Rear-end crashes on freeways contribute significantly to nonrecurring congestion. Reducing these events would significantly improve freeway capacity, particularly during peak hours. Although promising coun-termeasures, such as variable speed limits, changeable message signs, and vehicle-based improvements, are under consideration, currently there is a shortage of demonstrably proven countermeasures targeted at freeway rear-end crashes. Liability rules, in which the direct cost associated with a crash is divided between the drivers, their insurance companies, or both, are a primary mechanism for influencing the occurrence of freeway rear-end crashes. An exploratory effort uses concepts from evolutionary game theory to predict the effects of liability rules on rear-end crashes. In a typical two-vehicle car-following scenario, driving behavior can be associated with a utility that each driver expects to achieve depending on his or her and the opponent's actions. Such interactions between leader and follower are modeled as the outcome of an evolutionary process in which drivers with different driving behaviors are randomly and repeatedly matched against each other to play a two-player game. The outcome of these games determines the fraction of drivers pursuing a particular driving strategy for the next phase of the game. The stable long-run distribution of driving strategies is then used to predict the proportion of drivers who are more likely to be involved in a rear-end accident. It turns out that when direct crash costs are allocated evenly to the involved drivers, a population in which all drivers act to avoid crashes is not evolutionarily stable.

关键词：汽车；交通拥挤；博弈论

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In the absence of validated national benchmarks, or norms, this document stresses the need for each community paramedicine program to define its system-specific health status benchmarks and performance indicators and to use a variety of community health and public health interventions to improve the community's health status. The document also addresses reducing the burden of illness, chronic disease, and injury as a community-wide public health problem, not strictly as a patient care issue. Opportunities to review community paramedicine programs are beneficial because they allow for the assessment of the status of EMS activities and move systems forward in developing inclusive and comprehensive systems of care. Many EMS programs conduct their own internal or external reviews, and it is hoped that this document will serve as another tool used by these programs to assess the current status of community paramedicine programs and to provide guidance on future system enhancements. The assessment tool also provides a common framework by which data can be collected from multiple community paramedicine programs and aggregated to develop a snapshot of common successes and challenges. While the tool should be useful across both urban and rural programs it is specifically designed to address rural settings where community health/public health resources are often very limited. By encouraging emerging rural community paramedicine programs to use this evaluation framework as a planning tool, it should be possible to create stronger partnerships and linkages with scarce rural resources.

关键词：护人员；社区；公共健康；评估；医药

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The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 mandated the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program (the Competitive Bidding Program). The Competitive Bidding Program sets lower payment rates than conventional Medicare payment rates for selected durable medical equipment and supplies (DME items) while ensuring beneficiary access to quality items and services. In previous audits, we identified an estimated $16.5 million that the Illinois and Ohio Medicaid programs could have saved on diabetic test strips if they had obtained pricing similar to the pricing that Medicare obtained through the Competitive Bidding Program or by establishing a manufacturer rebate program. Test strips are just 1 of 339 DME items covered by the Competitive Bidding Program. Because we identified potential savings for test strips in Illinois and Ohio, we conducted this review of 42 selected DME items, including test strips in Minnesota. Our objective was to determine whether the Minnesota Medicaid program could achieve cost savings for the 42 selected DME items by obtaining pricing similar to the pricing that Medicare obtained through the Competitive Bidding Program.

关键词：医疗补助；付款；医疗器械；医疗用品

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A 37-year-old diesel mechanic employed by a railroad transportation company died when his loaded utility truck collided with the rear of a semi-trailer on a four-lane interstate highway. The mechanic was driving at highway speed during daylight hours when he failed to stop in time and struck the semi, which was moving slowly in traffic that had backed up due to a car fire two miles downstream. There was severe damage to the mechanic's truck, with underside of the cab and intrusion up to the right rear tires of the trailer ahead. The force of the collision caused a chain reaction, pushing the struck tractor-trailer forward into a second tractor-trailer that had stopped in backed up traffic. Fire and rescue responders arrived from the nearby town located four miles away. The mechanic, who was wearing a safety belt, suffered blunt force trauma as a result of the collision and was pronounced deceased at the scene. He was extricated by mechanical means from the truck cab and was found holding a cell phone. Law enforcement officers' examination of the phone activity revealed the mechanic had exchanged several voice/text messages prior to the crash and was initiating a voice/text message application at the time of the collision. The driver's failure to notice the tractor trailer ahead and stop in time was attributed to texting. Drivers of the other two vehicles were not severely injured.

关键词：汽车；交通安全；机动车事故

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In 2009, the Family Smoking Prevention and Tobacco Control Act granted FDA, an agency within the Department of Health and Human Services (HHS), authority to regulate tobacco products such as cigarettes. The act requires that tobacco manufacturers submit information to be reviewed by FDA in order to market new tobacco products and established tobacco user fees to fund FDA's tobacco-related activities. The act represents the first time that FDA has had the authority to regulate tobacco products. Manufacturers have raised concerns about the progress of CTP, the FDA center established by the act to implement its provisions. GAO was asked to examine CTP's review of new tobacco product submissions, responses to meeting requests, and use of funds. This report examines (1) the status of CTP's reviews of new tobacco product submissions; (2) how CTP responded to manufacturers' and other entities' meeting requests, and the length of time CTP took to hold the meetings; and (3) the extent to which FDA has spent its tobacco user fee funds. GAO analyzed data regarding submissions received by FDA as of January 7, 2013; reviewed data on meeting requests, spending plans, and amounts obligated; and interviewed CTP and tobacco industry officials.

关键词：烟草制品；美国FDA；香烟；医药

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Parking facilities are important to the construction and development of urban central commercial district. With the increase of urban economy and people's living standards, more and more cars, followed by more and more city parking is not convenient. Especially in the city center business district, "parking difficult" problem is particularly serious. In order to solve the parking problem, Yuan Yang-Cheng in T city commercial district is taken as the object, according to the investigation on the parking behavior. The survey results show that the key factors affecting the behavior of parking is price and the parking is interested in the convenient parking of parking guidance system. Also, the reasonable use of price lever parking supply and demand has great room for adjustment.

关键词：汽车；停车问题；城市中心

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The scope of this paper is to develop an advanced stated preferences (SP) survey customized to capture teenagers' behaviors and to estimate models of hybrid mode choices, in which the utilities depend on both the attributes of the mode and the latent variable willingness to walk or cycle. The SP scenarios include four alternative modes for the trip to school-car (escorted by parents), bus, bicycle, and walk-while the attributes are travel time; travel cost; walking tune to the bus station; availability of bike paths, sidewalks, and parking places; and weather conditions. The data are drawn from a survey that took place in all the high schools of Cyprus in 2012. The sample consists of 4,174 teenagers (ages 12 to 18) and covers 8.7% of the total high school population. For the model estimations, 8,348 SP observations are used. It was found that the existence of bike paths and wide pavements significantly affect the choice of active transport. The latent variable enters significantly into the specification of the choice model to assure that unobserved variables should be implemented in the choice process. Willingness to walk and to cycle has a positive effect on the choice of those alternatives and a negative effect on the choice of a car. Moreover, parents' level of education and mode use patterns and habits influence the development of attitudes toward mode choice. The results of the study provide insights on policies and campaigns that may help the next generation develop greener travel behavior.

关键词：交通；车辆；步行；青少年；选择意愿

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This paper presents an analysis of the degree of willingness to change from motorized travel modes to walking or cycling. The aim of the analysis is to reduce uncertainty between stated willingness to change and real shifts from car or transit to nonmotorized transportation modes. Data were collected in the city of Valencia, Spain, through a novel data collection effort based on multiple survey methods. Respondents traveling by car or transit were asked about their willingness to change to walking or cycling under the implementation of improvement measures to be selected. Then a hypothetical scenario was presented to respondents who stated a willingness to change; in the scenario, the previously selected measures were implemented and respondents were supposed to be cycling or walking. In addition, the costs of their usual travel mode were gradually reduced until they gave up cycling or walking. Those who decided to keep on walking or cycling were assumed to have a strong willingness to change. A statistical analysis performed with Heckman's sample selection model permitted identification of demographic, socioeconomic, and travel-related factors influencing the degree of willingness to change. Results revealed that car users presented a stronger willingness to switch to walking or cycling than transit users. In addition, older respondents showed a stronger willingness to change to both walking and cycling. Work- and school-related journeys were less associated with walking than noncommuting journeys, but they were more related to cycling. Policy implications of the results are highlighted.

关键词：汽车；意愿评估；模式选择

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Mining communities access to appropriate health care has not been well studied. Appropriate care includes competencies to adequately diagnose and treat mining related disease or illness. The current study has two primary objectives. First, we seek to understand whether mining communities face shortages in numbers of safety net providers compared to non-mining communities. To accomplish this, the study locates and maps mine locations in the U.S. and rural safety net providers (Rural Health Clinics, Federally Qualified Health Centers, Critical Access Hospitals and Black Lung Clinics). Second, we assess the capacity of rural safety net providers in mining areas to prevent, diagnose and treat mining related injury and illness. This was done through a survey of rural primary care providers practicing in safety net facilities co-located with mining communities.

关键词：矿工；保健；农村地区；职业安全与卫生；医药

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No abstract available.

关键词：用药；健康物质的使用；精神障碍；医药

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