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The Irvine Minnesota Inventory (IMI) was designed to measure environmental features that may be associated with physical activity and particularly walking. This study assesses how well the IMI predicts physical activity and walking behavior and develops shortened, validated audit tools. A version of the IMI was used in the Twin Cities Walking Study, a research project measuring how density, street pattern, mixed use, pedestrian infrastructure, and a variety of social and economic factors affect walking. Both bivariate and multivariate analyses were used to assess the predictive value of the IMI. We find that while this inventory provides reliable measurement of urban design features, only some of these features present associations with increased or decreased walking. This article presents two versions of shortened scales—a prudent scale, requiring association with two separate measures of a physical activity or walking behavior, and a moderate scale, requiring association with one measure of physical activity or walking. The shortened scales provide built environment audit instruments that have been tested both for inter-rater reliability and for associations with physical activity and walking. The results are also useful in showing which built environment variables are more reliably associated with walking for travel—characteristics of the sidewalk infrastructure, street crossings and traffic speeds, and land use are more strongly associated with walking for travel, while factors that measure aesthetics are typically less strongly associated with walking for travel.

Lake Chapala is a major source of water for crop irrigation and subsistence fishing for a population of 300,000 people in central Mexico. Economic activities have created increasing pollution and pressure on the whole watershed resources. Previous reports of mercury concentrations detected in fish caught in Lake Chapala have raised concerns about health risks to local families who rely on fish for both their livelihood and traditional diet. Our own data has indicated that 27% of women of childbearing age have elevated hair mercury levels, and multivariable analysis indicated that frequent consumption of carp (i.e., once a week or more) was associated with significantly higher hair mercury concentrations. In this paper we describe a range of environmental health research projects. Our main priorities are to build the necessary capacities to identify sources of water pollution, enhance early detection of environmental hazardous exposures, and deliver feasible health protection measures targeting children and pregnant women. Our projects are led by the Children's Environmental Health Specialty Unit nested in the University of Guadalajara, in collaboration with the Department of Environmental Health of Harvard School of Public Health and Department of Pediatrics of the New York School of Medicine. Our partnership focuses on translation of knowledge, building capacity, advocacy and accountability. Communication will be enhanced among women's advocacy coalitions and the Ministries of Environment and Health. We see this initiative as an important pilot program with potential to be strengthened and replicated regionally and internationally.

Lake Chapala is a major source of water for crop irrigation and subsistence fishing for a population of 300,000 people in central Mexico. Economic activities have created increasing pollution and pressure on the whole watershed resources. Previous reports of mercury concentrations detected in fish caught in Lake Chapala have raised concerns about health risks to local families who rely on fish for both their livelihood and traditional diet. Our own data has indicated that 27% of women of childbearing age have elevated hair mercury levels, and multivariable analysis indicated that frequent consumption of carp (i.e., once a week or more) was associated with significantly higher hair mercury concentrations. In this paper we describe a range of environmental health research projects. Our main priorities are to build the necessary capacities to identify sources of water pollution, enhance early detection of environmental hazardous exposures, and deliver feasible health protection measures targeting children and pregnant women. Our projects are led by the Children's Environmental Health Specialty Unit nested in the University of Guadalajara, in collaboration with the Department of Environmental Health of Harvard School of Public Health and Department of Pediatrics of the New York School of Medicine. Our partnership focuses on translation of knowledge, building capacity, advocacy and accountability. Communication will be enhanced among women's advocacy coalitions and the Ministries of Environment and Health. We see this initiative as an important pilot program with potential to be strengthened and replicated regionally and internationally.

Transportation planners, policymakers, urban designers, and activists have expended considerable effort over the past few decades promoting walking as one of several alternatives to driving.  More recently, the public health benefit of a physically active population, including a population that walks more often, has become another reason to encourage walking.  Amongst all of this excitement about walking, there has so far been little exploration of the role walking plays in people’s lives and cities’ welfare.  One little understood aspect of walking is its appeal beyond simple “derived demand” travel choice frameworks.  Though we might intuitively know that people walk for more than just to get from A to B, there’s been little to explain what people gain from walking beyond its potential health benefit.  An investigation of pedestrian behavior using the 2009 National Household Travel Survey suggests that the reasons that people choose to walk vary considerably across place and class, and that walking in urban areas may best be explained by a dual conceptualization of walking as the mode of last resort and a highly-prized urban amenity.  This seemingly self-contradictory dual role suggests that policies that want to encourage walking across a broad swath of the population will need to overcome barriers rooted in everyday lifestyles just as much as in the quality of the built environment.

The purpose of this effort has been to foster a dialogue among peers at transportation and planning agencies about their experiences with promoting public transit and, in particular, the challenges they face related to bus rapid transit (BRT) projects, as well as the solutions that they have developed in response. Agencies from dozens of large cities around the United States participated at three (3) peer-to-peer exchanges in New York City, Los Angeles, and Cleveland. The facilitated discussions were structure to address the unique barriers to BRT implementation on the streets of dense and/or highly congested large urban centers. Three major themes were the focus of the workshops: Network, Route and Street Design, Traffic Operations, and BRT as a Driver of Economic Development; Building Political, Interagency and Stakeholder Support. The results of the workshops make clear that better public transportation in general and BRT in particular can be cost-effective and useful tools for improving transportation, the environment and for restoring the livability of America‘s large cities.

Climate change mitigation and adaptation action plans are developing at a rapid pace, being driven by both local initiatives and emerging alliances and support organizations that cut across multiple jurisdictions. These plans include a broad range of approaches, many of which are evolving into best or leading practices and which will be increasingly used as a model for the plans of other locales. This paper draws attention to several best practices in both mitigation and adaptation for North American cities, and also highlights many of the supporting alliances and groups that disseminate key practices and drive potential synergies. Additionally, it is noted that despite the increasing rate of plan development, a continuing need exists for increased attention to adaptation at the local level.

This study examines how the neighborhood environments experienced over multiple generations of a family influence children's cognitive ability. Building on recent research showing strong continuity in neighborhood environments across generations of family members, the authors argue for a revised perspective on “neighborhood effects” that considers the ways in which the neighborhood environment in one generation may have a lingering impact on the next generation. To analyze multigenerational effects, the authors use newly developed methods designed to estimate unbiased treatment effects when treatments and confounders vary over time. The results confirm a powerful link between neighborhoods and cognitive ability that extends across generations. A family's exposure to neighborhood poverty across two consecutive generations reduces child cognitive ability by more than half a standard deviation. A formal sensitivity analysis suggests that results are robust to unobserved selection bias.

There has been little research to date on the linkages between air pollution and infectious respiratory illness in children, and the resulting health care costs. In this study we used data on air pollutants and national hospitalizations to study the relationship between fine particulate air pollution and health care charges and costs for the treatment of bronchiolitis, an acute viral infection of the lungs. We found that as the average exposure to fine particulate matter over the lifetime of an infant increased, so did costs for the child's health care. If the United States were to reduce levels of fine particulate matter to 7 percent below the current annual standard, the nation could save $15 million annually in reduced health care costs from hospitalizations of children with bronchiolitis living in urban areas. These findings reinforce the need for ongoing efforts to reduce levels of air pollutants. They should trigger additional investigation to determine if the current standards for fine-particulate matter are sufficiently protective of children's health.

Economic analyses are increasingly appearing in the children's environmental-health literature. In this review, an illustrative selection of articles that represent cost analyses, cost-effectiveness analyses, and cost-benefit analyses is analyzed for the relative merits of each approach. Cost analyses remain the dominant approach due to lack of available data. Cost-effectiveness and cost-benefit analyses in this area face challenges presented by estimation of costs of environmental interventions, whose costs are likely to decrease with further technological innovation. Benefits are also more difficult to quantify economically and can only be partially alleviated through willingness-to-pay approaches. Nevertheless, economic analyses in children's environmental health are highly informative and important informants to public-health and policy practice. Further attention and training in their appropriate use are needed.

Women now make up almost half of all U.S. workers and the majority of mothers with children under 18 are active in the labor market, with even higher rates of participation among single women mothers. Despite these shifts in workplace demographics and the fact that women remain the primary caretakers for family members, women continue to face limited flexible work options. This brief outlines the importance of workplace flexibility in the lives of women of color and describes the institutionalized barriers that limit their access to such arrangements as modified work schedules, time off, supported reentry, and paid leave. The brief also presents policy recommendations for the implementation of workplace flexibility measures and other programs that work to create a supportive working environment for women.

BACKGROUND:

Since Mexico's joining the North American Free Trade Agreement (NAFTA) and the Organization for Economic Cooperation and Development (OECD) in 1994, it has witnessed rapid industrialization. A byproduct of this industrialization is increasing population exposure to environmental pollutants, of which some have been associated with childhood disease. We therefore identified and assessed the adequacy of existing international and Mexican governance instruments and policy tools to protect children from environmental hazards.

METHODS:

We first systematically reviewed PubMed, the Mexican legal code and the websites of the United Nations, World Health Organization, NAFTA and OECD as of July 2007 to identify the relevant governance instruments, and analyzed the approach these instruments took to preventing childhood diseases of environmental origin. Secondly, we interviewed a purposive sample of high-level government officials, researchers and non-governmental organization representatives, to identify their opinions and attitudes towards children's environmental health and potential barriers to child-specific protective legislation and implementation.

RESULTS:

We identified only one policy tool describing specific measures to reduce developmental neurotoxicity and other children's health effects from lead. Other governance instruments mention children's unique vulnerability to ozone, particulate matter and carbon monoxide, but do not provide further details. Most interviewees were aware of Mexican environmental policy tools addressing children's health needs, but agreed that, with few exceptions, environmental policies do not address the specific health needs of children and pregnant women. Interviewees also cited state centralization of power, communication barriers and political resistance as reasons for the absence of a strong regulatory platform.

CONCLUSIONS:

The Mexican government has not sufficiently accounted for children's unique vulnerability to environmental contaminants. If regulation and legislation are not updated and implemented to protect children, increases in preventable exposures to toxic chemicals in the environment may ensue.

We examine the diffusion of sustainable planning and design concepts into neighbourhood development projects, based on findings of a survey of planners in all 180 cities of five Southern California counties. Sustainable neighbourhood development has particular significance in Southern California owing to the regions’s rapid growth. We compare ‘typical’ and ‘innovative’ neighbourhood developments to determine whether sustainable planning and design concepts are being incorporated in these projects. Although planners agree that ‘innovative’ projects are more likely than ‘typical’ projects to incorporate sustainable planning and design concepts, sustainability is not a high priority even in innovative neighbourhood projects. Our respondents identified significant barriers to and limited opportunities for encouraging sustainable neighbourhood development. These trends in planning and design appear likely to continue unless strong policy and other mechanisms are adopted to encourage sustainable neighbourhood development. The paper concludes with recommendations to promote more sustainable neighbourhood development.

FROM THE COFOUNDER OF SEVENTH GENERATION, the most trusted brand in environmentally friendly household products, comes this indispensable guide to maintaining absolutely everything in the home in a natural, nontoxic way. Jeffrey Hollender leads you through each room of the house with straightforward advice, comprehensive checklists, quick tips, and unparalleled resources while revealing the hidden repercussions of daily routines that most of us take for granted. From improving air quality in your bedroom to avoiding mildew in the bathroom, from sourcing local or organic food to safely laundering your clothes, Planet Home offers invaluable information for making conscious decisions for your family, your neighbors, and our shared planet home.

With additional information on power, garbage and recycling, air quality, and community activism, this book goes a step further to describe how any household is part of a much larger system. Planet Home offers a unique, comprehensive, educational, and easy approach to helping you and your family lead healthier lives as we collectively protect and maintain our shared resources for many years to come.

This paper documents the rise and fall of a micro-learning region in Philadelphia. The central actors in this region are undocumented Mexican immigrants who until recently were able to draw on the intensity of their workplace interactions and their heterodox knowledge to produce new and innovative building techniques in the city's residential construction. The new knowledge they developed was primarily tacit. More significantly, the learning practices through which immigrant workers developed skill and innovated new techniques were also heavily tacit. Because these practices were never made formal and were never made explicit, they remained invisible and difficult to defend. With the housing market collapse and subsequent decline in housing renovation in south-center region of Philadelphia, this tacit knowledge and the practices that gave it shape and significance, are no longer easily accessible. We draw on this case to demonstrate the importance of access to the political and economic resources to turn learning practices into visible structured institutions that protect knowledge and skill. Whether or not the practices that support knowledge development are themselves made explicit can determine whether the knowledge they produce becomes an innovation that is recognized and adopted or whether it remains confined to a set of ephemeral practices that exist only so long as they are being enacted.

This article examines informal training and skill development pathways of Latino immigrant construction workers in two different urban labor markets: Philadelphia, Pennsylvania, and Raleigh-Durham, North Carolina. We find that institutional differences across local labor markets not only shape how immigrants develop skills in specific places but also determine the localized obstacles they face in demonstrating and harnessing these skills for employment. To explain the role of local institutions in shaping differences in skill development experience and opportunities, we draw on the concept of tacit skill, a term that is rarely incorporated into studies of the labor market participation of less educated immigrants. We argue that innovative pathways that Latino immigrant workers have created to develop tacit skill can strengthen advocacy planning efforts aimed at improving employment opportunities and working conditions for marginalized workers, immigrant and nonimmigrant alike.

Questions of how public organizations control and manage resources have been relegated to an insular subfield of contemporary public management. This is both unfortunate and unnatural because insights from the study of budgeting and financial management have traditionally been a driving force of public management's conceptual and empirical development. In this paper we seek to address this problem by reconnecting contemporary findings from the budgeting and financial management subfield to broader concerns in public management. We focus our discussion on the centrality of management technique in contemporary public management, and we argue that research in select areas of contemporary public budgeting and financial management has and will continue to illuminate the implications of reform and innovation in management technique, particularly in our current environment of amorphous institutional arrangements and diffuse, shared power.

Although an increasing amount of community mental health research has investigated the deleterious effects of disasters and the targeting and efficacy of treatment in their aftermath, little research has sought to identify preexisting characteristics of the social environment that are predictive of post-disaster distress. A national US telephone survey fielded before and after September 11, 2001, was used to investigate the psychological distress among American adolescents related to the attacks, and to identify environmental and other characteristics that predisposed youth to experience higher or lower levels of post-disaster distress. The study found that widespread characteristics of children’s school environments—school disorder and physical threats—were at least as strongly associated with a proxy for psychological distress as exposure to the events of 9/11. Further, children exposed to physical threats at school appeared to be more vulnerable to the psychological effects of disasters than children in safer school environments.

Two landmark policy interventions to improve the lives of youth through neighborhood mobility—the Gautreaux program in Chicago and the Moving to Opportunity (MTO) experiments in five cities—have produced conflicting results and have created a puzzle with broad implications: Do residential moves between neighborhoods increase or decrease violence, or both? To address this question, we analyze data from a subsample of adolescents ages 9–12 years from the Project on Human Development in Chicago Neighborhoods, a longitudinal study of children and their families that began in Chicago—the site of the original Gautreaux program and one of the MTO experiments. We propose a dynamic modeling strategy to separate the effects of residential moving across three waves of the study from dimensions of neighborhood change and metropolitan location. The results reveal countervailing effects of mobility on trajectories of violence; whereas neighborhood moves within Chicago lead to an increased risk of violence, moves outside the city reduce violent offending and exposure to violence. The gap in violence between movers within and outside Chicago is explained not only by the racial and economic composition of the destination neighborhoods but also by the quality of school contexts, adolescents' perceived control over their new environment, and fear. These findings highlight the need to simultaneously consider residential mobility, mechanisms of neighborhood change, and the wider geography of structural opportunity.

Policy makers generally agree that childhood obesity is a national problem. However, it is not always clear whether enough is being spent to combat it. This paper presents nine scenarios that assume three different degrees of reduction in obesity/overweight rates among children in three age groups. A mathematical model was then used to project lifetime health and economic gains. Spending $2 billion a year would be cost-effective if it reduced obesity among twelve-year-olds by one percentage point. The analysis also found that childhood obesity has more profound economic consequences than previously documented. Large investments to reduce this major contributor to adult disability may thus be cost-effective by widely accepted criteria.

Purpose

This study investigates the degree to which the racial composition of the school environment may influence the body mass index (BMI) of children aged 10 to 18 years. This research may be viewed as extending prior work that has found that the prevalence of risk behaviors among nonwhite adolescents is influenced by exposure to white adolescents.

Methods

This research used data from the Survey of Adults and Youth, which was conducted as part of the evaluation of the Robert Wood Johnson Foundation's Urban Health Initiative. The study population for this analysis is comprised of parent and child respondents in the 2004 to 2005 survey wave who lived in one of the five program cities: Baltimore, Detroit, Oakland, Philadelphia, and Richmond. We constructed two-level school random effects models and added school and census tract-level variables that describe the racial composition of the residential community and the school attended.

Results

Black and Hispanic adolescent girls who attend schools with a mostly nonwhite student body have higher BMIs than do their white counterparts. However, black girls in predominately white schools do not have higher BMIs than white girls. Further, black and Hispanic girls whose schoolmates are predominately white have significantly lower BMIs than black and Hispanic girls in schools where fewer than half the students are white. These associations are not found among boys, and are net of a broad variety of individual, household, and group level characteristics.

Conclusions

Our findings suggest that the BMI of minority adolescent girls is influenced by the norms of the social environment.

Physical inactivity is one of the most important public health issues in the U.S. and internationally. Increasingly, links are being identified between various elements of the physical—or built—environment and physical activity. To understand the impact of the built environment on physical activity, the development of high-quality measures is essential. Three categories of built environment data are being used: (1) perceived measures obtained by telephone interview or self-administered questionnaires; (2) observational measures obtained using systematic observational methods (audits); and (3) archival data sets that are often layered and analyzed with GIS. This review provides a critical assessment of these three types of built-environment measures relevant to the study of physical activity. Among perceived measures, 19 questionnaires were reviewed, ranging in length from 7 to 68 questions. Twenty audit tools were reviewed that cover community environments (i.e., neighborhoods, cities), parks, and trails. For GIS-derived measures, more than 50 studies were reviewed. A large degree of variability was found in the operationalization of common GIS measures, which include population density, land-use mix, access to recreational facilities, and street pattern. This first comprehensive examination of built-environment measures demonstrates considerable progress over the past decade, showing diverse environmental variables available that use multiple modes of assessment. Most can be considered first-generation measures, so further development is needed. In particular, further research is needed to improve the technical quality of measures, understand the relevance to various population groups, and understand the utility of measures for science and public health.

In this paper, I argue that social science and genomics can be integrated; however, the way this marriage is currently occurring rests on spurious methods and assumptions and, as a result, will yield few lasting insights. However, recent advances in both econometrics and in developmental genomics provide scientists with a novel opportunity to understand how genes and environment interact to produce social outcomes. Key to any causal inference about the interplay between genes and social environment is that either genotype be exogenously manipulated (i.e. through sibling fixed effects) while environmental conditions are held constant, and/or that environmental variation is exogenous in nature, i.e. experimental or arising from a natural experiment of sorts. Further, initial allele selection should be motivated by findings from genetic experiments in model animal studies linked to orthologous human genes. Likewise, genetic associations found in human population studies should then be tested through knock-out and over-expression studies in model organisms.

There is a lack of consensus as to whether the relationship between the built environment and travel is causal and, if it is, the extent of this causality. This problem is largely caused by inappropriate research designs adopted in many studies. This paper proposes a new method (based on path choice) to investigate the causal effect of the pedestrian environment on the utility of walking. Specifically, the paper examines how the pedestrian environment affects subway commuters' egress path choice from a station to their workplaces in downtown Boston. The path-based measure is sensitive enough to capture minor differences in the environment experienced by pedestrians. More importantly, path
choice is less likely to correlate with job and housing location choices, and therefore largely avoids the self-selection problem. The results suggest that the pedestrian environment can significantly affect a person's walking experience and the utility of walking along a path.

BACKGROUND: The Senior Walking Environmental Assessment Tool (SWEAT), an instrument for measuring built environmental features associated with physical activity of older adults, was revised to create an easier-to-use tool for use by practitioners and community members. METHODS: Inter-rater and intra-rater reliability of the modified instrument (SWEAT-R) was assessed in Portland, Oregon in 2007. Five trained observers audited street segments in 12 neighborhoods, resulting in 361 pairs of audits, including 63 repeated audits. RESULTS: Overall, 88% and 75% of items assessed had good or excellent inter-rater and intra-rater reliability, respectively. The revised instrument required less time to complete than the original instrument, while obtaining more information. CONCLUSION: SWEAT-R provides easy to gather, reliable data for use in community-based audits of built environment in relation to walking among older adults.

Wiki Government shows how to bring innovation to government. In explaining how to enhance political institutions with the power of networks, it offers a fundamental rethinking of democracy in the digital age. Collaborative democracy-government of the people, by the people, for the people-is an old dream. Today, Wiki Government shows how technology can make that dream a reality. In this thought-provoking book, Beth Simone Noveck illustrates how collaborative democracy strengthens public decisionmaking by connecting the power of the many to the work of the few. Equally important, she provides a step-by-step demonstration of how collaborative democracy can be designed, opening policymaking to greater participation. "Wiki Government" tells the story behind one of the most dramatic public sector innovations in recent years - inviting the public to participate in the patent examination process. Patent examiners usually work in secret, cut off from essential information and racing against the clock to master arcane technical claims. The Peer-to-Patent project radically transformed this process by allowing anyone with Internet access to collaborate with the agency in reviewing patent applications. "Wiki Government" describes how a far-flung team of technologists, lawyers, and policymakers pried open a tradition-bound agency's doors. Noveck explains how she brought both fiercely competitive companies and risk-averse bureaucrats on board. She discusses the design challenges the team faced in creating software to distill online collaboration into useful expertise, not just rants or raves. And she explains how law, policy, and technology can be revamped to help government work in more open and participatory ways in a wide range of policy arenas, including education and the environment.

This issue of the New York Transportation Journal explores the theme of change, on a number of levels and perspectives. We have just concluded an historic election cycle which has brought significant political change to the nation. Recent developments in the areas of energy, the economy and the environment all underscore the current state of flux impacting the lives of those who live and work in the New York metropolitan region. Looking forward, we foresee change in all of these areas and we also anticipate change in forecasts of how we might grow and develop as a nation and as a region. Our articles are a reflection of this change and a response to it. They explore a variety of its characteristics and options for policies and approaches within the context it sets.

Franc McArdle, who served on the National Surface Transportation Policy and Revenue Study Commission, presents his ideas on the transportation imperatives he sees for the incoming administration of President Barack Obama. Martin Robbins offers his thoughts on transportation policy and planning options to be considered in the legislative process as the current Federal legislation which authorized spending for transportation improvements nationally expires and new legislation is developed.

While John Nolon and Jennie Nolon offer their perspective on the implications of expected growth in population and travel on future land use and transportation, Suzanne Seegmuller looks at emerging travel trends related both to this growth and to the economic, energy and environmental developments that are dominating our policy discussions.

In our region, planned improvements in the Interstate 287 corridor in the lower Hudson Valley promise far reaching change in that area's transportation system. In this issue's interview by Rachel Weinberger, Rockland County Executive C. Scott Vanderhoef and Westchester County Executive Andrew Spano provide their thoughts on these improvements, the changes they will bring and the outlook for growth in the northern suburbs.

A comprehensive and concise guide to performance improvement in healthcare, Performance Improvement in Hospitals and Health Systems describes the management engineering principles focused on designing optimal management and information systems and processes. The book covers topics such as:

• Key terminology and concepts in PI
• Scope, value and management of performance improvement projects
• Developing and leading performance improvement departments
• Simulation methods in patient flow
• Understanding cost and quality relationships
• Six Sigma and Lean in healthcare
• Data mining methods for process improvment
• Integrating nursing/clinical staff with performance improvement
• Evaluation and selection criteria for projects
• Decision support systems

Written for management engineers, performance improvement professionals, quality managers and internal consultants who use a combination of methods to improve systems and processes, this book has timely, practical and actionable information and valuable insights into improving the healthcare environment.

OBJECTIVE:

In this review we describe the approach taken by the National Children's Study (NCS), a 21-year prospective study of 100,000 American children, to understanding the role of environmental factors in the development of obesity.

DATA SOURCES AND EXTRACTION:

We review the literature with regard to the two core hypotheses in the NCS that relate to environmental origins of obesity and describe strategies that will be used to test each hypothesis.

DATA SYNTHESIS:

Although it is clear that obesity in an individual results from an imbalance between energy intake and expenditure, control of the obesity epidemic will require understanding of factors in the modern built environment and chemical exposures that may have the capacity to disrupt the link between energy intake and expenditure. The NCS is the largest prospective birth cohort study ever undertaken in the United States that is explicitly designed to seek information on the environmental causes of pediatric disease.

CONCLUSIONS:

Through its embrace of the life-course approach to epidemiology, the NCS will be able to study the origins of obesity from preconception through late adolescence, including factors ranging from genetic inheritance to individual behaviors to the social, built, and natural environment and chemical exposures. It will have sufficient statistical power to examine interactions among these multiple influences, including gene-environment and gene-obesity interactions. A major secondary benefit will derive from the banking of specimens for future analysis.

BACKGROUND:

While much attention is focused on national policies intended to protect human health from environmental hazards, states can also prevent environmentally mediated disease through legislation and regulation. However, relatively few analyses have examined the extent to which states protect children from chemical factors in the environment.

METHODS:

Using Lexis Nexis and other secondary sources, we systematically reviewed environmental regulation and legislation in the fifty states and the District of Columbia as of July 2007 intended to protect children against neurodevelopmental disabilities and asthma.

RESULTS:

States rarely address children specifically in environmental regulation and legislation, though many state regulations go far to limit children's exposures to environmental hazards. Northeast and Midwest states have implemented model regulation of mercury emissions, and regulations in five states set exposure limits to volatile organic compound emissions that are more stringent than US Environmental Protection Agency standards.

DISCUSSION:

Differences in state environmental regulation and legislation are likely to lead to differences in exposure, and thus to impacts on children's health. The need for further study should not inhibit other states and the federal government from pursuing the model regulation and legislation we identified to prevent diseases of environmental origin in children.

Research on urban design and walking often emphasizes macro-scale features of the physical environment, such as block length and number of intersections, that can be measured remotely using GIS and or aerial photographs. In contrast, urban designers emphasize the importance of micro-scale features in individuals' use and experience of neighbourhood environments. This paper moves beyond examining correlations of individual built environment features and walking, to begin to test proposals about which composite characteristics of the built environment (safety, comfort, etc.) may have the greatest impact on walking. Several urban design characteristics of 11 neighbourhoods throughout California were observed. Self-report, adult walking data on the number and types of walking trips were obtained from surveys administered to parents of 3rd–5th graders. Urban design features related to both accessibility and safety are associated with the amount of walking that adults do in their neighbourhoods. Grouping related urban design variables into indices provides some clarity as to how the built environment may impact walking. Safety emerges as the most important built environment characteristic (of those tested), related to both destination and recreational walking.

This paper investigates the impact of pedestrian environments on walking behavior, and the related choice of travel path for transit riders. Activity logs from trip surveys combined with transit-route and land-use information are used to fit discrete-choice models of how riders choose among multiple paths to downtown destinations. The work illustrates (1) how the quality of pedestrian environments along transit egress paths affects transfers inside a transit system, and (2) how the impedance of transferring affects egress walking path choices. The use of GIS techniques for path-based spatial analysis is key to understanding the impact of pedestrian environments on walking behavior at the street level. The results show that desirable pedestrian environments encourage transit riders to choose paths that are ‘friendlier', even if they involve more walking after leaving transit. Policy implications for land-use planning and transit service planning are discussed.

In this essay, we explore how the Environmental Protection Agency (EPA) might use technology to improve the agency's level of scientific expertise and to obtain useful information sooner to inform EPA policymaking. By creating a self-reinforcing collaboration between government and networked publics, new web-based tools could help produce change within government and without - namely governmental decisions informed by better data obtained through citizen participation and civic action coordinated with governmental priorities. The agency has the opportunity to help break the logjam of environmental policymaking by developing transparent and participatory mechanisms for expert citizen participation. The key insight is not to throw open the floodgates to undifferentiated public input, but to design group-based processes that enable online communities to collaborate on finding and vetting information for agencies.

General editor Haider-Markel (U. of Kansas) presents a two-volume encyclopedia intended to serve as a first-stop reference on state politics in the United States, which also includes some coverage of US overseas territories and Puerto Rico. The encyclopedia opens with four broad topical essays on the evolution and impact of state constitutions, the impact of direct democracy (voter initiatives and the like), cooperation between the states, and states as policy testing grounds. It then presents individual state profiles, about ten pages each, that are uniformly structured to allow comparison of state history, the political environment, elections and voting behavior, the legislative branch, the executive branch, the judicial branch, intergovernmental relations, state-tribal relations (where applicable), and long-term issues and policy trends. The state entries also include bibliographies; charts showing partisan distribution of presidential elections from 1988 to 2004; and data tables on political history, political environment, elections and voting behavior, the legislative branch, the executive branch, and the judicial branch. Also included are some 175 A-to-Z topical entries discussing general concepts related to governmental functions and procedures, government structures and bodies, political theory, and political behavior. Examples of specific topics would include gerrymandering, impeachment, public health, auditor, bicameralism, legislative leadership, common law, judicial review, and social welfare. Finally, statistical data on populations, economics, finance, the environment, government spending, voting, and campaign fundraising is presented for all 50 states, followed by a comprehensive index.

This article draws on the extensive literature on economic and social mobility in America to examine intergenerational contextual mobility, defined as the degree to which inequalities in neighborhood environments persist across generations. PSID data are analyzed to reveal remarkable continuity in neighborhood economic status from one generation to the next. The primary consequence of persistent neighborhood stratification is that the racial inequality in America's neighborhoods that existed a generation ago has been transmitted, for the most part unchanged, to the current generation. More than 70% of black children who grow up in the poorest quarter of American neighborhoods remain in the poorest quarter of neighborhoods as adults, compared to 40% of whites. The results suggest that racial inequality in neighborhood economic status is substantially underestimated with short-term measures of neighborhood income or poverty and, second, that the steps taken to end racial discrimination in the housing and lending markets have not enabled black Americans to advance out of America's poorest neighborhoods.

Pediatricians can help limit children's exposures to environmental hazards, but few studies have assessed their comfort with discussing and dealing with environmental health issues. We surveyed the membership of the Minnesota Chapter of the American Academy of Pediatrics to assess pediatricians' attitudes and beliefs about the effect the environment can have on children's health, and to assess their practices in regard to screening for, diagnosing, and treating illnesses related to environmental exposures. Results showed that Minnesota pediatricians agree that children are suffering from preventable illnesses of environmental origin but feel ill-equipped to educate parents about many common exposures and their consequences. Responses also indicated significant demand for education on the subject and for a referral center that can evaluate patients who may be suffering from environmental exposures.

This article examines the extent to which family wealth affects the Black–White test score gap for young children based on data from the Panel Study of Income Dynamics (aged 3–12). This study found little evidence that wealth mediated the Black–White test scores gaps, which were eliminated when child and family demographic covariates were held constant. However, family wealth had a stronger association with cognitive achievement of school-aged children than that of preschoolers and a stronger association with school-aged children’s math than on their reading scores. Liquid assets, particularly holdings in stocks or mutual funds, were positively associated with school-aged children’s test scores. Family wealth was associated with a higher quality home environment, better parenting behavior, and children’s private school attendance.

Parks play important roles in city life. They are a source of respite from the bustle of the urban environment, a place for active recreation and exercise for adults, and a safe place for children to play outdoors. In addition, parks preserve sensitive environmental areas, and, by making neighborhoods more attractive, enhance property values and the tax base of the city.

Essentials of Cost Accounting for Health Care Organizations, Third Edition is a comprehensive text that applies the tool and techniques of cost accounting to the health services field. It is an essential tools for all professionals who need to deal with the challenges of managing health facilities in a difficult economic environment.

OBJECTIVES:

We examined the mechanisms by which living in a disadvantaged minority community influences smoking and illegal cigarette sale and purchasing behaviors after a large cigarette tax increase.

METHODS:

Data were collected from 14 focus groups (n=104) that were conducted during the spring of 2003 among Blacks aged 18 years and older living in New York City.

RESULTS:

A large tax increase led to what focus group participants described as a pervasive illegal cigarette market in a low-income minority community. Perceived pro-smoking community norms, a stressful social and economic environment, and the availability of illegal cigarettes worked together to reinforce smoking and undermine cessation.

CONCLUSIONS:

Although interest in quitting was high, bootleggers created an environment in which reduced-price cigarettes were easier to access than cessation services. This activity continues to undermine the public health goals of the tax increase.

Background

Inter-rater reliability is an important element of environmental audit tools. This paper presents results of reliability tests of the Irvine–Minnesota Inventory, an extensive audit tool aimed at measuring a broad range of built environment features that may be linked to active living.

Methods

Inter-rater reliability was measured by percentage agreement between observers. Reliability was tested on a broad range of sites in both California and Minnesota.

Results

For the variables that remained in the inventory, in tests conducted at the University of California–Irvine, 76.8% of the variables had >80% agreement among the three raters. In tests conducted at the University of Minnesota, 99.2% of the variables had >80% agreement among the two raters.

Conclusions

Reliability was high for most items. The inventory was modified to eliminate items with low reliability. Differences in the use of the inventory and the goals of the research led to generally higher reliability in Minnesota. Those differences, limitations, and directions for future research are discussed.

Research on fear of crime typically examines the perceptions of those who fear, emphasizing women’s experiences of vulnerability in public space. In this paper, I invert this practice to examine instead men’s experiences of being feared in public spaces. Drawing on interviews with 82 male college students, I use a social constructionist approach to examine how men’s experiences of being feared interact with men’s formation of racial identities and the racialization of public places. Fear is a key mechanism for justifying and maintaining race privilege and exclusion. The experience and interpretation of being feared (or not feared) in public space intersects with men’s construction of gender and race identities, and the ways that men assign racial meanings to public places. This paper examines these processes and proposes strategies for challenging fear and the exclusion it supports.

Background

Inter-rater reliability is an important element of environmental audit tools. This paper presents results of reliability tests of the Irvine–Minnesota Inventory, an extensive audit tool aimed at measuring a broad range of built environment features that may be linked to active living.

Methods

Inter-rater reliability was measured by percentage agreement between observers. Reliability was tested on a broad range of sites in both California and Minnesota.

Results

For the variables that remained in the inventory, in tests conducted at the University of California–Irvine, 76.8% of the variables had >80% agreement among the three raters. In tests conducted at the University of Minnesota, 99.2% of the variables had >80% agreement among the two raters.

Conclusions

Reliability was high for most items. The inventory was modified to eliminate items with low reliability. Differences in the use of the inventory and the goals of the research led to generally higher reliability in Minnesota. Those differences, limitations, and directions for future research are discussed.

Abstract The U.S. faces rising rates of overweight and obesity. Active living-urban planning and design to promote physical activity?has emerged as a strategy to combat growing obesity. The active living movement initially targeted mostly middle-class, suburban communities. In this article, I argue that planning for active living must especially address low-income, Black, and Latino communities, where obesity and related health risks are greatest and resources least available. First I review the problem of obesity and related health conditions among low-income, Black, and Latino populations in the U.S., and identify the role of insufficient physical activity in this problem. I then examine physical environment and other factors that shape opportunities for physical activity in low-income communities and communities of color. Finally, I identify strategies that may help to promote active living in urban settings to better serve these communities. Abstract The U.S. faces rising rates of overweight and obesity. Active living-urban planning and design to promote physical activity?has emerged as a strategy to combat growing obesity. The active living movement initially targeted mostly middle-class, suburban communities. In this article, I argue that planning for active living must especially address low-income, Black, and Latino communities, where obesity and related health risks are greatest and resources least available. First I review the problem of obesity and related health conditions among low-income, Black, and Latino populations in the U.S., and identify the role of insufficient physical activity in this problem. I then examine physical environment and other factors that shape opportunities for physical activity in low-income communities and communities of color. Finally, I identify strategies that may help to promote active living in urban settings to better serve these communities.

In this longitudinal study, the proportion of time preschoolers directed their attention away from rewarding stimuli during a delay-of-gratification task was positively associated with efficiency (greater speed without reduced accuracy) at responding to targets in a go/no-go task more than 10 years later. The overall findings suggest that preschoolers' ability to effectively direct their attention away from tempting aspects of the rewards in a delay-of-gratification task may be a developmental precursor for the ability to perform inhibitory tasks such as the go/no-go task years later. Because performance on the go/no-go task has previously been characterized as involving activation of fronto-striatal regions, the present findings also suggest that performance in the delay-of-gratification task may serve as an early marker of individual differences in the functional integrity of this circuitry.

The article presents information on the role of power in negotiation. Power could generate competition or conflict in negotiations, however, effective channelization of power helps in bringing the win-win situation to both the parties. Social psychologists have described power as lack of dependence on others. Individuals possessing power tend to have the approach related to the behavior that includes positive mood or searching for rewards in their environment. On the other hand, powerless individuals show a great deal of self-inhibition and fear towards potential threats. INSETS: WOMEN: INCREASE YOUR POWER AT THE TABLE;POWER ACROSS CULTURES.

Compelling evidence links the chemicals in household products to cancer, asthma, allergies, multiple chemical sensitivity syndrome -- also known as environmental illness -- hormonal disruption, reproductive and developmental disorders, and other conditions. Yet cleaning products are exempt from the full ingredient disclosure on product labels as required for food and personal care products and enter the marketplace with little or no testing for potential health risks.

Naturally Clean explains the dangers of traditional cleaners and provides illuminating statistics that illustrate how the chemicals found in almost every home are known or likely to cause a host of serious health problems. The book's easy-to-understand introduction discusses basic household chemistry, concepts of toxicity and types of toxic exposure, and the difference between natural, organic, and synthetic chemicals.

New York State, because of its great diversity, has more extensive social and political conflict than most states. Governing New York State: Fifth Edition provides expert assessment of how these conflicts are organized and represented, and how the political process and political institutions work to seek to resolve them. This newly updated fifth edition contains significantly revised material and covers more topics than the prior edition.

The contributors examine conflicts between New York City and the rest of the state, and between federal, state, and local governments. The role of major political parties in organizing and representing broad coalitions of different groups is reviewed, along with the role of third parties, interest groups, and the media. Political institutions that shape the political process-the governor, the legislature, the courts, and the public authorities-are discussed, along with how these institutions affect the representation of responsiveness of various groups. Finally, Governing New York State investigates the major policy areas of the state: the economy, taxes, local education, higher education, health care, welfare, transportation, and the environment.

Prospective, multiyear epidemiologic studies have proven to be highly effective in discovering preventable risk factors for chronic disease. Investigations such as the Framingham Heart Study have produced blueprints for disease prevention and saved millions of lives and billions of dollars. To discover preventable environmental risk factors for disease in children, the US Congress directed the National Institute of Child Health and Human Development, through the Children's Health Act of 2000, to conduct the National Children's Study. The National Children's Study is hypothesis-driven and will seek information on environmental risks and individual susceptibility factors for asthma, birth defects, dyslexia, attention-deficit/hyperactivity disorder, autism, schizophrenia, and obesity, as well as for adverse birth outcomes. It will be conducted in a nationally representative, prospective cohort of 100,000 US-born children. Children will be followed from conception to 21 years of age. Environmental exposures (chemical, physical, biological, and psychosocial) will be assessed repeatedly during pregnancy and throughout childhood in children's homes, schools, and communities. Chemical assays will be performed by the Centers for Disease Control and Prevention, and banks of biological and environmental samples will be established for future analyses. Genetic material will be collected on each mother and child and banked to permit study of gene-environment interactions. Recruitment is scheduled to begin in 2007 at 7 Vanguard Sites and will extend to 105 sites across the United States. The National Children's Study will generate multiple satellite studies that explore methodologic issues, etiologic questions, and potential interventions. It will provide training for the next generation of researchers and practitioners in environmental pediatrics and will link to planned and ongoing prospective birth cohort studies in other nations. Data from the National Children's Study will guide development of a comprehensive blueprint for disease prevention in children.

Communities are traditionally built with one transportation mode and user in mindthe adult automobile driver. Recently, however, there has been an international focus on the trip to school as an opportunity to enhance childrens independent active travel. Several factors must be considered when designing programs to promote walking and bicycling. This paper examined the influence of child sex on caregivers decisions about travel mode choice to school. Caregivers of children in grades three to five from ten California Safe Routes to School communities were surveyed on their childs normal travel mode to school and factors that determined travel decisions. Results indicate that the odds of walking and bicycling to school are 40 percent lower in girls than boys; however, this relationship is significantly moderated by the caregivers own walking behavior. The findings suggest that programs that focus on increasing childrens active travel to school should consider multiple influences on health behavior, including the neighborhood physical activity of parents.

The concept of street efficacy, defined as the perceived ability to avoid violent confrontations and to be safe in one's neighborhood, is proposed as a mechanism connecting aspects of adolescents' "imposed" environments to the choices they make in creating their own "selected" environments that minimize the potential for violent confrontations. Empirical models using data from the Project on Human Development in Chicago Neighborhoods suggest that street efficacy is substantially influenced by various aspects of the social context surrounding adolescents. Adolescents who live in neighborhoods with concentrated disadvantage and low collective efficacy, respectively, are found to have less confidence in their ability to avoid violence after controlling for an extensive set of individual- and family-level factors. Exposure to violence also reduces street efficacy, although it does not explain the association between collective efficacy and individual street efficacy. Adolescents' confidence in their ability to avoid violence is shown to be an important predictor of the types of environments they select for themselves. In particular, adolescents with high levels of street efficacy are less likely to resort to violence themselves or to associate with delinquent peers.

Defines key lessons on financing pro-poor governance based on cases from Latin America, Asia and Africa (Colombia, Indonesia, Kenya and Uganda). The starting point for pro-poor fiscal decentralisation is that its major goals should be improved governance and performance, specifically, higher efficiency and equity in service delivery, economic development, and poverty alleviation. The enabling environment for fiscal decentralisation involves first the functions and the resources that might normally be allocated to local governments. Second, it can include alternative models and mechanisms to finance local governments, including intergovernmental transfers, markets, capital and donor financing.

Chronic diseases of environmental origin are a significant and increasing public health problem among the children of New York State, yet few resources exist to address this growing burden. To assess New York State pediatricians self-perceived competency in dealing with common environmental exposures and diseases of environmental origin in children, we assessed their attitudes and beliefs about the role of the environment in children's health. A four-page survey was sent to 1,500 randomly selected members of the New York State American Academy of Pediatrics in February 2004. We obtained a 20.3% response rate after one follow-up mailing; respondents and nonrespondents did not differ in years of licensure or county of residence. Respondents agreed that the role of environment in children's health is significant (mean 4.44 +/- 0.72 on 1-5 Likert scale). They voiced high self-efficacy in dealing with lead exposure (mean 4.16-4.24 +/- 0.90-1.05), but their confidence in their skills for addressing pesticides, mercury and mold was much lower (means 2.51-3.21 +/- 0.90-1.23; p < 0.001). About 93.8% would send patients to a clinic "where pediatricians could refer patients for clinical evaluation and treatment of their environmental health concerns." These findings indicate that New York pediatricians agree that children are suffering preventable illnesses of environmental origin but feel ill-equipped to educate families about common exposures. Significant demand exists for specialized centers of excellence that can evaluate environmental health concerns, and for educational opportunities.

Pediatricians can reduce exposures to environmental hazards but most have little training in environmental health. To assess whether Wisconsin pediatricians perceive a relative lack of self-efficacy for common environmental exposures and diseases of environmental origin, we assessed their attitudes and beliefs about the role of the environment in children's health. A 4-page survey was sent to the membership of the Wisconsin Chapter of the American Academy of Pediatrics. We obtained a 35.4% response rate after 1 follow-up mailing. Respondents agreed that the role of the environment in children's health is significant (mean 4.28 +/- .78 on 1-5 Likert scale). They expressed high confidence in dealing with lead exposure (means 4.22-4.27 +/- 1.01-1.09), but confidence in their skills for pesticide, mercury, and mold was much lower (means 2.49-3.09 +/- 1.06-1.26; P<.001). Of those surveyed, 88.6% would refer patients to a clinic "where pediatricians could refer patients for clinical evaluation and treatment of their environmental health concerns." These findings indicate that Wisconsin pediatricians agree that children are suffering preventable illnesses of environmental origin, but feel ill equipped to educate families about many common exposures. Significant demand exists for centers that can evaluate environmental health concerns, as well as for educational opportunities.

This chapter considers whether effects of antipoverty policy on children's school performance differ by ethnicity, and if so, why. We explore several hypotheses: those that derive from human capital theory, theories about family structure and family process, and person-environment fit theory. A major finding is that, in addition to the role of human capital, we find evidence to support the hypothesis that person-environment fit matters. That is, the fit between policy contexts and personal values and goals, such as motivation to pursue one's own education, appears to play a role in explaining differences by race and ethnicity in effects of welfare and employment policies on children.

Background

Walking or bicycling to school could contribute to children’s daily physical activity, but physical environment changes are often needed to improve the safety and convenience of walking and cycling routes. The California Safe Routes to School (SR2S) legislation provided competitive funds for construction projects such as sidewalks, traffic lights, pedestrian crossing improvements, and bicycle paths.

Methods

A cross-sectional evaluation examined the relationship between urban form changes and walking and bicycle travel to school. Surveys were distributed to parents of third- through fifth-grade children at ten schools that had a completed SR2S project nearby. Two groups were created based on whether parents stated that their children would pass the SR2S project on the way to school or not.

Results

Children who passed completed SR2S projects were more likely to show increases in walking or bicycle travel than were children who would not pass by projects (15% vs 4%), based on parents’ responses.

Conclusions

Results support the effectiveness of SR2S construction projects in increasing walking or bicycling to school for children who would pass these projects on their way to school.

Parkinson disease (PD) and Alzheimer disease (AD), the two most common neurodegenerative disorders in American adults, are of purely genetic origin in a minority of cases and appear in most instances to arise through interactions among genetic and environmental factors. In this article we hypothesize that environmental exposures in early life may be of particular etiologic importance and review evidence for the early environmental origins of neurodegeneration. For PD the first recognized environmental cause, MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), was identified in epidemiologic studies of drug abusers. Chemicals experimentally linked to PD include the insecticide rotenone and the herbicides paraquat and maneb; interaction has been observed between paraquat and maneb. In epidemiologic studies, manganese has been linked to parkinsonism. In dementia, lead is associated with increased risk in chronically exposed workers. Exposures of children in early life to lead, polychlorinated biphenyls, and methylmercury have been followed by persistent decrements in intelligence that may presage dementia. To discover new environmental causes of AD and PD, and to characterize relevant gene-environment interactions, we recommend that a large, prospective genetic and epidemiologic study be undertaken that will follow thousands of children from conception (or before) to old age. Additional approaches to etiologic discovery include establishing incidence registries for AD and PD, conducting targeted investigations in high-risk populations, and improving testing of the potential neurologic toxicity of chemicals.

As they ponder the final 9/11 commission report detailing the continued lack of preparedness among federal agencies, Congress and President Bush should also consider the parallel lack of preparedness among the citizenry as a whole.

As the Department of Homeland Security proceeds with its own recovery from hurricane Katrina, Americans have to wonder what, if anything, can be done to make sure the nation is ready for catastrophes such as earthquakes and terrorist attacks that come without warning.

Although political forces have largely driven decentralization in East Asia and most countries face similar reform challenges, their decentralization
experiences are far from uniform. Countries have adopted different intergovernmental structures,
proceeded at uneven paces, and adopted a wide range of implementation strategies. This diversity is not surprising, as East Asian countries vary greatly
in geographical size, population, history, economic structure, and political and institutional dynamics, all of which influence the form that decentralization
can and should take. This chapter provides expanded context for the analysis presented in chapter 1 and lays a foundation for later chapters. After reviewing the origins of decentralization, it compares the basic intergovernmental frameworks, structures, and processes
evolving in Cambodia, China, Indonesia, the Philippines, Thailand, and Vietnam.1 The chapter focuses, in turn, on enabling frameworks, the governance environment, fiscal decentralization, and the management and implementation of decentralization reforms.

The South Bronx is a low-income, minority community in New York City. It has one of the highest asthma rates in the country, which community residents feel is related to poor air quality. Community residents also feel that the air quality data provided by the New York State Department of Environmental Conservation (DEC) through its network of monitoring stations do not reflect the poor quality of the air they breathe. This is due to the fact that these monitoring stations are located 15 m above ground. In the year 2001 this project collected air quality data at three locations in the study area. They were collected close to ground-level at a height of 4 m by a mobile laboratory placed in a van as part of the South Bronx Environmental Health and Policy Study. This paper compares data collected by the project with data from DEC's monitoring stations in Bronx County during the same periods. The goal of the comparison is to gain a better understanding of differences in measured air quality concentrations at these different heights. Although there is good agreement in the data among DEC stations there are some important differences between ground-level measurements and DEC data. For PM_2.5 the measured concentrations by the van were similar to those recorded by DEC stations. In the case of ozone, the concentrations recorded at ground level were similar or lower than those recorded by DEC stations. For NO₂, however, the concentrations recorded at ground level were over twice as high as those recorded by DEC. In the case of SO₂, ground level measurements were substantially higher in August but very similar in the other two periods. CO concentrations measured at ground-level tend to be 60–90% higher than those recorded by DEC monitoring stations. Despite these differences, van measurements of SO₂ and CO concentrations were well below EPA standards.

For more than sixteen years, Jeffrey Hollender has presided over Seventh Generation, a world leader in manufacturing environmentally friendly, nontoxic household products. What Matters Most illuminates the successful practices of Seventh Generation-and many other pioneering companies around the world-to demonstrate the pragmatic aspects of a corporate strategy that hardwires social and environmental concerns into the company's culture, operating systems, and business relationships. It shows business leaders how to assess their own company's performance, adopt a socially responsible approach to doing business, and embark on a path of long-term growth.

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. "Digital Infrastructures" presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions. "Digital Infrastructures" addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security. "Digital Infrastructures" is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

The Balanced Budget Act of 1997 established federal grants to the states to create the State Children's Health Insurance Program (SCHIP). This presented the states with a number of implementation choices concerning administrative models for the new programs, as well as choices about eligibility standards, enrollment simplification, crowd-out, and cost sharing requirements. At the same time, the states were also implementing welfare reform. We describe the most important of these implementation choices, and using data from the Current Population Survey, we estimate the impacts of state policy on enrollment in this multiprogram environment. The results indicate that SCHIP programs that are administered as Medicaid expansions are more successful than either separate SCHIP plans or combination programs in enrolling children. States that remove asset tests and implement presumptive eligibility and self-declaration of income have higher enrollment levels. Continuous eligibility and adoption of mail-in applications have no effect on overall enrollment. Waiting periods and premiums reduce enrollment. Stringent welfare reform reduces children's enrollment, despite federal policy that was intended to protect children from the consequences of welfare reform. The negative impacts of a number of these policy reforms substantially reduce enrollment, potentially offsetting the more favorable impacts of other policy choices. We estimate that if all states adopted the policy options that facilitate program use, enrollment for children with family incomes less than 200 percent of the poverty line could be raised from the current rate of 42 percent to 58 percent.

This article is adapted from a new book by Paul Light entitled Sustaining Nonprofit Performance: The Case for Capacity Building and the Evidence to Support It, published in 2004 by the Brookings Institution Press.

Imagine a nonprofit's life as a journey up and down a development spiral. All organizations would start with a simple idea for some new program or service and then move up the spiral toward greater and greater impact, progressing through five landings, or stops, along the climb: (1) the organic phase of life, in which they struggle to create a presence in their environment; (2) the enterprising phase, in which they seek to expand their size and scope; (3) the intentional phase, in which they become focused more tightly on what they do best; (4) the robust phase, in which they strengthen their organizational infrastructure to hedge against the unexpected; and (5) the reflective phase, in which they address longer-term issues of succession and legacy.

The purpose was to examine attitudinal and contextual factors associated with the occurrence of sexual health assessments during adolescent primary care visits. A total of 313 primarily African-American youth aged 11-21 years from 16 community-based organizations in suburban Maryland and in New York City completed questionnaires focusing on sexually transmitted diseases (STD) and health care. The analysis examined the relationship of sexual activity, attitudes, and presence of the parent at the health care visit with discussion of three sexual health topics and testing for STD at the most recent health care visit. Data were analyzed using Chi-square tests and logistic regression. Overall, 74% of respondents reported that they had talked about at least one sexual health topic at their last health care visit but only 32% had discussed all three topics of sexual behavior, birth control, and STD. Females were more likely than males to discuss birth control although there were no gender differences in the overall likelihood of talking about a sexual health topic. Few adolescents initiated discussion of sexual issues. Positive attitudes toward discussing sexual issues with a provider and absence of a parent at the visit were independently associated with higher odds of discussing at least one sexuality topic and STD testing. Although relatively large numbers of adolescents in the sample received sexual health assessments, the proportion was below recommended guidelines. The opportunity to speak privately with a clinician and having positive attitudes about discussing sex with a doctor appear to be important influences on the receipt of sexual health assessments. Improving the quality of adolescent preventive care will require creating a health care environment that facilitates discussion of sexual health issues

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. Digital Infrastructures presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions.

Digital Infrastructures addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security.

Digital Infrastructures is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

All too often, telecommunications systems are treated as an alternative to transportation systems, as a substitute for the physical movement of people and services. The growing use of telecommunications systems is doing far more than influence where people work and live, but is actually changing the character of activities that occur in the home, workplace, and automobile. This chapter examines the way in which information and telecommunications are transforming everyday urban life; making the home into an extension of the office, shopping mall, and classroom; allowing the automobile and airplane to become workplaces; and converting the office building into a hub for social interaction and interpersonal contact. The diffusion of information technologies drastically increases the complexity of cities by increasing the number and type of interactions among individuals, firms, technical systems and the external environment. Information systems are permitting new combinations of people, equipment, and places; as a result, there is a dramatic change in the spatial organization of activities within cities and large metropolitan regions.

The South Bronx is a low-income, minority community in New York City. It has one of the highest asthma rates in
the country, which community residents feel is related to poor air quality. Community residents also feel that the air quality data provided by the New York State Department of Environmental Conservation (DEC) through its network
of monitoring stations do not reflect the poor quality of the air they breathe. This is due to the fact that these
monitoring stations are located 15m above ground. In the year 2001 this project collected air quality data at three
locations in the study area. They were collected close to ground-level at a height of 4m by a mobile laboratory placed in a van as part of the South Bronx Environmental Health and Policy Study. This paper compares data collected by the project with data from DEC's monitoring stations in Bronx County during the same periods. The goal of the comparison is to gain a better understanding of differences in measured air quality concentrations at these different heights. Although there is good agreement in the data among DEC stations there are some important differences between ground-level measurements and DEC data. For PM2.5 the measured concentrations by the van were similar to those recorded by DEC stations. In the case of ozone, the concentrations recorded at ground level were similar or lower than those recorded by DEC stations. For NO2, however, the concentrations recorded at ground level were over twice as high as those recorded by DEC. In the case of SO2, ground level measurements were substantially higher in August but very similar in the other two periods. CO concentrations measured at ground-level tend to be 60-90% higher than those recorded by DEC monitoring stations. Despite these differences, van measurements of SO2 and CO concentrations were well below EPA standards.

Globalization and technological innovation have changed the way people, goods, and information move through and about cities. To remain, or become, economically and environmentally sustainable, cities and their regions must adapt to these changes by creating cutting-edge infrastructures that integrate advanced technologies, communications, and multiple modes of transportation.

The book defines cutting-edge infrastructures, details their importance to cities and their regions, and addresses the obstacles - technical, jurisdictional, financial, and social - to creating those infrastructures. Additionally, it explores issues behind the creation of new infrastructures: their integrated, technical components, the decision making involved in their creation, and the equity and environmental questions they raise.

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. "Digital Infrastructures" presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions. "Digital Infrastructures" addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security. "Digital Infrastructures" is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

In a world that continues to increase in size and complexity, the dependence on information technologies (IT) that drive our life support systems is growing rapidly. Few other technologies have spread as rapidly. This book addresses the pervasive influence that IT has had on infrastructure, namely transportation, water supply and wastewater management, energy, and telecommunications, and its users. This is especially timely in light of the growing need for critical policy, management and technological choices about the reliability and security of IT and infrastructure systems, and in particular what was deemed critical infrastructure by the President's Commission on Critical Infrastructure Protection in 1997 (US Department of Commerce, Critical Infrastructure Assurance Office 1997) and again in 2003 by the White House (White House 2003).

Existing research typically examines fear in publicspace from women's perspectives. To date, environment–behavior researchers have largely overlooked men'sfear in publicspace, and the role of masculinity in shaping men's perceptions of fear and safety. This paper investigates the intersections of traditional, dominant masculinity—or masculinism—and men'sfear in publicspace, based on interviews with 82 undergraduate men students. Masculinism features qualities such as control, competition, aggression, and physical strength. We argue that, for many men, publicspaces and situations that challenge this masculinist identity may generate fear. Similarly, spaces and situations that promote feelings of safety do so, in part, by bolstering this identity. We employ the lens of masculinity to explore men's feelings of fear of the unknown, heightened awareness and safety, fear of confrontation, and safety in numbers. Conclusions examine implications for the development of masculinity and recommendations for future research.

Intelligent transportation systems (ITS) have gone beyond futuristic ideals and are becoming mainstream tools for managing highway and transit systems, as well as for providing information to the public. ITS has shown itself to be a cost-effective means for making best use of the current transportation system in an environment where the ability to expand capacity has become increasingly more difficult and expensive. There are several projects already in place at the regional level (e.g. E-ZPass, Transcom's IRVIN system, and MetroCard) and at the local level (e.g. sub-area traffic management centers and transit system real-time train information systems). More major ITS systems are expected in the next few years.

Public confidence is essential to America's 1.5 million charitable organizations and the 11 million Americans they employ. Confidence clearly affects the public's willingness to donate time and money, shapes the political and regulatory environment that governs charitable organizations, and has at least some influence on morale within the charitable workforce. Confidence slipped when charities were slow to respond after 9/11, and it has been battered in the past year by scandals. The news media have delved into lavish spending at some of the nation's leading philanthropies, improper payments at the United Way of the National Capitol Area, conflicts of interest at the Nature Conservancy, and the firing of new YWCA president and feminist leader Patricia Ireland after just six months on the job. In turn, these stories have sparked legislative investigations and calls for tighter regulation, most recently from the California State Attorney General, who joined his colleagues in Minnesota and New York in calling for a new era in charitable accountability and the legislation to create it. Where the media go, Congress, state attorneys
general, and watchdog groups are sure to follow.

Studies over the last decade have demonstrated the effectiveness of public health interventions based on social and behavioral science theory for many health problems. Little is known about the extent to which health departments are currently utilizing these theories. This study assesses the application of social and behavioral science to programs in the New York City Department of Health (NYCDOH). Structured open-ended interviews were conducted with executive and program management staff of the health department. Respondents were asked about the application of social and behavioral sciences within their programs, and about the benefits and barriers to increasing the use of such approaches. Themes related to the aims of the study were identified, a detailed coding manual developed, narrative data were coded independently by two investigators (kappa.85), and data analyzed. Interviews were conducted with 61 eligible individuals (response rate 88%). The most common applications of social and behavioral science were individual-level behavior change to prevent HIV transmission and community-level interventions utilizing community organizing models and/or media interventions for health promotion and disease prevention. There are generally positive attitudes about the benefits of utilizing these sciences; however, there are also reservations about expanded use because of resource constraints. While NYCDOH has successfully applied social and behavioral sciences in some areas of practice, many areas use them minimally or not at all. Increasing use will require additional resources. Partnerships with academic institutions can bring additional social and behavioral science resources to health departments and benefit researchers understanding of the health department environment.

Global climate change (GCC) is now well known, and its impacts are a stark reality. According to the Intergovernmental Panel on Climate Change (IPCC), changes in global climate in the 20th century, whether from human or natural causes, are already reflected in numerous indicators for atmospheric chemistry, weather, biological, physical and economic conditions, and members of the Intergovernmental Panel on Climate Change (IPCC) working groups have rated the probability of those changes as either actually occurring or at least likely to occur. The estimated impacts of these changes under varying scenarios are in many cases pronounced, and the ability to cope with these impacts varies considerably depending upon the capacity of individuals, groups and institutions to adapt.

The quality of the environment in communities with large minority populations has been a growing concern particularly with respect to public health given the potential for greater
exposure among minorities and the lower availability of health services to address such exposures. A public health and environmental policy analysis is being conducted by the Institute for Civil Infrastructure Systems (ICIS) at New York University's Wagner Graduate School of Public Service (NYU-Wagner) to address some of these issues in the South Bronx. The Wagner School study is part of a larger project funded by the U.S. EPA about environmental issues in the
South Bronx, NY that aims to provide relationships among air quality, transportation, waste transfer activity, and demographic characteristics in the South Bronx.

The international scientific community has begun to focus upon the reality of global climate change and sophisticated research techniques provide increasingly accurate models of the potential impacts of associated weather extremes, disease outbreaks, and global and local environmental destruction. Yet decision-making institutions have not, for the most part, incorporated global climate change in their policies and planning efforts. This report presents the implications of climate change, thus far considered largely in a global context, in very local terms. As research and discussion of climate change begin to focus on anticipated regional impacts, decision-makers in the Metropolitan East Coast (MEC) Region and elsewhere should begin to consider and implement practical adaptation policies affecting land use, infrastructure, natural resource management, public health, and emergency and disaster response.

The dramatic growth in the development and use of information technology (IT) has had an untold impact upon the nature and performance of the fundamental infrastructure systems that support our economy and social environment. The use of IT is no doubt already pervasive in these infrastructure systems from design and planning through operations and maintenance. IT has the potential to address many of the quality issues that infrastructure has faced, by providing detection capability for infrastructure condition, coordination of complex operations, and integration of multi-modal and multi-locational facilities to provide seamless services to consumers. Still to be understood are not only the opportunities IT provides (for example, in terms of improved performance) but also the barriers to its use (for example, in terms of IT and infrastructure compatibility). Moreover, little is known about how IT influences infrastructure and the social systems it supports. This white paper provides a background for the development of a research agenda that addresses both interrelationships between IT and infrastructure and its impacts ranging from infrastructure operations to social systems.

For the first time in more than four decades, the federal budget has registered two consecutive surpluses, and the need to reduce the deficit is not casting a pall over the policy debate. This new, highly accessible book examines the policy options that are available in this new environment to address the new and recurring challenges that face the nation.

The book, which continues the Brookings Institution's highly acclaimed and influential Setting National Priorities series, will serve as a guide for understanding many of the complex issues that will be discussed during the presidential and congressional campaigns of 2000. The book centers around three themes: providing opportunity in the domestic arena, restoring confidence in government, and adapting to the post-Cold War international environment. It tackles such critical issues as Medicare and social security, tax reform, and foreign policy spending, as well as many area not included in previous editions; namely, education, urban problems, the environment, trade, government renewal and reform, crime and drugs, and families.

Essentials of Cost Accounting for Health Care Organizations, Second Edition is a comprehensive text that applies the tool and techniques of cost accounting to the health services field. It is an essential tools for all professionals who need to deal with the challenges of managing health facilities in a difficult economic environment.

This paper investigates the effects of information from different sources on farmers' attitudes regarding the effects of pesticides and other agricultural chemicals on environmental quality using a survey of 2700 farmers in three mid-Atlantic states. Farmers' beliefs are similar to those of the general public on average, but are distributed more uniformly, suggesting that the farm community may be more polarized on environmental issues than the general public. Farmers regard first-hand sources of information such as direct field observation and pesticide labels as being the most important. Chemical dealers and extension rank next in importance. Farmers who attached greater importance to information from news media and extension expressed greater environmental concern. Farmers who found information from chemical dealers more important expressed greater concern about injury to wildlife and pesticides in drinking water but less concern about general environmental quality problems associated with agricultural chemicals.

Better Environmental Decisions responds to the need for improved environmental decision making by bringing together leading scholars and practitioners to provide a comprehensive interdisciplinary introduction to the subject. Each chapter describes an important aspect of environmental decision making; identifies key issues, problems, and barriers; and recommends ways to improve both the process and the final result.

To determine the effects of aspects of residency training on AIDS-related treatment practices. METHOD: The authors conducted a nationwide longitudinal panel study of 394 physicians who graduated in 1989 from six medical schools in New York State. Data were collected during the participants' fourth year of medical school, their third year of residency training, and six years after they had graduated from medical school. Questionnaires sought information about AIDS-related practice behaviors, including avoiding invasive procedures, minimizing contact, emphasizing AIDS prevention and education, and volume of people with AIDS treated. RESULTS: Aspects of residency training had a sustained impact on how the physicians cared for patients with AIDS but not on the numbers of patients they treated. Determinants of treatment practices included aspects of the residency environment (e.g., emphasis on problem solving, student orientation; p < .01), characteristics of the faculty (e.g., commitment to teaching, tolerance of varied viewpoints), cynicism about patient care (p < .001), social biases (homophobia and aversion to intravenous drug users; p < .001), and AIDS-related attitudes (p < .01). CONCLUSIONS: Fundamental changes to residency training, all of which are associated with learner-centered education, can improve physicians' treatment of their patients with HIV and AIDS.

This article synthesizes findings from a wide range of empirical research into how neighborhoods affect families and children. It lays out a conceptual framework for understanding how neighborhoods may affect people at different life stages. It then identifies methodological challenges, summarizes past research findings, and suggests priorities for future work.

Despite a growing body of evidence that neighborhood conditions play a role in shaping individual outcomes, serious methodological challenges remain that suggest some caution in interpreting this evidence. Moreover, no consensus emerges about which neighborhood characteristics affect which outcomes, or about what types of families may be most influenced by neighborhood conditions. Finally, existing studies provide little empirical evidence about the causal mechanisms through which neighborhood environment influences individual outcomes. To be useful to policy makers, future empirical research should tackle the critical question of how and for whom neighborhood matters.

This book bridges the gap between the many different disciplines used in applications of risk analysis to real world problems. Contributed by some of the world's leading experts, it creates a common information base and language for all risk analysis practitioners, risk managers, and decision makers. Valuable as both a reference for practitioners and a comprehensive textbook for students, Fundamentals of Risk Analysis and Risk Management is a unique contribution to the field. Its broad coverage ranges from basic theory of risk analysis to practical applications, risk perception, legal and political issues, and risk management.

This paper focuses on infrastructure's vulnerability to sea level change associated with global warming. It also addresses the degree to which that infrastructure can be altered to decrease its vulnerability and the vulnerability of the land surrounding it. It centers on the metropolitan New York City area (which includes portions of New Jersey and Connecticut), that is surrounded by an extensive shoreline subject to the risks of global warming.

Think of all the problems in the world, in the city or town where you live, on your own block: pollution, violence, children who can't read, housebound elderly people, litter in the street, the homeless. If only somebody would do something about these things. . . . Why not you? Why not now?

You don't need to be a high-profile social activist to effect positive social change. How to Make the World a Better Place, in this updated and expanded edition, shows how just one person can make a difference in solving global, national, and local problems. Whether you're interested in feeding the hungry, protecting the environment, helping the homeless, or making your community a safer place to live, you'll find the means to get started in this book. Each chapter alerts you to problems that require attention, explains the issues and what has to be done about them, tells you specifically what you can do to help, and lists the addresses and phone numbers of organizations that you can contact.

The twenty-fifth anniversary of Earth Day finds us all more socially and environmentally conscious than ever before. All it takes for you to make a difference is one first step-this book gives you the advice, the encouragement, the information, and the resources you need to take it. Then, instead of simply thinking about the world's problems, you'll be solving them.

Reports that environmental epidemiology increasingly is being used as a foundation for environmental health policy. Approaches to interpretation; Rules of evidence; Meta-analysis; Relationship between disease and risk factors; Studies compared; Chemicals at forefront of health policy debates; Dioxins; Benzene; Formaldehyde; Expanding number of health effects; Exposure specificity.

This article addresses the importance of economic and demographic assumptions in framing the public policy process. It examines functions of such assumptions as an important aspect of government and as a new challenge for public managers. Using Social Security as a case study, the article suggests that recent fore- casts have been inaccurate for four basic reasons: (I) the social and economic environment, (2) technique, (3) assumption drag, and (4) politics. Nevertheless, the assumptions have been crucial at several key legislative turning points in recent Social Security reforms. The article reviews the impact of political pressure in three specific instances and suggests an emerging pattern in the use and misuse of assumptions. The article concludes with suggestions on how to address the importance of assumptions in the public policy process.

One hundred and seventy-eight denial laboratory technicians and 69 non-exposed controls participated in an epidemiological respiratory study. Eight technicians who had a mean of 28 years' grinding nonprecious metal alloys were diagnosed as having a simple pneumoconiosis by chest radiograph. Mean value for per cent predicted FVC and FEV[sub 1] were reduced among male nonsmoker technicians compared to male nonsmoker controls: after controlling for age. there was also a reduction in spirometry with increasing work years. An industrial hygiene survey was conducted in 13 laboratories randomly selected from 42 laboratories stratified by size and type of operation in the Sah Lake City, Utah metropolitan area. Personal exposures to beryllium and cobalt exceeded the Threshold Limit Values (TLVs) in one laboratory. Occupational exposures ia dental laboratories need to be controlled to prevent beryllium-related lung disorders as well as simple pneumoconiosis.

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