Funding the utilization of community health workers in Texas

Community health workers (CHWs) are volunteers or paid members of communities that perform outreach, patient assistance, health education, and assist in navigation of healthcare system amongst other duties. The utilization of CHWs in hospital and community setting provides health benefits to their communities while reducing cost to the overall healthcare system. ^ The general population of Texas lacks adequate access to primary care. An important indicator of such a crisis is excessive usage of emergency department services in Texas, especially by the large minority population within the state. Also, unmanaged chronic diseases have been shown to be correlated with the excessive usage of emergency services. According to a recent survey of 25 Houston metropolitan area hospitals, almost 54% of the ER visits could have been resolved in primary care settings. A Galveston based study also indicated that the ER usage was higher amongst African-Americans and Latinos. Meanwhile, 28.5% of the total ER visits were made by Latinos from the surrounding areas (Begley et al., 2007). There is substantial evidence present which indicates enormous cost-savings that CHWs have produced in Texas and nationwide through reduction in unnecessary ER visits along with better management of chronic diseases (Fedder et al, 2003). ^ This paper provides an analysis regarding the need and importance for sustainable and stable sources of funding for Community health workers (CHWs) in Texas utilizing Kingdon's model of Agenda Setting as framework. The policy analysis is also aimed at reporting on the policy process and actions taken by Children at Risk to address this critical issue. Children at Risk, a Houston based advocacy organization, has created a legislative proposal that calls on the Texas Health and Human Commission to apply for a Medicaid §§1115 waiver to provide sustainable sources of funding for CHWs, Rep. John Zerwas sponsored HB 2244 bill and it was filed on March 3, 2011. The bill would affect the use of CHWs in Texas in two ways: 1) through the establishment and operation of a program designed to train and educate CHWs 2) by creating a statewide training and certification advisory committee. The advisory committee is required in the bill to submit recommendations for providing sustainable funding and employment for CHWs. The HB 2244 failed to move out of the House Public Health committee. However, HB2244 was amended into HB 2610 introduced by Representative Guillen. The House Bill 2610 is geared towards establishing a community-based navigator program in order to assist individuals applying for public assistance through the Internet. The House Bill 2610 was signed by the Governor and will be effective September 1, 2011.^

Economic evaluation of latent tuberculosis infection screening among health care workers in Houston

Since interferon-gamma release assays (IGRAs) were introduced in the 2000's, tuberculin skin testing (TST) and IGRAs have been used in various latent tuberculosis infection (LTBI) screening settings. IGRAs are laboratory-based tests and are considered not to be affected by previous Bacille de Calmette et Guérin (BCG) vaccination; however, they are more costly when compared directly with TST, which does not require specimen processing in a laboratory. This study aimed to examine TST and two types of IGRAs, QuantiFERON-TB Gold in Tube (QFT-GIT) and T-SPOT. TB (TSPOT), from an economic viewpoint. Firstly, a systematic literature review was conducted to identify cost related analyses of LTBI screening. Secondly, specific cost information detailing each test's items and labor was collected from an LTBI screening program of health care workers in Houston, and the cost of each test was computed. Thirdly, using the computed cost estimate of each test, cost-effectiveness analyses were conducted to compare TST and IGRAs.^ A literature search showed that a limited number of studies have been conducted, but the IGRA's economic advantages were common among studies. Cost analyses showed that IGRAs were much more costly than TST. The results were consistent with previous studies. In cost-effectiveness analyses, where test cost and consequential TB-related cost were considered, IGRAs showed variable advantages over TST depending on the targeted population. When only non BCG-vaccinated people were considered, TST was the least costly option among the three tests. On the other hand, when only BCG-vaccinated people were considered, IGRAs were less costly options. These results were mostly consistent even with varying assumption parameters.^ IGRAs can be more costly than TST, but their economic disadvantages are alleviated when the target population was BCG-vaccinated. Based on current knowledge, IGRAs may be recommended in a population where the BCG history is mixed. Additional studies are needed to better understand IGRA's reliability among low-incidence and low-risk populations in which background TB prevalence is low.^

Occupational health and safety among commercial sex workers in Ghana

The topic of occupational health and safety (OHS) has been investigated for many years and continues to be a concept often researched today. Generally speaking OHS research has been centered around food safety, construction safety, transportation safety, fire safety, drug and alcohol testing, health and medical management, and industrial hygiene to name a few. However, the concept of OHS concerning female commercial sex workers (FCSWs) has rarely been investigated, often neglected, seldom discussed and is lacking in sound research. Although regarded as the "oldest profession", commercial sex work (CSW) has consistently been ignored, disregarded and under-researched due to the illegality and stigmatization of prostitution. This paper reviews occupational safety and health issues faced by FCSWs in Tema and Accra, Ghana, through in-depth interviews, visits to women's homes, field work, informal conversations and participant observations with FCSWs over a period of two months. Facets of OHS that emerged among FCSWs included sexually transmissible infections, risks associated with harassment and violence from police and clients, alcohol and drug use, irregular hospital visits and/or lack of hospital visits, immigration issues, legal and policing risks. We argue that CSW be viewed as an occupation in great need of interventions to reduce workplace risks and improve the health and safety of FCSWs^

Ronald E. Heine, Origen. Scholarship in the service of the church, Oxford University Press, Oxford, 2010, pp. 275. ISBN 978-0-19-920907-1.

Fil: Peretó Rivas, Rubén.

Family diversity in social exclusion situations. Results and reflections on research, teaching and knowledge transfer activities

The purpose of this paper is to characterize the configurations of the families that live in contexts of social exclusion; provide conceptualizations of their operation mode; highlight the formative effects that neighborhood interdisciplinary practices with such families produce in the just graduated psychologists, included on the Extension Program. We wish to contribute to produce systematic knowledge that can account for such family configurations as potential receiver of integration policies. We are also interested on transferring the approach to diversity in the training of young professionals, in order not to be regarded as a deviation from ideal models, but as an expression of different strategies built by members of a community, to resolve children breeding and to bear their existences. This work is the result about reflections on productions inside a research fellowship: The complexities that takes the breeding in families who lives in a social exclusion situation; researches about breeding, carried out from signature Developmental Psychology II, and from de interdisciplinary work with psychologically assisted families in twelve suburbs of the city of La Plata (University Extension Program "Free Legal Offices" (Convention between Law and Social Sciences and Psychology Faculties, U.N.L.P.). From a qualitative methodology and an interdisciplinary participation, the results have arrive at the characterization and proposed conceptualizations of the included families and at the same time determine the benefits that brings with the work that articulates research and extension activities for the training of advanced students and young graduates.

Secret and power in social life

Secret and power constitute two fundamental instances of the social world. Secret takes care of the concealment of things and of social processes. Secret is also a power device. Power is the social capacity to do, create, not doing and stop from doing. Secret and power get mutual feedback. Power uses the secret to protect his potential, be it what may, to increment its operative strength. Secret uses the power to achieve its aims and proposals. Social sciences seem to ignore the huge explanatory capacity of these two interrelated concepts, and even more, their powerful intervention in societies.

Family diversity in social exclusion situations. Results and reflections on research, teaching and knowledge transfer activities

The purpose of this paper is to characterize the configurations of the families that live in contexts of social exclusion; provide conceptualizations of their operation mode; highlight the formative effects that neighborhood interdisciplinary practices with such families produce in the just graduated psychologists, included on the Extension Program. We wish to contribute to produce systematic knowledge that can account for such family configurations as potential receiver of integration policies. We are also interested on transferring the approach to diversity in the training of young professionals, in order not to be regarded as a deviation from ideal models, but as an expression of different strategies built by members of a community, to resolve children breeding and to bear their existences. This work is the result about reflections on productions inside a research fellowship: The complexities that takes the breeding in families who lives in a social exclusion situation; researches about breeding, carried out from signature Developmental Psychology II, and from de interdisciplinary work with psychologically assisted families in twelve suburbs of the city of La Plata (University Extension Program "Free Legal Offices" (Convention between Law and Social Sciences and Psychology Faculties, U.N.L.P.). From a qualitative methodology and an interdisciplinary participation, the results have arrive at the characterization and proposed conceptualizations of the included families and at the same time determine the benefits that brings with the work that articulates research and extension activities for the training of advanced students and young graduates.

Secret and power in social life

Secret and power constitute two fundamental instances of the social world. Secret takes care of the concealment of things and of social processes. Secret is also a power device. Power is the social capacity to do, create, not doing and stop from doing. Secret and power get mutual feedback. Power uses the secret to protect his potential, be it what may, to increment its operative strength. Secret uses the power to achieve its aims and proposals. Social sciences seem to ignore the huge explanatory capacity of these two interrelated concepts, and even more, their powerful intervention in societies.

Secret and power in social life

Secret and power constitute two fundamental instances of the social world. Secret takes care of the concealment of things and of social processes. Secret is also a power device. Power is the social capacity to do, create, not doing and stop from doing. Secret and power get mutual feedback. Power uses the secret to protect his potential, be it what may, to increment its operative strength. Secret uses the power to achieve its aims and proposals. Social sciences seem to ignore the huge explanatory capacity of these two interrelated concepts, and even more, their powerful intervention in societies.

Family diversity in social exclusion situations. Results and reflections on research, teaching and knowledge transfer activities

The purpose of this paper is to characterize the configurations of the families that live in contexts of social exclusion; provide conceptualizations of their operation mode; highlight the formative effects that neighborhood interdisciplinary practices with such families produce in the just graduated psychologists, included on the Extension Program. We wish to contribute to produce systematic knowledge that can account for such family configurations as potential receiver of integration policies. We are also interested on transferring the approach to diversity in the training of young professionals, in order not to be regarded as a deviation from ideal models, but as an expression of different strategies built by members of a community, to resolve children breeding and to bear their existences. This work is the result about reflections on productions inside a research fellowship: The complexities that takes the breeding in families who lives in a social exclusion situation; researches about breeding, carried out from signature Developmental Psychology II, and from de interdisciplinary work with psychologically assisted families in twelve suburbs of the city of La Plata (University Extension Program "Free Legal Offices" (Convention between Law and Social Sciences and Psychology Faculties, U.N.L.P.). From a qualitative methodology and an interdisciplinary participation, the results have arrive at the characterization and proposed conceptualizations of the included families and at the same time determine the benefits that brings with the work that articulates research and extension activities for the training of advanced students and young graduates.

Are Job Networks Localized in a Developing Economy? Search Methods for Displaced Workers in Thailand

Effects of localized personal networks on the choice of search methods are studied in this paper using evidence of displaced workers by establishment closure in Thailand Labor Force Survey, 2001. For the blocks/villages level, there is less significant evidence of local interactions between job-seekers and referrals in developing labor markets. The effects of localized personal networks do not play an important role in the probability of unemployed job-seekers seeking assistance from friends and relatives. Convincing evidence from the data supports the proposition that both self-selection of individual background-like professions and access to large markets determine the choice of job search method.

Identifying Topics in Social Media Posts using DBpedia

This paper describes a method for identifying topics in text published in social media, by applying topic recognition techniques that exploit DBpedia. We evaluate such method for social media in Spanish and we provide the results of the evaluation performed.

Automated attribute inference in complex service workflows based on sharing analysis

The properties of data and activities in business processes can be used to greatly facilítate several relevant tasks performed at design- and run-time, such as fragmentation, compliance checking, or top-down design. Business processes are often described using workflows. We present an approach for mechanically inferring business domain-specific attributes of workflow components (including data Ítems, activities, and elements of sub-workflows), taking as starting point known attributes of workflow inputs and the structure of the workflow. We achieve this by modeling these components as concepts and applying sharing analysis to a Horn clause-based representation of the workflow. The analysis is applicable to workflows featuring complex control and data dependencies, embedded control constructs, such as loops and branches, and embedded component services.

Leader Rural Development Program in Spain: Profile and Functions of Workers in Local Action Groups.

Occupations in the labor market are linked with to a minimum basic training and other capacities. Hired workers should be able to accomplish required functions related to their specific job. Regarding the rural development labor market, local action groups? workers have defined performance areas?projects, strategy, organization and training & market?but specific functions within each of these areas are not as clearly defined. Neither both, basic training and capacities needed to perform each job profile within the local action group are defined. This communication analyses training and other capacities linked to each of the job profiles within the local action group. Functions within each of the performance areas previously defined are also analyzed regarding the job profiles.

Integration of congestion pricing and intertemporal preference rate in social welfare function

Assessing social benefits in transport policy implementation has been studied by many researchers using theoretical or empirical measures. However, few of them measure social benefit using different discount rates including the inter-temporal preferences rate of users, the private investment discount rate and the inter-temporal preferences rate of the government. In general, the social discount rate used is the same for all social actors. Therefore, this paper aims to assess a new method by integrating different types of discount rate belonging to different social actors in order to measure the real benefits of each actor in the short, medium and long term. A dynamic simulation is provided by a strategic Land-Use and Transport Interaction (LUTI) model. The method is tested by optimizing a cordon toll scheme in Madrid considering socio- economic efficiency and environmental criteria. Based on the modified social welfare function (WF), the effects on the measure of social benefits are estimated and compared with the classical WF results as well. The results of this research could be a key issue to understanding the relationship between transport system policies and social actors' benefits distribution in a metropolitan context. The results show that the use of more suitable discount rates for each social actor had an effect on the selection and definition of optimal strategy of congestion pricing. The usefulness of the measure of congestion toll declines more quickly overtime.