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PubMed1999

Notice inviting applications for new award for fiscal year 1999. The Office of the Assistant Secretary for Planning and Evaluation (ASPE), DHHS.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) announces the availability of funds and invites applications for research into the status of applicants and potential applicants to the Temporary Assistance to Needy Families (TANF) program, individuals and families entering the TANF caseload, and individuals and families who leave TANF. Approximately four to six States or large counties will receive funding that will enable them to monitor and conduct research into the progress of individuals who apply for TANF benefits and their families. ASPE is particularly interested in targeting those applicants who apply for cash assistance but are never enrolled because of non-financial eligibility requirements, participation in up-front job search or other diversion programs, or failure to complete the application process. Proposed studies of new entrants onto the TANF program and of individuals leaving welfare also will be given consideration. Research topics could fall into the broad categories of employment and earnings, participation in government assistance programs, and child and family well-being. Grant applicants may choose any method for their proposed studies, including the linking of administrative data, surveys, or other methods as appropriate. The funds could either support a newly designed project or could be used to add new data sources and analyses to an existing project.

Eligibility Determination↗
PubMed2004

The transcriptional program of terminal granulocytic differentiation.

To characterize the transcriptional program that governs terminal granulocytic differentiation in vivo, we performed comprehensive microarray analyses of human bone marrow populations highly enriched in promyelocytes (PMs), myelocytes/metamyelocytes (MYs), and neutrophils (bm-PMNs). These analyses identified 11 310 genes involved in differentiation, of which 6700 were differentially regulated, including previously unidentified effector proteins and surface receptors of neutrophils. Differentiation of PMs toward MYs was accompanied by a marked decline of proliferative and general cellular activity as defined by down-regulation of E2 promoter binding factor (E2F) target genes; cyclin dependent kinases 2, 4, and 6; and various metabolic, proteasomal, and mitochondrial genes. Expression patterns of apoptosis genes indicated death control by the p53 pathway in PMs and by death receptor pathways in bm-PMNs. Effector proteins critical for host defense were expressed successively throughout granulocytic differentiation, whereas receptors and receptor ligands essential for the activation of the host defense program were terminally up-regulated in bm-PMNs. The up-regulation of ligand-receptor pairs, which are defined inducers as well as target genes of nuclear factor-kappa B (NF-kappa B), suggests a constitutive activation of NF-kappa B in bm-PMNs by autocrine loops. Overall, these results define a granulocytic differentiation model governed by a highly coordinated fail-safe program, which promotes completion of differentiation before cells gain responsiveness toward activating stimuli that accompany infections.

Apoptosis↗
PubMed1997

Treating prison inmates with co-occurring disorders: an integrative review of existing programs.

The tremendous growth in state and federal correctional populations has focused greater attention on the needs of mentally ill and substance abusing inmates. Although an estimated 3-11% of prison inmates have co-occurring mental health (psychotic and major mood) disorders and substance abuse disorders, few treatment programs are described in the literature and there is little available information regarding effective treatment strategies for this population. The current study provides an integrative review of seven 'dual diagnosis' treatment programs that recently have been developed in state and federal prisons. Many of these have evolved from existing substance abuse treatment programs and approaches. Key program components include an extended assessment period, orientation/motivational activities, psychoeducational groups, cognitive-behavioral interventions such as restructuring of 'criminal thinking errors', self-help groups, medication monitoring, relapse prevention, and transition into institution or community-based aftercare facilities. Many programs use therapeutic community approaches that are modified to provide (a) greater individual counseling and support, (b) less confrontation, (c) smaller staff caseloads, and (d) cross-training of staff. Research is underway in three of the seven sites to examine the effectiveness of these new programs.

Adult↗
PubMed2004

The politics of preventable deaths: local spending, income inequality, and premature mortality in US cities.

OBJECTIVE: To examine the association between (1) local political party, (2) urban policies, measured by spending on local programmes, and (3) income inequality with premature mortality in large US cities. DESIGN: Cross sectional ecological study. OUTCOME MEASURES: All cause death rates and death rates attributable to preventable or immediate causes for people under age 75. PREDICTOR MEASURES: Income inequality, city spending, and social factors. SETTING: All central cities in the US with population equal to or greater than 100 000. RESULTS: Income inequality is the most significant social variable associated with preventable or immediate death rates, and the relation is very strong: a unit increase in the Gini coefficient is associated with 37% higher death rates. Spending on police is associated with 23% higher preventable death rates compared with 14% lower death rates in cities with high spending on roads. CONCLUSIONS: Cities with high income inequality and poverty are so far unable to reduce their mortality through local expenditures on public goods, regardless of the mayoral party. Longitudinal data are necessary to determine if city spending on social programmes reduces mortality over time.

Adolescent↗
PubMedDate not supplied

State contracting initiatives for quality improvement in asthma care.

This article examines the role of a state Medicaid program in standardizing and implementing quality performance measures for providers. It describes the Asthma Education and Primary Care Clinician Linkages Quality Improvement Program (QIP), one aspect of the ongoing Hospital Quality Initiative in Massachusetts. In October 1996, the second year of the initiative, the Massachusetts Division of Medical Assistance requested that all contracting hospitals submit quality improvement process and outcome measures related to asthma care, including practice guidelines, patient education materials, and documentation mechanisms to facilitate patients' appropriate follow-up contact with primary care clinicians. A team of evaluators reviewed these materials to determine whether hospitals had baseline data in place for asthma QIP development. Information forums were held with three reviewers and the hospitals to discuss various programs and progress toward quality improvement in asthma care. Reviewers also worked to identify hospital programs that could be used as models and those that would benefit from assistance in meeting the state's program goals.

Asthma↗
PubMedDate not supplied

Using administrative data to reward agency performance: the case of the federal adoption incentive program.

This article explores the history of the federal Adoption Incentive Program, the first federal child welfare outcome-based incentive program to rely solely on administrative data, and discusses it within the context of other prior and ongoing federal child welfare incentive programs. Various data-related issues are also examined, including the use of data to project program utilization and costs, set baselines for the number of adoptions, and award funds. Challenges in the legislatively required use of AFCARS data for determining the amount of incentive funds awarded and the impact of the program on AFCARS reporting are also discussed. The article concludes with a look at the impact of the Adoption Incentive Program on adoption and predictions for the future.

Adoption↗
PubMed2000

Financing Estonia's unemployment insurance system: problems and prospects.

In recent years, favorable media coverage of the glowing employment situation in the United States has been the norm. History, for one, won't permit us, however, to become complacent with what appears on the books to be a rosy economic picture for the nation. Moreover, the mounting recognition that the U.S. economy is inextricably tied to those of other nations--large and small--serves to keep us vigilant. This paper allows us a comparative exploration of the employment conditions in Estonia and the problems and prospects of financing its unemployment insurance program.

Cross-Cultural Comparison↗
PubMed2005

University of Wyoming College of Engineering undergraduate design projects to aid Wyoming persons with disabilities, a mid-program review.

In Spring 2002 the University of Wyoming received National Science Foundation funding from the Division of Bioengineering and Environmental Systems to provide a meaningful design experience for University of Wyoming, College of Engineering students that will directly aid individuals with disabilities within the state of Wyoming. At the 2003 RMBS we presented a paper on the value of starting such a program. We have found that students receive a much richer capstone design experience when developing a project for direct use by a challenged individual. We are now approximately midway through this project. Since its inception the program has blossomed to include serving individuals in several regional states, outreach short courses to the community, projects have become of increasing difficulty and involve interdisciplinary teamwork, and many challenged individuals have been provided specialized one of a kind assistive devices. In this paper we will report on these advancements, lessons learned, and benefits received by participating in this vital program.

Biomedical Engineering↗
PubMed1981

Federal funding formulas and the 1980 census.

Distribution of federal funds has achieved equal status with Congressional reapportionment as a motivation and justification for the Census of Population and Housing. This article describes the effects that U.S. population redistribution during the 1970s, as measured by the 1980 Census, will have on the spatial distribution of federal grants-in-aid provided to state and local governments through programs with formula-based funding systems. The conclusion is that funding changes will not match population changes. The overall redistribution of federal grants-in-aid to state and local governments occurring in response to incorporation of 1980 Census population counts into federal funding formulas will be far less than the level of population redistribution since 1970. Use of intercensal data, formula specifications, limited geographic specificity in many formula allocations, and nonformula determinants of formula-based grants all weaken the relationship between Census-measured population change and the receipt of federal funds at the local level. Despite all the intervening factors, it is probably that in many programs there will be some redistribution of funds when the 1980 Census counts are incorporated into the allocation formulas. But the importance of measurement errors and threshold and reclassification effects may equal that of true population change in determining the funds received by local communities.

Financing, Government↗
PubMed2003

Elimination of sanctions for refusal of vocational rehabilitation services without good cause. Final rule.

We are amending our regulations to remove provisions relating to the imposition of benefit sanctions on account of a beneficiary's refusal of rehabilitation services. We are making these changes to reflect the repeal of sections 222(b) and 1615(c) of the Social Security Act (the Act). Prior to their repeal, these sections of the Act authorized the Commissioner of Social Security to impose sanctions against the benefits of a disabled or blind beneficiary who refused, without good cause, to accept rehabilitation services made available by a State vocational rehabilitation (VR) agency. The Ticket to Work and Work Incentives Improvement Act of 1999 repealed these sections of the Act, effective January 1, 2001. We are amending our regulations by removing rules and related provisions that are obsolete as a result of the repeal of these sections of the Act to conform our regulations to the changes in the statute.

Adult↗
PubMedDate not supplied

Tuberculosis control in Alberta. A federal, provincial and regional public health partnership.

The number of cases of tuberculosis in Alberta or Canada may not be large, but the public health and medical costs of just a few cases can be prohibitive. For example, the costs of managing cases of multidrug-resistant tuberculosis and their contacts, can exceed the entire annual budget of a program. This was evident in New York City in the late 1980s and early 1990s, when $1 billion in public funds were spent reversing a major resurgence of drug-resistant and susceptible tuberculosis. In Canada, the Walkerton Inquiry has identified an apparent failure of provincial public policy to adequately address public health needs. This has resulted in decreased public confidence and potential liabilities for the policy-makers. In the design of the Tuberculosis Control Program of Alberta, the notion of a quasicentralized or quasidecentralized program is rejected. Rather there is an appeal to the notion of a partnership of responsibility that recognizes jurisdictional and non-jurisdictional public health, case management and epidemiologic realities, the integral contribution of each level of government and the need to be accountable to the public's health and purse. For levels of government not to properly discharge their responsibilities may be perceived as an abrogation of the public trust and a disregard of the Tuberculosis Control Policy Package and operational directives of the World Health Organization.

Alberta↗
PubMed2004

Key elements for successful integrated health information systems: lessons from the States.

The Genetic Services Branch, Maternal and Child Health Bureau of the Health Services and Resources Administration has provided funding to state health departments to integrate their newborn dried blood-spot screening programs with other early child health information systems since 1999. In 2001, All Kids Count conducted site visits to these grantees to identify and describe best practices in planning, developing, and implementing their integration projects. The site visits were organized around 9 key elements considered critical to the success of an information systems integration project: leadership, project governance, project management, stakeholder involvement, organizational and technical strategy, technical support and coordination, financial support and management, policy support and evaluation. Best practices for each of the key elements and 5 lessons learned were documented in Integration of Newborn Screening and Genetic Service Systems with Other Maternal & Child Health Systems: A Sourcebook for Planning and Development. The lessons learned are overarching conclusions that agencies should consider when planning and implementing integrated information systems. This article briefly describes the key elements, their best practices as implemented by states, and the lessons learned.

Child↗
PubMed2006

Business and public health collaboration for emergency preparedness in Georgia: a case study.

BACKGROUND: Governments may be overwhelmed by a large-scale public health emergency, such as a massive bioterrorist attack or natural disaster, requiring collaboration with businesses and other community partners to respond effectively. In Georgia, public health officials and members of the Business Executives for National Security have successfully collaborated to develop and test procedures for dispensing medications from the Strategic National Stockpile. Lessons learned from this collaboration should be useful to other public health and business leaders interested in developing similar partnerships. METHODS: The authors conducted a case study based on interviews with 26 government, business, and academic participants in this collaboration. RESULTS: The partnership is based on shared objectives to protect public health and assure community cohesion in the wake of a large-scale disaster, on the recognition that acting alone neither public health agencies nor businesses are likely to manage such a response successfully, and on the realization that business and community continuity are intertwined. The partnership has required participants to acknowledge and address multiple challenges, including differences in business and government cultures and operational constraints, such as concerns about the confidentiality of shared information, liability, and the limits of volunteerism. The partnership has been facilitated by a business model based on defining shared objectives, identifying mutual needs and vulnerabilities, developing carefully-defined projects, and evaluating proposed project methods through exercise testing. Through collaborative engagement in progressively more complex projects, increasing trust and understanding have enabled the partners to make significant progress in addressing these challenges. CONCLUSION: As a result of this partnership, essential relationships have been established, substantial private resources and capabilities have been engaged in government preparedness programs, and a model for collaborative, emergency mass dispensing of pharmaceuticals has been developed, tested, and slated for expansion. The lessons learned from this collaboration in Georgia should be considered by other government and business leaders seeking to develop similar partnerships.

Bioterrorism↗