Objectives: This study examined a multicommunity alternative transportation program available 24 hours a day, 7 days a week, for any purpose, offering door-through-door service in private automobiles to members who either do not drive or are transitioning away from driving. Specific aims were to describe the characteristics of members by driving status and ride service usage of these members.
Methods: Data came from administrative records maintained by a nonprofit ride service program and include 2,661 individuals aged 65+ residing in 14 states who joined the program between April 1, 2010, and November 8, 2013. Latent class analysis was used to group current drivers into 3 classes of driving status of low, medium, and high self-regulation, based on their self-reported avoidance of certain driving situations and weekly driving frequency. Demographics and ride service use rate for rides taken through March 31, 2014, by type of ride (e.g., medical, social, etc.) were calculated for nondrivers and drivers in each driving status class.
Results: The majority of ride service users were female (77%) and aged 65–74 years (82%). The primary method of getting around when enrolling for the transportation service was by riding with a friend or family member (60%). Among the 67,883 rides given, nondrivers took the majority (69%) of rides. Medical rides were the most common, accounting for 40% of all rides.
Conclusions: Reported ride usage suggests that older adults are willing to use such ride services for a variety of trips when these services are not limited to specific types (e.g., medical). Further research can help tailor strategies to encourage both nondrivers and drivers to make better use of alternative transportation that meets the special needs of older people. 相似文献
Adult respiratory distress syndrome (ARDS) is a clinical syndrome which occurs due to various direct or indirect noxious agents and pyhsical mechanisms. One of the etiological factors is ingested chemicals (e.g. paraquat, ethylene glycol). The organophosphorous (OP) insecticides are the most toxic and frequently encountered chemicals that produce poisoning in humans. Studies were undertaken to investigate whether OP insecticides may produce ARDS. Fifteen autopsy cases due to suicidal OP insecticide poisoning were investigated. Toxicological analyses were performed with a gas chromatography-nitrogen phosphorous detector (GC-NPD). Methamidophos, dimefox and dichlorvos were the detected OP. Lungs were examined macroscopically. Two cases showed features compatible with ARDS in which the only cause of death was OP poisoning. Due to the severity of ARDS it is important to assess insecticidal exposure in an attempt to enhance survival patterns following OP poisoning in patients in order to initiate therapy. 相似文献
Objective: Studies of alcohol-related harm (violence, injury, illness) suggest that the most significant risk factors are the amount of alcohol consumed and whether obviously intoxicated patrons continue to be served. This study's objective was to investigate the effects of a responsible beverage service (RBS)/enhanced alcohol enforcement intervention on bars, bar patrons, and impaired driving.
Method: Two communities—Monroe County, New York, and Cleveland, Ohio—participated in a demonstration program and evaluation. The intervention applied RBS training, targeted enforcement, and corrective actions by law enforcement to a random sample of 10 identified problem bars in each community compared to 10 matched nonintervention problem bars. Data were collected over 3 waves on bar serving practices, bar patron intoxication, drinking and driving, and other alcohol-related harm from intervention and control bars and treatment and comparison communities.
Results: In Monroe County, New York, of the 14 outcome measures analyzed, 7 measures showed statistically significant differences from pre- to postintervention. Six of those measures indicated changes in the desired or positive direction and 2 measures were in the undesired or negative direction. Of note in the positive direction, the percentage of intervention bar patrons who were intoxicated decreased from 44 to 27% and the average blood alcohol concentration of patrons decreased from 0.097 to 0.059 g/dL pre- to postintervention. In Cleveland, Ohio, 6 of the 14 measures showed statistically significant changes pre- to postintervention with 6 in the positive direction and 4 in the negative direction. Of note, the percentage of pseudo-intoxicated patrons denied service in intervention bars increased from 6 to 29%.
Conclusions: Of the 14 outcome measures that were analyzed in each community, most indicated positive changes associated with the intervention, but others showed negative associations. About half of the measures showed no significance, the sample sizes were too small, or the data were unavailable. Therefore, at best, the results of these demonstration programs were mixed. There were, however, some positive indications from the intervention. It appears that when bar managers and owners are aware of the program and its enforcement and when servers are properly trained in RBS, fewer patrons may become intoxicated and greater efforts may be made to deny service to obviously intoxicated patrons. Given that about half of arrested impaired drivers had their last drink at a licensed establishment, widespread implementation of this strategy has the potential to help reduce impaired driving. 相似文献
Stakeholder engagement is a crucial concept of extension education. Engagement expresses democratic values of the land-grant
mission by providing opportunities for stakeholders to influence program planning, including setting the agenda and negotiating
resource allocations. In practice, the concept of engagement guides the formation of partnerships among extension, communities,
industry, and government. In the area of sustainable agriculture, however, stakeholders may conflict, presenting challenges
to the engagement process. Results from a study of a Canadian sustainable agriculture program, produced using cultural anthropology
and participatory action research, detail challenges of the engagement process that led to reconstruction of a farmer-extension
partnership. Notable in the early phase of the reconstruction process were critical reflection, stakeholder forums, exclusion
through caucusing, and coalition building. An argument for a neopragmatist view provides a theoretical basis for understanding
counterintuitive dimensions of engagement revealed by the study. 相似文献