Branas, Charles

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Now showing 1 - 10 of 21
  • Publication
    Trauma Center-Community Partnerships to Address Firearm Injury: It can be Done
    (2004-10-25) Richmond, Therese S; Branas, Charles; Schwab, C William
    Firearm violence is often framed as a problem of the inner cities and of the criminal justice system. However, this focus may direct attention away from smaller communities that also face firearm violence, including suicide. Ten years ago, the Firearm and Injury Center at Penn (FICAP) developed and implemented a model program in three smaller cities, using trauma centers to spearhead community partnerships. This Issue Brief describes the development and implementation of these partnerships, and highlights one community’s ongoing activities to reduce firearm injury.
  • Publication
    To the Rescue: Optimally Locating Trauma Hospitals and Helicopters
    (2000-09-18) Branas, Charles; ReVelle, Charles S; Mackenzie, Ellen J
    Injury (trauma) is the leading cause of death in the United States for people younger than 45 years of age. Each day, more than 170,000 men, women, and children are injured severely enough to seek medical care. About 400 of these people will die and another 200 will sustain a long-term disability as a result of their injuries. An estimated 20-40% of trauma-related deaths could be prevented if all Americans lived in communities that were served by a well-organized system of trauma care. This Issue Brief describes a new computer model that can help State and regional policymakers decide where to place designated trauma hospitals and helicopter depots to maximize their residents’ access to trauma care.
  • Publication
    No Time to Spare: Improving Access to Trauma Care
    (2005-09-29) Branas, Charles
    Since the September 11 attacks, policymakers are paying increasing attention to the adequacy of the U.S. trauma care system to handle potential mass casualty incidents. This attention has led to questions about how well the trauma system covers the population for day-to-day trauma, such as motor vehicle accidents and gunshot wounds. Although the number of trauma centers has increased in the last decade, no national plan exists to assure that everyone has timely access to a specialized trauma center if needed. This Issue Brief summarizes a new study that estimates the proportion of residents that can reach a trauma center by ground or air ambulance within one hour of where they live, using objective measures of travel times and distances.
  • Publication
    State Helmet Laws and Motorcycle Rider Death Rates
    (2001-09-24) Branas, Charles; Knudson, Martha
    Motorcycles are the most dangerous form of motorized transportation. Per vehicle miles traveled, motorcyclists are about 3 times as likely as passenger car occupants to be injured in a crash, and 16 times as likely to die. Because the majority of these deaths are caused by head injury, safety advocates have recommended mandatory use of motorcycle helmets. Others contend that state laws mandating helmet use infringe on motorcyclists’ rights, and question whether such laws really reduce motorcycle deaths and injury. Scientific evidence cannot address the appropriate balance between personal freedom and public safety, but it can address the effectiveness of mandatory helmet laws. This Issue Brief summarizes a new analysis of the effects of motorcycle helmet laws on death rates, and points out the need to account for other potential factors when comparing death rates across states.
  • Publication
    Alcohol Consumption, Alcohol Outlets, and the Risk of Being Assaulted With a Gun
    (2009-05-01) Branas, Charles; Richmond, Therese S; Culhane, Dennis P; Wiebe, Douglas; Elliott, Michael R
    BACKGROUND: We conducted a population-based case-control study to better delineate the relationship between individual alcohol consumption, alcohol outlets in the surrounding environment, and being assaulted with a gun. METHODS: An incidence density sampled case-control study was conducted in the entire city of Philadelphia from 2003 to 2006. We enrolled 677 cases that had been shot in an assault and 684 population-based controls. The relationships between 2 independent variables of interest, alcohol consumption and alcohol outlet availability, and the outcome of being assaulted with a gun were analyzed. Conditional logistic regression was used to adjust for numerous confounding variables. RESULTS: After adjustment, heavy drinkers were 2.67 times as likely to be shot in an assault when compared with nondrinkers (p < 0.10) while light drinkers were not at significantly greater risk of being shot in an assault when compared with nondrinkers. Regression-adjusted analyses also demonstrated that being in an area of high off-premise alcohol outlet availability significantly increased the risk of being shot in an assault by 2.00 times (p < 0.05). Being in an area of high on-premise alcohol outlet availability did not significantly change this risk. Heavy drinkers in areas of high off-premise alcohol outlet availability were 9.34 times (p < 0.05) as likely to be shot in an assault. CONCLUSIONS: This study finds that the gun assault risk to individuals who are near off-premise alcohol outlets is about the same as or statistically greater than the risk they incur from heavy drinking. The combination of heavy drinking and being near off-premise outlets resulted in greater risk than either factor alone. By comparison, light drinking and being near on-premise alcohol outlets were not associated with increased risks for gun assault. Cities should consider addressing alcohol-related factors, especially off-premise outlets, as highly modifiable and politically feasible approaches to reducing gun violence.
  • Publication
    Vacant Properties and Violence in Neighborhoods
    (2012-01-01) Branas, Charles; Rubin, David; Guo, Wensheng
    Objectives. Violence remains a significant public health issue in the United States. To determine if urban vacant properties were associated with an increased risk of assaultive violence and if this association was modified by important neighborhood institutions (e.g., schools, parks/playgrounds, police stations, and alcohol outlets). Methods. Longitudinal ecologic study of all 1816 block groups in Philadelphia. Aggravated assault and vacant property data were compiled yearly from 2002 to 2006 and linked to block groups. A mixed effects negative binomial regression model examined the association of vacant properties and assaults between and within block groups. Results. Among all block groups, 84% experienced at least one vacant property, 89% at least one aggravated assault, and 64% at least one gun assault. Between block groups, the risk of aggravated assault increased 18% for every category shift of vacant properties (IRR 1.18, 95% CI: 1.12, 1.25, P < 0.001). Parks/playgrounds and alcohol outlets potentially modified the association between vacant properties and aggravated assaults but only at low levels of vacancy. Conclusions. Increasing levels of vacancy were associated with increased risk of assaultive violence in urban block groups.
  • Publication
    Guatemala & the University of Pennsylvania: Meeting in the Middle
    (2013-01-01) Barg, Frances K; Weiss, Eve; Branas, Charles
    The GUATEMALA-PENN relationship is a partnership that is borne from more than a century of research, service and scholarship. Our goal, with this book and with our programs, is to grow this partnership based upon the reciprocal needs of our Guatemalan stakeholders and the mission of the university. Guatemala is only one country away from the US. Our shared heritage and joint economic and social interests make it critical to foster a strong and mutually beneficial relationship between our two countries. Our connections have evolved over time in response to new knowledge gained about each other. This book is a testament to our collective past, present and future. For more information or to donate visit: http://www.med.upenn.edu/globalhealth/guatemalapartners.shtml
  • Publication
    Time, Distance, and Access to Emergency Care in the United States
    (2009-04-30) Carr, Brendan G; Branas, Charles
    As national health care reform advances, increasing attention is being paid to the adequacy of existing resources to meet health care needs. Do we have the right mix of providers and facilities? Are they located and organized efficiently? These persistent questions are especially relevant to the provision of emergency care, in which timely access can save lives. This Issue Brief describes the first national study of population access to emergency care, taking into account the locations of emergency departments (EDs), people, and transportation.
  • Publication
    Novel Linkage of Individual and Geographic Data to Study Firearm Violence
    (2008-08-01) Branas, Charles; Culhane, Dennis P; Richmond, Therese S; Wiebe, Douglas
    Firearm violence is the end result of a causative web of individual-level and geographic risk factors. Few, if any, studies of firearm violence have been able to simultaneously determine the population-based relative risks that individuals experience as a result of what they were doing at a specific point in time and where they were, geographically, at a specific point in time. This paper describes the linkage of individual and geographic data that was undertaken as part of a population-based case-control study of firearm violence in Philadelphia. New methods and applications of these linked data relevant to researchers and policymakers interested in firearm violence are also discussed.
  • Publication
    Fears of Violence During Morning Travel to School
    (2013-07-01) Wiebe, Douglas; Guo, Wensheng; Richmond, Therese S; Branas, Charles; Allison, Paul D; Anderson, Elijah
    PURPOSE: Children's safety as they travel to school is a concern nationwide. We investigated how safe children felt from the risk of being assaulted during morning travel to school. METHODS: Children between 10 and 18 years old were recruited in Philadelphia and interviewed with the aid of geographic information system (GIS) mapping software about a recent trip to school, situational characteristics, and how safe they felt as they travelled based on a 10-point item (1 = very unsafe, 10 = very safe). Ordinal regression was used to estimate the probability of perceiving different levels of safety based on transportation mode, companion type, and neighborhood characteristics. RESULTS: Among 65 randomly selected subjects, routes to school ranged from 7 to 177 minutes (median = 36) and .1-15.1 street miles (median = 1.9), and included between 1-5 transportation modes (median = 2). Among students interviewed, 58.5% felt less than very safe (i.e.,8, for example, was .99 while in a car and .94 while on foot but was .86 and .87 when on a public bus or trolley. Probability was .98 while with an adult but was .72 while with another child and .71 when alone. Also, perceived safety was lower in areas of high crime and high density of off-premise alcohol outlets. CONCLUSIONS: Efforts that target situational risk factors are warranted to help children feel safe over their entire travel routes to school.