Northside neighborhood, Chapel Hill, Orange County : an action-oriented community diagnosis : findings and next steps of action

This document is the final report on an action-oriented community diagnosis (AOCD) of the Northside Neighborhood in Chapel Hill, North Carolina. The assessment was aimed at identifying the strengths and challenges of the Northside community as described by service providers and community members. The AOCD was conducted by a team of five graduate students from the University of North Carolina-Chapel Hill School of Public Health between September of 2004 and May of 2005. The student team was guided by Delores Bailey, a service provider and community member who served as the students’ community preceptor. Mrs. Bailey is the co-director of EmPOWERment Incorporate, and non-profit organization focusing on sustainable economic development in Northside and other communities. The team first attended community events to observe neighborhood dynamics and gain entrée. The team then examined secondary data about the neighborhood’s geography, history, demographics, economics, and education. After being approved by the School of Public Health’s Institutional Review Board (IRB), we conducted qualitative, key informant interviews with 11 service providers, 14 community members, and 2 youth focus groups to listen to issues of concern to them. After analyzing the data from these interviews and data from secondary sources, our team organized the results into broad domains. These were: economics, housing, crime, and community dynamics. Service providers and community members’ views on these domains were then expressed as themes for each domain. With input from a planning committee of community members and service providers, five themes were selected for discussion at a community forum. These selected domains were crime and safety, housing, economics, services for youth, and services for seniors. The Community Forum on May 10, 2005 was attended by 150 community members and service providers. The following action steps were recommended: Economics: Service providers and community members agreed that local businesses and local government should provide more opportunities for people to learn job skills. - Increasing awareness of programs currently offered by EmPOWERment, Inc. Investigating the state of vocational programs in Chapel Hill-Carrboro schools. Encouraging existing minority owned businesses to hire minority employees. Youth services: Community members and service providers feel that services, including those offered by Hargraves, are not meeting the needs of youth in the community. Ensuring Hargraves employees distribute information to parents. Deliver flyers to the Chapel Hill-Carrboro schools central office. Provide van transportation to meetings for parents. Organize more events for parents and children. Provide summer activities for children over the age of twelve. Petition the recreation commission for more teenage programs. Senior services: Community members and service providers feel that services, including those offered by Hargraves, are not meeting the needs of senior citizens. Mobilizing a committee to address the needs of senior citizens. Housing: Community members and service providers share a mutual concern for the current and future state of housing for long term resident of Northside. Creating a committee dedicated to addressing the many issues concerning housing. Compiling a list of current city codes (trash, noise, parking, landscaping). Creating standards specific to Northside from community meetings. Delegating accountability for deviations from standards. Publicizing the list to residents, landlords, and town officials. Crime and safety: Community members and service providers agreed that Northside is generally a safe neighborhood, but could be made safer by eliminating drug activity. Inviting neighbors to community watch meetings. Distributing information about meetings to churches and public housing communities. Placing the community patrol on the next community watch meeting agenda. It is our hope that this document will be of use to those concerned about the health and quality of life of people living and working in Northside.Master of Public Healt

Telehealth and Mobile Health Applied To IntegratedBehavioral Care: OpportunitiesFor Progress In New Hampshire

This paper is an accompanying document to a webinar delivered on May 16, 2017, for the New Hampshire Citizens Health Initiative (Initiative). As integrated behavioral health efforts in New Hampshire gain traction, clinicians, administrators, payers, and policy makers are looking for additional efficiencies in delivering high quality healthcare. Telehealth and mobile health (mHealth) have the opportunity to help achieve this while delivering a robust, empowered patient experience. The promise of video-based technology was first made in 1964 as Bell Telephone shared its Picturephone® with the world. This was the first device with audio and video delivered in an integrated technology platform. Fast-forward to today with Skype, FaceTime, and webinar tools being ubiquitous in our personal and business lives, but often slow to be adopted in the delivery of medicine. Combining technology-savvy consumers with New Hampshire’s high rate of electronic health record (EHR) technology adoption, a fairly robust telecommunications infrastructure, and a predominately rural setting, there is strong foundation for telehealth and mHealth expansion in New Hampshire’s integrated health continuum

Integrating Behavioral Health & Primary Care in New Hampshire: A Path Forward to Sustainable Practice & Payment Transformation

New Hampshire residents face challenges with behavioral and physical health conditions and the interplay between them. National studies show the costs and the burden of illness from behavioral health conditions and co-occurring chronic health conditions that are not adequately treated in either primary care or behavioral health settings. Bringing primary health and behavioral health care together in integrated care settings can improve outcomes for both behavioral and physical health conditions. Primary care integrated behavioral health works in conjunction with specialty behavioral health providers, expanding capacity, improving access, and jointly managing the care of patients with higher levels of acuity In its work to improve the health of NH residents and create effective and cost-effective systems of care, the NH Citizens Health Initiative (Initiative) created the NH Behavioral Health Integration Learning Collaborative (BHI Learning Collaborative) in November of 2015, as a project of its Accountable Care Learning Network (NHACLN). Bringing together more than 60 organizations, including providers of all types and sizes, all of the state’s community mental health centers, all of the major private and public insurers, and government and other stakeholders, the BHI Learning Collaborative built on earlier work of a NHACLN Workgroup focused on improving care for depression and co-occurring chronic illness. The BHI Learning Collaborative design is based on the core NHACLN philosophy of “shared data and shared learning” and the importance of transparency and open conversation across all stakeholder groups. The first year of the BHI Learning Collaborative programming included shared learning on evidence-based practice for integrated behavioral health in primary care, shared data from the NH Comprehensive Healthcare Information System (NHCHIS), and work to develop sustainable payment models to replace inadequate Fee-for-Service (FFS) revenues. Provider members joined either a Project Implementation Track working on quality improvement projects to improve their levels of integration or a Listen and Learn Track for those just learning about Behavioral Health Integration (BHI). Providers in the Project Implementation Track completed a self-assessment of levels of BHI in their practice settings and committed to submit EHR-based clinical process and outcomes data to track performance on specified measures. All providers received access to unblinded NHACLN Primary Care and Behavioral Health attributed claims data from the NHCHIS for provider organizations in the NH BHI Learning Collaborative. Following up on prior work focused on developing a sustainable model for integrating care for depression and co-occurring chronic illness in primary care settings, the BHI Learning Collaborative engaged consulting experts and participants in understanding challenges in Health Information Technology and Exchange (HIT/HIE), privacy and confidentiality, and workforce adequacy. The BHI Learning Collaborative identified a sustainable payment model for integrated care of depression in primary care. In the process of vetting the payment model, the BHI Learning Collaborative also identified and explored challenges in payment for Substance Use Disorder Screening, Brief Intervention and Referral to Treatment (SBIRT). New Hampshire’s residents will benefit from a health care system where primary care and behavioral health are integrated to support the care of the whole person. New Hampshire’s current opiate epidemic accentuates the need for better screening for behavioral health issues, prevention, and treatment referral integrated into primary care. New Hampshire providers and payers are poised to move towards greater integration of behavioral health and primary care and the Initiative looks forward to continuing to support progress in supporting a path to sustainable integrated behavioral and primary care

Pressure Support vs. Thermal Broadening in the Lyman-alpha Forest I: Effects of the Equation of State on Longitudinal Structure

In the low density intergalactic medium (IGM) that gives rise to the Lyman-alpha forest, gas temperature and density are tightly correlated. The velocity scale of thermal broadening and the Hubble flow across the gas Jeans scale are of similar magnitude (Hlambda_J ~ sigma_th). To separate the effects of gas pressure support and thermal broadening on the Lya forest, we compare spectra extracted from two smoothed particle hydrodynamics (SPH) simulations evolved with different photoionization heating rates (and thus different Jeans scales), imposing different temperature-density relations on the evolved particle distributions. The turnover scales in the flux power spectrum and flux autocorrelation function are determined mainly by thermal broadening rather than pressure. However, the insensitivity to pressure arises partly from a cancellation effect with a sloped temperature-density relation (T ~ rho^{0.6} in our simulations): the high density peaks in the colder, lower pressure simulation are less smoothed by pressure support than in the hotter simulation, and it is this higher density gas that experiences the strongest thermal broadening. Changes in thermal broadening and pressure support have comparably important effects on the flux probability distribution (PDF), which responds directly to the gas overdensity distribution rather than the scale on which it is smooth. Tests on a lower resolution simulation show that our statistical results are converged even at this lower resolution. While thermal broadening generally dominates the longitudinal structure in the Lya forest, we show in Paper II that pressure support determines the transverse coherence of the forest observed towards close quasar pairs. [ABRIDGED]Comment: 12 figures, MNRAS in pres

The clustering of galaxies in the SDSS-III Baryon Oscillation Spectroscopic Survey: Analysis of potential systematics

We analyze the density field of galaxies observed by the Sloan Digital Sky Survey (SDSS)-III Baryon Oscillation Spectroscopic Survey (BOSS) included in the SDSS Data Release Nine (DR9). DR9 includes spectroscopic redshifts for over 400,000 galaxies spread over a footprint of 3,275 deg^2. We identify, characterize, and mitigate the impact of sources of systematic uncertainty on large-scale clustering measurements, both for angular moments of the redshift-space correlation function and the spherically averaged power spectrum, P(k), in order to ensure that robust cosmological constraints will be obtained from these data. A correlation between the projected density of stars and the higher redshift (0.43 < z < 0.7) galaxy sample (the `CMASS' sample) due to imaging systematics imparts a systematic error that is larger than the statistical error of the clustering measurements at scales s > 120h^-1Mpc or k < 0.01hMpc^-1. We find that these errors can be ameliorated by weighting galaxies based on their surface brightness and the local stellar density. We use mock galaxy catalogs that simulate the CMASS selection function to determine that randomly selecting galaxy redshifts in order to simulate the radial selection function of a random sample imparts the least systematic error on correlation function measurements and that this systematic error is negligible for the spherically averaged correlation function. The methods we recommend for the calculation of clustering measurements using the CMASS sample are adopted in companion papers that locate the position of the baryon acoustic oscillation feature (Anderson et al. 2012), constrain cosmological models using the full shape of the correlation function (Sanchez et al. 2012), and measure the rate of structure growth (Reid et al. 2012). (abridged)Comment: Matches version accepted by MNRAS. Clarifications and references have been added. See companion papers that share the "The clustering of galaxies in the SDSS-III Baryon Oscillation Spectroscopic Survey:" titl

Neutrino masses from clustering of red and blue galaxies: a test of astrophysical uncertainties

Combining measurements of the galaxy power spectrum and the cosmic microwave background (CMB) is a powerful means of constraining the summed mass of neutrino species sum(m_nu), but is subject to systematic uncertainties due to non-linear structure formation, redshift-space distortions and galaxy bias. We empirically test the robustness of neutrino mass results to these effects by separately analyzing power spectra of red and blue galaxies from the Sloan Digital Sky Survey (SDSS-II) Data Release 7 (DR7), combined with the CMB five-year Wilkinson Microwave Anisotropy Probe (WMAP5) data. We consider fitting for a range of maximum wavenumber k using twelve different galaxy bias models. For example, using a new model based on perturbation theory and including redshift space distortions (Saito et al. 2009), the all-galaxy power spectrum combined with WMAP5 for a wavenumber range of k<0.2 Mpc/h yields 95% CL sum(m_nu)<0.46 eV. The red and blue galaxy power spectra give 0.41 and 0.63 eV respectively for this model. Using mock catalogues, we find the expected difference in these limits assuming a true neutrino mass of zero is 0.10 + or - 0.14 eV. Thus the difference of 0.22 eV between upper limits on neutrino mass for red and blue galaxies is approximately 1 sigma from the expected value. We find similar results for the other models and k ranges tested. This indicates good agreement for current data but hints at possible issues for next-generation surveys. Being able to perform such systematic tests is advantageous, and future surveys would benefit by including broad galaxy populations and luminosities that enable such a decomposition.Comment: 15 pages, 6 figures, matches version published in MNRA

The clustering of galaxies in the SDSS-III Baryon Oscillation Spectroscopic Survey: measurements of the growth of structure and expansion rate at z=0.57 from anisotropic clustering

We analyze the anisotropic clustering of massive galaxies from the Sloan Digital Sky Survey III Baryon Oscillation Spectroscopic Survey (BOSS) Data Release 9 (DR9) sample, which consists of 264,283 galaxies in the redshift range 0.43 < z < 0.7 spanning 3,275 square degrees. Both peculiar velocities and errors in the assumed redshift-distance relation ("Alcock-Paczynski effect") generate correlations between clustering amplitude and orientation with respect to the line-of-sight. Together with the sharp baryon acoustic oscillation (BAO) standard ruler, our measurements of the broadband shape of the monopole and quadrupole correlation functions simultaneously constrain the comoving angular diameter distance (2190 +/- 61 Mpc) to z=0.57, the Hubble expansion rate at z=0.57 (92.4 +/- 4.5 km/s/Mpc), and the growth rate of structure at that same redshift (d sigma8/d ln a = 0.43 +/- 0.069). Our analysis provides the best current direct determination of both DA and H in galaxy clustering data using this technique. If we further assume a LCDM expansion history, our growth constraint tightens to d sigma8/d ln a = 0.415 +/- 0.034. In combination with the cosmic microwave background, our measurements of DA, H, and growth all separately require dark energy at z > 0.57, and when combined imply \Omega_{\Lambda} = 0.74 +/- 0.016, independent of the Universe's evolution at z<0.57. In our companion paper (Samushia et al. prep), we explore further cosmological implications of these observations.Comment: 19 pages, 11 figures, submitted to MNRAS, comments welcom

The clustering of galaxies in the SDSS-III Baryon Oscillation Spectroscopic Survey : baryon acoustic oscillations in the Data Releases 10 and 11 Galaxy samples

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations (BAO) in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 (DR11) sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released DR9 and DR10 samples. Assuming a concordance Λ cold dark matter (ΛCDM) cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = (1264 ± 25 Mpc)(rd/rd,fid) at z = 0.32 and DV = (2056 ± 20 Mpc)(rd/rd,fid) at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = (1421 ± 20 Mpc)(rd/rd,fid) and H = (96.8 ± 3.4 km s−1 Mpc−1)(rd,fid/rd). Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant.Publisher PDFPeer reviewe

The clustering of galaxies in the SDSS-III Baryon Oscillation Spectroscopic Survey: Baryon Acoustic Oscillations in the Data Release 9 Spectroscopic Galaxy Sample

We present measurements of galaxy clustering from the Baryon Oscillation Spectroscopic Survey (BOSS), which is part of the Sloan Digital Sky Survey III (SDSS-III). These use the Data Release 9 (DR9) CMASS sample, which contains 264,283 massive galaxies covering 3275 square degrees with an effective redshift z=0.57 and redshift range 0.43 < z < 0.7. Assuming a concordance Lambda-CDM cosmological model, this sample covers an effective volume of 2.2 Gpc^3, and represents the largest sample of the Universe ever surveyed at this density, n = 3 x 10^-4 h^-3 Mpc^3. We measure the angle-averaged galaxy correlation function and power spectrum, including density-field reconstruction of the baryon acoustic oscillation (BAO) feature. The acoustic features are detected at a significance of 5\sigma in both the correlation function and power spectrum. Combining with the SDSS-II Luminous Red Galaxy Sample, the detection significance increases to 6.7\sigma. Fitting for the position of the acoustic features measures the distance to z=0.57 relative to the sound horizon DV /rs = 13.67 +/- 0.22 at z=0.57. Assuming a fiducial sound horizon of 153.19 Mpc, which matches cosmic microwave background constraints, this corresponds to a distance DV(z=0.57) = 2094 +/- 34 Mpc. At 1.7 per cent, this is the most precise distance constraint ever obtained from a galaxy survey. We place this result alongside previous BAO measurements in a cosmological distance ladder and find excellent agreement with the current supernova measurements. We use these distance measurements to constrain various cosmological models, finding continuing support for a flat Universe with a cosmological constant.Comment: 33 page

The Baryon Oscillation Spectroscopic Survey of SDSS-III

The Baryon Oscillation Spectroscopic Survey (BOSS) is designed to measure the scale of baryon acoustic oscillations (BAO) in the clustering of matter over a larger volume than the combined efforts of all previous spectroscopic surveys of large scale structure. BOSS uses 1.5 million luminous galaxies as faint as i=19.9 over 10,000 square degrees to measure BAO to redshifts z<0.7. Observations of neutral hydrogen in the Lyman alpha forest in more than 150,000 quasar spectra (g<22) will constrain BAO over the redshift range 2.15<z<3.5. Early results from BOSS include the first detection of the large-scale three-dimensional clustering of the Lyman alpha forest and a strong detection from the Data Release 9 data set of the BAO in the clustering of massive galaxies at an effective redshift z = 0.57. We project that BOSS will yield measurements of the angular diameter distance D_A to an accuracy of 1.0% at redshifts z=0.3 and z=0.57 and measurements of H(z) to 1.8% and 1.7% at the same redshifts. Forecasts for Lyman alpha forest constraints predict a measurement of an overall dilation factor that scales the highly degenerate D_A(z) and H^{-1}(z) parameters to an accuracy of 1.9% at z~2.5 when the survey is complete. Here, we provide an overview of the selection of spectroscopic targets, planning of observations, and analysis of data and data quality of BOSS.Comment: 49 pages, 16 figures, accepted by A