LEAH interdisciplinary training program

This article describes the Leadership Education in Adolescent Health (LEAH) interdisciplinary training program in the United States. The Maternal and Child Health Bureau authorized by legislation provides monies to train leaders in adolescent health through a competitive grant process. Currently, seven academic medical centers have funding to provide leadership in adolescent health (LEAH) training in five core disciplines: medicine, nursing, psychology, social work and nutrition. LEAH training programs both ensure high clinical competence in core disciplines serving adolescents and prepare trainees for leadership positions in adolescent health and public health care realms. Together, these programs trained almost 1000 long-term trainees across these five disciplines, and graduates from these programs are working in 45 of the 50 states within the United States. About 90% of these graduates are working with maternal and child/adolescent health populations, and almost all have held leadership positions in the areas of public health, advocacy, public policy, academic medical centers and/or clinical care settings

Enhanced Accessibility for People with Disabilities Living in Urban Areas

[Excerpt] People with disabilities constitute a significant proportion of the poor in developing countries. If internationally agreed targets on reducing poverty are to be reached, it is critical that specific measures be taken to reduce the societal discrimination and isolation that people with disabilities continue to face. Transport is an important enabler of strategies to fight poverty through enhancing access to education, employment, and social services. This project aims to further the understanding of the mobility and access issues experienced by people with disabilities in developing countries, and to identify specific steps that can be taken to start addressing problems. A major objective of the project is to compile a compendium of guidelines that can be used by government authorities, advocacy groups, and donor/loan agencies to improve the access of people with disabilities to transport and other services in urban areas

Fuzzy cellular model for on-line traffic simulation

This paper introduces a fuzzy cellular model of road traffic that was intended for on-line applications in traffic control. The presented model uses fuzzy sets theory to deal with uncertainty of both input data and simulation results. Vehicles are modelled individually, thus various classes of them can be taken into consideration. In the proposed approach, all parameters of vehicles are described by means of fuzzy numbers. The model was implemented in a simulation of vehicles queue discharge process. Changes of the queue length were analysed in this experiment and compared to the results of NaSch cellular automata model.Comment: The original publication is available at http://www.springerlink.co

Human behavior as origin of traffic phases

It is shown that the desire for smooth and comfortable driving is directly responsible for the occurrence of complex spatio-temporal structures (``synchronized traffic'') in highway traffic. This desire goes beyond the avoidance of accidents which so far has been the main focus of microscopic modeling and which is mainly responsible for the other two phases observed empirically, free flow and wide moving jams. These features have been incorporated into a microscopic model based on stochastic cellular automata and the results of computer simulations are compared with empirical data. The simple structure of the model allows for very fast implementations of realistic networks. The level of agreement with the empirical findings opens new perspectives for reliable traffic forecasts.Comment: 4 pages, 4 figures, colour figures with reduced resolutio

Macroscopic Dynamics of Multi-Lane Traffic

We present a macroscopic model of mixed multi-lane freeway traffic that can be easily calibrated to empirical traffic data, as is shown for Dutch highway data. The model is derived from a gas-kinetic level of description, including effects of vehicular space requirements and velocity correlations between successive vehicles. We also give a derivation of the lane-changing rates. The resulting dynamic velocity equations contain non-local and anisotropic interaction terms which allow a robust and efficient numerical simulation of multi-lane traffic. As demonstrated by various examples, this facilitates the investigation of synchronization patterns among lanes and effects of on-ramps, off-ramps, lane closures, or accidents.Comment: For related work see http://www.theo2.physik.uni-stuttgart.de/helbing.htm

Coherent Moving States in Highway Traffic (Originally: Moving Like a Solid Block)

Recent advances in multiagent simulations have made possible the study of realistic traffic patterns and allow to test theories based on driver behaviour. Such simulations also display various empirical features of traffic flows, and are used to design traffic controls that maximise the throughput of vehicles in heavily transited highways. In addition to its intrinsic economic value, vehicular traffic is of interest because it may throw light on some social phenomena where diverse individuals competitively try to maximise their own utilities under certain constraints. In this paper, we present simulation results that point to the existence of cooperative, coherent states arising from competitive interactions that lead to a new phenomenon in heterogeneous highway traffic. As the density of vehicles increases, their interactions cause a transition into a highly correlated state in which all vehicles practically move with the same speed, analogous to the motion of a solid block. This state is associated with a reduced lane changing rate and a safe, high and stable flow. It disappears as the vehicle density exceeds a critical value. The effect is observed in recent evaluations of Dutch traffic data.Comment: Submitted on April 21, 1998. For related work see http://www.theo2.physik.uni-stuttgart.de/helbing.html and http://www.parc.xerox.com/dynamics

Modeling and Simulation of Multi-Lane Traffic Flow

A most important aspect in the field of traffic modeling is the simulation of bottleneck situations. For their realistic description a macroscopic multi-lane model for uni-directional freeways including acceleration, deceleration, velocity fluctuations, overtaking and lane-changing maneuvers is systematically deduced from a gas-kinetic (Boltzmann-like) approach. The resulting equations contain corrections with respect to previous models. For efficient computer simulations, a reduced model delineating the coarse-grained temporal behavior is derived and applied to bottleneck situations.Comment: For related work see http://www.theo2.physik.uni-stuttgart.de/helbing.htm

Incident and long-term opioid therapy among patients with psychiatric conditions and medications: a national study of commercial health care claims

There is growing evidence that opioid prescribing in the United States follows a pattern in which patients who are at the highest risk of adverse outcomes from opioids are more likely to receive long-term opioid therapy. These patients include, in particular, those with substance use disorders (SUDs) and other psychiatric conditions. This study examined health insurance claims among 10,311,961 patients who filled prescriptions for opioids. Specifically, we evaluated how opioid receipt differed among patients with and without a wide range of preexisting psychiatric and behavioral conditions (ie, opioid and nonopioid SUDs, suicide attempts or other self-injury, motor vehicle crashes, and depressive, anxiety, and sleep disorders) and psychoactive medications (ie, antidepressants, benzodiazepines, hypnotics, mood stabilizers, antipsychotics, and medications used for SUD, tobacco cessation, and attention-deficit/hyperactivity disorder). Relative to those without, patients with all assessed psychiatric conditions and medications had modestly greater odds of subsequently filling prescriptions for opioids and, in particular, substantially greater risk of long-term opioid receipt. Increases in risk for long-term opioid receipt in adjusted Cox regressions ranged from approximately 1.5-fold for prior attention-deficit/hyperactivity disorder medication prescriptions (hazard ratio [HR] = 1.53; 95% confidence interval [CI], 1.48-1.58) to approximately 3-fold for prior nonopioid SUD diagnoses (HR = 3.15; 95% CI, 3.06-3.24) and nearly 9-fold for prior opioid use disorder diagnoses (HR = 8.70; 95% CI, 8.20-9.24). In sum, we found evidence of greater opioid receipt among commercially insured patients with a breadth of psychiatric conditions. Future studies assessing behavioral outcomes associated with opioid prescribing should consider preexisting psychiatric conditions