Hispanic incorporation and access to health care in Houston and Harris County, Texas: Adopting an Hispanic perspective to the Aday and Andersen model

This study examines Hispanic levels of incorporation and access to health care. Applying the Aday and Andersen framework for the study of access, the study examined the relationship between two levels of Hispanic incorporation into U.S. society, i.e., mainstream versus ethnic, and potential and realized measures of access to health care. Data for the study were drawn from a 1992 telephone survey of 600 randomly selected Hispanics in Houston and Harris County.^ The hypotheses tested were: (1) Hispanics who are incorporated into mainstream society are more likely to have better potential and realized access to health care than those who are incorporated into ethnic-group enclaves regardless of their socioeconomic status (SES), health status and health needs, and (2) there is no interaction between the levels of incorporation (mainstream or ethnic) and SES, health status, and health needs in predicting potential and realized access.^ The data analysis supported Hypothesis One for the two measures of potential access. The results of bivariate and multiple logistic regression analyses indicated that for Hispanics in Houston and Harris County, being in the "mainstream" incorporation category increased their potential access to care, having "health insurance" and a "regular place of care". For the selected measure of realized access, having a "regular check-up", the analysis did not demonstrate statistically significant differences in having a regular check-up among Hispanics incorporated in the ethnic or mainstream incorporation categories.^ Hypothesis Two, that there is no interaction between the levels of incorporation and socioeconomic characteristics, health status, and health needs in predicting potential and realized access among Hispanics was supported by the data. The results of the logistic regression analysis showed that, after adjusting for socioeconomic status, health status, and health needs, the association between "level of incorporation" and the two measures of potential access ("health insurance" and having a "usual place of care") was not modified by the control variables nor by their interaction with level of incorporation. That is, the effect of incorporation on Hispanics' health insurance coverage, and having a usual place of care, was homogenous across Hispanics with different SES and health status.^ The main research implication of this dissertation is the employment of a theoretical framework for the assessment of cultural factors essential to research on migrating heterogeneous subpopulations. It also provided strategies to solve practical and methodological difficulties in the secondary analyses of data on these populations. ^

A DESCRIPTION AND EVALUATION OF EDUCATIONAL PROGRAMS FOR HEALTH MANPOWER IN NIGERIA

A descriptive study of the current educational programs of selected health personnel in Nigeria was made in 1986. Data on the content of educational programs was obtained from personal communication with the Heads of the various institutions and from their published materials (catalogs, course outlines and program descriptions). Adequacy of these programs was judged in the light of current health problems and needs of the population. Evaluation was based on the following criteria: (a) Selection of students to maximize their usefulness in the provision of health care. (b) Relevance of the curriculum to the tasks the trainee will be called upon to perform. (c) Types of courses that focus on community health needs. Using official reports, the health situation in the country was described to give a relative priority of health services.^ Findings indicate the following: (1) Health conditions in Nigeria are related to a high prevalence of illness and disease, unsanitary living conditions, a high ratio of infant mortality and a shortage of public health services. Priority needs for improvement call for attitudinal and environmental changes. (2) All health training programs have improved the relevance of education to community health needs by strengthening practical field experience, and teaching those courses which focus on disease prevention. (3) Prospective nurses and community health workers are selected on the basis of a number of personal and intellectual characteristics, but academic performance alone is the criterion for medical students. (4) The curriculum in the medical school needs to be restructured to cut back on time devoted to enriching the medical "background". Basic sciences need better integration with hospital work. (5) Managerial and organization courses have been well incorporated into the nursing and community health workers' curricula. (6) There is a marked overlap in the tasks the community health workers are expected to perform. This causes some redundancy in having four separate categories of these health personnel. ^

AN EPIDEMIOLOGIC DESCRIPTION AND ANALYSIS OF LOST WORKDAY OCCUPATIONAL BURN INJURIES

Background research consisted of a hospital case series of all adult burn patients (n = 162) admitted to John Sealy Hospital's burn unit from January 1978 to June 1979. Comparisons between occupationally and nonoccupationally burned adults demonstrated that occupationally burned adults were significantly more likely to have been active in the burn injury event and to have changed jobs during the prior year. They were significantly less likely to have physical or mental problems which contributed to sustaining the burn injury. Comparisons between occupational and nonoccupational burn injury events concluded that occupational burn injury events were significantly more likely to involve multiple sources of energy, sparks as the source of ignition and gases as the source of combustion. Other salient characteristics of occupational burn injuries indicated that subsequent research should focus upon lost workday occupational burns and other injuries sustained by blue-collar petrochemical workers employed in Galveston County, Texas.^ Subsequent research consisted of a historical cohort study of occupational injuries sustained in 1979 by a cohort of blue-collar petrochemical workers (n = 1771) who belonged to O.C.A.W. Local 4-449 in Texas City, Texas. Specific cohort injury rates included 15.08 occupational injuries per 100 person work-years, 11.98 lost workday occupational injuries per 100 person work-years, and 1.64 lost workday occupational burn injuries per 100 person work-years. Salient results from this study indicate that burn injuries are a very important type (in terms of both frequency and severity) of occupational injury sustained by blue-collar petrochemical workers, pipefitters are at greatest risk of lost workday injuries and lost workday burn injuries, company-specific experiences are comparable for lost workday occupational injuries, differences among company-specific nonlost workday occupational injury experiences may not be "safety-related", and minimal job-specific experience may not place employees at greater risk of lost workday burn injuries.^

Description and analysis of variation in dairy product and concomitant nutrient purchases between Hispanic and non -Hispanic households using a panel of shoppers' purchase records

The purpose of this research was development of a method of estimating nutrient availability in populations as approximated by supermarket purchase records. Demographic information describing 12,516 panel households was obtained from a marketing and advertising program operated by H. E. Butt Grocery Company of San Antonio, Texas. A non-probability sample of 2,161 households meeting expenditure criteria was selected and all purchases of dairy products for this sample of households were organized into a database constructed to facilitate the retrieval, aggregation, and analysis of dairy product purchases and their nutrient contents. Two hypotheses were tested: (1) no difference would be found between Hispanic and non-Hispanic purchases of dairy product categories during the study period and (2) no difference would be found between Hispanic and non-Hispanic purchases of nutrients contained in those dairy products during the thirteen-week study period.^ Food purchase records were used to estimate nutrient exposure on a weekly, per capita basis for Hispanic and non-Hispanic households by linking some 40,000 dairy purchase Universal Product code (UPC) numbers with food composition values contained in USDA Handbook 8-1. Results of this study suggest Hispanic sample households consistently purchased fewer dairy products than did non-Hispanic sample households and consequently had fewer nutrients available from dairy purchases. While weekly expenditures for dairy products among the sample households remained relatively constant during the study period, shifts in the types of dairy products purchased were observed. The effect of ethnicity on dairy product and nutrient purchases was significant over the thirteen-week period. A database consisting of customer, household, and purchase information can be developed to successfully associate food item UPC numbers with a standard reference of food composition to estimate nutrient availability in a population over extended periods of time. ^

Family Business in Mexico: Responses to Human Resource Limitations and Management Succession

Indigenous firms in Mexico, as in most developing countries, take the shape of family businesses. Regardless of size, the most predominant ones are those owned and managed by one or more families or descendent families of the founders. From the point of view of economics and business administration, family business is considered to have variety of limitations when it seeks to grow. One of the serious limitations is concerning human resource, which is revealed at the time of management succession. Big family businesses in Mexico deal with human resource limitations adopting measures such as the education and training of the successors, the establishment of management structure that makes control by the owner family possible and divisions of roles among the owner family members, and between the owner family members and the salaried managers. Institutionalization is a strategy that considerable number of family businesses have adopted in order to undergo the succession process without committing serious errors. Institutionalization is observed in such aspects as the establishment of the requisite condition to be met by the candidate of future successor and the screening by an institution which is independent of the owner family. At present these measures allow for the continuation of family businesses in an extremely competitive environment.

Real exchange rate appreciation, resource boom, and policy reform in Myanmar

In the five-year period from 2006 to 2011, the real exchange rate of the Myanmar kyat appreciated 200 percent, signifying that the value of the US dollar in Myanmar diminished to one third of its previous level. While the resource boom is suspected as a source of the real exchange rate appreciation, its aggravation is related to administrative controls on foreign exchange and imports. First, foreign exchange controls prevented replacement of the negotiated transactions of foreign exchange with the bank intermediation. This hampered government interventions in the market. Second, import controls repressed imports, aggravating excess supply of foreign exchange. Relaxation of administrative controls is necessary for moderating currency appreciation.

Towards description and optimization of abstract machines in an extension of prolog

Competitive abstract machines for Prolog are usually large, intricate, and incorpórate sophisticated optimizations. This makes them difñcult to code, optimize, and, especially, maintain and extend. This is partly due to the fact that efñciency considerations make it necessary to use low-level languages in their implementation. Writing the abstract machine (and ancillary code) in a higher-level language can help harness this inherent complexity. In this paper we show how the semantics of basic components of an efficient virtual machine for Prolog can be described using (a variant of) Prolog which retains much of its semantics. These descriptions are then compiled to C and assembled to build a complete bytecode emulator. Thanks to the high level of the language used and its closeness to Prolog the abstract machine descriptions can be manipulated using standard Prolog compilation and optimization techniques with relative ease. We also show how, by applying program transformations selectively, we obtain abstract machine implementations whose performance can match and even exceed that of highly-tuned, hand-crafted emulators.

Ontology driven description and engineering of autonomous systems: application to process system engineering

Autonomous systems refer to systems capable of operating in a real world environment without any form of external control for extended periods of time. Autonomy is a desired goal for every system as it improves its performance, safety and profit. Ontologies are a way to conceptualize the knowledge of a specific domain. In this paper an ontology for the description of autonomous systems as well as for its development (engineering) is presented and applied to a process. This ontology is intended to be applied and used to generate final applications following a model driven methodology.

The living plant; a description and interpretation of its functions and structure, by William F. Ganong.

1913

Ethics and access to teaching materials in the medical library: the case of the Pernkopf atlas*

Conflicts can occur between the principle of freedom of information treasured by librarians and ethical standards of scientific research involving the propriety of using data derived from immoral or dishonorable experimentation. A prime example of this conflict was brought to the attention of the medical and library communities in 1995 when articles claiming that the subjects of the illustrations in the classic anatomy atlas, Eduard Pernkopf's Topographische Anatomie des Menschen, were victims of the Nazi holocaust. While few have disputed the accuracy, artistic, or educational value of the Pernkopf atlas, some have argued that the use of such subjects violates standards of medical ethics involving inhuman and degrading treatment of subjects or disrespect of a human corpse. Efforts were made to remove the book from medical libraries. In this article, the history of the Pernkopf atlas and the controversy surrounding it are reviewed. The results of a survey of academic medical libraries concerning their treatment of the Pernkopf atlas are reported, and the ethical implications of these issues as they affect the responsibilities of librarians is discussed.

Extended theory about the allocation of time: Description and application to the increase in the retirement age policies

This paper revises mainstream economic models which include time use in an explicit and endogenous manner, suggesting a extended theory which escape from the main problem existing in the literature. In order to do it, we start by presenting in section 2 the mainstream time use models in economics, showing their main features. Once this is done, we introduce the reader in the main problems this kind of well established models imply, within section 3, being the most highlighted the problem of joint production. Subsequently, we propose an extended theory which solves the problem of joint production; this is extensively described in section 4. Last, but not least, we apply this model to offer a time use analysis of the effect of a policy which increases the retirement age in a life-cycle perspective for a representative individual.

Digitization for Preservation and Access: Restoring the Usefulness of the Nitrate Negative Collections at the American Geographical Society Library

Film-based photographic collections of nitrate negatives pose major challenges to preservation and access because of unstable media and the lack of item-level indexing. Digitization offers an opportunity to capture the content of deteriorating negatives, to extend access to them, and to restore their usefulness as information resources. Digitization as a preservation strategy has been the subject of ongoing debate. This article contributes to the discussion by exploring access to and the preservation of film-based photographic collections and by presenting the digiti- zation project at the American Geographical Society Library as a case study. The project, Saving and Sharing the AGS Library’s Historic Nitrate Negative Images, was undertaken from 2010 to 2012 to preserve and provide access to over 69,000 nitrate negatives from its historic collections.

Sustainability in the Upper Colorado River Basin: A Struggle Between Water Resource Use and Remnants of the Natural Ecosystem

This study evaluated whether development of the Colorado River system has exceeded sustainability by comparing the trends in water use in the Colorado River. Two sustainable areas were identified in the upper basin and one in the lower-- the mainstream Colorado River, Green and Yampa rivers, and the Little Colorado River. These areas are also high priority recovery areas for four endangered fishes and protected by critical habitat provisions of the ESA. Unfortunately, the endangered fishes are declining because of habitat destruction and non-native species. If increasing water demand causes the fishes to go extinct the few sustainable areas will be lost. It will take careful management of the endangered fishes and water users to ensure these areas are maintained.