Philomath Couplet

2005 ◽  
Vol 1931 (1) ◽  
pp. 49-57
Author(s):  
Marcy Schwartz ◽  
John Willis ◽  
Bruce Erickson
Keyword(s):  
Decision Process ◽  
Local Community ◽  
Small Town ◽  
Evaluation Criteria ◽  
The United States ◽  
Small Towns ◽  
Lessons Learned ◽  
Context Sensitive ◽  
Cost Constraints ◽  
Main Streets

Values associated with statewide freight and tourist mobility; traffic, pedestrian, and bicycle safety; and small-town livability create competing objectives that are difficult to balance when main streets of small towns are also state highways. Many communities opt for bypass solutions to these issues, but the Philomath Couplet Project represents a main street solution that is sensitive to both the demands of the state highway system and the character of the local community. The controversial 10-month decision process culminated in the selection of a preferred alternative. Final design is under way, and construction is scheduled for 2006. Although many projects are developed according to context-sensitive solution principles, the Philomath Couplet Project represents a class of projects with characteristics likely to be faced throughout the United States in relation to the management of state highways that are also main streets of small towns. The difficulties encountered in conducting this project provide important insights to guide context-sensitive solutions implementation in these circumstances. The lessons learned shared in this paper highlight the need to manage the “end game” of small-town politics, the value of time and cost constraints, the need for a structured decision process, and the usefulness of evaluation criteria based on interactions of land use and transportation.

An Academic-Community Collaboration to Deliver Medication Therapy Management (MTM) Services to Patients Living in Rural Counties of a Southwestern State in the United States

2021 ◽  
pp. 089719002110002
Author(s):  
David Rhys Axon ◽  
Melissa Johnson ◽  
Brittany Abeln ◽  
Stephanie Forbes ◽  
Elizabeth J. Anderson ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Program Effectiveness ◽  
Small Town ◽  
The United States ◽  
Small Towns ◽  
Academic Community ◽  
Service Needs ◽  
Medication Therapy

Background: Patients living in rural communities often experience pronounced health disparities, have a higher prevalence of diabetes and hypertension, and poorer access to care compared to urban areas. To address these unmet healthcare service needs, an established, academic-based MTM provider created a novel, collaborative program to provide comprehensive, telephonic services to patients living in rural Arizona counties. Objective: This study assessed the program effectiveness and described differences in health process and outcome measures (e.g., clinical outcomes, gaps in care for prescribed medications, medication-related problems) between individuals residing in different rural-urban commuting area (RUCA) groups (urban, micropolitan, and small town) in rural Arizona counties. Methods: Subjects eligible for inclusion were 18 years or older with diabetes and/or hypertension, living in rural Arizona counties. Data were collected on: demographic characteristics, medical conditions, clinical values, gaps in care, medication-related problems (MRPs), and health promotion guidance. Subjects were analyzed using 3 intra-county RUCA levels (i.e., urban, micropolitan, and small town). Results: A total of 384 patients were included from: urban (36.7%), micropolitan (19.3%) and small town (44.0%) areas. Positive trends were observed for clinical values, gaps in care, and MRPs between initial and follow-up consultations. Urban dwellers had significantly lower average SBP values at follow-up than those from small towns (p < 0.05). A total of 192 MRPs were identified; 75.0% were resolved immediately or referred to providers and 16.7% were accepted by prescribers. Conclusion: This academic-community partnership highlights the benefits of innovative collaborative programs, such as this, for individuals living in underserved, rural areas.

scholarly journals Okotoks: From Trading Post to Suburb

2013 ◽  
Vol 8 (2) ◽  
pp. 3-22 ◽  
Author(s):  
Lewis G. Thomas
Keyword(s):  
United States ◽  
Urban History ◽  
First Generation ◽  
Small Town ◽  
The United States ◽  
Small Towns ◽  
Southern Alberta ◽  
English Speaking ◽  
Complex Patterns

In spite of a growing interest in urban history, Canadian scholars have paid little attention to small towns. In this article a small town in southern Alberta is examined during the years 1890-1950, with particular attention paid to the decade of the 1920s. The author argues that a closer examination of such small centres might throw new light on the complex patterns of Canadian development. Small towns like Okotoks provided a means whereby the first generation of Alberta settlers, predominantly English-speaking, Protestant and British oriented, asserted their peculiar values in the life of the province in spite of the arrival after 1896 of new waves of settlers from the United States and continental Europe.

You Have to Deal with Everybody

2013 ◽  
Author(s):  
Robert Wuthnow
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Sexual Orientation ◽  
Small Town ◽  
The United States ◽  
Small Towns ◽  
Education Level ◽  
Service Class ◽  
The People ◽  
Family Style

This chapter examines the marks of distinction that residents use to describe social strata in their communities as well as the local expectations that blur these distinctions. To understand how people in small towns view their communities, and how their communities shape their behaviors and attitudes, a good start is to look at the people themselves. Doing so reveals an interesting irony. The millions of people in the United States who live in small towns are quite diverse. They vary in background, race, age, family style, sexual orientation, education level, occupation, and income. At the same time, townspeople argue that they are not so different from one another. They see their fellow residents as similar to themselves: profoundly democratic, neighborly, and basically equal. The chapter considers the socioeconomic status of small-town residents as well as various categories of residents, namely: gentry, service class, wageworkers, and pensioners.

Signatures of Commerce in Small-Town Hotel Guest Registers

2009 ◽  
Vol 33 (1) ◽  
pp. 17-45 ◽  
Author(s):  
David A. Fyfe ◽  
Deryck W. Holdsworth
Keyword(s):  
New York ◽  
Information System ◽  
Popular Culture ◽  
Small Town ◽  
Urban System ◽  
Small Towns ◽  
Travel Patterns ◽  
American Popular Culture ◽  
Gis Software ◽  
Main Streets

Guest registers for six commercial hotels are analyzed to reveal everyday, nonmigratory travel patterns associated with small towns and villages in the upper Susquehanna valleys of New York and Pennsylvania at the turn of the twentieth century. The residences of guests are mapped using geographic information system (GIS) software and reveal two broad patterns of connectivity, a translocal cluster of visitors from places within the immediate vicinity and a set of visitors from more distant places up the urban system. Census and directory data identify many repeat visitors, such as hucksters and peddlers extending the reach of rural stores and merchants traveling circuits as agents of metropolitan manufacturing centers. In addition to commercial travelers, the presence of traveling entertainments, such as vaudeville acts and circuses, in hotel guest registers reveals shifts in American popular culture and entertainments on small-town Main Streets. These registers offer a fixed window onto a mobile world, and the signatures hint at the types of connections between these settlements and the outside world.

Confronting the Problems of Professional Sports: A Public Policy Response to Franchise Relocation and Stadium Subsidization

2005 ◽  
Vol 1 ◽  
Author(s):  
Taylor F Brinkman
Keyword(s):  
Local Community ◽  
Professional Sports ◽  
The United States ◽  
Direct Result ◽  
Sports Organizations ◽  
Sports Leagues ◽  
Sports Finance ◽  
Sports Venues ◽  
Benefits And Costs

During the past decade, forty-six professional sports venues were constructed in the United States, while only 16 expansion teams were created by the major sports leagues. Nearly two thirds of these newly built stadiums and arenas were funded with public tax revenues, despite substantial evidence showing no positive economic impact of new sports stadium construction on local communities. In reviewing the economic literature, this article investigates the role of professional sports organizations in the construction and public subsidization of new sports venues. Franchise relocation and public stadium subsidization is a direct result of the monopoly power of professional sports leagues, whose franchise owners extract large subsidies from their host communities by threatening to relocate to viable alternative locations. After explaining how the most common methods of stadium subsidization project a disproportionate allocation of the benefits and costs of hosting a professional team to local community interests, this article outlines several considerations for local policymakers who seek to reinvigorate public discussion of equity concerns in professional sports finance.

Characteristics of Physician Relocation Following Hurricane Katrina

2009 ◽  
Vol 95 (1) ◽  
pp. 6-12
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
The United States ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Impact

ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P &lt; .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.

Winning the Argument and Moving the Fight: The Legacy of a Grassroots Humanitarian

Public Voices ◽  
2016 ◽  
Vol 14 (1) ◽  
pp. 115
Author(s):  
Mary Coleman
Keyword(s):  
Higher Education ◽  
United States ◽  
Winning Strategy ◽  
Supreme Court Decision ◽  
The United States ◽  
Colleges And Universities ◽  
Lessons Learned ◽  
The Political ◽  
Political Actors ◽  
Trade Offs

The author of this article argues that the two-decades-long litigation struggle was necessary to push the political actors in Mississippi into a more virtuous than vicious legal/political negotiation. The second and related argument, however, is that neither the 1992 United States Supreme Court decision in Fordice nor the negotiation provided an adequate riposte to plaintiffs’ claims. The author shows that their chief counsel for the first phase of the litigation wanted equality of opportunity for historically black colleges and universities (HBCUs), as did the plaintiffs. In the course of explicating the role of a legal grass-roots humanitarian, Coleman suggests lessons learned and trade-offs from that case/negotiation, describing the tradeoffs as part of the political vestiges of legal racism in black public higher education and the need to move HBCUs to a higher level of opportunity at a critical juncture in the life of tuition-dependent colleges and universities in the United States. Throughout the essay the following questions pose themselves: In thinking about the Road to Fordice and to political settlement, would the Justice Department lawyers and the plaintiffs’ lawyers connect at the point of their shared strength? Would the timing of the settlement benefit the plaintiffs and/or the State? Could plaintiffs’ lawyers hold together for the length of the case and move each piece of the case forward in a winning strategy? Who were plaintiffs’ opponents and what was their strategy? With these questions in mind, the author offers an analysis of how the campaign— political/legal arguments and political/legal remedies to remove the vestiges of de jure segregation in higher education—unfolded in Mississippi, with special emphasis on the initiating lawyer in Ayers v. Waller and Fordice, Isaiah Madison

Psyche and Soul in America

2020 ◽  
Author(s):  
Robert H. Abzug
Keyword(s):  
United States ◽  
Small Town ◽  
Sense Of Self ◽  
The United States ◽  
Inner Life ◽  
The 1950S ◽  
The Relationship

Rollo May (1909‒1994), internationally known psychologist and popular philosopher, came from modest roots in the small town Protestant Midwest intending to do “religious work” but eventually became a psychotherapist and in best-selling books like Love and Will and The Courage to Create he attracted an audience of millions of readers in the United States, Europe, and Asia. During the 1950s and 1960s, these books combined existentialism and other philosophical approaches, psychoanalysis, and a spiritually-philosophy to interpret the damage bureaucratic and technocratic aspects of modernity and their inability of individuals to understand their authentic selves. Psyche and Soul in America deals not only with May’s public contributions but also to his turbulent inner life as revealed in unprecedentedly intimate sources in order to demonstrate the relationship between the personal and public in a figure who wrote about intimacy, its loss, and ways to regain an authentic sense of self and others.

scholarly journals The Global Limb Anatomic Staging System (GLASS) for CLTI: Improving Inter-Observer Agreement

2021 ◽  
Vol 10 (16) ◽  
pp. 3454
Author(s):  
Joep G. J. Wijnand ◽  
Devin Zarkowsky ◽  
Bian Wu ◽  
Steven T. W. van Haelst ◽  
Evert-Jan P. A. Vonken ◽  
...  
Keyword(s):  
Staging System ◽  
The United States ◽  
Lessons Learned ◽  
Observer Agreement ◽  
Lesion Length ◽  
Solid Base ◽  
Stepwise Approach ◽  
Additional Tool ◽  
Atherosclerotic Lesions ◽  
Stenosis Severity

Objective: The 2020 Global Vascular Guidelines aim at improving decision making in Chronic Limb-Threatening Ischemia (CLTI) by providing a framework for evidence-based revascularization. Herein, the Global Limb Anatomic Staging System (GLASS) serves to estimate the chance of success and patency of arterial pathway revascularization based on the extent and distribution of the atherosclerotic lesions. We report the preliminary feasibility results and observer variability of the GLASS. GLASS is a part of the new global guideline and posed as a promising additional tool for EBR strategies to predict the success of lower extremity arterial revascularization. This study reports on the consistency of GLASS scoring to maximize inter-observer agreement and facilitate its application. Methods: GLASS separately scores the femoropopliteal (FP) and infrapopliteal (IP) segment based on stenosis severity, lesion length and the extent of calcification within the target artery pathway (TAP). In our stepwise approach, we used two angiographic datasets. Each following step was based on the lessons learned from the previous step. The primary outcome was inter-observer agreement measured as Cohen’s Kappa, scored by two (step 1 + 2) and four (step 3) blinded and experienced observers, respectively. Steps 1 (n = 139) and 2 (n = 50) were executed within a dataset of a Dutch interventional RCT in CLTI. Step 3 (n = 100) was performed in randomly selected all-comer CLTI patients from two vascular centers in the United States. Results: In step 1, kappa values were 0.346 (FP) and 0.180 (IP). In step 2, applied in the same dataset, the use of other experienced observers and a provided TAP, resulted in similar low kappa values 0.406 (FP) and 0.089 (IP). Subsequently, in step 3, the formation of an altered stepwise approach using component scoring, such as separate scoring of calcification and adding a ruler to the images resulted in kappa values increasing to 0.796 (FP) and 0.730 (IP). Conclusion: This retrospective GLASS validation study revealed low inter-observer agreement for unconditioned scoring. A stepwise component scoring provides acceptable agreement and a solid base for further prospective validation studies to investigate how GLASS relates to treatment outcomes.

scholarly journals The COVID Army: Experiences from the Deployment of Non-Hospitalist Physician Volunteers during the 2020 COVID Pandemic

2021 ◽  
pp. 1-15
Author(s):  
Kevin Hauck ◽  
Katherine Hochman ◽  
Mark Pochapin ◽  
Sondra Zabar ◽  
Jeffrey A Wilhite ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Medical Center ◽  
The United States ◽  
Lessons Learned ◽  
Front Line ◽  
Clinical Leadership ◽  
Team Members ◽  
Medical Centers ◽  
Hospitalist Physician

Abstract Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.

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