It takes all the running you can do to keep in the same place --The Red Queen
Do not go where the path may lead, go instead where there is no path and leave a trail. --Emerson
"Consider the study's results: In the three years before the helmet law was repealed on July 1, 2000, 9 percent of the 515 motorcyclists killed in crashes were not wearing a helmet.
In the three years after the repeal, 61 percent of the 933 fatally injured motorcyclists were not helmeted.
Of the 35 motorcyclists younger than 21 killed in crashes in the three years before the repeal, 26 percent were not wearing helmets.
Of the 101 riders younger than 21 who were killed in the repeal, 45 percent were not wearing helmets.JUSTIN GEORGELed by Ronda Storms, the county cuts funding to a teen educational program.
TAMPA - The idea came from Hillsborough County Commissioner Ronda Storms: eliminate funding for a teen educational program sponsored by Planned Parenthood.
Commissioners went along with her Thursday, while expressing none of their personal feelings about the nonprofit group that supports women's reproductive rights.
But Storms had made her feelings clear in a conversation last week, said Barbara Zdravecky, who oversees Planned Parenthood in 15 counties, including the Tampa Bay area.
Storms supports life - Zdravecky remembers hearing her say - and Planned Parenthood supports death.
"I have to say I was pretty shaken," Zdravecky said. "I'm used to taking hits. But I was surprised at her lack of humanity."
Zdravecky, other nonprofit officials and proponents had just finished lobbying the commission the night of July 21 and were standing around after nearly three hours of budget discussion.
They wanted commissioners to give them $39,500 during the next two years for Source Teen Theater, a $130,000 program in which Tampa teens teach other kids about such topics as sexual activity, drugs, gangs and family violence.
Storms remembers the conversation, too.
She had called for Planned Parenthood's removal from the budget. Zdravecky asked her to reconsider. Surely, Zdravecky asked, the commissioner must support preventing teen pregnancy, even if she doesn't support Planned Parenthood.
"There is nothing you can say or do for me to support you," the commissioner said, according to Storms' version of the conversation. "Thank you very much for your comments."
But Zdravecky pressed on.
"I am prolife and you're not," Storms remembers saying.
Storms thanked them and told them she could not support the request. She even remembers that she smiled at them.
She told them that their organization is "prodeath from its founding." She told them how Planned Parenthood founder Margaret Sanger advocated eugenics - the study of improving hereditary qualities by controlling human reproduction - as her basis for supporting abortion.
In an interview with the St. Petersburg Times, Storms continued to make her case.
"Women are dying at the hands of Planned Parenthood today," she said, noting that the organization continues to promote the abortion pill RU-486. She pointed to a news account that questioned the drug's safety.
Those are the facts, Storms said. Lobbying, she added, "is not for the thin-skinned."
"She could have walked away and not had her feelings hurt," Storms said of Zdravecky.
Zdravecky remembers a more blunt conversation where Storms said, "I am prolife, you are prodeath" twice.
"I believe anyone who professes to be a proponent of Christianity would treat me with more dignity than the way I was treated," Zdravecky said.
Storms often takes controversial stands. On June 15, she led a commission vote to distance the county from gay pride events, a policy that has generated national attention.
Planned Parenthood of Southwestern Central Florida has been in Hillsborough for at least 25 years and operates a clinic in Temple Terrace. About 95 percent of the 65,000 clients Planned Parenthood sees annually in the region aren't coming for abortion services, Zdravecky said.
Last year, 1,700 did.
Hillsborough County has funded Source Teen Theater intermittedly during the past few years. It does not fund any other Planned Parenthood programs.
During the budget discussion that led to Thursday's 5-2 vote, Storms didn't comment other than to call for the elimination of the project's funding.
Commissioner Brian Blair spoke at length about how he favored the way the Pregnancy Center of Plant City operated. He said that its crisis pregnancy counselors encourage "the young women to choose life" and that its executive director raises money without asking for county help.
After the meeting, he said he voted against the program for fiscal reasons. He said his decisions are evenhanded, pointing to his rejection of a $250,000 request from Praise Cathedral and a $112,000 request from Redlands Christian Migrant Association. But Commissioner Kathy Castor, who voted against the motion with Commissioner Thomas Scott, said Planned Parenthood's program was the only project eliminated after a high rating from a county committee that reviews nonprofit funding requests.
Castor said that Hillsborough had $8-million to give to nonprofit groups.
"Their request," she said, "was one of the more modest."
Why are poor people more likely to contract HIV? Why are certain groups, such as racial minorities, in affluent societies, like the
It is not an accident of history that HIV/AIDS prevention messages and treatment programs have favored some individuals while skewing the vulnerability to the disease towards other individuals throughout the world. Instead a number of historical events generated the current distribution of HIV risk and account for the epidemiological profile of current HIV prevalence disparities.
In this manuscript, I examine the natural history of the AIDS epidemic in one community –
There are 3 goals that I hope to accomplish by writing this manuscript:
1. I hope to show ways in which we can erase health disparities that exist between socioeconomic and racial minority groups by illustrating the distribution of inequality in prevention policy that leads to a distribution of inequality in HIV prevalence and HIV outcomes. The goal of my dissertation work is to help focus future treatment efforts in order to serve all members of a HIV+ community equally, but we must also work on shifting the distribution of risk factors for HIV away from a skewed set of factors that target the poor.
2. By summarizing and documenting the official and cultural responses to an epidemic that arose and escalated rapidly, this manuscript can assist city planners and officials in coping with future epidemiological events.
3. The creation of an anthropological narrative of HIV/AIDs within a large metropolitan area provides a voice to those on the margins of this epidemic and those who have worked diligently as clinicians and observers of this disease during the past 25 years.
RESEARCH HYPOTHESES:
ABSTRACT
The Healthy People 2010 initiative focuses on eliminating health disparities between populations. The incidence and prevalence of HIV infection between ethnic groups and socioeconomic levels within the state of
Previous studies have demonstrated variation in health outcomes among HIV+ individuals (Arno et al., 2004). Some populations experience higher incidence of comorbidity, such as PCP, and some populations may experience higher mortality rates both from AIDS and HIV-related illnesses. Furthermore, past work has shown that there are differences in health outcomes between populations, even after controlling for socioeconomic status and level of insurance. For example, black women are more likely to die of an acute MI than white women even after controlling for age, SES, and insurance (2003).
Diez-Roux et al., (2002) has also demonstrated that neighborhood resources are directly predictive of disease risk and play a significant role in changing health outcomes. The authors examined a number of neighborhood indicators and found it is possible to index neighborhoods into risk of acquiring chronic diseases and suffering from acute events such as myocardial infarction.
In this study, I will examine the health disparities present within the HIV+ community of the state of
Zip-codes will be used to define a population and census data will be used to characterize that population. Using the HARS data set, HIV information will be explored in order to examine the relationship between HIV outcomes and populations.
Diez-Roux, A.V. (2002). Investigating area and neighborhood effects on health. American Journal of Public Health. 91: 1783-89.
Two recent amendments passed by
First, I will review two Amendments which allow these changes and second I will introduce a policy proposal that can be adopted using the current laws, infrastructure, and resources available to our state.
In November,
A panel was assembled in the winter and spring of 2005 that made recommendations to the state House of Representatives. Finally, the House followed many of these recommendations and a final Amendment was passed that modified the original legislation into a law that would not cause a significant burden on
These two Amendments should be welcomed by the both the legal and medical community, as well as by patients, and but not in the current way in which the Amendments are executed. If we do not continue pursuits of additional malpractice reform,
The major concern cited by opponents to the non-economic damages cap is that attorneys will be unable to take on malpractice cases due to the high cost by the law firm in gathering expert witnesses and investing the claim. Therefore, attorneys will be unable to take on the majority of liability claims due to the potential loss of their investment.
It is also important to note that only 2% of patients injured by negligent care ever file a malpractice claim and the current malpractice system only compensates 1 in 14 people. These low odds and the lack of precedent cause attorneys to adopt a strategy of swamping the courts with malpractice claims, 4 out of 5 of which are found to be invalid. A system of standards for awards and for care would greatly reduce frivolous suits and would allow attorneys, patients, and physicians to modify their practices and behavior accordingly.
There is a solution to these problems that would be in complete alignment with Amendment 3 and Amendment 8. The Progressive Policy Institute, among others, proposes a system of health courts for liability claims and written standards of liability settlement that would function similar to the workers compensation claims process operated by the Board of Labor.
The most striking and revolutionary changes that would follow the health court system would be a shift from designating blame to a particular physician into assigning a process of blame to a team, group, or institution. Furthermore, and maybe most controversial, the system would end jury awards for malpractice and would rely on written standards to dispense benefits.
The basic tenants of the Progressive Policy Institute proposed Health Court system include (1) replacing civil courts with health courts to hear liability claims (similar to specialized tax courts), (2)creating a written standard of accelerated compensation events (ACEs) of common medical mistakes and errors (e.g. bleeding after colon surgery requiring an additional surgery) that would detail a benefit schedule that could be included with lost wages and direct economic damages, (3) ability for patients to directly file liability claims with the health care provider or hospital, (4) a local board that would review injury claims and determine if they meet ACE designation or if they require further judafication, (5) a system of state and federal health care boards with mixed funding at each level, (6) the establishment of additional ACEs and benefit standards determined by written case law (7) experts will be paid and obtained by the court and board, not by the attorneys from either side, (8)the ability to monitor truly negligent hospitals and institutions over time and (9) use of evidence based medicine to establish a standards board for practicing physicians.
The benefits of this system are that physicians will have a clear idea of what constitutes malpractice and liable behavior because their will be a written set of standards developed from court rulings. This will decrease overall health care expenses by decreasing the practice of “defensive medicine” which is common among physicians (an over abundance of tests are ordered to cover liability). Furthermore, all patients will have access and ability to pursue injury claims in a similar manner in which they already pursue worker’s compensation claims. In addition, the hiring of experts by the court will reduce attorney fees significantly making it easier for low-income individuals to obtain representation. Also, juries should not be in the business of deciding law, they should be focused on deciding fact. However, the unclear precedents in current malpractice suits make it so that the jury focuses their efforts on deciding law since there are no clear standards of care. It is quite possible that two people suffering identical injuries will receive very different awards simply based on the jury they receive. A physician faces the same fate at the mercy of an assembled jury. Health Courts remove juries from these decisions and allow clear expectations and standards to develop over time.
The Progressive Policy Institute has also outlined a number of potential objections to this system. The objections will likely come from attorneys for two reasons – (1) citizens have the right to a jury trial and (2) malpractice attorneys could suffer decreased compensation and less demand for services. However, the workers compensation model is ideal for demonstrating that it is possible to settle liability claims without a jury. Furthermore, if only 2% of malpractice injury claims are pursued at present, and only 1 in 14 of those receive an award, attorneys may be able to find compensation simply by the increased frequency of malpractice cases they will be able to take on.
One other potential problem is that large jury awards have been significant for increasing reform in other industries. For example, tobacco lawsuits resulted in billions of dollars in jury awards that threatened tobacco companies and resulted in significant modifications within their industry and an increase in positive health outcomes among the community. However, the large jury awards are not useful in altering physician behavior or hospital practices. Since there are no clear standards in place, it is not possible that a systematic practice of negligent and liable behavior is occurring. In other words, there is no behavior to deter by these awards. As a matter of fact, the large awards are linked to increased health care costs due to the practice of defensive medicine and high insurance rates.
Most importantly,
I was able to finish another book on my Summer Reading List (see below) over the weekend. This time it was Thomas Friedman’s work, the NY Times Bestseller – The World is Flat. In college I, as I’m sure many of you did, encountered Friedman on a number of occasions (Beirut to Jeruselum for example) and have continued to read his pieces in the Times. The book, as can be expected, was basically an articulated and comprehensive summary of many of the ideas expressed in his columns and previous books. However, in this manuscript, those ideas are unified to create a well formed argument concerning globalization, American economy, quality of life, and international relations. I’ve written a short review of the book below - but I suggest you buy it and read it, the anecdotes are entertaining and writing makes for easy and enjoyable reading.
In The World is Flat, Thomas Friedman argues that the rate of globalization has increased tremendously since the year 2000, fueled by technological advances and political reform. Furthermore, his major thesis is that the
First, Friedman outlines 3 major phases of Globalization both chronologically and methodologically. He suggests that the first phase of Globalization took place before the Industrial Revolution, during the period of exploration by
Early in the manuscript, Friedman outlines the 10 major innovations, inventions, or advances that have allowed the flattening of the world. These include: the fall of the Berlin Wall, the invention and public release of the Netscape browser, Open source software, the Windows operating system, outsourcing, offshoring, supply chaining, insourcing, and PDAs/cellphones.
Throughout the early portion of the book, the author makes his case for why each of these innovations was so significant. The Berlin Wall opened up a new market, a new community of hungry and ready workers and consumers. The release of Netscape allowed people to easily access data without understanding the nuances of computer technology and http file transfer. Open source software allows individuals to modify and change software to fit their needs and allows exponential and mass changes to take-hold and increase the efficacy of software programs. The Windows OS helped make computers easy to use for all populations and individuals. Outsourcing, and this is critical, reshapes the American economy, allowing American companies to invest more money in research and development, creating new jobs that did not previously exist in our country. Offshoring allows opportunities for people in India, South Korea, China and other locations and also provides low status American jobs to individuals in areas where the jobs are higher status – providing them with educational and advancement opportunities. Furthermore, offshoring changes the PATTERN of jobs (not the number) in all involved countries and in the country doing the offshoring requires upskilling or retraining of workers for new jobs that are created or not yet invented. Supply chaining allows goods to be moved rapidly and cheaply over large geographical distances and also may play a role in social interactions and cooperation between countries (discussed below). Insourcing generates new jobs that did not exist previously in established countries and allows organizations to increase their efficacy and redefine their role. UPS is the best example of this, argues Friedman, since they now come into a company and take over operation from warehousing to transport and ordering, allowing the company to focus on design, creation, research, and development. In-forming represents the easy access to information and knowledge via the internet and internet search engines such as Google. This makes all knowledge accessible to all people and goes hand in hand with the final significant innovation, the development and spread of PDAs and cellphones. These devices empower individuals to carry knowledge and to create media and act as journalists and archivers of their environment with relatively little expense.
Much of these changes, suggests Friedman were driven by the Dot-Com Boom of the mid to late 90s, most notably, the overinvestment in fiber optic cable which allows those in Bangalore to have high speed internet access and communicate and share data in real time all over the world.
The author also suggests that these technologies converged during the year 2000 to drive a global revolution in economics and market forces.
In the first half of his work, Friedman lays out and supports his case for rapid individual and technology driven globalization after the year 2000. In the second half of the book, Friedman suggests ways in which the
Overall, there is a bit of “the sky is falling” feel to the book, however, Friedman articulates something that everyone kinda knows already – the world changed a lot over the past few years the jobs of my generation and my kids generation won’t look anything like the jobs of our parents or their parents. I think Friedman has gotten it right – we are in the middle of an economic revolution that will change the world even more greatly than the Industrial Revolution and will allow the potential for corporation and innovation between countries or conflict and war for energy, resources, and jobs. American policy must be greatly altered to recognize our role in this global marketplace or our protectionist and isolationist past will lead to an economic downturn and decreased quality of life in the future.
Amazon.com The World Is Flat
NY TIMES Thomas Friedman Column






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