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At least 73 records · Page 4Linked to original sources
PubMed1997

Marking progress toward service integration: learning to use evaluation to overcome barriers.

While federal statutes defining categorical programs and funding streams are most often cited as barriers to service integration efforts, there is evidence that service integration efforts are also being stymied by factors at the state and local levels as well. This case study examines five types of barriers to service integration that have been evident in Georgia's Family Connection and describes how an evaluation instrument and process was developed to assess progress toward service integration at the local level. The findings of a pilot study of the use of this instrument suggest that it can help to: (a) define starting points for service integration efforts; (b) identify specific service integration activities that are feasible in the context of a unique community; (c) specify the time needed to be allocated to service integration efforts; (d) identify the local costs and benefits of engaging in service integration; and (e) provide specifications for conducting a self-assessment of progress at the local level toward service integration goals.

Benchmarking↗
PubMed2000

Current medicolegal and confidentiality issues in large, multicenter research programs.

The convenience of fast computers and the Internet have encouraged large collaborative research efforts by allowing transfers of data from multiple sites to a single data repository; however, standards for managing data security are needed to protect the confidentiality of participants. Through Dartmouth Medical School, in 1996-1998, the authors conducted a medicolegal analysis of federal laws, state statutes, and institutional policies in eight states and three different types of health care settings, which are part of a breast cancer surveillance consortium contributing data electronically to a centralized data repository. They learned that a variety of state and federal laws are available to protect confidentiality of professional and lay research participants. The strongest protection available is the Federal Certificate of Confidentiality, which supersedes state statutory protection, has been tested in court, and extends protection from forced disclosure (in litigation) to health care providers as well as patients. This paper describes the careful planning necessary to ensure adequate legal protection and data security, which must include a comprehensive understanding of state and federal protections applicable to medical research. Researchers must also develop rules or guidelines to ensure appropriate collection, use, and sharing of data. Finally, systems for the storage of both paper and electronic records must be as secure as possible.

Confidentiality↗
PubMedDate not supplied

Assistive technology for postsecondary students with learning disabilities: an overview.

The number of postsecondary students with learning disabilities has increased dramatically over the last several years. This increase, coupled with federal legislation mandating "academic adjustments" for students with disabilities, has prompted the development of postsecondary learning disability support service programs. One support service that has begun to attract considerable attention is assistive technology. The purpose of this article is to provide an overview of assistive technology as it relates to postsecondary students with learning disabilities by (a) briefly tracing the development of assistive technology service for postsecondary students with learning disabilities; (b) identifying basic models of assistive technology service delivery and specific services; (c) providing a description of specific assistive technologies; (d) reviewing research on the effectiveness of assistive technology with postsecondary students with learning disabilities, with a focus on the authors' 3-year federally funded study; and (e) concluding with a summary and recommendations.

Adult↗
PubMed2005

The U.S. experience in promoting sustainable chemistry.

BACKGROUND, AIM AND SCOPE: Recent developments in European chemicals policy, including the Registration, Evaluation and Authorization of Chemicals (REACH) proposal, provide a unique opportunity to examine the U.S. experience in promoting sustainable chemistry as well as the strengths and weaknesses of existing policies. Indeed, the problems of industrial chemicals and limitations in current regulatory approaches to address chemical risks are strikingly similar on both sides of the Atlantic. We provide an overview of the U.S. regulatory system for chemicals management and its relationship to efforts promoting sustainable chemistry. We examine federal and state initiatives and examine lessons learned from this system that can be applied to developing more integrated, sustainable approaches to chemicals management. MAIN FEATURES: There is truly no one U.S. chemicals policy, but rather a series of different un-integrated policies at the federal, regional, state and local levels. While centerpiece U.S. Chemicals Policy, the Toxic Substances Control Act of 1976, has resulted in the development of a comprehensive, efficient rapid screening process for new chemicals, agency action to manage existing chemicals has been very limited. The agency, however, has engaged in a number of successful, though highly underfunded, voluntary data collection, pollution prevention, and sustainable design programs that have been important motivators for sustainable chemistry. Policy innovation in the establishment of numerous state level initiatives on persistent and bioaccumulative toxics, chemical restrictions and toxics use reduction have resulted in pressure on the federal government to augment its efforts. RESULTS AND CONCLUSIONS: It is clear that data collection on chemical risks and phase-outs of the most egregious chemicals alone will not achieve the goals of sustainable chemistry. These alone will also not internalize the cultural and institutional changes needed to ensure that design and implementation of safer chemicals, processes, and products are the focus of the future. Thus, a more holistic approach of 'carrots and sticks'--that involves not just chemical producers but those who use and purchase chemicals is necessary. Some important lessons of the US experience in chemicals management include: (1) the need for good information on chemicals flows, toxic risks, and safer substances.; (2) the need for comprehensive planning processes for chemical substitution and reduction to avoid risk trade-offs and ensure product quality; (3) the need for technical and research support to firms for innovation in safer chemistry; and (4) the need for rapid screening processes and tools for comparison of alternative chemicals, materials, and products.

Chemical Industry↗
PubMed1998

Challenges of establishing a nursing center in rural eastern Oregon.

The success of the center, in fact its very existence, is the result of cooperation among many persons and agencies. Financial gifts, loans and grants have given the clinic a three-year time period to learn valuable lessons on how to organize for self-sufficiency. Staff have learned how to market to increase patient visit and have obtained Federal Rural Health Clinic status which will increase revenues substantially. Nurse Practitioners are learning appropriate visit coding and hold regular brainstorming meetings to develop creative business opportunities to assure financial stability. As a result of these experiences, the NP faculty have been able to design learning experiences for the nurse practitioner students which introduce them to entrepreneurial realities. Challenges are being met by the NPs in this rural practice which require vigor, creativity, and vigilance. Once the center reaches the level of self-sufficiency, it is the intent of the community to build a facility which can support a significant increase in patient load and still have room for other social and health services to operate within the facility. Bridges to the medical community are being strengthened through better communication and more community involvement. Educating the public and the medical community about the role of nurse practitioners and the broad base of nursing centers is a continual challenge for both faculty and students at the School of Nursing.

Community Health Centers↗
PubMed1993

Hemophiliacs--a picture from a developing country: Karnataka, a south Indian state.

Forty cases of hereditary bleeding disorders, who are the members of Karnataka Hemophilia Society (a State Chapter of the Hemophilia Federation of India) were studied to learn their problems. Twenty-four cases were thoroughly investigated including factor assay and in 16 cases the diagnosis was based on classical clinical presentation and pattern of inheritance. There were 16 cases of hemophilia A, 3 cases of hemophilia B, 2 cases of von Willebrand's disease, 1 case of factor XIII deficiency and 2 cases of hereditary afibrinogenemia. The age group varied from 3 months to 36 years; 39 were male. The age of onset of symptoms, type of bleeding, type of joints involved, disabilities experienced by these patients, severity of the disorder, presence of antibodies to factor, presence of HBsAg and HIV, the availability of treatment for these patients, treatment received and the financial burden faced by these patients were studied. Thirty-three cases (82.5%) had joint bleeds, 60% of the patients experienced various type of disabilities, 11 (27.5%) had epistaxis, 10 (25%) had GI bleeds, 5 (12.5%) had dental bleeding, 8 (20%) had haematomas, 3 (7.5%) had umbilical stump bleeds and 19 cases (47.5%) had previous blood transfusions.

Adolescent↗
PubMedDate not supplied

Federal law and the accommodation of students with LD: the lawyers' look at the BU decision.

This article explores the genesis and development of the Guckenberger v. Boston University case, detailing the pertinent facts and issues of the case and analyzing the court's decision. The overall question posed by the case (as considered from the perspective of the plaintiffs' attorneys) was whether Boston University violated federal law in its response to the requests for reasonable accommodations by students with learning disabilities. The article quotes primarily from the decision issued by Federal Judge Patti Saris. The court's decision signified an important development in the field of higher education and set an extraordinary precedent in favor of students with disabilities under both the Americans with Disabilities Act and the Rehabilitation Act of 1973.

Adult↗
PubMed1994

When academic assistance is not enough: addressing the mental health issues of adolescents and adults with learning disabilities.

This article focuses on an answer to a critical question for adolescents and adults with learning disabilities: How can professionals assist students with learning disabilities who have psychosocial issues that appear to be affecting their academic progress and life adjustment? Inherent in this inquiry are other, equally important issues, such as: How do learning disabilities service providers know when to involve other service providers? What are the steps in referring a student for further assistance with different mental health issues? When are team interventions necessary? How are team interventions conducted in either secondary or postsecondary settings? How should learning disabilities service providers establish the boundaries of their professional expertise and/or responsibilities to adequately meet the needs of individuals with learning disabilities? This article illustrates answers to these questions by providing examples of interventions and case studies from two federally funded research/demonstration projects at the University of Minnesota: the Learning Disabilities Transition Project and Project Extra. The authors describe theoretical models for mental health services that address the psychosocial issues frequently encountered in academic or vocational settings. Recommendations are also included that discuss how the models can be personalized to fit the reader's home institution or agency.

Adolescent↗
PubMed1996

A status report on transition planning for individuals with learning disabilities.

The predominant focus of the transition movement has been on individuals with moderate and severe disabilities. Only recently have professionals begun to comprehensively address the transition needs of individuals with learning disabilities. Although certain transition planning components are applicable to all youth, regardless of disability, the unique needs of specific disability categories must be recognized. The purpose of this article is to provide a review of transition as it relates to students with learning disabilities. Specifically, it provides (a) an overview of state and federal mandates and initiatives that influence transition practices, and (b) a discussion of transition practices for individuals with learning disabilities.

Adolescent↗
PubMed2005

In conclusion: the promise of comprehensive cancer control.

THE PROMISE OF COMPREHENSIVE CANCER CONTROL: Operationally, comprehensive cancer control (CCC) brings together diverse experts and interested partners to review together the cancer experience of their community, to identify key areas in need of improvement, to develop collaborative approaches to address individual and system changes and strategies to meet the needs of the population, and to combine resources - fiscal, relational, and intellectual - to maximize positive outcomes. Specific positive outcomes related to CCC are as follows: Comprehensive cancer plans; A cadre of collaborating partners; Support for the continuum of cancer-related functions and needs; New opportunities to learn and build skills; Coordinated appeals for federal, state, and private resources; Combined strategies to address major system changes that individual programs could not hope to address on their own; and Greater impact than single programs or partners could accomplish alone. A NUMBER OF FACTORS CAN AT TIMES IMPEDE SUCCESS: Sustainability; Resources; and Competition. Continuing the extraordinary progress of the past 5 years will fundamentally alter the trajectory of cancer and the burden of this disease in the United States. The readers are challenged to add their voices, skills, resources, perspectives, connections, and passion to this remarkable effort.

Health Planning↗
PubMedDate not supplied

Who is our consumer? Shaping nursing programs to meet emerging needs.

Demographic changes are occurring in some states at a faster rate than in others; yet it is projected that these changes will be mirrored throughout the United States in the coming half-century. In California, persons of Hispanic origin now constitute more than 25 per cent of the population, and noncaucasian racial groups total 31 per cent. As a health care discipline, it is critical that nursing recruit individuals into the profession who reflect the population that nurses serve, and the curriculum and clinical learning opportunities should be culturally relevant. Moreover, federally funded research is now required to generate knowledge about all groups, regardless of ethnicity, race, or gender. Current demographic data provide information about the emerging ethnic and racial composition of the population, birthrates, and types of health care services that are likely to be needed. Implications of these trends can guide goal setting for educational programs, research, and clinical practice to ensure that academic nursing addresses the public need.

California↗
PubMedDate not supplied

Disaster planning and emergency preparedness: lessons learned.

Following the terrorist attacks of September 11, 2001, the federal response plan was activated immediately, with most efforts focused on helping recovery workers at Ground Zero in New York City. Comprehensive pharmacy services were critical in protecting the health of those potentially exposed to anthrax at U.S. Postal Service facilities and the U.S. Capitol. Responding to anthrax attacks taught many valuable lessons to emergency workers on how to manage a bioterrorist attack. Because of its central place in the life of many American communities, pharmacy is a natural and important ally of public health.

Anthrax Vaccines↗
PubMed2006

Web based distance learning at Faculty of Medicine of Sarajevo University.

The time in which we live is defined by the significant influence of the information technologies on our lives, changes and development of society and the efficacy of all the organization systems. Increase and development of distance learning (DL) technologies over the past decade has exposed the potential and the efficiency of new technologies. Number of events has organized by teaching staff from Cathedrae for Medical Informatics in order to promote distance learning and web based education are very extensive: professional-scientific events, workshops and congresses, first tele-exam at the Medical Faculty, Introducing of Distance learning in curriculum at biomedical faculties, etc. At the University in Sarajevo in year 2003 was opened the e-learning center for the support to the faculties the distance studies by use of the information technology. At Medical Faculty of University of Sarajevo at Cathedrae for Medical Informatics since 2002 is in progress realization of the project named: "Possibilities of introducing distance learning in medical curriculum", approved by the Federal and the Cantonal ministry of science and education. Pilot project was realized during three past school years, theoretical and practical education of subject Medical informatics are adapted to the new concepts of education using world trends of education from the distance. One group of students was included in the project finalized by electronic exam registration and electronic exam on 20 June 2005, publicly, in the Physiology amphitheatre of the Medical Faculty in Sarajevo.

Bosnia and Herzegovina↗
PubMed1993

Future trends in dermatology.

If the specialty of dermatology is to enjoy a bright future in medicine, excellence in education and basic research, use of technologic advances, and advancement of our scientific and clinical knowledge through general and subspecialty dermatology must continue. The specialty needs to be unified and must learn to function in local, state, and federal governmental appropriations, regulations, legislation, and administration. The specialty needs to establish dermatologists as primary care physicians for dermatologic medical and surgical services. Dermatologists deliver the highest quality of dermatologic care and are cost-effective health care providers. The specialty of dermatology has developed a strong organizational structure to effectively deal with these six strategic components so as to afford a bright future for dermatology. Effective actions by the specialty will require increased participation by the constituents and continued involvement of the varied dermatology organizations. The future cannot be predicted with certainty, but a well-prepared society can continue its past success and look forward to a future beyond its highest expectations.

Dermatology↗
PubMedDate not supplied

Lessons from the Georgia floods.

In July 1994, tropical storm Alberto brought heavy rains to parts of Alabama, Florida, and Georgia. In South Georgia, rivers rose 44 feet above flood stage, muddy water covered 10,000 square miles, and 31 lives were lost. In implementing the Health and Medical Services portion of the FEMA Federal Response Plan, the Public Health Service learned lessons from this experience that can be applied to planning for other natural disasters. Continuous reassessment to assure the best utilization of resources in rapidly changing conditions, cross-training in the content of emergency plans at all levels, and on-going face-to-face liaison among response managers will improve response efforts. Populations with special medical needs must become part of any response design. The effects that any response activity may have on the community as a whole should be carefully considered before action is taken.

Disaster Planning↗
PubMed1988

Law on the reception and accommodation of refugees, 12 December 1988.

This Law provides that localities have the duty of receiving and accommodating asylum applicants and that the Ministry of the Interior is to determine how many applicants for each inhabitant must be received. Under the law, the Government of Baden-Wuertemberg is to reimburse to social care agencies 90% of legally mandated support payments; the costs of social advice and care of up to 250 DM per refugee per year, including assistance in daily life, in becoming accustomed to the Federal Republic, in leaving the country, and in learning German; the necessary costs of accommodation; and the costs of other social benefits. The Government is also to reimburse the localities for administrative costs of up to 300 DM per refugee per year and the necessary costs of creating accommodations.

Demography↗