American journal of public health
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We evaluated the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. ⋯ Utilizing competency mapping to assess clinical-public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies.
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Comparative Study
Evaluating the safety effects of bicycle lanes in New York City.
We evaluated the effects of on-street bicycle lanes installed prior to 2007 on different categories of crashes (total crashes, bicyclist crashes, pedestrian crashes, multiple-vehicle crashes, and injurious or fatal crashes) occurring on roadway segments and at intersections in New York City. ⋯ Our results indicate that characteristics of the built environment have a direct impact on crashes and that they should thus be controlled in studies evaluating traffic countermeasures such as bicycle lanes. To prevent crashes at intersections, we recommend installation of "bike boxes" and markings that indicate the path of bicycle lanes across intersections.
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We evaluated the relationship between maternal H1N1 vaccination and fetal and neonatal outcomes among singleton births during the 2009-2010 H1N1 pandemic. ⋯ Our results suggest that second- or third-trimester H1N1 vaccination was associated with improved fetal and neonatal outcomes during the recent pandemic. Our findings need to be confirmed in future studies with designs that can better overcome concerns regarding biased estimates of vaccine efficacy.
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Comparative Study
Prevalence of perceived stress and mental health indicators among reserve-component and active-duty military personnel.
We examined stress levels and other indicators of mental health in reservists and active-duty military personnel by deployment status. ⋯ Our results suggest that deployment has a greater impact on reservists than on active-duty members, thus highlighting the urgent need for services addressing reservists' unique postdeployment mental health issues. Also, deployment to any theater, not only Iraq or Afghanistan, represents unique threats to all service members' mental well-being.
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One of the 3 goals for accountable care organizations is to improve population health. This will require that accountable care organizations bridge the schism between clinical care and public health. ⋯ This creates an attribution problem, particularly in large urban centers, where multiple health care providers often serve any given neighborhood. We suggest potential innovations that could allow urban accountable care organizations to accept accountability, and rewards, for measurably improving population health.