OBJECTIVETo conduct a bedside study to determine the factors driving insulin noncompliance in inner-city patients with recurrent diabetic ketoacidosis (DKA).RESEARCH DESIGN AND METHODSWe analyzed socioeconomic and psychological factors in 164 adult patients with DKA who were admitted to Grady Hospital between July 2007 and August 2010, including demographics, diabetes treatment, education, and mental illness. The Patient Health Questionnaire-9 and the Short Form-36 surveys were used to screen for depression and assess quality of life.RESULTSThe average number of admissions was 4.5 ± 7 per patient. A total of 73 patients presented with first-time DKA, and 91 presented with recurrent DKA; 96% of patients were African American. Insulin discontinuation was the leading precipitating cause in 68% of patients; other causes were new-onset diabetes (10%), infection (15%), medical illness (4%), and undetermined causes (3%). Among those who stopped insulin, 32% gave no reasons for stopping, 27% reported lack of money to buy insulin, 19% felt sick, 15% were away from their supply, and 5% were stretching insulin. Compared with first-time DKA, those with recurrent episodes had longer duration of diabetes (P < 0.001), were a younger age at the onset of diabetes (P = 0.04), and had higher rates of depression (P = 0.04), alcohol (P = 0.047) and drug (P < 0.001) abuse, and homelessness (P = 0.005). There were no differences in quality-of-life scores, major psychiatric illnesses, or employment between groups.CONCLUSIONSPoor adherence to insulin therapy is the leading cause of recurrent DKA in inner-city patients. Several behavioral, socioeconomic, psychosocial, and educational factors contribute to poor compliance. The recognition of such factors and the institution of culturally appropriate interventions and education programs might reduce DKA recurrence in minority populations.

Abstract. Plants possessing generalized dispersal syndromes are likely to be more invasive than those relying on specialist dispersal agents. To address this issue on a local and regional scale, avian seed dispersal of the invasive alien Chinese tallow tree (Sapium sebiferum (L.) Roxb.) was assessed in forests and spoil areas of South Carolina and along forest edges in Louisiana during the 1997–99 fruiting seasons. Tallow trees in these floristically distinct habitats had a few common and many casual visitors, and considerable species overlap among habitats was found. However, bird species differed in the importance of dispersing and dropping seeds among habitats. Important dispersal agents common to forests and spoil areas of South Carolina included Northern Flicker, American Robin and Red‐winged Blackbird, whereas Red‐bellied Woodpecker and European Starling were important in the former and latter habitat, respectively. In Louisiana, Red‐bellied Woodpecker, American Robin, Northern Cardinal and Eastern Bluebird dispersed many seeds. Nearly all species foraging on seeds were winter residents. Estimated numbers of seeds dispersed and dropped were higher in spoil areas of South Carolina than in Louisiana because of higher numbers of individuals per visit, higher seed consumption and seed dropping rates, and longer foraging durations. Within South Carolina, more seeds were dispersed and dropped in spoil areas than in forests because of higher numbers of birds per visit. These findings show that among habitats, tallow tree attracts diverse but variable coteries of dispersal agents that are qualitatively similar in seed usage patterns. We suggest that its generalized dispersal syndrome contributes to effective seed dispersal by many bird species throughout its range. Effects of differential avian use among locales may include changes in local bird communities, and differing tallow tree demographics and invasion patterns.

The current network of weather surveillance radars within the United States readily detects flying birds and has proven to be a useful remote-sensing tool for ornithological study. Radar reflectivity measures serve as an index to bird density and have been used to quantitatively map landbird distributions during migratory stopover by sampling birds aloft at the onset of nocturnal migratory flights. Our objective was to further develop and validate a similar approach for mapping wintering waterfowl distributions using weather surveillance radar observations at the onset of evening flights. We evaluated data from the Sacramento, CA radar (KDAX) during winters 1998–1999 and 1999–2000. We determined an optimal sampling time by evaluating the accuracy and precision of radar observations at different times during the onset of evening flight relative to observed diurnal distributions of radio-marked birds on the ground. The mean time of evening flight initiation occurred 23 min after sunset with the strongest correlations between reflectivity and waterfowl density on the ground occurring almost immediately after flight initiation. Radar measures became more spatially homogeneous as evening flight progressed because birds dispersed from their departure locations. Radars effectively detected birds to a mean maximum range of 83 km during the first 20 min of evening flight. Using a sun elevation angle of −5° (28 min after sunset) as our optimal sampling time, we validated our approach using KDAX data and additional data from the Beale Air Force Base, CA (KBBX) radar during winter 1998–1999. Bias-adjusted radar reflectivity of waterfowl aloft was positively related to the observed diurnal density of radio-marked waterfowl locations on the ground. Thus, weather radars provide accurate measures of relative wintering waterfowl density that can be used to comprehensively map their distributions over large spatial extents.

Despite using the aerosphere for many facets of their life, most flying animals (i.e., birds, bats, some insects) are still bound to terrestrial habitats for resting, feeding, and reproduction. Comprehensive broad-scale observations by weather surveillance radars of animals as they leave terrestrial habitats for migration or feeding flights can be used to map their terrestrial distributions either as point locations (e.g., communal roosts) or as continuous surface layers (e.g., animal densities in habitats across a landscape). We discuss some of the technical challenges to reducing measurement biases related to how radars sample the aerosphere and the flight behavior of animals. We highlight a recently developed methodological approach that precisely and quantitatively links the horizontal spatial structure of birds aloft to their terrestrial distributions and provides novel insights into avian ecology and conservation across broad landscapes. Specifically, we present case studies that (1) elucidate how migrating birds contend with crossing ecological

To protect and restore wintering waterfowl habitat, managers require knowledge of routine wintering waterfowl movements and habitat use. During preliminary screening of Doppler weather radar data we observed biological movements consistent with routine foraging flights of wintering waterfowl known to occur near Lacassine National Wildlife Refuge (NWR), Louisiana. During the winters of 2004-2005 and 2005-2006, we conducted field surveys to identify the source of the radar echoes emanating from Lacassine NWR. We compared field data to weather radar reflectivity data. Spatial and temporal patterns consistent with foraging flight movements appeared in weather radar data on all dates of field surveys. Dabbling ducks were the dominant taxa flying within the radar beam during the foraging flight period. Using linear regression, we found a positive log-linear relationship between average radar reflectivity (Z) and number of birds detected over the study area (P < 0.001, r 2 ¼ 0.62, n ¼ 40). Ground observations and the statistically significant relationship between radar data and field data confirm that Doppler weather radar recorded the foraging flights of dabbling ducks. Weather radars may be effective tools for wintering waterfowl management because they provide broad-scale views of both diurnal and nocturnal movements. In addition, an extensive data archive enables the study of wintering waterfowl response to habitat loss, agricultural practices, wetland restoration, and other research questions that require multiple years of data.

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Provides a comprehensive assessment of the impacts of the 2005 hurricanes in the Gulf of Mexico as well as the important role of science in landscape restoration and community recovery"-Provided by publisher. Includes bibliographical references and index.