Maryland Community Research Articles

THE TAPHONOMIC FIDELITY OF SEED SIZE IN FOSSIL ASSEMBLAGES: A LIVE-DEAD CASE STUDY

Trends in the size distributions of fossil seed assemblages over geologic time have been interpreted as evidence of fundamental changes in the structure of terrestrial ecosystems. It is not clear, however, how accurately fossil seed assemblages reflect the original flora. As a case study, the seed-size distribution of a living hardwood forest and a salt marsh community in Maryland was compared to that of its potential fossil assemblage, seeds extracted from sediment cored in the adjacent tidal estuary. Results indicated that the death assemblage was significantly different from the source community, lacking most of the smaller-seed morphotypes. The biased accumulation was not driven solely by over- or underrepresentation of plants of a particular dispersal mode or growth form. Although there was a sedimentological gradient along the transects, there was no correlation between grain size and seed-size distributions within the cores. The difference appears to be primarily an issue of transport: 45% of morphotypes identified in the death assemblage were present in the life assemblage, and only 33% identified in the life assemblage were also in the death assemblage. These results indicate that (1) estuarine deposits capture a partial representation of the local seed flora with significant regional influences, and (2) fossil seed assemblages should not be compared directly to seed-size distributions documented in living communities.

Segregation and Disparities in Health Services Use

We compared race disparities in health services use in a national sample of adults from the 2002 Medical Expenditure Panel Survey and data from the Exploring Health Disparities in Integrated Communities Project, a 2003 survey of adult residents from a low-income integrated urban community in Maryland. In the Medical Expenditure Panel Survey data, African Americans were less likely to have a health care visit compared with Whites. However, in the Exploring Health Disparities in Integrated Communities Project, the integrated community, African Americans were more likely to have a health care visit than Whites. The race disparities in the incidence rate of health care use among persons who had at least one visit were similar in both samples. Our findings suggest that disparities in health care utilization may differ across communities and that residential segregation may be a confounding factor.

The Accountability of Nonprofit Hospitals: Lessons from Maryland's Community Benefit Reporting Requirements

Under Internal Revenue Service requirements, nonprofit hospitals will begin filing new community benefit reports in 2010. Maryland has had similar requirements since 2004. This paper, based on interviews at 20 hospitals, describes how Maryland's requirements affected hospitals and their activities. Increases in reported community benefit expenditures since the program began are due to both changes in activities and better data capture. Charity care accounts for one-third of community benefit dollars. A key distinction concerns whether hospitals take an accounting or managerial approach to community benefit. The Maryland experience suggests the issues that will arise when the national requirements are implemented.

Psychometric Properties of Commonly Used Low Back Disability Questionnaires: Are They Useful for Older Adults with Low Back Pain?

To evaluate the psychometric properties of two commonly used low back pain (LBP) disability questionnaires in a sample solely comprising community-dwelling older adults. Single-group repeated measures design. Four continuing care retirement communities in Maryland and in Virginia. Participants. Convenience sample of 107 community-dwelling men and women (71.9%) aged 62 years or older with current LBP. Outcome Measures. All participants completed modified Oswestry Disability (mOSW) and Quebec Back Pain Disability (QUE) questionnaires, as well as the Medical Outcomes Survey Short-Form 36 questionnaire at baseline. At follow-up, 56 participants completed the mOSW and the QUE for reliability assessment. Test-retest reliability of the mOSW and QUE were excellent with intraclass correlation coefficients of 0.92 (95% confidence interval [CI]: 0.86, 0.95) and 0.94 (95% CI: 0.90, 0.97), respectively. Participants with high pain severity and high levels of functional limitation had higher scores on the mOSW (P < 0.0001) and QUE (P < 0.001) scales than other participants, which represents good construct validity for both scales. The threshold for minimum detectable change is 10.66 points for the mOSW and 11.04 points for the QUE. Both questionnaires had sufficient scale width to accurately measure changes in patient status. It appears that both questionnaires have excellent test-retest reliability and good construct validity when used to evaluate LBP-related disability for older adults with varying degrees of LBP. Neither questionnaire appears to have superior psychometric properties; therefore, both the Oswestry and Quebec can be recommended for use among geriatric patients with LBP.

Associations of back and leg pain with health status and functional capacity of older adults: Findings from the retirement community back pain study

Low back pain (LBP) is the most frequently reported musculoskeletal problem in older adults, but its impact on health status is not well understood. Our objective was to determine whether LBP and concurrent leg pain are associated with health-related quality of life (HRQOL) and function in a cohort of older adults, and to examine care-seeking behaviors related to LBP. This was a population-based, cross-sectional survey study of 522 community-dwelling men and women (67.4%) ages >or=62 living in 4 retirement communities in Maryland and northern Virginia. LBP status in the past year was categorized as no pain in the low back or leg, LBP only, and LBP with leg pain. HRQOL and function were measured with the Medical Outcomes Study Short Form 36 (SF-36). A total of 26.8% of the sample reported LBP only and 21.3% reported LBP plus leg pain. Participants with LBP and LBP plus leg pain had lower scores in all SF-36 domains, reflecting worse HRQOL (P < 0.0001). LBP and LBP plus leg pain were associated with 2-fold greater odds of falling and increased difficulty lifting grocery bags, walking several blocks, and bathing. LBP plus leg pain was associated with difficulty in social interactions (odds ratio 10.63, 95% confidence interval 3.57-31.60). Less than half sought care for LBP and those who did had poorer health status and greater pain burden. LBP is common among older adults and strongly associated with reduced HRQOL and function. These findings argue strongly for both identifying cases of LBP by health care practitioners and pursuing effective treatments for LBP given the potential consequences.

Six Community College Presidents: Organizational Pressures, Change Processes and Approaches to Leadership

A total of six Maryland community college presidents were guided through conversations to identify the organizational challenges and uncertainties that have forced organizational changes in their respective colleges. Another thrust of the research was to discover what organizational change processes these presidents have implemented to overcome the challenges and to describe what leadership approaches they have used to lead change. Seven challenges, two general change process categories consisting of 12 different steps, and three leadership approaches emerged using a qualitative ethnomethodological research technique. The presidents' definitions of leadership and its essence, along with their leadership development experiences, are also presented.

The Life and Times of LeRoy “Boots” Battle: Band Educator/Jazz Musician

Biography is to history what the telescope is to the stars. It reveals the invisible, extracts detail from myriad points of light, uncovers sources of illumination, and helps us disaggregate and reconstruct large heavenly pictures. (2) A time of dynamic social change unfolded in Prince George's County, Maryland, during the 1950s, '60s, and '70s. This biography of LeRoy Battle, based on oral history testimony and practice, focuses upon the nature of music education in this rapidly growing, racially divided county in the suburbs of Washington, D.C. Battle's work as a music educator provides a framework, allowing the reader a glimpse of culture and customs at that time. Battle is an African American. He was born in 1921 and came to Prince George's County from an integrated community in New York City. Battle became a role model for students of his race and students of music education. He developed a music program that had a profound effect on his students and the surrounding community in Maryland of the 1950-70s. Battle retired in 1978 and twenty-seven years later, on August 27, 2005, former students honored him and his work by hosting a gala event. In attendance were more than 300 former students, relatives, and friends who still remember Battle's impact. This is the story of how he built a music program, trained youngsters, and reacted to life in a racially segregated society. Political and Social Milieu: Battle's Terrain In 1950, the roads leading to Douglass Junior/Senior High School in Upper Marlboro, Maryland, were lined with tobacco fields, the crop that made Upper Marlboro the colonial shipping capitol of the Chesapeake Bay. Upper Marlboro was and remains the Prince George's County seat. A courthouse and the law offices to the county government face Main Street, where from time to time community activities such as parades occur. A highly developed social structure, maintained from colonial times, continued where important people hosted social events catering to lawyers, landowners, and merchants. Vestiges of attitudes prevalent at a time when farming was dependent on slave labor carried over into the twentieth century. At the county courthouse, whites only drinking fountains remained up to the 1960s. (3) At the time that Battle assumed his music teaching position in Prince George's County in 1950, these attitudes could still lead to blatant ridicule of blacks. He describes clowns in blackface at county parades: They would have these clowns in blackface and these whiskey bottles. All the firehouses had a group. They planned all this. You couldn't see a parade without seeing them making fun of blacks and all that. The guy'd be going with a checkered thing, shoes floppin', whiskey bottle with big X's on it. (4) This disregard for another person's dignity was not part of Battle's home in an integrated Brooklyn community. As a youth he and his family socialized with others in the adjoining back yards. Battle recalls times with an Italian neighbor, Mr. Sandorian: And I remember once a month he'd have his whole family and we'd have my whole family, my aunt, my mother and everything. We'd meet in the back yard under the, they had a big vine, a grapevine. They had big tables and all that. We would meet there. He would bring down, his family would bring down--that's when I first tasted olive oil in salad, you know, the ethnic thing that he would have. Lasagna and all like that. And then my aunt would fix the roast turkey. So, we'd have a good time out there. (5) There were other examples of obvious differences between life in New York City and in Prince George's County during the 1950s: The social life was very disappointing [in Prince George's County]. What I felt was not so much for myself, see because I played music and I was out and about, but for the students. …

Relation of Adult-Onset Asthma to Coronary Heart Disease and Stroke

Asthma was associated with atherosclerotic disease in several studies, with evidence that this association may be limited to women. However, most previous studies failed to account for the heterogeneity of asthma subtypes. We previously reported increased carotid intima-medial thickness in women with adult-onset asthma. In this study, the association of adult- and child-onset asthma with incident coronary heart disease (CHD) and stroke were examined. Subjects were classified according to self-report of physician-diagnosed asthma and age of asthma onset. Cox proportional hazards models were used to test the association of adult- and child-onset asthma with incident CHD and stroke, testing for gender interaction. Subanalysis was also performed using only never smokers. Women with adult-onset asthma experienced a 2-fold increase in incident CHD and stroke that was independent of other risk factors, including smoking, body mass index, and physical activity, and persisted when analysis was restricted to never smokers. No significant association was found in women with child-onset asthma or in men. In conclusion, adult-onset asthma may be a significant risk factor for CHD and stroke in women, but not men.

Transmissibility of the Influenza Virus in the 1918 Pandemic

BackgroundWith a heightened increase in concern for an influenza pandemic we sought to better understand the 1918 Influenza pandemic, the most devastating epidemic of the previous century.Methodology/Principal FindingsWe use data from several communities in Maryland, USA as well as two ships that experienced well-documented outbreaks of influenza in 1918. Using a likelihood-based method and a nonparametric method, we estimate the serial interval and reproductive number throughout the course of each outbreak. This analysis shows the basic reproductive number to be slightly lower in the Maryland communities (between 1.34 and 3.21) than for the enclosed populations on the ships (R0 = 4.97, SE = 3.31). Additionally the effective reproductive number declined to sub epidemic levels more quickly on the ships (within around 10 days) than in the communities (within 30–40 days). The mean serial interval for the ships was consistent (3.33, SE = 5.96 and 3.81, SE = 3.69), while the serial intervals in the communities varied substantially (between 2.83, SE = 0.53 and 8.28, SE = 951.95).Conclusions/SignificanceThese results illustrate the importance of considering the population dynamics when making statements about the epidemiological parameters of Influenza. The methods that we employ for estimation of the reproductive numbers and the serial interval can be easily replicated in other populations and with other diseases.

Advance Directives at End-of-Life: Nursing Home Resident Preferences for Artificial Nutrition

Nursing homes are increasingly the place where many Americans die. Thus, advance directives are critical to the preservation of the autonomous wishes at end-of-life. The purpose of this paper is to determine if preferences for artificial nutrition, as stated in the advance directives of nursing home residents, are honored in the last 2 months of life. Secondary analysis. Six Maryland community nursing homes. Fifty-seven consented residents (age 62 to 98) from the parent study who died during the study period. Retrospective document review including advance directives and clinical care provided in the last 2 months of life. Most of the nursing home residents in this sample refused feeding tubes, and these preferences were honored during the last 2 months of life (93%), despite some (17% to 26%) with documented weight loss. A small percentage (8.8%) of residents received feeding tubes at end-of-life and, of those, only 1 was consistent with advance directive preferences. Most advance directives in this study included feeding tube preferences. In this nursing home sample, advance directives were significant documents guiding decisions on artificial nutrition, and feeding tubes were in fact uncommon at the end of life. The study suggests that advance care planning, quality palliative care training, and administrative support are necessary for the honoring of preferences. Future research is needed to examine more broadly tube-feeding practices and prevalence in nursing homes.

Disaster Planning for Pandemic Flu: An Assessment of the Potential Effects of an Influenza Pandemic on Local Community Health Care Resources

The eventuality of another influenza pandemic and the recent concern over H5N1, avian flu, require an assessment of local community healthcare capabilities. As the federal government has recently stated that such local communities will be primarily responsible for public health planning and implementation during a severe pandemic, an assessment of the current capabilities in these communities and planning for deficiencies must commence immediately. In this article, we have assessed the impact and capabilities of a model local county community in suburban Maryland. Our two statistical models demonstrate the likely impact of a mild, 1968 Hong Kong Flu pandemic in comparison to a severe, 1918 Spanish Flu type pandemic respectively. Both of these statistical models reveal significant resource deficiencies that many local communities may face. Additionally, we discuss some negative consequences that pandemic policy implementation itself may have on local communities and healthcare systems. Some recommendations for pandemic planning are suggested.

Longitudinal Mapping of Cortical Thickness and Clinical Outcome in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

Data from a previous prospective study of lobar volumes in children with attention-deficit/hyperactivity disorder (ADHD) are reexamined using a measure of cortical thickness. To determine whether regional differences in cortical thickness or cortical changes across time characterize ADHD and predict or reflect its clinical outcome. Longitudinal study of 163 children with ADHD (mean age at entry, 8.9 years) and 166 controls recruited mainly from a local community in Maryland. Participants were assessed with magnetic resonance imaging. Ninety-seven patients with ADHD (60%) had 2 or more images and baseline and follow-up clinical evaluations (mean follow-up, 5.7 years). Cortical thickness across the cerebrum. Patients with ADHD were divided into better and worse outcome groups on the basis of a mean split in scores on the Children's Global Assessment Scale and persistence/remission of DSM-IV-defined ADHD. Children with ADHD had global thinning of the cortex (mean reduction, -0.09 mm; P=.02), most prominently in the medial and superior prefrontal and precentral regions. Children with worse clinical outcome had a thinner left medial prefrontal cortex at baseline than the better outcome group (-0.38 mm; P=.003) and controls (-0.25 mm; P=.002). Cortical thickness developmental trajectories did not differ significantly between the ADHD and control groups throughout except in the right parietal cortex, where trajectories converged. This normalization of cortical thickness occurred only in the better outcome group. Children with ADHD show relative cortical thinning in regions important for attentional control. Children with a worse outcome have "fixed" thinning of the left medial prefrontal cortex, which may compromise the anterior attentional network and encumber clinical improvement. Right parietal cortex thickness normalization in patients with a better outcome may represent compensatory cortical change.

Relationship Among Tree Canopy Quantity, Community Demographics, and Tree City USA Program Participation in Maryland, U.S.

The Tree City USA (TCUSA) program is a national program in the United States that provides recognition to communities that meet certain standards, including having a tree ordinance and spending at least US$2.00 per capita on urban forestry. Census data for 2000 were combined with records on TCUSA program participation and tree canopy cover data for 74 communities in Maryland, U.S., to ascertain relationships among tree canopy quantity, community demographics, and Tree City USA program participation. Communities participating in TCUSA had widely varying demographics (2.2% to more than 97% nonwhite) but tended to have larger overall populations and larger nonwhite populations than did nonparticipating communities, with the percentage of nonwhite population slightly higher for nonparticipants. Multivariate statistical analysis showed that the most predictive variable related to the amount of canopy cover is the size of the city in hectares (acres). A combination of city population, hectares (acres) of tree cover, expenditures per capita on trees, and city size in hectares (acres) produced the greatest predictability in whether a city participates in the TCUSA program. The relationship between quantity of tree canopy and total population was stronger in participating than in nonparticipating communities. However, the relationship between land area and quantity of tree canopy was stronger for nonparticipants than for participants, and overall percentage of canopy cover as well as mean percentage of canopy cover were higher in nonparticipating communities. TCUSA participants in Maryland have similar land areas, similar ethnic demographics, higher populations, and canopy coverage more closely related to population than land area when compared to non-TCUSA communities and are most likely to be found in an urban/suburban context, while non-TCUSAs are more likely to be found in a rural (agricultural/forest) context.

A recidivism analysis of Maryland's community probation program

This study employed a type of quasi-experimental research design that compared a sample of offenders who underwent community supervision (HotSpot) with a matched sample of offenders who underwent “normal” probation supervision (presample) in Maryland. In addition to examining the recidivism pattern of both offender groups, specific attention was also devoted to the potential inhibiting effects of social bonds. Twelve months of recidivism information was collected to include both rearrest and technical violations. Results suggested that the survival distribution (for both rearrest and technical violation) of HotSpot probationers was not significantly different from the survival distribution for pre-HotSpot probationers. In addition, probationer's level of “stakes in conformity” served to inhibit both measures of recidivism, suggesting that offenders with more social bonds were less likely to incur a rearrest or citation for a technical violation. Theoretical and policy implications are highlighted, as are directions for future research.

Prevention versus Treatment under Precautionary Regulation: A Case Study of Groundwater Contamination under Uncertainty

AbstractPolicy discussions on agricultural pollution problems characterize prevention as more cost effective and precautionary than ex post treatment. We derive conditions under which treatment alone is more cost effective in situations involving multiple sources of emissions, multiple sites affected, and a commonly used precautionary approach to uncertainty. We also show that a greater degree of precaution can result in less reliance on prevention. An empirical case study indicates that treatment alone is the most cost‐effective means of dealing with nitrate in most Maryland community water system wells. The use of leaching prevention measures is restricted to the most intensive poultry producing areas. The incremental cost of precaution is substantial.

Missed Opportunity: Use of Driver License Manuals to Educate Drivers About Roundabouts in Small- and Medium-Sized Communities

Modern roundabouts have become increasingly popular in small and medium cities in the United States because of their success in reducing speeds and collisions. According to many traffic engineers, modern roundabouts are an attractive and cost-effective speed-control device for intersections. They have been constructed in small and medium communities in California, Colorado, Florida, Indiana, Kansas, Maryland, Oregon, Utah, Washington, and Wisconsin. Geometric designs and right-of-way rules at roundabouts and traffic circles are distinct, and student drivers must be educated and informed of the correct way to use them. State driver manuals could be used to ensure fast dissemination of information to residents in small and medium communities. Review of the manuals of 32 states and the District of Columbia in 1998 and 2002 indicated that very little information is provided and by very few states. Between 1998 and 2002, only three states of those studied updated the information on roundabouts and traffic circles in the driver manuals. The manual of the state of Oregon is best for both traffic circles and roundabouts. The information in most of the manuals is covered in one sentence, and some states have used the term “traffic circle” to mean both circle and roundabout. It is imperative that the manuals be revised with adequate information on the correct way to use roundabouts so that the drivers in small and medium communities are better informed and less resistant to these devices.

Acculturation and adaptation of Soviet Jewish refugee adolescents: predictors of adjustment across life domains.

This study explores how acculturation is related to adaptation across different life spheres for 162 Soviet Jewish refugee adolescents in a suburban community in Maryland. Because the different contexts of refugee adolescents' lives vary in acculturative demands, different patterns of acculturation should be related to adaptation in different life spheres. The study uses a multidimensional measure of acculturation and assesses acculturation to both American and Russian cultures as it relates to psychological adaptation, peer relations, and school and family outcomes. Findings support the general ecological thesis that acculturation to different cultures is differentially related to adaptation across life domains. Acculturation to American culture predicted better grades and perceived support from American peers. Acculturation to Russian culture predicted perceived support from Russian peers. Both American acculturation and Russian acculturation predicted reduced loneliness and perceived support from parents. Further, different dimensions of acculturation, such as language and identity, were differentially related to adaptation. Implications for acculturation theory and measurement are drawn, and cautions are offered about the interpretation of acculturation studies using single proxies such as language use or preference.

High trait anger increased stroke in people ≤60 years and those with high density lipoprotein cholesterol concentrations >47 mmol/l

(2002) Stroke 33, 13; Williams JE, Nieto FJ, Sanford CP, et al. . The association between trait anger and incident stroke risk: the Atherosclerosis Risk in Communities (ARIC) Study. ....

The Human genome project and minority communities: ethical, social, and political dilemmas

Preface The Age of Biology and the Responsible Ancestor by Martha A. Krebs and Daniel Drell The Human Genome Project: Hereditary Diseases and Implications for Gene Therapy by Karen E. Nelson The Genetics of Human Behavior: Lessons from the Human Genome Project by Jonathan Beckwith The Human Genome Project and the African American Community: Race, Diversity, and American Science by Fatimah Jackson Scientific and Folk Ideas about Heredity by Jonathan M. Marks Social and Medical Implications of New Genetic Techniques by Robert F. Murray, Jr. Genetic Education to African American and Russian Immigrant Communities in Northwest Baltimore by Ilana Suez Mittman The Human Genome Project and Buddhism by Akey C. F. Hung Thoughts on the Human Genome Project and Maryland by Kathleen Kennedy Townsend The Human Genome Project: Reaching Minority Communities in Maryland, A Report of Results of the Conference Evaluation Study prepared by the Survey Research Center The Human Genome Project and Minority Communities: The Importance of Dialogue and Access to Information by Raymond A. Zilinskas and Peter J. Balint

At-risk drinkers use safe ride services to avoid drinking and driving.

A central question pertinent to the efficacy of safe rides (SRs) in preventing driving while intoxicated (DWI) is whether individuals at high risk for DWI use them. Barroom surveys (N = 472) and in situ breath tests (N = 51) were conducted as part of an assessment of an alternative transportation intervention in a Maryland community. Bivariate analyses and stepwise logistic regression were performed comparing 42 barroom respondents who reported using a SR in the last 12 months to non-users. Bivariate analyses showed that SR users drank more frequently outside the home and achieved higher estimated blood alcohol concentrations (BACs) when they did. Also, they were more likely to be heavy drinkers, to have driven when feeling intoxicated, and to have been arrested for DWI. Although SR users were more likely to ride with an intoxicated driver, they were also more likely to use a designated driver (DD). Stepwise logistic regression showed SR users were more likely to be heavy drinkers and to use DDs. In situ breath test data showed SR users' BACs ranged from 0.031 to 0.248, with a mean of 0.146. SR programs attract drinkers at high risk for DWI. DWI prevention efforts would benefit from future research exploring how at-risk drinkers make drinking and driving decisions.