Spatiotemporal association between birth outcomes and coke production and steel making facilities in Alabama, USA: a cross-sectional study.

BACKGROUND: Previous research has shown exposure to air pollution increases the risk of adverse birth outcomes, although the effects of residential proximity to significant industrial point sources are less defined. The objective of the current study was to determine whether yearly reported releases from major industrial point sources are associated with adverse birth outcomes. METHODS: Maternal residence from geocoded Alabama birth records between 1991 and 2010 were used to calculate distances from coke and steel production industries reporting emissions to the U.S. Environmental Protection Agency. Logistic regression models were built to determine associations between distance or yearly fugitive emissions (volatile organic compounds, polycyclic aromatic compounds, and metals) from reporting facilities and preterm birth or low birth weight, adjusting for covariates including maternal age, race, payment method, education level, year and parity. RESULTS: A small but significant association between preterm birth and residential proximity (≤5.0 km) to coke and steel production facilities remained after adjustment for covariates (OR 1.05 95% CI: 1.01,1.09). Above average emissions from these facilities of volatile organic compounds during the year of birth were associated with low birth weight (OR 1.17 95% CI: 1.06, 1.29), whereas metals emissions were associated with preterm birth (OR 1.07 95% CI: 1.01, 1.14). CONCLUSIONS: The present investigation suggests fugitive emissions from industrial point sources may increase the risk of adverse birth outcomes in surrounding neighborhoods. Further research teasing apart the relationship between exposure to emissions and area-level deprivation in neighborhoods surrounding industrial facilities and their combined effects on birth outcomes is needed.

Impact of a transitional care program for heart failure patients at Baylor Scott & White Health: a pilot study.

Heart failure is a chronic health condition characterized by complex symptom management and costly hospitalizations. Hospitalization for the treatment of heart failure symptoms is common; however, many hospitalizations are thought to be preventable with effective self-management. This study describes the small, pilot implementation of a new, interventional, self-management heart failure program, "Engagement in Heart Failure Care" (EHFC), developed to assist heart failure patients with the management of disease symptoms following discharge from an inpatient hospital stay. EHFC was designed to engage patients in managing their symptoms and coaching them in skills that enable them to access medical and supportive care services across community, clinic, and hospital settings to help address both their current and future needs. The results of this pilot study suggest that EHFC's coaching model may have positive benefits on key health and well-being indicators of the patients enrolled.

A geospatial mixed methods approach to assessing campus safety.

BACKGROUND: While there is no panacea for alleviating campus safety concerns, safety experts agree that one of the key components to an effective campus security plan is monitoring the environment. Despite previous attempts to measure campus safety, quantifying perceptions of fear, safety, and risk remains a challenging issue. Since perceptions of safety and incidents of crime do not necessarily mirror one another, both were utilized in this investigation. PURPOSE: The purpose of this article is to describe an innovative, mixed methods approach for assessing campus safety at a large, urban campus in the southeast region of the United States. METHOD: A concurrent triangulation design was implemented to allow investigators the opportunity to collect qualitative and quantitative data simultaneously and integrate results in the interpretation phase. Data were collected from four distinct sources of information. RESULTS: Student focus groups yielded data regarding perceptions of risk, and kernel density analysis was used to identify "hot spots" of campus crime incidents. CONCLUSION: While in many cases perceived risk and actual crime incidents were associated, incidents of hot spots of each type occurred independently with such frequency that an overall correlation of the two was not significant. Accordingly, while no significant correlation between perceived risk and crime incidents was confirmed statistically, the geospatial integration of these data suggested three types of safety conditions. Further, the combination of focus group data and spatial analyses provided a more comprehensive and, therefore, more complete understanding of the multifaceted issues related to campus safety.