Esthetic and Recreational Potential of Small Naturalistic Streams Near Urban Areas

The purpose of this study was to find a way to evaluate the esthetic and recreational potential of small streams and their watersheds. Research was limited to naturalistic streams with drainage areas under 100 square miles and located within 25 miles of a city. A methodology, based on some previous work of the U.S. Soil Conservation Service and the principles or concepts of terrain analysis, land use planning, value Judgment philosophy and the economics of outdoor recreation, was developed and applied in detail to two streams (Boone and Jessamine Creeks) near Lexington, Kentucky. Evaluations were made of the streams\u27 potential for camping (primitive, transient and group), fishing, picnicking, a trail system (hiking, horseback riding, bicycling and auto tour routes), esthetic enjoyment (sightseeing, nature walks and walking for pleasure) and the establishment of natural, scenic and historic areas, Limited applications were also made to two other watersheds and to selected recreation sites on Boone and Jessamine Creeks. Extensions of these case studies resulted in procedures for estimating: visitation to a developed site, future participation demand generated by an urban area and the proportion of that demand that would be satisfied at a specific site, and the economic benefits that would accrue if the sites were developed. Conclusions reached were: (1) Esthetic and recreational values can be identified, inventoried and used to evaluate a watershed\u27s development potential. (2) The methodology yielded fairly accurate evaluations for most of the recreational activities considered. (3) The case studies revealed that many small stream areas possess medium to high potential for camping, fishing, picnicking, trail system development and some forms of esthetic enjoyment. (4) Visitation estimates were judged to be only approximate due to lack of relevant data on similar existing recreation areas. Estimates of participation demand, acreage requirements and annual benefits were somewhat more reliable. Suggestions for further research include: (1) Additional applications of the evaluation methodology to streams in other Kentucky urban areas and in states having climatic, topographic and socio-economic conditions different from Kentucky\u27s and (2) A feasibility study of the use of a psychometrics approach to determine personal preferences about outdoor recreation and the preservation of natural areas

Measuring the Intangible Values of Natural Streams, Part II

This report describes the work done during Part II of a project which had as its aim the development of a way to quantify those intangible values peculiar to a small stream and its watershed. Part I was concerned with an application of the uniqueness concept in the evaluation of fifty-eight Kentucky streams. The results of this effort are in Report #40, U. K. Water Resources Institute (1971). During the second part of the project: A method was developed whereby peoples\u27 preferences for natural landscapes could be measured. The method utilized projected color slides and a rating system based on the semantic differential. Fourteen preference studies were conducted using different types of subjects and stimuli (color slides). The data were factor analyzed and scores computed for three factors (Natural Beauty, Force and Starkness) for each slide-subject group combination. The scenic content of each slide was measured and related to the factor scores by a series of linear regression equations. The uniqueness ratio approach was modified to include fewer stream characteristics (thirty-seven) and the work of Part I essentially repeated. A new method of stream evaluation was developed which yields a factor score for a given stream on each of six factors (Scenic Attractiveness, Land Use-Topo, Litter, Aquatic Habitat, Extractive Industry, Development). Conclusions were as follows: A scene that includes a view of running water is usually preferred over one that includes still water or no water at all. The stark beauty of a desert, lava flow or a winter pasture is not perceived by most people. Some types of visual pollution (i.e.; misfit billboards) are not recognized as such by some groups of people. Familiar scenes are not considered particularly beautiful even though they may be so to outsiders. Occupation and life style seem to have more effect on an individual\u27s concept of natural beauty than age or sex. People agree on what\u27s very beautiful or very ugly in a scene but disagree on the in-between. The semantic differential method as applied in this study yields measures of preference that are well-correlated with on-site evaluations by competent judges. Predicting preference from the physical content of a scene yields only approximate results. Reducing the number of stream characteristics used to compute uniqueness ratios did not greatly change the uniqueness rankings of the fifty-eight study streams. The recommended procedure for evaluating small streams is the factor score approach supplemented by a carefully conceived and executed preference study. The procedure should be applied to a random sample of all small streams in a state or region to establish a stream hierarchy. Factor scores and/ or rankings for a given stream could, if desired, be worked into a benefit-cost or other such computation in the form of a weight or multiplier

Public Health Emergency Preparedness and Response Communications with Health Care Providers: A Literature Review

<p>Abstract</p> <p>Background</p> <p>Health care providers (HCPs) play an important role in public health emergency preparedness and response (PHEPR) so need to be aware of public health threats and emergencies. To inform HCPs, public health issues PHEPR messages that provide guidelines and updates, and facilitate surveillance so HCPs will recognize and control communicable diseases, prevent excess deaths and mitigate suffering. Public health agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. Public health agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. We conducted a literature review to investigate the systems and tools used by public health to generate PHEPR communications to HCPs, and to identify specific characteristics of message delivery mechanisms and formats that may be associated with effective PHEPR communications.</p> <p>Methods</p> <p>A systematic review of peer- and non-peer-reviewed literature focused on the following questions: 1) What public health systems exist for communicating PHEPR messages from public health agencies to HCPs? 2) Have these systems been evaluated and, if yes, what criteria were used to evaluate these systems? 3) What have these evaluations discovered about characterizations of the most effective ways for public health agencies to communicate PHEPR messages to HCPs?</p> <p>Results</p> <p>We identified 25 systems or tools for communicating PHEPR messages from public health agencies to HCPs. Few articles assessed PHEPR communication systems or messaging methods or outcomes. Only one study compared the effectiveness of the delivery format, device or message itself. We also discovered that the potential is high for HCPs to experience "message overload" given redundancy of PHEPR messaging in multiple formats and/or through different delivery systems.</p> <p>Conclusions</p> <p>We found that detailed descriptions of PHEPR messaging from public health to HCPs are scarce in the literature and, even when available are rarely evaluated in any systematic fashion. To meet present-day and future information needs for emergency preparedness, more attention needs to be given to evaluating the effectiveness of these systems in a scientifically rigorous manner.</p

Do women residents delay childbearing due to perceived career threats

PURPOSE: To assess gender differences among residents regarding their plans to have children during residency and determine the most influential reasons for these differences. METHOD: Using the Health Belief Model as a framework, the authors created an instrument to survey 424 residents from 11 residency programs at three academic medical institutions about their intentions to have children during residency. The authors developed a scale to assess the perceived career threats of having children during residency, evaluated its psychometric properties, and calculated the effect of the mediators. RESULTS: The response rate was 77% (328/424). Forty-one percent of men versus 27% of women planned to have children during residency (P = .01). The instrument measured four career threats-extended training, loss of fellowship positions, pregnancy complications, and interference with career plans-on a five-point Likert scale. The scale had a Cronbach alpha of 0.84 and an eigenvalue of 2.2. Compared with men, women had higher scores for each item and a higher mean score (2.9 versus 2.1, P = .001), signifying greater belief in the potential of pregnancy to threaten careers. After adjusting for age, institution, postgraduate year, and knowledge of parental leave policies, women were less likely to plan to have children during residency (odds ratio 0.46 [95% confidence interval 0.25-0.84]). In mediation analysis, threats to career explained 67% of the gender variance. CONCLUSIONS: Women residents intentionally postpone pregnancy because of perceived threats to their careers. Medical educators should be aware of these findings when counseling female trainees

The Effect of Physician Continuity on Diabetic Outcomes in a Resident Continuity Clinic

BACKGROUND: Conflicting data exists regarding the effect of continuity on diabetes care. Resident physicians frequently treat patients with diabetes in their continuity clinics; however, maintaining continuity in a resident clinic can be very challenging. OBJECTIVE: To determine if resident continuity is associated with improvement in diabetic outcomes (HgA1c, LDL, blood pressure) in a resident clinic. DESIGN AND SETTING: Retrospective analysis of data obtained from a medical record review of diabetic patients seen in a resident physician clinic. MEASUREMENTS: We measured continuity, using the Usual Provider of Continuity Index (UPC) for residents and faculty preceptors. We measured changes in HgA1c, LDL, and blood pressure over a 3-year period. Using repeated measures analysis of variance (ANOVA), we assessed the relationship between UPC and change in these diabetic outcomes. RESULTS: The resident UPC was 0.43, and the faculty preceptor UPC was 0.76. The overall change in HgA1c was -0.3. There was a statistically significant relationship between improvement in HgA1c and resident UPC (p = 0.02), but not faculty preceptor UPC. There was no association between resident or faculty preceptor continuity and change in LDL or blood pressure. CONCLUSION: This study showed a link between resident continuity and improvement in glycemic control in diabetic patients. Resident physicians have a greater opportunity to develop a personal relationship with their patients. This interpersonal continuity may be of benefit in patients with illnesses that requires a significant amount of self-management behaviors. Medical training programs should focus efforts on improving continuity in resident primary care clinics