must be regarded with caution. A cursory description of related problems elucidated in previous research is discussed, and procedures that can minimize these artifacts are suggested.

Augmented Kinematic Feedback for Motor Learning.

Although the study of feedback about goal achievement (knowledge of results, KR) has been important for the development principles of augmented information feedback in simple skills, there is reason to question the generalizability of these findings to many common learning situations. A more appropriate type of information for skill learning appears to be augmented kinematic (or kinetic) feedback regarding the movement pattern. The experiments presented here extend recent findings about KR to a paradigm involving kinematic feedback. In Experiment 1, we examined how several kinds of temporal and spatial kinematic information supplement KR in learning. Spatial kinematic variables were more effective than temporal variables, as indicated by performance in a retention test without kinematic feedback. In Experiment 2, we manipulated the schedule of augmented kinematic feedback in a method that paralleled previous KR work. We contrasted averaged schedules of augmented feedback, in which information was given either after every trial or as averaged information after every set of five trials. On retention tests without kinematic feedback given 1 day and 1 week after acquisition, averaged schedules led to enhanced performance over an every-trial format. Together, these results begin to define the variables important in kinematic feedback, and suggest that this feedback may influence learning in ways parallel to KR.

Methodology for motor learning: a paradigm for kinematic feedback.

Knowledge of results (KR)--information feedback about goal achievement--has been one of the most extensively examined variables in motor learning. In most natural movement learning situations, however, instructors more common]y provide augmented information regarding various kinematic or kinetic aspects of the movement pattern itself (sometimes termed knowledge of performance, KP). But despite the inherent interest in kinematic feedback, several factors reviewed here have operated to inhibit its study, the most important of which has been the lack of a suitable laboratory task and paradigm. The limitations of earlier paradigms have concerned (a) the use of overly simple motor behaviors, probably to minimize the problems in kinematic measurement, (b) the tendency for the environmental goal or the task to be isomorphic with the kinematic pattern, and (c) thc failure to use transfer or retention tests as measures of learning effects of the feedback manipulations. In this article, we describe our efforts to create a new paradigm for kinematic feedback, the rationale for its development, and the details of its operation. Finally, we provide evidence that the task and paradigm are sensitive to manipulations of kinematic feedback, providing some assurance that the paradigm can potentially answer future research questions about the role of kinematic feedback for learning.

Treatment of recurrent aborters by immunization with paternal cells--controlled trial.

A paired sequential trial was undertaken to establish whether paternal mononuclear cells improved the prognosis in couples with recurrent abortions. For this purpose, 10(7)-10(8) cells obtained from the blood of partners were injected intravenously, subcutaneously, and intra-dermally into women who had had three or more consecutive miscarriages with the same partner. Control women were given normal saline, injected in the same manner. The result of the sequential analysis showed that there was no significant beneficial effect of the cells compared to control. The overall success rate was 70% (32/46 couples). The success rate in patients given cells was 62% (13/21), while in those given saline it was 76% (19/25). While the overall success rate in this study compares with a number of other studies, we find an equally high success rate with non-immunized patients. We conclude that the value of immunization for the prevention of recurrent miscarriage has not been established.

Cree Indian healing practices and western health care: a comparative analysis.

In this article, Cree Indian methods of treating disease are compared with the treatment process and procedures used in the Western health Care system. Ethnographic data permitted the identification of the five components of Cree healing: the ritual, contract, treatment, didactic, and closure components. These components are compared with equivalent phases in the physician-patient and nurse-patient relationship. In particular, the process of comparison permits the identification of incongruities that the Cree may encounter when using the Western system. These include the inability to identify one's own state of health and abnormalities; a passive, rather than a participatory role in healing; the incomprehensible notion of "silent" diseases and preventative treatment; the specialization of the caring, curing, and counselling roles of practitioners and the limited perspective of "holism" in health care.

Control of asymmetrical bimanual movements.

When movements are performed together in the upper-limbs, a strong tendency emerges to synchronize the patterns of motor output. This is most apparent when trying to do different things at the same time. The present experiment explored the simultaneous organization and control of spatiotemporally different movements. There were two practice conditions: symmetrical and asymmetrical. In the symmetrical condition, subjects performed a series of unidirectional elbow flexion movements, followed by a series of elbow flexion-extension-flexion (reversal) movements in both limbs simultaneously. In the asymmetrical practice condition, subjects performed the unidirectional movement in the left limb together with the reversal movement in the right limb. Findings revealed a tendency for each limb movement to assimilate the features of its counterpart under the latter condition. This effect was "asymmetrical" in that the unidirectional movement was more attracted to the reversal movement than vice versa. Nevertheless, subjects were able to partly suppress this synchronization tendency as was evident from the moderate cross correlations between the angular acceleration patterns of both limb movements and from an increasingly successful differentiation of the activity levels in the right and left limb muscles. All together, these findings provide evidence for some degree of parallel control of spatiotemporally different actions. The data are discussed in view of the possible suppression of a bilaterally distributed motor control system, that is mainly held responsible for activiting proximal limb musculature.

Platinum-based combination chemotherapy for malignant mixed mesodermal tumors of the ovary.

Although considerable clinical data are available to guide treatment decisions for patients with ovarian epithelial malignancies, therapy for the rare malignant mixed mesodermal (mullerian) tumor (MMMT) of the ovary is poorly studied. Ten untreated patients diagnosed with primary ovarian MMMT were managed with cis-platinum-based combination chemotherapy from 1980 to 1985. Six of the 10 patients were stage III suboptimal with evaluable residual disease; 4 of these 6 had CRs with a median duration of response of 13 months. The remaining 2 patients had PRs, of 2 and 11 months duration. Four patients had stage III optimal disease; 1 progressed at 7 months, 1 progressed at 16 months and the other 2 patients have no clinical evidence of disease at 12+ and 22+ months. Despite impressive initial response rates, survival overall was poor, with a median survival for all 10 patients of 16+ months.

Summary knowledge of results for skill acquisition: support for the guidance hypothesis.

Summary knowledge of results (KR) involves the presentation KR for each of a set of trials (e.g., 10) only after the last trial in the set has been completed. Earlier, Lavery (1962) showed that, relative to providing KR after each trial, a 20-trial summary KR was detrimental to performance in a practice phase with KR present but was beneficial for a no-KR retention test. Using a relatively simple ballistic-timing task, we examined summary lengths of 1 (essentially KR after every trial), 5, 10, and 15 trials, searching for an inverted-U relationship between summary length and retention performance as predicated by a guidance hypothesis for KR. During acquisition when KR was present and being manipulated, all groups showed improvements in performance across practice, while increased summary lengths generally depressed performance. However, in a delayed no-KR retention test, there was an inverse relation between the summary length in acquisition and absolute constant error on the retention test. A guidance hypothesis is favored to explain how, relative to immediate KR, long KR summaries can provide detrimental effects in acquisition while enhancing retention performance.

Nocturnal enuresis: a review of treatment approaches.

Nocturnal enuresis, a common childhood problem, has several plausible etiologies: adverse environmental circumstances, psychologic disturbances and physiologic mechanisms. A wait-and-see approach is commonly adopted, since spontaneous resolution occurs in many children. Moderate success has been reported with the use of tricyclic antidepressants. Two behavioral conditioning approaches are reported to be highly successful in ameliorating enuretic episodes.

Cost savings as an indicator of successful nursing intervention.

The purpose of this study was to provide cost-related data from an intervention study in the care of patients with peripheral vascular disease (PVD). In a previously reported study, the study group patients increased exercise more than control patients, but there were no differences on any other health promoting behaviors or clinical outcomes. However, analysis of the differences between the study (N = 44) and the control patients (N = 42) on costs for health care during the course of the study demonstrated substantial differences. A fixed per diem rate was used to determine inpatient and outpatient costs. Study patients required significantly fewer PVD-related hospitalization and health care costs than control patients but not on vascular-related and nonvascular-related illnesses. Since there were no differences between the study and control on non-PVD illnesses, it appears that the intervention targeted to influence PVD problems did so. Limitations to the study are identified and additional research in this area is warranted.

Rhinosporidiosis. A report of two cases from Arkansas.

Two human native cases of ocular-conjunctival rhinosporidiosis from Arkansas are believed to be the first documented reports in this part of the country. The common mode of infection was accidental injury to the eye by possible contaminated soil-dust. The appearance of the polypoid growth was relatively fast, 6-16 days, and unresponsive to topical antibiotic and steroid treatment. Surgical excision, with one recurrence in one case, was the elective treatment. Both patients are asymptomatic 10-12 months after treatment, respectively, with no evidence of other recurrence, dissemination, or major complications. From 1939 to September, 1983, only nine cases of conjunctival rhinosporidiosis were reported in the United States.

Effectiveness of health promotion interventions.

The purpose of the study was to determine whether patients who participated in an intervention program would improve exercise and foot-care habits, reduce smoking, and would, in turn, have fewer PVD-related illnesses than patients not exposed to the intervention. Eighty-six patients with ankle/brachial pressure indices of less than 1.0 on one or both legs were randomly assigned to a study (N = 42) or control (N = 44) group. All patients were assessed on a variety of health-related and activity behaviors prior to and again 26 weeks after enrollment in the study. Study patients who participated in the intervention worked with professionals on selecting programs designed to modify and improve their smoking, exercise, and/or foot-care habits. At the end of 26 weeks, chi-square analysis showed no significant differences between study and control groups on change in smoking and foot care, although the results were in the anticipated direction. Study patients who chose to increase their exercise showed greater increase than control patients in frequency (p = .001), distance (p = .007), and length (p = .002) of walks. Although behaviors were modified, especially in the area of exercise, it was felt that longer interventions on a larger sample size are needed.

Evaluation of the V-osteotomy as a procedure to alleviate the intractable plantar keratoma.

This paper will discuss the distal V-osteotomy procedure of the lesser metatarsals as performed at the Hugar Surgery Center. Sixty-six patients in this study had V-osteotomies performed upon one or more of the middle metatarsals within a 2-year period. Evaluation was based upon patient satisfaction and clinical improvement as measured by the alleviation of the original lesion and the presence of any transfer lesions under the adjacent metatarsal heads. Perioperative steroid injection, early ambulation, and postoperative orthoses contributed to the excellent surgical results.