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.     

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.     

Aphid population response to agricultural landscape change: A spatially explicit,individual-based model

A spatially explicit individual-based simulation model has been developed to represent aphid population dynamics in agricultural landscapes. The application of the model to Rhopalosiphum padi (L.) population dynamics is detailed, including an outline of the construction of the model, its parameterisation and validation. Over time, the aphids interact with the landscape and with one another. The landscape is modified by varying a simple pesticide regime, and the multi-scale spatial and temporal implications for a population of aphids is analysed. The results show that a spatial modelling approach that considers the effects on the individual of landscape properties and factors such as wind speed and wind direction provides novel insight into aphid population dynamics both spatially and temporally. This forms the basis for the development of further simulation models that can be used to analyse how changes in landscape structure impact upon important species distributions and population dynamics.     

A new satellite-based methodology for continental-scale disturbance detection.

The timing, location, and magnitude of major disturbance events are currently major uncertainties in the global carbon cycle. Accurate information on the location, spatial extent, and duration of disturbance at the continental scale is needed to evaluate the ecosystem impacts of land cover changes due to wildfire, insect epidemics, flooding, climate change, and human-triggered land use. This paper describes an algorithm developed to serve as an automated, economical, systematic disturbance detection index for global application using Moderate Resolution Imaging Spectroradiometer (MODIS)/Aqua Land Surface Temperature (LST) and Terra/MODIS Enhanced Vegetation Index (EVI) data from 2003 to 2004. The algorithm is based on the consistent radiometric relationship between LST and EVI computed on a pixel-by-pixel basis. We used annual maximum composite LST data to detect fundamental changes in land-surface energy partitioning, while avoiding the high natural variability associated with tracking LST at daily, weekly, or seasonal time frames. Verification of potential disturbance events from our algorithm was carried out by demonstration of close association with independently confirmed, well-documented historical wildfire events throughout the study domain. We also examined the response of the disturbance index to irrigation by comparing a heavily irrigated poplar tree farm to the adjacent semiarid vegetation. Anomalous disturbance results were further examined by association with precipitation variability across areas of the study domain known for large interannual vegetation variability. The results illustrate that our algorithm is capable of detecting the location and spatial extent of wildfire with precision, is sensitive to the incremental process of recovery of disturbed landscapes, and shows strong sensitivity to irrigation. Disturbance detection in areas with high interannual variability of precipitation will benefit from a multiyear data set to better separate natural variability from true disturbance.     

Trends and sources of particulate matter in the Superstition Wilderness using air trajectory and aerosol cluster analysis

Ambient aerosols adversely affect human health and visibility and impact climate. Identification of sources of particulate matter and its precursors is necessary for developing control strategies. The goal of this research is to utilize long-term speciated particulate matter data and back-trajectory cluster analyses to determine trends and sources of particulate matter in the Superstition Wilderness, a rural area east of Phoenix, Arizona. Twenty-four hour back-trajectories were calculated for every hour of every 24-h particulate matter sample obtained by IMPROVE from 1991 to 2004. Days that included back-trajectories with considerable spatial variance were excluded from further analyses. To minimize uncertainties inherent in single trajectories, all calculated trajectories for each sampling day were averaged to represent the air mass sampled during that day. Cluster analysis of trajectories identified four unique regions, including a region with Phoenix, a region with copper smelters, and one with coal-fired power plants. Yearly averages of sulfate, nitrate, soil, and carbon concentrations were calculated for each region. Statistically significant trends in species concentrations by region and independent of region and differences in concentrations between regions were examined.Sulfate concentrations from the region with smelters were higher than other regions but decreased during the study period. Emissions data from the smelters indicate that much of the sulfate from the region was due to the smelters. The overall 2.2% year⁻¹ decrease in sulfate concentrations at TNM is likely due to decreased emissions from the copper smelters. A 3.6% year⁻¹ increase in nitrate concentrations was driven largely by increasing NO_x concentrations from Phoenix and to a lesser extent the region southwest of the site which includes Tucson and suburban/urban areas between Phoenix and Tucson. Soil concentrations were higher from regions with deserts than the region without desert. This method could not identify trends or source regions of carbonaceous aerosols at this site.     

Analysis of gaseous diisocyanates in air using chemosorption sampling

A sampling procedure for 2,4- and 2,6-toluenediisocyanate (TDI) and 4,4′-diphenylmethane diisocyanate (MDI) in the range 0.007-0.7 mg/m³ in a 15 L air sample is described. The sampling is performed with 9-(N-methylaminomethyl)-anthracene (MAMA) adsorbed on a solid sorbent, Amberlite XAD-2. The recoveries are 80–100% in this chemosorption reaction. The urea derivatives are desorbed with N,N-dimethylformamide and analysed by high performance liquid chromatography (HPLC). Samples and prepared chemosorption tubes are stable for at least two weeks if stored in the dark. To complete the investigation, field measurements of TDI were performed in an industrial atmosphere.