Access to care improved from 1996 to 1998 but remained suboptimal. Blacks, Latinos, women, the uninsured, and Medicaid-insured all had less desirable patterns of care. Strategies to ensure optimal care for patients with HIV requires identifying the causes of deficiency and addressing these important shortcomings in care.

The relationship between total foliar nitrogen content and feeding by Odontota dorsalis Thun. on Black Locust trees (Robinia pseudoacacia L.) was examined via experimental manipulation of foliar nitrogen levels. Trees with high concentrations of foliar nitrogen received more herbivory by adult O. dorsalis, but herbivory by larvae was independent of foliar nitrogen concentration. Late in the growing season, leaf abscission induced by herbivory tends to mask the dependence of herbivory by adults on foliar nitrogen concentration. The percentage of variation in herbivory attributable to foliar nitrogen concentration drops from 20% in June to 2% by August. These observations suggest that variation in the interaction between R. pseudoacacia and O. dorsalis is at least partially conditioned on variation in foliar nitrogen concentration.

Strategic, targeted, carefully designed methods and surveys can achieve high reach and response rates in hard-to-reach populations. Similar procedures could be used to obtain cooperation of groups who may not be accessible with traditional methods.

Standard bioassays were studied to evaluate their value in guiding remedial action decisions at sites contaminated with wood treatment operation wastes. The toxicities of sediment, sediment elutriate and whole water samples collected from a creek adjacent to a wood treatment site in Mississippi were estimated using six bioassays and compared with estimated concentrations of creosote and related materials obtained from the same samples by infrared spectroscopy. Of the bioassays, Duphniu and Microtox were most sensitive to the contaminants from the wood treatment operation. Based on an analysis of these samples, chemical analysis alone is insufficient to guide cleanup decisions, but bioassays alone can provide usable guidance, especially if more than one contaminant is present. Keywords-CreosoteBioassay Chemical waste Toxicity Sediments IN T R 0 DUCT I 0 N Rarely are waste sites contaminated with single chemicals, so chemical analyses alone are uninformative regarding actual environmental hazards [ 11. The actual toxicity of a site may also not be reflected by a simple list of the chemicals present because of the interactive nature of contaminants. Bioassays are a cost-effective alternative for estimating not only the concentration of myriad known and unknown chemicals but also the actual environmental toxicity at a hazardous waste site. Information from bioassays can be used to rank sites according to hazard potential and to locate contamination for cleanup operations [ 1,2].

Goal: The objective of this study was to evaluate the prevalence of burnout and professional fulfillment among healthcare administrative leaders and examine the association between burnout and professional fulfillment and personal and professional characteristics. Methods: Between June 7 and June 30, 2021, we performed a national survey of CEOs and other senior operational leaders to evaluate their personal work experience. Burnout and professional fulfillment—as well as a sleep-related impairment and self-valuation—were assessed using standardized instruments. Principle Findings: Of the 5,994 members of the American College of Healthcare Executives who were sent an invitation to participate, 1,269 (21.2%), including 279 CEOs, submitted usable responses. The mean overall burnout score was 2.71 (range: 0–10), and 33% of participants had burnout scores that fell in the high range (unfavorable). Mean professional fulfillment score was 7.29 (range: 0–10), with 56.6% scoring in the high range (favorable). Burnout and professional fulfillment scores varied by role. On multivariable analysis, sleep-related impairment (OR for each 1-point increase = 1.29, 95% CI [1.19–1.41]; p < .001) and self-valuation (OR for each 1-point increase = 0.63, 95% CI [0.57–0.68]; p < .001) were independently associated with burnout after adjusting for all other variables. Applications to Practice: Results of this study suggest that healthcare leaders had lower burnout and professional fulfillment scores than clinicians. Nonetheless, one third of healthcare leaders had burnout scores that fell in the high range. At the individual level, improved sleep health and self-valuation appear to reduce risk of burnout and promote professional fulfillment.