Digital Commons Network^™

Cost Analysis Of The Built Environment: The Case Of Bike And Pedestrian Trials In Lincoln, Neb, Guijing Wang, Caroline A. Macera, Barbara Scudder-Soucie, Tom Schmid, Michael Pratt, David Buchner, Gregory Heath

United States Public Health Resources

We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using construction and maintenance costs provided by the Department of Parks and Recreation of Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a period of useful life of 10, 30, and 50 years. The average cost per mile and per user was calculated.
Trail length averaged 3.6 miles (range=1.6–4.6 miles). Annual cost in 2002 dollars ranged from $25 762 to $248479 (mean=$124927; …

Monitoring Physical Activity: Uses And Measurement Issues With Automated Counters, Michelle L. Granner, Patricia A. Sharpe

Faculty Publications

Background: Promotion of physical activity is a public health priority, and environmental factors influence physical activity behavior. Valid and reliable automated measurement tools of physical activity for assessment and evaluation within public settings are needed. Methods: Searches of the research literature and governmental reports from physical activity, transportation, and recreation fields were conducted to identify methods of automated counting and validation studies. The article provides a summary of (a) current methods and uses of automated counters, (b) information about validity and reliability where available, (c) strengths and limitations of each methods, and (d) measurement issues. Results: Existing automated counting technology …

State Efforts To Expand Health Coverage: One Bite At A Time, Christopher Stream

Public Policy and Leadership Faculty Research

For more than twenty years, health scholars and advocates have warned us about the lack of adequate health coverage among a growing number of Americans. Health insurance premiums are rising. Many employers, especially small employers who employ over half of the country’s workforce, and individuals are seeing premium increases of 30, 40, and even 50 percent. Not surprisingly, America’s uninsured population is rising— to more than 41 million people. States are feeling the budget crunch as the economy sags and more and more people turn to state Medicaid and other public health care systems. This all means that state policy …

The Florida Legislature’S Physical Activity And Nutrition Bills And Florida’S Youth: A Health Professional’S Call To Action

Florida Public Health Review

No abstract provided.

A Brief Interview With Vice Admiral Richard H. Carmona, Md, Mph, Facs Surgeon General Of The United States

Florida Public Health Review

No abstract provided.

Examination Of Impact Of Polk County Florida’S Safe And Drug Free Schools Program

Florida Public Health Review

No abstract provided.

Minority Youth: “Big Tobacco’S” 21st Century Marketing Targets

Florida Public Health Review

No abstract provided.

Perceptions Of Access To U.S. Health Care Of Haitian Immigrants In South Florida

Florida Public Health Review

No abstract provided.

School Health Is Public Health

Florida Public Health Review

No abstract provided.

An Overview And Evaluation Of Cultural Competence Training For Public Health Professionals

Florida Public Health Review

No abstract provided.

Use Of Hospitals, Physician Visits, And Hospice Care During Last Six Months Of Life Among Cohorts Loyal To Highly Respected Hospitals In The United States, J. E. Wennberg, Elliot S. Fisher, Therese A. Stukel, Jonathan S. Skinner

Dartmouth Scholarship

Objective: To evaluate the use of healthcare resources during the last six months of life among patients of US hospitals with strong reputations for high quality care in managing chronic illness.

Causal Inference In Hybrid Intervention Trials Involving Treatment Choice, Qi Long, Rod Little, Xihong Lin

The University of Michigan Department of Biostatistics Working Paper Series

Randomized allocation of treatments is a cornerstone of experimental design, but has drawbacks when a limited set of individuals are willing to be randomized, or the act of randomization undermines the success of the treatment. Choice-based experimental designs allow a subset of the participants to choose their treatments. We discuss here causal inferences for experimental designs where some participants are randomly allocated to treatments and others receive their treatment preference. This paper was motivated by the “Women Take Pride” (WTP) study (Janevic et al., 2001), a doubly randomized preference trail (DRPT) to assess behavioral interventions for women with heart disease. …

Necessary But Not Sufficient? Physician Volunteerism And The Health Care Safety Net, Eileen Salinsky

National Health Policy Forum

This paper examines the role of physician-sponsored charity care in meeting the health care needs of the uninsured. The paper provides an overview of current charity care levels by medical specialties and geographic regions, discusses limitations in available data, and describes the settings in which charity care is provided. The paper also summarizes the factors that motivate physicians to provide volunteer services, as well as the barriers that hinder volunteer activities, including malpractice insurance concerns. Also discussed are a range of public policies, both existing and considered, that support volunteer activities, with a particular emphasis on the expansion of Federal …

Health Educators In Florida’S County Public Health Departments: Frequency Of And Perceived Confidence In Performing Entry-Level Competencies, Michele Johnson Moore

Florida Public Health Review

No abstract provided.

A Bayesian Hierarchical Approach To Multirater Correlated Roc Analysis, Tim Johnson, Valen Johnson

The University of Michigan Department of Biostatistics Working Paper Series

In a common ROC study design, several readers are asked to rate diagnostics of the same cases processed under different modalities. We describe a Bayesian hierarchical model that facilitates the analysis of this study design by explicitly modeling the three sources of variation inherent to it. In so doing, we achieve substantial reductions in the posterior uncertainty associated with estimates of the differences in areas under the estimated ROC curves and corresponding reductions in the mean squared error (MSE) of these estimates. Based on simulation studies, both the widths of confidence intervals and MSE of estimates of differences in the …

Confronting The Impending Public Health Workforce Crisis In America: Perspectives From Academia And Public Health Practice.

Florida Public Health Review

No abstract provided.

Construction Laborer Dies From Heat Stroke At End Of Workday, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On June 27, 2003, a 41-year-old, male laborer died from heat stroke one day after being taken to the hospital. The laborer was working on an addition to a factory sawing boards to make concrete forms. He worked until 5:00 pm that day and was in the parking lot on his way to his vehicle when he apparently collapsed beside his vehicle. A worker on the second shift at the factory was taking scrap material outside to a dumpster when he found the laborer on the ground. The factory worker returned to the plant and told his supervisor there was …

Highway Construction Worker Dies When Struck By Semi-Tractor Trailer, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

At approximately 8:30 am on April 16, 2003, a 48-year-old male (decedent) highway construction laborer working in an interstate highway median, died when he was struck by an out-of-control double trailer (a semi-truck pulling two trailers). The laborer was speaking with the job foreman and another laborer in the median next to a grading machine. As the decedent looked toward the traffic, he saw a double trailer traveling on the right-hand shoulder swerve into the left-hand lane and drive into the median where all three men were standing. He told the other two to get out of the way as …

28-Year-Old Man Dies After Falling With Lift, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

On June 27, 2003, a 28-year-old male sound technician died due to injuries received after falling approximately 50 feet from a lift. Three men (one chief sound engineer and two sound technicians) were sent to repair a sound system in a school gymnasium. Upon arriving and assessing the situation, the three diagnosed that a particular speaker, located in the rafters, should be removed from its location. Using a 30-year-old telescoping, self-leveling lift belonging to the school, the chief engineer used controls located at the base of the lift, to hoist the two sound technicians to the speaker in the rafter. …

Self-Reported Memory Symptoms With Coronary Artery Disease: A Prospective Of Cabg Patients And Nonsurgical Controls, Ola A. Selnes, Maura A. Grega, Louis M. Borowicz, Jr., Sarah Barry, Scott L. Zeger, Guy M. Mckhann

Johns Hopkins University, Dept. of Biostatistics Working Papers

Background. Subjective memory complaints are common after coronary artery bypass grafting (CABG), but previous studies have concluded that such symptoms are more closely associated with depressed mood than objective cognitive dysfunction. We compared the incidence of self-reported memory symptoms at 3 and 12 months after CABG with that of a control group of patients with comparable risk factors for coronary artery disease but without surgery.

Methods. Patients undergoing CABG (n = 140) and a demographically similar nonsurgical control group with coronary artery disease (n = 92) were followed prospectively at 3 and 12 months. At each follow-up time, participants were …

Fatal Tractor Overturns: Don't Let Them Roll Over You!, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Tractors/Logging

To prevent tractor injuries:

• All tractors should be equipped with a Roll Over Protective Structure (ROPS) and a seat belt.
• Tractors should be equipped with front-end counterweights and tractor wheels
• should be weighted to increase stability.
• Community farm safety training with safe operating procedures and hazard identification should be offered to novice or limited- experience operators.

The Influence Of Social Status On Token Women Leaders’ Expectations About Leading Male-Dominated Groups, Theodore W. Mcdonald, Loren L. Toussaint, Jennifer A. Schweiger

Public and Population Health Faculty Publications and Presentations

Prior research has shown that women report mostly negative expectations about being a gender-token in male-dominated work groups. We speculate that this is partially caused by the socially-ascribed status devaluation of women. In the present study we investigated the degree to which elevated social status may lessen negative expectations of gender-token women assigned to leadership positions. Sixty-three undergraduate women participated in one of three tokenism conditions: 1) nontoken, 2) gender-token, and 3) high-status gender-token. In all conditions participants were led to believe that they would be leading a group of men in a decision-making exercise. Leader expectations were then assessed. …

Impact Of Appropriate Pharmaceutical Therapy For Chronic Conditions On Direct Medical Costs And Workplace Productivity: A Review Of The Literature, Neil Goldfarb, Christine Weston, Christine W. Hartmann, Mirko Sikirica, Albert Crawford, Hope He, Jamie Howell, Vittorio Maio, Janice Clarke, Bhaskar Nuthulaganti, Nicole Cobb

College of Population Health Faculty Papers

This paper presents the findings of a literature review investigating the economic impact of appropriate pharmaceutical therapy in treating four prevalent chronic conditions - asthma, diabetes, heart failure, and migraine. The goal of the review was to identify high-quality studies examining the extent to which appropriate pharmaceutical therapy impacts overall medical expenditure (direct costs) and workplace productivity (indirect costs). The working hypothesis in conducting the review was that the costs of pharmaceuticals for the selected chronic conditions are offset by savings in direct and indirect costs in other areas. The literature provides evidence that appropriate drug therapy improves the health …

An Assessment Of Hiv/Aids Risk In Higher Education Students In Yerevan, Armenia, Talin Babikian, Mary Catherin Freier, Gary L. Hopkins, Ralph Diclemente, Duane C. Mcbride, Matt Riggs

Faculty Publications

Armenia's current sociopolitical and economic instability and the alarming HIV incidence rates in neighboring countries amplify its risk for a national epidemic. The goals of this study were to assess HIV/AIDS knowledge and risk behaviors among higher education students in Yerevan. Knowledge of HIV transmission through sexual intercourse was markedly higher than that on intravenous transmission and prevailing myths; however, HIV/AIDS knowledge was not related to risk behaviors. Tobacco and alcohol prevalence was relatively high. Students reported risky sexual behaviors, including inconsistent condom use, casual sex, and multiple partners. In addition to descriptive statistics delineating gender differences across the target …

A Bayesian Chi-Squared Test For Goodness Of Fit, Valen Johnson

The University of Michigan Department of Biostatistics Working Paper Series

This article describes an extension of classical x 2 goodness-of-fit tests to Bayesian model assessment. The extension, which essentially involvesevaluating Pearson's goodness-of-fit statistic at a parameter value drawn from its posterior distribution, has the important property that it is asymptoti-cally distributed as a x2 random variable on K-1 degrees of freedom, indepen-dently of the dimension of the underlying parameter vector. By averaging over the posterior distribution of this statistic, a global goodness-of-fit diagnostic is obtained. Advantages of this diagnostic{which may be interpreted as the area under an ROC curve{include ease of interpretation, computational conve-nience, and favorable power properties. The proposed …

The Health Care Safety Net In South Carolina: A Test Of Tenacity, Jennifer Ryan, Randy Desonia

National Health Policy Forum

This site visit to the state of South Carolina provided an opportunity to experience and understand the unique makeup of the health care safety net in a southern state. Site visitors had the opportunity to interact with health care providers, state officials, faith-based organizations and leaders of provider-driven volunteer initiatives. They also learned about the challenges of access to care in rural areas and among diverse population groups. The group visited the Sea Island Medical Center and Our Lady of Mercy Community Outreach and Wellness House; a migrant farm worker camp on Johns Island; and a “medical home” site, Medical …

Individualized Predictions Of Disease Progression Following Radiation Therapy For Prostate Cancer., Jeremy Taylor, Menggang Yu, Howard M. Sandler

The University of Michigan Department of Biostatistics Working Paper Series

Background: Following treatment for localized prostate cancer, men are monitored with serial PSA measurements. Refining the predictive value of post-treatment PSA determinations may add to clinical management and we have developed a model that predicts for an individual patient future PSA values and estimates the time to future clinical recurrence.

Methods: Data from 934 patients treated for prostate cancer between 1987 and 2000 were used to develop a comprehensive statistical model to fit the clinical recurrence events and pattern of PSA data. A logistic regression model was used for the probability of cure, non-linear hierarchical mixed models were used for …

Fpha President’S Message For The Florida Public Health Review

Florida Public Health Review

No abstract provided.

Single-Payer National Health Insurance: Physicians' Views, Danny Mccormick, David U. Himmelstein, Stephanie Woolhandler, David H. Bor

Publications and Research

Background
Forty-one million Americans have no health insurance and, despite the growth of managed care, medical costs are again increasing rapidly. One proposed solution is a single-payer health care financing system with universal coverage. Yet, physicians' views of such a system have not been well studied.

Methods
We surveyed a random sample of physicians (from the American Medical Association Masterfile) in Massachusetts, regarding their views on a single-payer health care financing system and other financing and physician work-life issues that such a system might affect.

Results
Of 1787 physicians, 904 (50.6%) responded to our survey. When asked which structure would …

The Prevalence And Treatment Of Pain Among Rural Medicaid Beneficiaries With Disabilities, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Pain has an enormous impact on the lives of many people with disabilities. Recent research suggests that nearly 80% of people whose primary disability is not a pain disorder are still limited by pain as a secondary condition. As many as half of those people report that their pain is ongoing, intractable and limiting (Ehde, Jensen, Engel, Turner, Hoffman & Cardenas, 2003). Our research suggests strong associations between an individual’s pain and his or her quality of life, depression and the number of hours worked.