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[PMID]:28795842
[Au] Autor:Ambaye AB; Goodwin AJ; MacLennan SE; Naud S; Weaver DL
[Ad] Endereço:From the Departments of Pathology and Laboratory Medicine (Drs Ambaye, Goodwin, and Weaver) and Surgery (Dr MacLennan), University of Vermont Medical Center, Burlington; and the Department of Medical Biostatistics, University of Vermont, Burlington (Dr Naud).
[Ti] Título:Recommendations for Pathologic Evaluation of Reduction Mammoplasty Specimens: A Prospective Study With Systematic Tissue Sampling.
[So] Source:Arch Pathol Lab Med;141(11):1523-1528, 2017 Nov.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: - Breast reduction mammaplasty (RMP) for symptomatic macromastia or correction of asymmetry is performed in more than 100 000 patients per year in the United States. The reported incidence of significant pathologic findings (SPF), that is, carcinoma and atypical hyperplasia, ranges from 0.06% to 12.8%. No standard pathology assessment for RMP exists. OBJECTIVES: - To propose standard sampling for microscopic evaluation in RMP specimens, to evaluate the incidence of occult carcinoma and atypical hyperplasia, and to identify clinical risk factors for SPF in patients undergoing RMP. DESIGN: - All RMP specimens from 2006 to 2013 at a single institution were prospectively examined. After baseline gross and microscopic evaluations, each specimen was subjected to systematic additional sampling. The incidence of SPF was tabulated, and variables such as age, specimen weight, previous history of SPF, and results of preoperative mammogram were examined. Clinical follow-up review was also subsequently undertaken. RESULTS: - A total of 595 patients were evaluated. Significant pathologic findings were present in 9.8% (58 of 595) of patients. No cancer was identified in patients younger than 40 years; the rates of carcinoma were 2.4% (14 of 595) in all patients, 3.6% (14 of 392) in patients aged 40 years or older, and 4.3% (10 of 233) in patients aged 50 years or older. No carcinoma or atypical hyperplasia was identified on preoperative mammogram. Increased sampling was associated with a significantly greater frequency of SPF only in patients aged 40 years or older. CONCLUSIONS: - In patients younger than 35 years, gross-only evaluation is sufficient. However, increased sampling may be necessary in patients older than 40 years.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico
Mama/anormalidades
Mama/patologia
Detecção Precoce de Câncer/métodos
Hipertrofia/cirurgia
Mamoplastia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Mama/crescimento & desenvolvimento
Mama/cirurgia
Carcinoma de Mama in situ/complicações
Carcinoma de Mama in situ/diagnóstico
Carcinoma de Mama in situ/epidemiologia
Carcinoma de Mama in situ/patologia
Neoplasias da Mama/complicações
Neoplasias da Mama/epidemiologia
Neoplasias da Mama/patologia
Carcinoma Intraductal não Infiltrante/complicações
Carcinoma Intraductal não Infiltrante/diagnóstico
Carcinoma Intraductal não Infiltrante/epidemiologia
Carcinoma Intraductal não Infiltrante/patologia
Feminino
Seguimentos
Seres Humanos
Hiperplasia
Hipertrofia/complicações
Incidência
Meia-Idade
Guias de Prática Clínica como Assunto
Prevalência
Estudos Prospectivos
Fatores de Risco
Vermont/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0492-OA


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[PMID]:28727619
[Au] Autor:Richardson BM
[Ad] Endereço:Author Affiliation: Clinical Nurse Specialist, Transitional Care Southwestern Vermont Medical Center, Bennington.
[Ti] Título:An Innovative Transitional Care Program Improves Community Health.
[So] Source:J Nurs Adm;47(7-8):357-358, 2017 Jul/Aug.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this month's Magnet® Perspectives column, Barbara Richardson, MSN, RN-BC, CCRN, clinical nurse specialist at the Southwestern Vermont Medical Center, examines the ways in which a robust transitional care program improves community health, reduces readmissions and emergency department visits, and provides valuable social support for even the most complex patients. Richardson shares critical factors that impacted the program's success, including a Magnet® environment of innovation, a visionary hospital leadership team, strong community alliances, and collaborative solutions to previously intractable problems. Her efforts to build and implement a successful transitional care program earned Richardson the 2016 National Magnet® Nurse of the Year Award for Structural Empowerment.
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária/organização & administração
Inovação Organizacional
Qualidade da Assistência à Saúde/organização & administração
Cuidado Transicional/organização & administração
[Mh] Termos MeSH secundário: Seres Humanos
Vermont
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000493


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[PMID]:28334066
[Au] Autor:Calderwood L; Cubins J; Vesty D; Darby H
[Ad] Endereço:Department of Plant and Soil Science, University of Vermont, 63 Carrigan Dr., Burlington, VT 05405 (lbc75@cornell.edu; julija.cubins@uvm.edu; dbvesty@uvm.edu).
[Ti] Título:Effect of Drive Row Ground Covers on Hop (Rosales: Cannabaceae) Yard Arthropod Pests in Vermont, USA.
[So] Source:Environ Entomol;46(2):183-190, 2017 04 01.
[Is] ISSN:1938-2936
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Alternatives to pesticides are necessary for the management of hop (Humulus lupulus L.) arthropod pests. The three major arthropod pests in northeastern US hop production include two-spotted spider mite, Tetranychus urticae Koch, hop aphid Phorodon humuli (Schrank), and potato leafhopper, Empoasca fabae Harris. This 3-yr study (2012-2014) in Vermont investigated the effect of flowering ground covers on arthropod pest abundance. Hop cultivars 'Nugget' and 'Cascade' were evaluated under a strip-split plot experimental design. Ground cover treatments included 1) Control: mowed red clover (Trifolium pratense) and resident weeds, 2) Clover: red clover, and 3) Diverse: common yarrow (Achillea millefolium), beebalm (Monarda fistulosa), red clover, and annual sunflower (Helianthus annuus). Natural enemies were grouped by associated pest and indicated by our mixed model to be strong predictors of the number of hop aphid and potato leafhopper on hop plants. In year two, ground cover treatment had a significant effect on two-spotted spider mite abundance where fewer two-spotted spider mite were observed on hop plants in Diverse plots. The established, un-mowed Clover treatment was preferred by potato leafhopper over Diverse ground cover and hop plants. This revealed the potential for clover ground cover to serve as a trap crop for potato leafhopper management in northeastern hop yards. Our findings are evidence that ground covers implemented for conservation biological control may serve more specific pest management functions instead of or in addition to boosting top-down pest pressure.
[Mh] Termos MeSH primário: Agricultura/métodos
Humulus/crescimento & desenvolvimento
Magnoliopsida/crescimento & desenvolvimento
Controle Biológico de Vetores
Tetranychidae/fisiologia
[Mh] Termos MeSH secundário: Animais
Afídeos/fisiologia
Hemípteros/fisiologia
Dinâmica Populacional
Estações do Ano
Vermont
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171126
[Lr] Data última revisão:
171126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.1093/ee/nvw069


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[PMID]:28195783
[Au] Autor:Quinn K; Sanders C; Petroll AE
[Ad] Endereço:Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
[Ti] Título:"HIV Is Not Going to Kill Me, Old Age Is!": The Intersection of Aging and HIV for Older HIV-Infected Adults in Rural Communities.
[So] Source:AIDS Educ Prev;29(1):62-76, 2017 Feb.
[Is] ISSN:1943-2755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Older adults with HIV/AIDS living in rural areas face unique challenges to accessing HIV care and medications, and suffer greater mortality than non-rural HIV-infected individuals. This qualitative study examined the intersection of aging and HIV to identify factors that affect overall health, engagement in care, and medication adherence among this understudied population. Qualitative interviews were conducted by phone with 29 HIV-positive adults over the age of 50 living in U.S. rural counties and analyzed using thematic content analysis. Individuals reported complex medical needs in addition to their HIV and noted difficulty discerning whether symptoms were associated with HIV or aging. Although reported medication adherence rates were high, participants also cited several barriers to maintaining adherence. Given the increase in rural individuals living with HIV, interventions are needed to address the complex intersection of aging and HIV, especially for those in rural environments.
[Mh] Termos MeSH primário: Envelhecimento
Infecções por HIV/psicologia
Acesso aos Serviços de Saúde
Adesão à Medicação
Polimedicação
População Rural
[Mh] Termos MeSH secundário: Adulto
Idoso
Alabama
Doença Crônica/epidemiologia
Comorbidade
Feminino
Infecções por HIV/epidemiologia
Disparidades nos Níveis de Saúde
Seres Humanos
Entrevistas como Assunto
Masculino
Meia-Idade
Relações Médico-Paciente
Pesquisa Qualitativa
Tennessee
Vermont
Wisconsin
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1521/aeap.2017.29.1.62


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[PMID]:28103923
[Au] Autor:Finison K; Mohlman M; Jones C; Pinette M; Jorgenson D; Kinner A; Tremblay T; Gottlieb D
[Ad] Endereço:Onpoint Health Data, 254 Commercial Street, Suite 257, Portland, ME, 04101, USA. kfinison@onpointhealthdata.org.
[Ti] Título:Risk-adjustment methods for all-payer comparative performance reporting in Vermont.
[So] Source:BMC Health Serv Res;17(1):58, 2017 Jan 19.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge. METHODS: This study evaluated different levels of risk adjustment for primary care practice populations - from basic adjustments for age and gender to a more comprehensive "full model" risk-adjustment method that included additional demographic, payer, and health status factors. It applied risk adjustment to populations attributed to patient-centered medical homes (283,153 adult patients and 78,162 pediatric patients) in the state of Vermont that are part of the Blueprint for Health program. Risk-adjusted expenditure and utilization outcomes for calendar year 2014 were reported in 102 adult and 56 pediatric primary-care comparative practice profiles. RESULTS: Using total expenditures as the dependent variable for the adult population, the r for the model adjusted for age and gender was 0.028. It increased to 0.265 with the additional adjustment for 3M Clinical Risk Groups and to 0.293 with the full model. For the adult population at the practice level, the no-adjustment model had the highest variation as measured by the coefficient of variation (18.5) compared to the age and gender model (14.8); the age, gender, and CRG model (13.0); and the full model (11.7). Similar results were found for the pediatric population practices. CONCLUSIONS: Results indicate that more comprehensive risk-adjustment models are effective for comparing cost, utilization, and quality measures across multi-payer populations. Such evaluations will become more important for practices, many of which do not distinguish their patients by payer type, and for the implementation of incentive-based or alternative payment systems that depend on "whole-population" outcomes. In Vermont, providers, accountable care organizations, policymakers, and consumers have used Blueprint profiles to identify priorities and opportunities for improving care in their communities.
[Mh] Termos MeSH primário: Medicaid/economia
Medicare/economia
Atenção Primária à Saúde/economia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Pré-Escolar
Custos e Análise de Custo
Feminino
Reforma dos Serviços de Saúde/economia
Gastos em Saúde
Seres Humanos
Lactente
Masculino
Meia-Idade
Reembolso de Incentivo
Risco Ajustado/economia
Risco Ajustado/métodos
Estados Unidos
Vermont
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170121
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2010-0


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[PMID]:27821675
[Au] Autor:Vacek PM; Callas PW
[Ad] Endereço:Medical Biostatistics Unit and Department of Pathology, University of Vermont College of Medicine, Burlington, Vermont, USA.
[Ti] Título:Lung-cancer mortality among Vermont granite workers: factors influencing exposure-response evaluation.
[So] Source:Occup Environ Med;74(3):211-217, 2017 Mar.
[Is] ISSN:1470-7926
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To understand why 2 studies relating crystalline silica exposure to lung-cancer mortality in Vermont granite workers yielded conflicting results. METHODS: Data used in the 2 studies were linked to identify discrepancies. Mortality data and employment histories from the earlier study were revised based on data obtained in the later study. SMR were computed and Poisson regressions corresponding to those in the earlier study were performed using the original and revised data. Analyses were repeated with the addition of workers omitted from the earlier study. RESULTS: After correction of incomplete mortality and employment information in the original data, the overall SMR for the cohort in the earlier study increased from 1.17 (95% CI 1.03 to 1.36) to 1.39 (95% CI 1.22 to 1.59), and was similar to the SMR of 1.37 observed in the later study (95% CI 1.23 to 1.52). The exposure-response relationship was attenuated, particularly when person-years in all exposure categories were included in the analysis. Inclusion of additional workers had a smaller impact on the SMRs but further attenuated the exposure-response relationship. CONCLUSIONS: Differing results from the 2 studies are partly attributable to incomplete vital status and work history information used in the earlier study, as well as differences in cohort inclusion criteria. However, differences in length of follow-up and other factors likely play a larger role.
[Mh] Termos MeSH primário: Neoplasias Pulmonares/induzido quimicamente
Neoplasias Pulmonares/mortalidade
Doenças Profissionais/induzido quimicamente
Doenças Profissionais/mortalidade
Exposição Ocupacional/efeitos adversos
Dióxido de Silício/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Viés
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise de Regressão
Vermont/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (granite); 7631-86-9 (Silicon Dioxide)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161109
[St] Status:MEDLINE
[do] DOI:10.1136/oemed-2015-103527


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[PMID]:27811236
[Au] Autor:Winters JP; Morris CS; Holmes CE; Lewis P; Bhave AD; Najarian KE; Shields JT; Charash W; Cushman M
[Ad] Endereço:1 Thrombosis and Hemostasis Program, Division of Hematology - Oncology, Department of Medicine, and Cardiovascular Research Institute of Vermont, Larner College of Medicine, University of Vermont, Burlington, VT, USA.
[Ti] Título:A multidisciplinary quality improvement program increases the inferior vena cava filter retrieval rate.
[So] Source:Vasc Med;22(1):51-56, 2017 Feb.
[Is] ISSN:1477-0377
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Published reports indicate low retrieval rates for retrievable inferior vena cava (IVC) filters. We performed a historic-controlled study of a 5-year intervention (March 2007 to February 2012) to improve IVC filter retrieval rates at a university medical center serving a rural area. All adults with a retrievable filter placed were included, except those with a life expectancy <6 months. The intervention included initial verbal counseling and printed educational materials, correspondence after discharge, and a hematology consultation. The control group included patients with retrievable filters placed in the 15 months preceding study initiation. In the control group, 116 filters were placed and 27 (23%) were removed, compared to 378 filters placed and 169 (45%) removed during the intervention. Adjusting for patient characteristics, the odds ratio of retrieval during the intervention was 3.03 (95% CI 1.85-4.27) compared to the control period. An intervention including patient education and hematology follow-up appeared to significantly improve IVC filter retrieval rates.
[Mh] Termos MeSH primário: Remoção de Dispositivo/métodos
Equipe de Assistência ao Paciente
Avaliação de Processos (Cuidados de Saúde)
Implante de Prótese/instrumentação
Melhoria de Qualidade
Indicadores de Qualidade em Assistência à Saúde
Filtros de Veia Cava
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Idoso
Remoção de Dispositivo/normas
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Hematologia
Estudo Historicamente Controlado
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Equipe de Assistência ao Paciente/normas
Educação de Pacientes como Assunto
Avaliação de Processos (Cuidados de Saúde)/normas
Avaliação de Programas e Projetos de Saúde
Estudos Prospectivos
Melhoria de Qualidade/normas
Indicadores de Qualidade em Assistência à Saúde/normas
Encaminhamento e Consulta
Estudos Retrospectivos
Serviços de Saúde Rural
Fatores de Tempo
Resultado do Tratamento
Vermont
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161105
[St] Status:MEDLINE
[do] DOI:10.1177/1358863X16676658


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[PMID]:27940713
[Au] Autor:Emond JA; Lansigan RK; Ramanujam A; Gilbert-Diamond D
[Ad] Endereço:Department of Biomedical Data Sciences, jennifer.a.emond@dartmouth.edu.
[Ti] Título:Randomized Exposure to Food Advertisements and Eating in the Absence of Hunger Among Preschoolers.
[So] Source:Pediatrics;138(6), 2016 Dec.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Preschoolers in the United States are heavily exposed to unhealthy food advertisements. Whether such exposure promotes cued eating has not been documented in this age group. METHODS: Randomized experiment among 60 children, aged 2 to 5 years, recruited in 2015-2016 from New Hampshire and Vermont. Children completed the experiment at a behavioral laboratory. Children were provided with a healthy snack to consume upon arrival then randomized to view a 14-minute TV program embedded with advertisements for either a food or a department store. Children were provided 2 snack foods to consume ad libitum while viewing the TV program; 1 of those snacks was the food advertised. Eating in the absence of hunger (EAH) was operationalized as the kilocalories of snack foods consumed. t tests were used to compare EAH by advertisement condition; linear regression models assessed effect modification by the child's age, sex, BMI percentile, and parental feeding restriction. RESULTS: Mean age was 4.1 (SD 0.9) years, 55% of children were male, 80% were non-Hispanic white, and 20% were overweight or obese. There were no differences in child or socioeconomic characteristics by advertisement condition. Child BMI was not related to EAH. Mean kilocalories consumed during the EAH phase was greater among children exposed to the food advertisements (126.8, SD: 58.5) versus those exposed to the nonfood advertisements (97.3, SD: 52.3; P = .04), an effect driven by greater consumption of the advertised food (P < .01). There was no evidence of effect modification. CONCLUSIONS: Findings suggest that food advertisement exposure may encourage obesogenic-eating behaviors among the very young.
[Mh] Termos MeSH primário: Publicidade como Assunto
Metabolismo Energético
Comportamento Alimentar/psicologia
Fome
Obesidade Pediátrica/prevenção & controle
[Mh] Termos MeSH secundário: Terapia Comportamental/métodos
Índice de Massa Corporal
Pré-Escolar
Ingestão de Alimentos/fisiologia
Feminino
Seres Humanos
Masculino
New Hampshire
Relações Pais-Filho
Medição de Risco
Vermont
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE


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[PMID]:27632044
[Au] Autor:Stern G
[Ti] Título:To Be the Best, Department Starts 'Cert Now!'.
[So] Source:Biomed Instrum Technol;50(5):377-9, 2016 Sep-Oct.
[Is] ISSN:0899-8205
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Tecnologia Biomédica/normas
Certificação/normas
Instrução por Computador/métodos
Capacitação em Serviço/normas
Liderança
Administração de Recursos Humanos/normas
[Mh] Termos MeSH secundário: Certificação/métodos
Vermont
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170127
[Lr] Data última revisão:
170127
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160916
[St] Status:MEDLINE
[do] DOI:10.2345/0899-8205-50.5.377


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[PMID]:27611325
[Au] Autor:Sonter LJ; Watson KB; Wood SA; Ricketts TH
[Ad] Endereço:The Gund Institute for Ecological Economics, University of Vermont, Burlington, VT 05405, United States of America.
[Ti] Título:Spatial and Temporal Dynamics and Value of Nature-Based Recreation, Estimated via Social Media.
[So] Source:PLoS One;11(9):e0162372, 2016.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Conserved lands provide multiple ecosystem services, including opportunities for nature-based recreation. Managing this service requires understanding the landscape attributes underpinning its provision, and how changes in land management affect its contribution to human wellbeing over time. However, evidence from both spatially explicit and temporally dynamic analyses is scarce, often due to data limitations. In this study, we investigated nature-based recreation within conserved lands in Vermont, USA. We used geotagged photographs uploaded to the photo-sharing website Flickr to quantify visits by in-state and out-of-state visitors, and we multiplied visits by mean trip expenditures to show that conserved lands contributed US $1.8 billion (US $0.18-20.2 at 95% confidence) to Vermont's tourism industry between 2007 and 2014. We found eight landscape attributes explained the pattern of visits to conserved lands; visits were higher in larger conserved lands, with less forest cover, greater trail density and more opportunities for snow sports. Some of these attributes differed from those found in other locations, but all aligned with our understanding of recreation in Vermont. We also found that using temporally static models to inform conservation decisions may have perverse outcomes for nature-based recreation. For example, static models suggest conserved land with less forest cover receive more visits, but temporally dynamic models suggest clearing forests decreases, rather than increases, visits to these sites. Our results illustrate the importance of understanding both the spatial and temporal dynamics of ecosystem services for conservation decision-making.
[Mh] Termos MeSH primário: Natureza
Recreação
Mídias Sociais
Análise Espaço-Temporal
[Mh] Termos MeSH secundário: Conservação dos Recursos Naturais
Seres Humanos
Modelos Estatísticos
Vermont
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160910
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0162372



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