Branas, Charles
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Publication Hospital-Reported Pneumococcal Susceptibility to Penicillin(2004-01-01) Branas, Charles; Metlay, Joshua P.; Fishman, Neil O.Geographic variation in drug susceptibility among isolates of Streptococcus pneumoniae has influenced national treatment guidelines for community-acquired pneumonia. Whether individual hospital susceptibility data provide reliable and valid information for providers is unclear. We examined the geographic and temporal variability in hospital-reported rates of pneumococcal susceptibility. We surveyed all 52 hospitals that provided acute adult care in the five counties surrounding Philadelphia and collected data on levels of penicillin susceptibility among all pneumococcal blood isolates from 1998 to 2000. In 1998, pneumococcal nonsusceptibility to penicillin varied from 0% to 67% of all blood isolates across the 33 hospitals with ≥10 isolates in that year. Hospital location did not correlate with the level of reported pneumococcal susceptibility (p = 0.8). In addition, correlations were not significant in reported pneumococcal susceptibility to penicillin within individual hospitals during the 3 years.Publication Vacant Properties and Violence in Neighborhoods(2012-01-01) Branas, Charles; Rubin, David; Guo, WenshengObjectives. 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 The Case for Enhanced Data Collection of Gun Type(2004-01-01) Richmond, Therese S; Branas, Charles; Cheney, Rose Ann; Schwab, C WilliamBackground: National surveillance systems have differentiated long guns into rifles and shotguns but fail to do so for handgun type. We sought to determine whether specific gun type data could be collected and whether knowledge of specific gun types (rifle, shotgun, pistol, revolver) could be used to distinguish gun homicide victims with respect to important injury parameters such as number of wounds. Methods: Data on gun fatalities over a 5-year period in three communities were abstracted from medical examiner/coroner, police, and crime laboratory records. Results: Gun type was obtained for 92% of 490 guns linked to 405 gun homicides. Handguns were associated with more wounds per gun than long guns (p = 0.001) and more entry wounds per gun than long guns (p = 0.002). Among handguns, pistols were associated with more wounds per gun (p < 0.001) and entry wounds per gun (p = 0.001) than revolvers. These same associations were not found among specific long gun types (i.e., rifles and shotguns). Conclusion: Our findings demonstrate that information about gun type can be obtained and that significant differences exist in wounds per gun between long guns and handguns and between pistols and revolvers. Classification of long guns into rifles and shotguns and handguns into pistols and revolvers should be included in local, regional, and national data collection systems.Publication Trauma Center-Community Partnerships to Address Firearm Injury: It can be Done(2004-10-25) Richmond, Therese S; Branas, Charles; Schwab, C WilliamFirearm 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 Guatemala & the University of Pennsylvania: Meeting in the Middle(2013-01-01) Barg, Frances K; Weiss, Eve; Branas, CharlesThe 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.shtmlPublication PhillydotMap: The Shape of Philadelphia(2009-10-01) Branas, Charles; Davitt, Joan K; Hillier, Amy; Cheetham, Robert; Cheetham-Richard, Rachel; Cohen, Rachel B; Decker, Joan; Heckert, Megan; Steinberg, Harris; Sullivan-Marx, Eileen; Hutchins, Jason; Tomlin, C. Dana; Kerman, Lucy; Volpe, Stella; Lechner, Zachary L; Wiebe, Douglas; McLarnon, Michael; Newlin, Heather; Scholssberg, Dina; Wormley, Diane-LouiseThis book is the outgrowth of a working group entitled, “Modeling Urban Environmental Impacts on Health, Development, and Behavior" sponsored by the University of Pennsylvania Institute for Urban Research. The purpose of the working gropu was to engage faculty from across campus and to encourage their collaborative use of GIS technology in the modeling of urban form and function. These ten chapters represent a wide range of GIS applications, from community-based social services to public history to social science research.Publication No Time to Spare: Improving Access to Trauma Care(2005-09-29) Branas, CharlesSince 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 Methods for Linking Community Views to Measureable Outcomes in a Youth Violence Prevention Program(2012-01-01) McDonald, Catherine C; Richmond, Therese S; Guerra, Terry; Branas, Charles; Thomas, Nicole A; TenHave, Thomas; Walker, Alia; Leff, Stephen S; Vaughn, Nicole A; Hausman, Alice JBackground: All parties in community–academic partnerships have a vested interest prevention program success. Markers of success that reflect community’s experiences of programmatic prevention success are not always measurable, but critically speak to community-defined needs. Objective: The purpose of this manuscript was to (1) describe our systematic process for linking locally relevant community views (community-defined indicators) to measurable outcomes in the context of a youth violence prevention program and (2) discuss lessons learned, next steps, and recommendations for others trying to replicate a similar process. Methods: A research team composed of both academic and community researchers conducted a systematic process of matching community-defined indicators of youth violence prevention programmatic success to standardized youth survey items being administered in the course of a program evaluation. The research team of three community partners and five academic partners considered 43 community-defined indicators and 208 items from the youth surveys being utilized within the context of a community-based aggression prevention program. At the end of the matching process, 92 youth survey items were identified and agreed upon as potential matches to 11 of the community-defined indicators. Conclusions: We applied rigorous action steps to match community-defined indicators to survey data collected in the youth violence prevention intervention. We learned important lessons that inform recommendations for others interested in such endeavors. The process used to derive and assess community-defined indicators of success emphasized the principles of community-based participatory research (CBPR) and use of existing and available data to reduce participant burden.Publication Acute Alcohol Consumption, Alcohol Outlets, and Gun Suicide(2011-01-01) Branas, Charles; Richmond, Therese S; Ten Have, Thomas; Wiebe, DouglasA case-control study of 149 intentionally self-inflicted gun injury cases (including completed gun suicides) and 302 population-based controls was conducted from 2003 to 2006 in a major US city. Two focal independent variables, acute alcohol consumption and alcohol outlet availability, were measured. Conditional logistic regression was adjusted for confounding variables. Gun suicide risk to individuals in areas of high alcohol outlet availability was less than the gun suicide risk they incurred from acute alcohol consumption, especially to excess. This corroborates prior work but also uncovers new information about the relationships between acute alcohol consumption, alcohol outlets, and gun suicide. Study limitations and implications are discussed.Publication Mapping Activity Patterns to Quantify Risk of Violent Assault in Urban Environments(2016-01-01) Wiebe, Douglas; Richmond, Therese S; Guo, Wensheng; Nance, Michael L.; Branas, Charles; Allison, Paul D; Hollander, Judd EBACKGROUND: We collected detailed activity paths of urban youth to investigate the dynamic interplay between their lived experiences, time spent in different environments, and risk of violent assault. METHODS: We mapped activity paths of 10- to 24-year-olds, including 143 assault patients shot with a firearm, 206 assault patients injured with other types of weapons, and 283 community controls, creating a step-by-step mapped record of how, when, where, and with whom they spent time over a full day from waking up until going to bed or being assaulted. Case-control analyses compared cases with time-matched controls to identify risk factors for assault. Case-crossover analyses compared cases at the time of assault with themselves earlier in the day to investigate whether exposure increases acted to the trigger assault. RESULTS: Gunshot assault risks included being alone (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.3, 1.9) and were lower in areas with high neighbor connectedness (OR = 0.7, 95% CI = 0.6, 0.8). Acquiring a gun (OR = 1.4, 95% CI = 1.1, 1.6) and entering areas with more vacancy, violence, and vandalism (OR = 1.7, 95% CI = 1.1, 2.7) appeared to trigger the risk of getting shot shortly thereafter. Nongunshot assault risks included being in areas with recreation centers (OR = 1.2, 95% CI = 1.1, 1.4). Entering an area with higher truancy (OR = 1.6, 95% CI = 1.1, 2.5) and more vacancy, violence, and vandalism appeared to trigger the risk of nongunshot assault. Risks varied by age group. CONCLUSIONS: We achieved a large-scale study of the activities of many boys, adolescents, and young men that systematically documented their experiences and empirically quantified risks for violence. Working at a temporal and spatial scale that is relevant to the dynamics of this phenomenon gave novel insights into triggers for violent assault.
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