Digital Commons Network^™

How Vulnerable Is The Nation's Food Supply? Linking Food Safety And Food Security, Robin J. Strongin

National Health Policy Forum

This paper reviews the food safety regulatory apparatus in place today, especially the activities of the two lead agencies in assuring food safety — the Food and Drug Administration within the Department of Health and Human Services and the Food Safety and Inspection Service within the Department of Agriculture. It examines the system's strengths and vulnerabilities, particularly in light of the post–September 11 environment that includes the heightened threat of terrorism. The paper also touches upon legislative and budgetary proposals aimed at improving food security, including the growing but debated interest in a single food safety agency.

Applying Managed Fee-For-Service Delivery Models To Improve Care For Dually Eligible Beneficiaries, Stuart Bratesman, Paul Saucier

Disability & Aging

No abstract provided.

Public Health Emergency Preparedness: Fundamentals Of The "System", Eileen Salinsky

National Health Policy Forum

This paper examines the existing public health infrastructure, with an emphasis on the resources and activities necessary for public health emergency preparedness and response. It provides a brief historical overview of the evolution of public health and contrasts public health interventions with medicine and health care services. The paper summarizes the broad range of activities that constitute public health practice today and provides a more detailed review of functions and services that are critical to emergency response capabilities. It explores the legal foundation for public health authorities, discussing constitutional, federal, and state public health law. The paper also summarizes how …

Child And Family Health Initiatives In The Bay Area, Jennifer Ryan, Wakina Scott

National Health Policy Forum

This site visit to the San Francisco Bay Area provided an opportunity to study locally based health initiatives in Santa Clara, Alameda, and San Francisco Counties that were designed to reach beyond the existing structures of the Medi-Cal and Healthy Families programs. Site visitors had the opportunity to interact with health care providers, state officials, and consumer advocates, as well as leaders in health coverage innovation. They also met with many of the leaders of the three local initiatives; visited Asian Health Services (AHS), a local clinic that has been serving the Asian community for over 25 years; and toured …

Key Health Issues Facing Latinas, Dharma E. Cortés, Helen Cajigas, Odilia Bermúdez

Gastón Institute Publications

Acknowledging the relationship that exists among health outcomes, socioeconomic factors, and access to health care is key to understanding the health status of Latinas in Massachusetts. For example, poverty disproportionately affects Latinos in Massachusetts, and they have the lowest rate of health insurance in the Commonwealth despite the fact that Massachusetts has one of the most inclusive and comprehensive public health insurance programs in the nation. This situation impacts access to regular health care for Latinos and affects their overall health status. This fact sheet provides information on the following health areas of particular concern to Latinas: maternal and child …

Pharmacy Benefits: New Concepts In Plan Design, Veronica V. Goff

National Health Policy Forum

This issue brief examines changes to prescription drug benefit coverage in large-employer plans and implications for a Medicare prescription drug benefit. The brief discusses reasons behind employer benefit plan redesign and recent coverage trends, as well as potential paths to modernize benefits.

Transitions Along The Continuum Of Care: Elderly And Disabled Persons In New York, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit examined transitions along the continuum of care for elderly and disabled persons in New York. The state offers its residents an extensive array of services, including nursing homes, home health care, personal care, and community-based services. New York spends more than any other state on its Medicaid program, which is reflected in a comprehensive benefit package, full-cost reimbursement of hospitals, high nursing home rates, and extensive coverage of personal care services. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed transitions …

Welfare Reform Reauthorization In 2002:What Are The Issues For Tribal Communities And Indian Families?, Kathleen A. Maloy

Health Policy and Management Issue Briefs

American Indian tribes have new options under the 1996 Welfare Reform legislation that created Temporary Assistance for Needy Families (TANF), a block grant enacted to replace the Aid to Families with Dependent Children (AFDC). TANF, which expires in September of this year, provides cash assistance to poor families with children, including poor American Indian Families, and gives tribes the option to design and administer their own family assistance programs following approval of the plan by the Department of Health and Human Services. As Congress considers TANF reauthorization, three new publications prepared for the Kaiser Family Foundation provide insight into the …

Bse: Risk, Uncertainty, And Policy Change, Enda Cummins, Pat Grace, Kevin Mcdonnell, Shane Ward

RISK: Health, Safety & Environment (1990-2002)

The authors discuss how, in our "risk society," a range of potential risks and uncertainties are associated with new technologies and new diseases, such as BSE. These risks bring with them worries about human health, while the ability to assess and manage new health scares is an essential skill for government and related industries.

The Precautionary Principle And Radiation Protection, Kenneth L. Mossman, Gary E. Marchant

RISK: Health, Safety & Environment (1990-2002)

The authors examine the application of the precautionary principle through a case study of ionizing radiation control and suggest a reevaluation of current radiation safety standards and practices.

Comparing Bottled Water And Tap Water: Experiments In Risk Communication, Branden B. Johnson

RISK: Health, Safety & Environment (1990-2002)

The author discusses results of experiments in risk communication comparing bottled water and tap water.

Welfare Reform In Maryland: Flexibility In Action, Jennifer Ryan, Judith D. Moore

National Health Policy Forum

This site visit took federal participants on a tour around Maryland, providing a three-way comparison of suburban, urban, and rural service delivery in a diverse state. The site visit focused on the Family Investment Program, a statewide effort to reduce the state's welfare caseload through temporary cash assistance (TCA) and other needed supports to help customers become self-sufficient. In particular, site visitors examined rural perspectives on reform, substance abuse assessment and treatment innovations, and fatherhood and family support initiatives. The group heard from state officials, researchers, advocates, and a variety of direct service providers about the successes and challenges of …

Promoting Marriage As Welfare Policy: Looking At A Public Role In Private Lives, Jane Koppelman

National Health Policy Forum

This issue brief discusses the interest in and politics surrounding government's using welfare reform legislation to carve out a stronger role in promoting marriage. It examines trends in family formation, their impact on society, and the effect of single parenting, divorce, and stepparenting on child well-being. The paper also looks at the treatment of marriage in current government programs, new state activities to promote marriage, proposals for a stronger government role, and marriage experts' expectations for the success of marriage education programs.

From Diagnosis To Payment: The Dynamics Of Coding Systems For Hospital, Physician, And Other Health Services, Karen Matherlee

National Health Policy Forum

This background paper reviews the two principal coding systems used to describe health services in the United States: ICD-9-CM and HCPCS, a combination of CPT-4 and national and local codes. It probes the relationships of these coding systems to payment policy, administrative simplification under HIPAA, and other concerns. The paper also addresses four coding issues: governance of CPT; adoption of ICD-10-CM; the appropriateness, accuracy, and responsiveness to change of the codes themselves; and the degree of documentation needed to monitor health services and determine payment.

Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague

National Health Policy Forum

This site visit was a return trip to southern California to examine the state of managed care. Between the Forum's last visit (in late 1998) and this one, the marketplace underwent considerable change, including significant movement away from global capitation, the collapse of physician practice management firms, and the development of new insurance products. Site visitors were briefed on managed care trends in the state, and panel discussions focused on issues related to physician group solvency, employer and consumer expectations, managed care regulation, and plan and provider strategies for surviving and prospering in the difficult southern California market. Site visitors …

Estimating Causal Parameters In Marginal Structural Models With Unmeasured Confounders Using Instrumental Variables, Tanya A. Henneman, Mark Johannes Van Der Laan, Alan E. Hubbard

U.C. Berkeley Division of Biostatistics Working Paper Series

For statisticians analyzing medical data, a significant problem in determining the causal effect of a treatment on a particular outcome of interest, is how to control for unmeasured confounders. Techniques using instrumental variables (IV) have been developed to estimate causal parameters in the presence of unmeasured confounders. In this paper we apply IV methods to both linear and non-linear marginal structural models. We study a specific class of generalized estimating equations that is appropriate to these data, and compare the performance of the resulting estimator to the standard IV method, a two-stage least squares procedure. Our results are applied to …

Effectiveness Of Colors Used On Safety And Health Signs For Communicating Severity Of Injury, Andrew M. Mccammack, Roger C. Jensen

Safety Health & Industrial Hygiene

Signs are used extensively in workplaces and on products to identify hazards and provide instructions for appropriate behavior. A fundamental element of these signs is the signal-word panel located at the top of the sign. The colors and words in this panel are intended to convey information about the hazard identified. One type of hazard information concerns the severity of injury/illness associated with the hazard. The standard of the American National Standards Institute (ANSI) for facility signs uses three severity categories: 1) death or serious injury, 2) minor or moderate injury, and 3) property damage. The standard specifies which signal-word …

Safety And Health Sign Colors And Signal Words For Communicating Information On Likelihood And Imminence Of Threat, Roger C. Jensen, Andrew M. Mccammack

Safety Health & Industrial Hygiene

Signs are used extensively in workplace facilities and on products to identify hazards and provide instructions and safety information. A fundamental component of these signs is a signal-word panel located at the top of the sign. Certain colors and signal words in this panel are intended to convey information about a hazard, including likelihood of harm and imminence of the threat. The purpose of this study was to determine if young adults without prior training on safety signs associate signal words and color with likelihood of harm and imminence of the threat. The sample population consisted of 59 college students. …

Comparison Of Domestic Violence Outcomes Among Emergency Department Nurses, Pamela S. Neal

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationships between domestic violence education, organizational support, screening, danger assessment, safety planning, and referral practices among professional registered nurses in two ED settings.

Sample & Setting: A convenience sample of 63 professional registered nurses provided data from two EDs. An ED located in Kentucky where state mandated continuing education in domestic violence was required (n = 33) and an ED in West Virginia (n = 30) where mandated continuing education in domestic violence was not required was the setting for the study. The samples were separated based on nurses who …

Mainecare Enrollees With Disabilities Work Experience: Results From A 2002 Survey, Sara T. Salley, Larry Glantz

Disability & Aging

No abstract provided.

Managed Healthcare And Integrated Delivery Systems: A Model For Getting Ahead Of The Change Curve, Philip Sheridan Carney

Theses Digitization Project

Managed care became the dominant model for moderating healthcare costs in the 1990's. The later half of this past decade witnessed early signs of a return to escalating premiums. Providers and consumers have reacted negatively to perceptions of health plan micro-management and restriction of choice.

Providers Choices In Web-Medical Records: An Analysis Of Trade-Offs Made By Physicians In San Bernardino County, Jay Eriah Shankar

Theses Digitization Project

This thesis concluded that offering physicians an appropriate Web-based transcription service should be well received and improve their medical record management and patient care.

Characteristic Differences Between Parents/Guardians Who Keep Immunization Records And Those Who Do Not, Rebecca Bonilla Mangual

Theses Digitization Project

No abstract provided.

Barriers To Initiation And Continuation Of Vision Care Among Diabetics, Jennifer Eilleen Werner

Theses Digitization Project

No abstract provided.

Delays In The Emergency Department And Their Effects On The Ambulance Provider, Simon Peter Moore

Theses Digitization Project

This thesis is a case analysis of the nature of delays in emergency room admissions and the effects on ambulance dispatching and availability as it occurred in Southern California.

The Hand Center: Considerations Related To The Design, Planning, Staffing, And Marketing, Marcia L. Miller

Community & Environmental Health Theses & Dissertations

A therapist intent on planning a hand therapy center has no resources that are specific to this specialty area of practice. There are contributions utilized to plan occupational and physical therapy departments that can be synthesized to a degree in the planning of a hand therapy center. The practice of hand therapy incorporates a high degree of physical interaction, with close proximity to the patient and handling by the therapist. This paper explores the unique requirements of a hand therapy department. In order to determine hand therapists' preferences for equipment and space utilization a survey was developed and distributed to …

Integrating Hiv Prevention And Care Into Maternal And Child Health Care Settings: Lessons Learned From Horizons Studies, Naomi Rutenberg, Sam Kalibala, Charles Mwai, James Rosen

HIV and AIDS

Many women in the developing world still lack access to high-quality HIV/AIDS prevention and care services. To address this problem, Horizons has undertaken a range of operations research efforts that examine the integration of HIV-related care in the maternal-child health setting. At a workshop held in Kenya in July 2001, participants discussed the experience to date and formulated practical strategies for improving the integration. This consultation report summarizes that discussion according to the following seven key program components: Training and Motivation to Improve the Performance of Health Workers; Supervision of HIV Services and Quality Assurance of HIV Testing; Caring for …

Hiv/Aids-Related Stigma And Discrimination: A Conceptual Framework And An Agenda For Action, Richard Parker, Peter Aggleton, Kathy Attawell, Julie Pulerwitz, Lisanne Brown

HIV and AIDS

In 1987, Jonathan Mann, then director of the WHO Global Programme on AIDS, identified three phases of the HIV/AIDS epidemic: the epidemic of HIV, the epidemic of AIDS, and the epidemic of stigma, discrimination, and denial. Despite international efforts to tackle HIV/AIDS since then, stigma and discrimination (S&D) remain among the most poorly understood aspects of the epidemic. This poor understanding is due in part to the complexity and diversity of S&D, but also to limitations in current thinking within the field and the inadequacy of available theoretical and methodological tools. This paper proposes a new conceptual framework to help …

Ic107: Program: 8th Biennial Symposium On Minorities, The Medically Underserved & Cancer. Awareness Is Not Enough, Intercultural Cancer Council

Informational and Promotional Materials

Program details the events, speakers, attendees, and discussions during the 8th Biennial Symposium on Minorities, the Medically Underserved & Cancer presented by Intercultural Cancer Council and jointly sponsored by Baylor College of Medicine. The symposium took place February 6-10 at the OMNI Shoreham in Washington, DC. See more at Intercultural Cancer Council Records.

Pathogenesis Of Human And Bovine Cryptosporidium Parvum In Gnotobiotic Pigs, Sonia J. Pereira, Norma E. Ramirez, Lihua Xiao, Lucy A. Ward

United States Public Health Resources

To compare the pathogenesis of human genotype 1 (HuGl) and bovine genotype 2 (BoG2) Cryptosporidium parvum, neonatal gnotobiotic pigs were given 1-10 HuGl or BoG2 oocysts. The prepatent and patent periods were significantly longer for HuGl than for BoG2 C. parvum (prepatent, 8.6 vs. 5.6 days; patent, 16.6 vs. 10.3 days). BoG2-infected pigs developed signif- icantly more severe disease than did HuGl-infected pigs. BoG2 parasites were seen micro- scopically throughout the intestines during the prepatent and patent periods. HuGl parasites were only detected during the patent period in the ileum and colon but colonized the mucosal surface in significantly …