Healthcare utilization and costs among older adult female drivers and former drivers

PurposeThis study compared the healthcare utilization and costs for specific types of medical services among older adult women who currently drive and those who no longer drive.MethodsThis study included 347 women aged 65 or older who were either former (had stopped driving) or current drivers, randomly sampled from a large U.S. health plan to participate in a telephone survey, and who had automated health records with healthcare utilization and cost data. Bivariate analyses and generalized linear modeling were used to examine associations between driving status and healthcare utilization and costs.ResultsAdjusting for age, income, and marital status, former drivers were more likely than current drivers to use mental health care services (RR = 3.37; 95% CI: 1.03, 10.98). Former drivers also tended to use more inpatient (RR = 1.85; 95% CI: 0.88, 3.87) and emergency services (RR = 1.89; 95% CI: 0.96, 3.70), but results did not reach statistical significance. Total annual healthcare costs in 2005 were almost twice as high for former drivers compared with current drivers ($13,046 vs. $7,054; mean difference = $5,992; 95% CI: -$360, $12,344), although this relationship was not statistically significant (CR = 1.61; 95% CI: 0.88, 2.96).Impact on IndustryFormer drivers were more than three times as likely as current drivers to use mental health services, and tended to use more emergency and inpatient services. Further research on factors that potentially mediate the relationship between driving status and health service use is warranted.     

Adult opinions about the age at which children can be left home alone, bathe alone, or bike alone: Second Injury Control and Risk Survey (ICARIS-2)

ProblemThis study describes adult opinions about child supervision during various activities.MethodsData come from a survey of U.S. adults. Respondents were asked the minimum age a child could safely: stay home alone; bathe alone; or ride a bike alone. Respondents with children were asked if their child had ever been allowed to: play outside alone; play in a room at home for more than 10 minutes alone; bathe with another child; or bathe alone.ResultsThe mean age that adults believed a child could be home alone was 13.0 years (95% CI = 12.9-13.1), bathe alone was 7.5 years (95% CI = 7.4-7.6), or bike alone was 10.1 years (95% CI = 10.0-10.3). There were significant differences by income, education, and race.DiscussionAssessing adult's understanding of the appropriate age for independent action helps set a context for providing guidance on parental supervision. Guidelines for parents should acknowledge social norms and child development stages.Impact on IndustryKnowledge of social norms can help guide injury prevention messages for parents.     

A moderated mediation test of personality,coping, and health among deployed soldiers

Our study examines how personality and coping influence soldiers' psychological health among 648 US Army personnel who were at that time deployed in Iraq at the height of an insurgency. Conscientiousness, neuroticism, and extraversion were associated with different coping behaviors, and these were in turn related to psychological distress. Conscientiousness was positively associated with problem‐focused coping and negatively with avoidance coping, whereas neuroticism was most positively associated with avoidance coping. Extraversion was positively related to both seeking social support and avoidance coping. As expected, avoidance coping was positively associated with psychological distress. Coping style explained more variance in the relationship between personality and distress among soldiers who perceived higher levels of threat, thus supporting a moderated mediation hypothesis. We discuss implications for facilitating the stress coping of workers who face acute and potentially traumatic stress exposures. Copyright © 2011 John Wiley & Sons, Ltd.     

Working conditions,psychological/physical symptoms and occupational accidents. Bayesian network models

Each day thousands of workers suffer occupational accidents of varying degrees of severity. Accidents at work render workers incapable of carrying out their day to day activities, either temporarily or permanently, and they also have detrimental effects on family life, the company, and the general public. In order to reduce the occupational accident rate, it is necessary to determine the causes of those accidents. Although there are many different types of accidents, they generally stem from poor working conditions. The purpose of this study was to analyze the influence of working conditions on occupational accidents from data gathered in the VI National Survey of Working Conditions (VI NSWCs) in 2007. This survey utilized a random sample of the active population of Spain. The sample comprised 11,054 people (5917 males and 5137 females). In order to carry out the study, a probabilistic model was built using Bayesian networks. The model included the following variables: hygiene conditions, ergonomic conditions, job demands, physical symptoms, psychological symptoms, and occupational accidents. The study demonstrated that there were strong relationships between hygiene conditions and occupational accidents; it has been shown that poor hygienic conditions duplicate the probability of accident. Physical symptoms increased almost 50% due to poor ergonomic conditions. And finally, high job demands almost duplicated the psychological symptoms. The investigation also showed a high degree of interdependence between physical and psychological symptomatologies and the relationship between these and occupational accidents.     

Biomechanical response targets for physical and computational models of the pediatric trunk

Objectives: This paper quantifies pediatric thoracoabdominal response to belt loading to guide the scaling of existing adult response data and to assess the validity of a juvenile porcine abdominal model for application to the development of physical and computational models of the human child. Methods: Table-top belt-loading experiments were performed on 6, 7, and 15 year-old pediatric post-mortem human subjects (PMHS). Response targets are reported for diagonal belt and distributed loading of the anterior thorax and for horizontal belt loading of the abdomen. Results: The pediatric PMHS exhibited abdominal response similar to the swine, including the degree of rate sensitivity. The thoraces of the PMHS were as stiff as, or slightly more stiff than, published adult corridors. Conclusions: An assessment of age-related changes in thoracic stiffness suggests that the effective stiffness of the chest increases through the fourth decade of life and then decreases, resulting in stiffness values similar for children and elderly adults.     

Call structure may affect male mating success in the quacking frog<Emphasis Type="Italic"> Crinia georgiana</Emphasis> (Anura: Myobatrachidae)

We investigated the relationship between mating success, male size and variation in the advertisement call in the frog Crinia georgiana under field conditions. Mating success in 91 males was determined by following 32 females as they moved through the chorus. Our analyses indicated that successful males had a higher number of pulses in the first note and/or called at a higher rate. However, we did not detect a significant relationship between mating success and dominant frequency, the property that varied most strongly with body size, suggesting that size is not an important influence on mate choice in this species. Even so, smaller males were more successful if they called at a higher rate whereas larger males were more successful if they had more pulses in their first note. Accordingly, males of different size may use different calling tactics to attract females. These results provide a framework for further experimental studies aimed at investigating the independent impacts of both inter- and intra-sexual selection on the advertisement call and body size of C. georgiana.     

Modelling gas release event behaviour in hazardous waste tanks

Certain radioactive waste storage tanks at the United States Department of Energy Hanford facilities continuously generate gases as a result of radiolysis and chemical reactions. The congealed sludge in these tanks traps the gases beneath it and causes the level of the waste within the tanks to rise. The waste level continues to rise until the sludge loses its buoyancy and rolls over, changing places with fluid on top. During a rollover, the trapped gases are released, resulting in a sudden drop in the waste level. This is known as a gas release event (GRE). After a GRE, the waste re-congeals and gas again accumulates, leading to another GRE. We are interested in the time between consecutive GREs. Understanding the probabilistic behaviour of the time between consecutive GREs is important because the hydrogen and nitrous oxide gases released during a GRE are flammable and the ammonia that is released is a health risk. From a safety perspective, activity around such waste tanks should be halted when a GRE is imminent. With a credible probability model for the time between consecutive GREs, we can establish time windows in which waste tank research and maintenance activities can be safely performed. We discuss the application of non-linear time series models to this problem.     

Recruitment of Hexagenia mayfly nymphs in western Lake Erie linked to environmental variability.

After a 40-year absence caused by pollution and eutrophication, burrowing mayflies (Hexagenia spp.) recolonized western Lake Erie in the mid 1990s as water quality improved. Mayflies are an important food resource for the economically valuable yellow perch fishery and are considered to be major indicator species of the ecological condition of the lake. Since their reappearance, however, mayfly populations have suffered occasional unexplained recruitment failures. In 2002, a failure of fall recruitment followed an unusually warm summer in which western Lake Erie became temporarily stratified, resulting in low dissolved oxygen levels near the lake floor. In the present study, we examined a possible link between Hexagenia recruitment and periods of intermittent stratification for the years 1997 2002. A simple model was developed using surface temperature, wind speed, and water column data from 2003 to predict stratification. The model was then used to detect episodes of stratification in past years for which water column data are unavailable. Low or undetectable mayfly recruitment occurred in 1997 and 2002, years in which there was frequent or extended stratification between June and September. Highest mayfly reproduction in 2000 corresponded to the fewest stratified periods. These results suggest that even relatively brief periods of stratification can result in loss of larval mayfly recruitment, probably through the effects of hypoxia. A trend toward increasing frequency of hot summers in the Great Lakes region could result in recurrent loss of mayfly larvae in western Lake Erie and other shallow areas in the Great Lakes.