High Hopes: Public Health Approaches to Reducing the Need for Health Care

Driven in part by a desire to contain health care costs, policymakers are looking beyond medical care for opportunities to reduce the need for expensive services. This paper briefly reviews current public health concepts and strategies for improving health that emphasize nonmedical factors such as behavior, socioeconomic status, and environment. It also provides examples of how these concepts and strategies undergird many of the public health provisions of the Patient Protection and Affordable Care Act, other legislation, and several programs and initiatives. These concepts include prevention, health in all policies, global health, the One Health Initiative, and climate change and health

Rocky Mountain Highs and Lows: Efforts to Improve Health and Reduce Costs in Denver

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health care; and interprofessional education, training, and practice to foster the development of the teams of health professionals envisioned for the future. The site visit also examined the intersections among and disconnects between these critical aspects of a comprehensive approach to a healthy city. The agenda included visits to several communities in the Denver Metro Area; a variety of health care delivery sites ranging from a small school-based clinic to a large academic medical center under expansion; and the new interprofessional Anschutz Medical Campus which houses the University of Colorado schools of medicine, nursing, dentistry, pharmacy, and public health. The agenda also included several panels convened in the hotel and at various other sites

Resilience and Renaissance: Efforts to Rebuild a Healthier New Orleans

The National Health Policy Forum sponsored a site visit to New Orleans, Louisiana, in May 2009 to explore the city\u27s health challenges, which are similar to those faced by other cities but were all greatly exacerbated by Hurricane Katrina and its aftermath. The agenda focused on three themes: primary care and behavioral health services availability and access, public health preparedness, and rebuilding healthier communities. It examined how these themes and others intersect in two distinct communities within New Orleans: the Holy Cross community surrounding the Lower Ninth Ward Center for Sustainable Engagement and Development and the community surrounding the Mary Queen of Viet Nam Community Development Corporation in New Orleans East. The agenda also included several panels convened in the hotel and on site, as well as visits to sites in the Bywater and Algiers neighborhoods, highlighting success stories as well as remaining challenges. Site visit participants learned about ongoing struggles to recover and rebuild after the disaster, efforts to improve preparedness for future public health threats, the continuing challenge to coordinate among providers to reorient the health care system away from centralized inpatient care and toward community-based primary care, and multifaceted, community-led initiatives to rebuild stronger, safer, healthier communities

Air mass origin and its influence over the aerosol size distribution: a study in SE Spain

International audienceA k-means cluster analysis of 96 hour trajectories arriving in Southeast (SE) Spain at 3000, 1500 and 500 m for the 7-year period 2000?2006 has been performed to identify and describe the main flows arriving at the study area. The dependence of the aerosol size distribution on the air mass origin has been studied by using non-parametric statistics. There are statistically significant differences on aerosol size distribution and meteorological variables at surface level according to the identified clusters

Patterns and Long Range Correlations in Idealized Granular Flows

An initially homogeneous freely evolving fluid of inelastic hard spheres develops inhomogeneities in the flow field (vortices) and in the density field (clusters), driven by unstable fluctuations. Their spatial correlations, as measured in molecular dynamics simulations, exhibit long range correlations; the mean vortex diameter grows as the square root of time; there occur transitions to macroscopic shearing states, etc. The Cahn--Hilliard theory of spinodal decomposition offers a qualitative understanding and quantitative estimates of the observed phenomena. When intrinsic length scales are of the order of the system size, effects of physical boundaries and periodic boundaries (finite size effects in simulations) are important.Comment: 13 pages with 7 postscript figures, LaTeX (uses psfig). Submitted to International Journal of Modern Physics

Influence of meteorological input data on backtrajectory cluster analysis ? a seven-year study for southeastern Spain

International audienceBacktrajectory differences and clustering sensitivity to the meteorological input data are studied. Trajectories arriving in Southeast Spain (Elche), at 3000, 1500 and 500 m for the 7-year period 2000?2006 have been computed employing two widely used meteorological data sets: the NCEP/NCAR Reanalysis and the FNL data sets. Differences between trajectories grow linearly at least up to 48 h, showing faster growing after 72 h. A k-means cluster analysis performed on each set of trajectories shows differences in the identified clusters (main flows), partially because the number of clusters of each clustering solution differs for the trajectories arriving at 3000 and 1500 m. Trajectory membership to the identified flows is in general more sensitive to the input meteorological data than to the initial selection of cluster centroids

Influence of correlations on the velocity statistics of scalar granular gases

The free evolution of inelastic particles in one dimension is studied by means of Molecular Dynamics (MD), of an inelastic pseudo-Maxwell model and of a lattice model, with emphasis on the role of spatial correlations. We present an exact solution of the 1d granular pseudo-Maxwell model for the scaling distribution of velocities and discuss how this model fails to describe correctly the homogeneous cooling stage of the 1d granular gas. Embedding the pseudo-Maxwell gas on a lattice (hence allowing for the onset of spatial correlations), we find a much better agreement with the MD simulations even in the inhomogeneous regime. This is seen by comparing the velocity distributions, the velocity profiles and the structure factors of the velocity field.Comment: Latex file: 6 pages, 5 figures (.eps). See also http://axtnt3.phys.uniroma1.it/Maxwel

Antipsychotic drugs: is more worse? a meta-analysis of the published randomized control trials

Effectiveness and side-effects of high- versus low-dose neuroleptic treatment of chronic psychosis have been assessed through a meta-analysis of 22 published randomized control trials comparing different neuroleptic doses. No incremental clinical improvement was found at doses above 375 mg equivalent of chlorpromazine, while a significant increase in adverse reactions was observe