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Brockman, Ruth R., Carmen T. Agouridis, Stephen R. Workman, Lindell E. Ormsbee, and Alex W. Fogle, 2012. Bankfull Regional Curves for the Inner and Outer Bluegrass Regions of Kentucky. Journal of the American Water Resources Association (JAWRA) 48(2): 391-406. DOI: 10.1111/j.1752-1688.2011.00621.x Abstract: Bankfull regional curves that relate channel dimensions and discharge to watershed drainage area are useful tools for assisting in the correct identification of bankfull elevation and in stream restoration and reconstruction. This study assessed 28 stable streams located in two physiographic regions of Kentucky: the Inner Bluegrass and the Outer Bluegrass. Bankfull channel dimensions, discharge, and return period as well as average channel slope, median bed material size, sinuosity, Rosgen stream classification, and percent impervious area were determined. Significant relationships were found between drainage area and the bankfull characteristics of cross-sectional area, width, mean depth, and discharge for both the Inner Bluegrass and Outer Bluegrass regions (α = 0.05). It was also found that the percent impervious area in a watershed had minimal effect on bankfull dimensions, which is attributed to the well-vegetated nature of the streambanks, cohesive streambank materials, and bedrock control. No significant differences between any of the Inner Bluegrass and Outer Bluegrass regional curves were found (α = 0.05). Comparisons were made between the Inner Bluegrass and Outer Bluegrass curves and others developed in karst-influenced areas in the Eastern United States. Although few significant differences were found between the regional curves for bankfull discharge and width, a number of the curves differed with regards to bankfull cross-sectional area and mean depth. [ABSTRACT FROM AUTHOR]

Brockman, Ruth R., Carmen T. Agouridis, Stephen R. Workman, Lindell E. Ormsbee, and Alex W. Fogle, 2012. Bankfull Regional Curves for the Inner and Outer Bluegrass Regions of Kentucky. Journal of the American Water Resources Association (JAWRA) 48(2): 391-406. DOI: 10.1111/j.1752-1688.2011.00621.x Abstract: Bankfull regional curves that relate channel dimensions and discharge to watershed drainage area are useful tools for assisting in the correct identification of bankfull elevation and in stream restoration and reconstruction. This study assessed 28 stable streams located in two physiographic regions of Kentucky: the Inner Bluegrass and the Outer Bluegrass. Bankfull channel dimensions, discharge, and return period as well as average channel slope, median bed material size, sinuosity, Rosgen stream classification, and percent impervious area were determined. Significant relationships were found between drainage area and the bankfull characteristics of cross-sectional area, width, mean depth, and discharge for both the Inner Bluegrass and Outer Bluegrass regions (α = 0.05). It was also found that the percent impervious area in a watershed had minimal effect on bankfull dimensions, which is attributed to the well-vegetated nature of the streambanks, cohesive streambank materials, and bedrock control. No significant differences between any of the Inner Bluegrass and Outer Bluegrass regional curves were found (α = 0.05). Comparisons were made between the Inner Bluegrass and Outer Bluegrass curves and others developed in karst-influenced areas in the Eastern United States. Although few significant differences were found between the regional curves for bankfull discharge and width, a number of the curves differed with regards to bankfull cross-sectional area and mean depth. [ABSTRACT FROM AUTHOR]

Background: Despite recent advances in the treatment and prevention of cardiovascular disease, a treatment gap for secondary prevention medications still exists. Objective: To develop and implement a program ensuring appropriate prescription of aspirin, statins, β-blockers, angiotensin-converting enzyme inhibitors, and warlarin at hospital discharge. Design: A nonrandomized before-after study comparing patients hospitalized before (1996-1998) and after (1999-2002) implementation of a discharge medication program (DMP). Patients were followed for up to 1 year. Setting: The 10 largest hospitals in the Utah-based Intermountam Health Care system. Patients: In the pre-DMP and DMP time periods, 26 000 and 31 465 patients, respectively, were admitted to cardiovascular services (n = 57465). Measurements: Prescription of indicated medications at hospital discharge; post discharge death or readmission. Results: By 1 year, the rate of prescription of each medication increased significantly to more than 90% (P< 0.001); this rate was sustained. At 1 year, unadjusted absolute event rates for readmission and death, respectively, were 210 per 1000 person-years and 96 per 1000 person-years before OMP implementation and 191 per 1000 person-years and 70 per 1000 person-years afterward. Relative risk for death and readmission at 30 days decreased after OMP implementation; hazard ratios (HRs) for death and readmission were 0.81 (95% CI, 0.73 to 0.89) and 0.92 (CI, 0.87 to 0.99) (P < 0.001 and P = 0.017, respectively). At I year, risk for death continued to decrease (hazard ratio, 0.79 [CI, 0.75 to 0.84]; P < 0.001) while risk for readmission stabilized (hazard ratio, 0.94 [CI, 0.90 to 0.98]; P= 0.002), probably because survivors had more opportunities to be readmitted. Limitations: The study design was observational and nonrandomized, and the authors could not control for potential confounders or determine the extent to which secular trends accounted for the observed improvements. Conclusions: A relatively simple quality improvement program aimed at enhancing the prescription of appropriate discharge medications among cardiovascular patients is feasible and can be sustained within an integrated multihospital system. Such a program may be associated with improvements in cardiovascular readmission rates and mortality. [ABSTRACT FROM AUTHOR]