bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of the Effect of a Hypertension Education Program Among Black and White Participants
Authors: Piane Ginamarie
Published: July 2012

Black Americans face a higher risk of hypertension than other Americans. Because of the differences in risk status and environmental or genetic factors that may contribute to hypertension, it is important to compare the effectiveness of hypertension intervention for blacks and for whites. While a diminished effect of intervention among blacks might be expected due to such factors as lower socioeconomic status, high stress, and salt-sensitivity, a comparison between black and white participants in a six-session hypertension education series showed no significant differences in outcome. Overall, the program was successful in improving knowledge gained regarding control of blood pressure; encouraging positive behavior changes; and in reducing by 68 percent the number of participants whose blood pressure was elevated by the end of the program. However, program attendance was less frequent in black communities than in white communities. Marketing strategies to attract more black participants, and adherence strategies to retain those who are recruited, are discussed.
Alcohol and Drug Abuse Treatment of Homeless Persons: Results from the NIAAA Community Demonstration Program
Authors: Orwin Robert G. , Goldman Howard H. , Sonnefeld L. Joseph , Ridgely M. Susan , Smith Nancy Gray , Garrison-Mogren Roberta , O'Neill Ellen , Sherman Anne
Published: July 2012

In a national evaluation, we assessed the implementation and outcomes of a multisite demonstration program for homeless persons with alcohol and other drug problems. We developed comprehensive case studies from data on client characteristics, utilization of services, implementation of interventions, and community systems of care at nine project sites. Client-level outcome data were analyzed to estimate the effectiveness of the interventions in a subset of projects with experimental or quasi-experimental evaluation designs. After controlling for baseline predictors, treatment clients in the majority of sites were significantly more likely than comparison clients to report improvement on one or more outcome dimensions. On alcohol use, for example, under conservative assumptions the average treatment client was drinking less at follow-up than were 57 percent of comparison clients. Analyses of predictor-by-treatment interactions suggested that clients with fewer problems benefited most from the interventions. The implementation analysis yielded a number of lessons for policymakers and program planners.
Economic Issues in Managed Care
Authors: Dobbins Ronald
Published: July 2012

Economic issues abound in managed care. The advent of health insurance in the United States, which was created to ensure payment to hospitals, diminished an early emphasis on charity care. Escalating health care costs have ensued. Today, economic considerations dictate the need to control health care expenditures while guaranteeing responsible care. Managed care organizations can achieve both goals by establishing financial partnerships with physicians while instituting quality-control audits, management review teams, and home-care arrangements.
Implications of Health-Care Reform Proposals for Black Americans
Authors: Leigh Wilhelmina A.
Published: July 2012

A recent increase in the number of black Americans who lack public or private health insurance means that current proposals to reform the U.S. health-care system have particular relevance for the black community. This paper reviews the major reform proposals offered by President Clinton and Congressional leaders with an eye toward estimating the possible impact on black Americans. The proposals offer concepts ranging from managed competition and "play or pay" to caps on health-insurance premiums, incentives for primary-care providers, "sin" taxes, and outcomes analysis. Though some of these concepts offer opportunities for improving black Americans' access to quality care, most have potential shortcomings that could worsen health status in the black community.
Violence in America: An Integrated Approach to Understanding and Prevention
Authors: Rosenberg Mark L.
Published: July 2012

Violence in our country has reached epidemic proportions, especially among our youth. Of 22 industrialized nations, the United States has the highest homicide rate among young males 15 to 24 years of age. To reduce the incidence of violence, we must radically shift our approach to emphasize prevention and intervention. There are several ways of achieving violence reduction through these means. The scientific approach requires the determination of causation and risk factors to shed light on the patterns of violence and the effects on subgroups of the population. Also required is the development of targeted programs aimed at specific high-risk populations. In the area of youth violence intervention, programs must focus on young children and their parents, often children themselves, to prompt appropriate changes in knowledge, skills, and attitudes. Community-based programs can go a step further to initiate changes in the social environment that will create opportunities for adequate housing, job training or employment, or academic achievement. These efforts exemplify the notion that violence is not a factor of race, but rather is based on socioeconomic factors, particularly poverty and racism.
Addressing Domestic Violence in the African American Community
Authors: Dennis Ruth E. , Key L. John , Kirk Alton L. , Smith Alice
Published: July 2012

This paper focuses on the problem of spouse abuse in the African American community and discusses intervention programs designed to reduce domestic violence. The problem of domestic violence is not new. However, there is increased concern about it, such that the criminal justice system has changed its policy toward this act. This policy considers domestic violence a crime, and arrest the most efficient way to prevent it. Further, providing counseling programs to men is one of the efforts some criminal justice departments are now using. The two programs discussed in this paper are programs used by the criminal justice system. They are designed to prevent repeated domestic violence by focusing on the education of conflict resolution to deal with anger, denial, and jealousy, and the development of interpersonal skills that assist in channeling anger and poor interpersonal communication into positive modes of conduct. Some characteristics of batterers are noted.
The Impact of Obesity on Hypertension Management in African Americans
Authors: Kumanyika Shiriki K.
Published: July 2012

Blood pressure is strongly related to body weight, and control of obesity is a critical component of hypertension prevention and control. Data from multicenter studies such as the Trials of Hypertension Prevention, the Trials of Antihypertensive Interventions and Management, and the Trial of Nonpharmacologic Interventions in the Elderly help to set aside previous questions about whether the association of obesity with hypertension applies to African Americans. Given the high prevalence of overweight among African Americans, especially women, the issue is not whether weight reduction should be a component of hypertension prevention and treatment but how to design and implement programs that will help overweight African American men and women achieve permanent weight loss. Modest weight losses can not only prevent or reverse blood pressure elevations but also have a favorable impact on obesity-related cardiovascular risk factors such as diabetes and hyperlipidemia.
Community Health Centers: Unrecognized Partners in Health Professions Education
Authors: Cooksey Judith A. , Kaur Kulvinder , Matters Michael D. , Simone Bridget , Chun Eunmee , Hoekstra Anna
Published: July 2012

Increasing demand for health professionals with training in ambulatory and primary care practice is placing stress on existing training site capacity. Community health centers can serve as model training sites, offering comprehensive multidisciplinary health care services and teaching clinician role models. In this study, 32 Illinois community and migrant health centers and federally qualified health centers were surveyed to assess their involvement with training in the past three years. Thirty centers had offered training to students from many disciplines, with nursing (27 centers) and medicine (24) the most frequent. Most centers had established formal relationships with training institutions but generally had limited involvement with course planning. Continued participation will likely require adequate funding, with some centers also seeking stronger institutional relationships and better integration of community health issues. Educators and policy makers may need to take a more active role in supporting centers, acquiring funds, and other enabling factors.
Comparing the Medical Expenses of Adults with Medicaid and Commercial Insurance in a Health Maintenance Organization
Authors: Ray G. Thomas , Lieu Tracy A.
Published: July 2012

The objective of this study was to compare the health care costs of adults with Medicaid aged 19 to 65 years ( n = 29,680) and adults in the same age range with commercial insurance ( n = 29,680) who were members of the same health maintenance organization between 1996 and 1998. After adjusting for age and sex, income-eligible Medicaid-insured adults were $35 (29 percent) per month more expensive than commercially insured adults. The medically needy/indigent (excluding "spenddown") were $61 (51 percent) per month more expensive than commercially insured adults, and the blind or disabled were $289 (240 percent) per month more expensive. When the analysis adjusted for health status as well as age and sex, however, income-eligible Medicaid adults were $12 ( p = 0.01) per month less costly than commercially insured adults. The costs of Medicaid-insured adults were substantially higher than those of commercially insured adults; these differences were likely due to higher rates of pregnancy and to worse health status among the Medicaid cohort.
Dietary Behavior in Relation to Socioeconomic Characteristics and Self-Perceived Health Status
Authors: Lu Ning , Samuels Michael E. , Huang Kuo-Cherh
Published: July 2012

The purposes of this study were to examine the relationship between dietary behavior and self-perceived health status and to demonstrate the relative significance of people's socioeconomic characteristics in relation to their dietary behavior. Data came from the 1994 Behavioral Risk Factor Surveillance System of South Carolina. Descriptive statistics were performed to provide a profile of the general characteristics of the sample. Multivariate linear regression modeling was used to examine the relative significance of socioeconomic status in relation to dietary behavior and the association between dietary behavior and self-perceived general, physical, and mental health status, controlling for other behavioral risk factors, such as smoking and sedentary lifestyle. Socioeconomically disadvantaged individuals with low income and low educational level were more likely to engage in poor dietary practice than were their counterparts. Dietary behavior was found strongly associated with self-perceived general and mental health status.
Research and Policy Directions in Violence: A Developmental Perspective
Authors: Tomes Henry
Published: July 2012

Violence and violence-related behaviors have become important research and policy considerations in the 1990s. Both private and public institutions have assembled considerable research associated with male violence directed against children, youth, women, and other males. Data currently available indicate that focusing on males as perpetrators is an appropriate direction for violence research. In this paper, suggestions are offered regarding a developmental-socialization hypothesis for further research in the area of male violence.
The Role Of Managed Care: The National and Tennessee Experiences
Authors: Cebrun Anthony J.
Published: July 2012

The United States is the only developed country with no national health care policy. What exists is a national health insurance system. The problem with this system arises when paying for health care for the poor, who often require the most expensive type of care for acute or episodic ailments. Managed care, though not a panacea, has the potential of providing the organization to effectively control costs and change the existing health care paradigm from one of fee-for-service inpatient care to one of ambulatory care, home-based care, and physician office-based procedures. An example of a state-based initiative that has cut medical costs is Tennessee's TennCare. Under TennCare, approximately 1.2 million Tennesseans are covered, nearly 400,000 of whom were previously uninsured. Such programs, both state and national, must now look to including prevention and wellness care to effectively change the underlying epidemiology of illness among the poor.
Diagnosis and Therapeutic Intervention in the Management of Coronary Artery Disease in African Americans
Authors: Potts James L.
Published: July 2012

Coronary artery disease (CAD) is the leading cause of death in African Americans, despite the lower prevalence of anatomic coronary atherosclerosis in this group. Risk factors for CAD in African Americans are considerable; however, the specific role of these risk factors in the excess mortality rates as compared with that of whites is not clarified. Factors such as differences in vascular pathobiology may be important in determining the cause of the excess mortality. The higher prevalence of normal coronary angiograms in African Americans with angina may be caused by pathobiology related to microvascular function and reserve. When access is available, the initial approach to diagnoses and management of coronary artery disease in African Americans is no different from that in other populations. Diagnostic approaches and therapeutic interventions are needed to identify the cause and modify the effects of the excess risks from coronary artery disease in African Americans.
Clinical Violence Intervention: Lessons from Battered Women
Authors: Flitcraft Anne H.
Published: July 2012

Attempts to address violence intervention and prevention in clinical practice are hampered by the difficulty of creating definitions and categories that accurately reflect community experience. Current medical and legal paradigms, for instance, do not integrate gendered experience into definitional understanding of domestic violence and, consequently, risk the development of systems of care that poorly address women's needs. A model of women's experience of domestic violence and key elements of clinical intervention are presented. Health and public health agencies need to actively integrate an understanding of gender relations in violence intervention and prevention.
Strategies for Enhancing Research and Research Training Programs for African Americans: Viewing Barriers as Opportunities
Authors: Curry Charles
Published: July 2012

Minorities have long been excluded from biomedical research programs, both as researchers and as study participants. One reason for the dearth of minority researchers is their lack of awareness that federal and private financial assistance programs exist on their behalf. To provide opportunities for minorities in biomedical research, minority institutions must be given expanded opportunities to participate in federally sponsored biomedical research programs. Thus both governmental and private agencies need to apprise minority research institutions of the kinds of assistance available and how to access funds. One means of disseminating such information would be to post it on the Internet. Minority institutions, for their part, must make basic research a priority and engage in mentorship programs that encourage minority precollege students to pursue careers in the sciences. Researchers can gain the trust of African Americans through outreach programs, which may lead to the greater inclusion of this population in clinical trials.
Exercise Participation in a Frail Elderly Population
Authors: Hickey Tom , Sharpe Patricia A. , Wolf Fredric M. , Robins Lynne S. , Wagner Marilyn B. , Harik Wafa
Published: July 2012

A low-intensity exercise demonstration project was developed jointly by researchers, social service practitioners, and program participants to actively involve frail older people in their own health maintenance. This article describes this collaborative process and its impact on the success of the health promotion program, which was conducted at three senior centers serving a low-income, urban elderly population. Participants were predominantly sedentary women over age 70 with multiple chronic conditions. The program was conducted with peer leaders to facilitate its continuation after the research demonstration phase. In addition to positive health outcomes related to functional mobility, blood pressure maintenance, and overall well-being, this intervention was successful in sustaining active participation in regular physical activity through the use of peer leaders selected by the program participants. The planning, implementation, and outcomes of this project illustrate the benefits and challenges of combining research and practice perspectives in conducting health promotion interventions with older populations.
Setting the Agenda for Research and Education on Coronary Heart Disease
Authors: Fulwood Robinson
Published: July 2012

Coronary heart disease (CHD) disproportionately affects the African American population with death and disability. The disparity in mortality continues to exist between the general population and African Americans despite decreases in death rates in both groups since the 1970s. The National Heart, Lung, and Blood Institute (NHLBI) is committed to developing and supporting research and activities that improve the health of African Americans through community partnership initiatives. One such initiative is the CHD in Blacks Project, developed to increase awareness of the adverse effects of CHD, encourage healthy lifestyle behaviors, and, among health professionals, ensure that the latest treatment guidelines from the NHLBI in high blood pressure, high blood cholesterol, and obesity are used. The NHLBI has also established a network of health professionals from across the country to assist in developing medical education programs and community education outreach activities in conjunction with the National Medical Association, the Association of Black Cardiologists, and the National Black Nurses Association.
Cardiovascular Risk Factor Screening and Intervention in African American Adults
Authors: Anderson J. Thomas , Watson Mary , Hilleman Daniel
Published: July 2012

The Cardiac Health and Rehabilitation program of St. Thomas Hospital in Nashville, Tennessee, has developed a project to assess the effectiveness of a community-based cardiovascular risk assessment and intervention program directed at African American adults. The specific aim of this program is to assess the feasibility of implementing a community-based cardiovascular disease risk factor reduction program directed at African American adults. Its ultimate goal is to be able to teach African American adults cost-efficient, simple methods of exercise, nutrition, and weight management; smoking cessation; and blood pressure control. The program is expected to raise the African American community's awareness of the importance of modifiable cardiovascular disease risk factors and their effect on cardiac morbidity and mortality. The program is also expected to be able to evaluate the success of cardiovascular disease risk factor intervention and patient satisfaction with the program.
Physical Activity and Smoking: Gender Comparisons Among Older African American Adults
Authors: Lockery Shirley A. , Stanford E. Percil
Published: July 2012

Little effort has been expended on the examination of systematic health risk behaviors among adult African Americans by gender. Using data from the national Health and Retirement Study (HRS), this article compares differences between male and female physical activity and smoking behaviors of African Americans aged 50 to 61. The analysis highlights a clear pattern of socioeconomic differences with current male smokers, who are more likely to be unmarried and in the lower income and educational levels. Among women, the relationship between smoking patterns, income, and education is less definitive and consistent. Our findings, confirmed by earlier studies, indicate that the largest percentage of the study population, both male and female, are not engaged in any form of regular physical exercise. Thus human service providers must be more attentive to gender and sociodemographic differences in smoking habits and patterns of physical activities to tailor policies and programs accordingly.
Utilizing Patient Satisfaction Surveys to Prepare for Medicaid Managed Care
Authors: Fields Tina Taylor , Gomez Paula S.
Published: July 2012

To prepare for Medicaid managed care, a community health center incorporated the business principle of continuous quality improvement, often used in the private sector to improve customer service, into its planning process. The initial endeavor was to create a patient satisfaction survey that was appropriate for the uniqueness of the community. The survey, taken monthly, resulted in both staff and patients making active improvements in the clinic environment. Staff showed more enthusiasm, and patients were more assertive in their attitudes toward the clinic. The empowerment of the patient to take ownership in the clinic will be coupled with the next step of the formalized plan, that of educating patients on the steps necessary to ensure that their Medicaid managed care facility will be the local community health center.
Research in Coronary Heart Disease in Blacks: Issues and Challenges
Authors: Francis Charles K.
Published: July 2012

Research on coronary heart disease (CHD) has contributed to the decline in cardiovascular disease morbidity and mortality during the past three decades. However, life expectancy and rates of illness and death from CHD have not improved for blacks as for whites. Blacks have not experienced the full benefit of research advancements for a variety of reasons, including insufficient scientific data, lack of research focused on minority populations, and limited access to health care resources and technology. In order to address these disparities in prevention, diagnosis, treatment, and outcomes of CHD in blacks, the National Heart Lung, and Blood Institute convened a Working Group on Research in Coronary Heart Disease in Blacks. In its deliberations, the working group identified 10 priority research areas, which are treatment, epidemiology (data collection and analysis), evaluation of chest pain and diagnosis of CHD, prevention and behavior, risk factors, genetics, vascular biology, left ventricular hypertrophy, coronary microvasculature, and sudden cardiac death.
Women's Receptivity to Church-Based Mobile Mammography
Authors: Derose Kathryn Pitkin , Duan Naihua , Fox Sarah A.
Published: July 2012

Mobile mammography can increase access to preventive screening and might be effective in church-based settings. Among 1,117 women ages 50 to 80 from 45 Los Angeles County churches, 31.7 percent said they would definitely use a mobile van at church, 21.9 percent would probably use one, 28.7 percent would probably not use one, and 17.6 percent would definitely not use one. The odds of saying yes to mobile mammography were six times higher for Spanish-speaking Latinas than for whites, over two times higher for English-speaking nonwhites than for whites, five times higher for the uninsured than for those with public or private health insurance, and three times higher for women who reported no mammogram in the previous 24 months than for women who reported a mammogram. Partnering with churches to provide mobile mammography offers the potential to increase screening adherence for traditionally underscreened women.
Determining Needs and Setting Priorities for HIV-Affected and HIV-Infected Persons: Northeast Ohio and San Diego
Authors: Loue Sana , Faust Marlene , O'Shea Daniel
Published: July 2012

The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1991 requires that communities receiving Title I funding engage in a needs assessment and priority process to guide the allocation of those funds to various services within the local community. This paper reports on the process and results of the needs assessments in northeast Ohio and San Diego County for 1996-1997 and 1998. Data from northeast Ohio's 1998 needs assessment indicated significant differences between whites and nonwhites in the utilization of HIV specialist care, HIV-related prescription medications such as antiretrovirals, and health insurance. A need for additional dental care, complementary therapies, housing, and assistance with utility payments was found in both geographic areas. Consumer participation in San Diego's health department-based needs assessment process was more extensive than in northeast Ohio's academic-based approach but was also related to increased community-borne expense.
Predicting Health Services Utilization Among Homeless Adults: A Prospective Analysis
Authors: Stein Judith A. , Andersen Ronald M. , Koegel Paul , Gelberg Lillian
Published: July 2012

This study expands on the Andersen-Newman health services utilization (HSU) model. In a community-based homeless sample (n = 363) baseline predisposing, enabling, and needs-based variables predicted hospitalization and ambulatory outpatient service utilization within 1 year after baseline. Standard predisposing and enabling variables were supplemented with latent constructs representing substance use, mental illness, poor housing status, social support, community support, and barriers to health care. Need is represented by baseline health status. Poor physical health, more barriers, drug use, African American ethnicity, less community support, and less education predicted hospitalization, the least desirable form of HSU. Poor health, female gender, a regular source of care, community support, drug use, and fewer alcohol problems predicted an office visit. Because outpatient visits for acute conditions provide an opportunity for generally neglected preventive services and health screenings, this study suggests convenient multiservice health-related programs for the homeless that include drug and alcohol treatment.
HIV Risk Among a Sample of Mexican and Puerto Rican Men and Women
Authors: Loue Sana , Cooper Marlene , Fiedler Jay
Published: July 2012

HIV/AIDS has disproportionately affected the Hispanic communities in the United States. Consequently, Hispanic communities at risk for HIV infection should be considered a high priority for prevention and education efforts. Although such efforts ideally consider variations across subpopulations, including differences in high-risk behaviors and routes of transmission by national origin, gender, and acculturation levels, relatively few studies of risk behavior have considered such differences. This paper reports on an interview-based study of HIV knowledge, risk behavior, and protective behaviors among a sample of 143 men and women of Mexican ethnicity in San Diego County, California and 189 men and women of Puerto Rican ethnicity in Cuyahoga County, Ohio. The authors' findings indicate that individuals who have been in the United States for longer periods of time and who are younger in age are at increased risk of HIV infection. Increased perceived risk may also be predictive of increased actual risk.
Legal Protections to Ensure Linguistically Appropriate Health Care
Authors: Perkins Jane , Vera Yolanda
Published: July 2012

Nearly 32 million people in the United States, 13.8 percent of the population, speak a language other than English at home, and our health care delivery system is hard-pressed to handle this diversity. Most pressing is the need for adequate translation services. Many U.S. hospitals rely on untrained employees or advise patients to bring friends or family members with them to translate. Thus, interpreter and translation needs often go unmet or are handled inappropriately. A number of federal and state laws impose legal obligations on health care providers to offer at least minimally adequate translation services for limited English-proficient patients. This article outlines the scope of these legal requirements and discusses the need to ensure linguistically appropriate care in the emerging managed care delivery system.
Barriers to Enrollment and Successful Outreach Strategies in CHIP: Reflections on the Arizona Experience
Authors: Mathieson Kathleen M. , Kronenfeld Jennie Jacobs
Published: July 2012

This paper presents a case study of the efforts by one state (Arizona) to increase Children's Health Insurance Program enrollment through outreach projects funded by private foundations. Barriers to enrollment include the organization of the Children's Health Insurance Program and perceptions of parents. The most successful outreach either involves intensive personal contact or is connected with a health care provider agency. The paper concludes by discussing how the barriers and successful outreach strategies in Arizona can be generalized to other states and can inform Children's Health Insurance Program outreach broadly.
The Public's Health, Its National Identity, and the Continuing Dilemma of Minority Status
Authors: Murray-García Jann
Published: July 2012

Racial and ethnic disparities in health status are persistent phenomena well described in the arena of public health. Such disparities are perhaps best understood in their full social, political, and historical context. While recognizing the rich literature on social determinants of health, this paper provides a specific discussion of the status of "the minority" in the United States. The dynamic nature of the American identity is first presented, along with implications for differential health status. Next discussed are emerging paradigms in research and intervention that incorporate the dynamic nature of the American identity as both an explanation and an opportunity for remedy of health status disparities. Finally, a critical leadership role for the public health profession is proposed as urgently needed and as yet incompletely embraced.
Maternal Drug Use and the Timing of Prenatal Care
Authors: Brady Thomas M. , Visscher Wendy , Feder Moshe , Burns Allison M.
Published: July 2012

This paper explores the role of maternal drug use and the timing of prenatal care. The study data were collected from women delivering live births at eight participating hospitals in the Washington, D.C., Metropolitan Area Drug Study. An estimated 16.9 percent of the women in this sample initiated prenatal care in their third trimester or received no prenatal care. After adjusting for age, race/ethnicity, education, parity, and attitude toward pregnancy, cocaine use was strongly associated with the timing of prenatal care. Using multivariable ordinal logistic regression, the data suggest significant barriers to prenatal care for substance abusers, especially cocaine users. Increasing access to prenatal care continues to be an important public health policy objective, particularly in urban areas where substance abuse is prevalent. Health services research must test strategies that address the timing of prenatal care among drug-dependent, urban women.
The Pervading Role of Language on Health
Authors: Torres Roberto E.
Published: July 2012

The purpose of this paper is twofold: (1) to highlight the complex and multidimensional nature of the language barrier problem relative to the health status of U.S. ethnic groups and to health care delivery in the United States and (2) to identify the challenges faced by the U.S. health care system to overcome these obstacles as we enter the 21st century. The paper illustrates the multiple facets of this public health issue by examining current literature focusing on how ethnic groups such as Latino, Asian Pacific Islander, and Arab Americans are affected by these impediments. To overcome these barriers, managed care initiatives developed by provider networks and health plans will have to become more responsive to these impediments and invest financial resources if health care access problems are to be prevented.
Postadmission Disparities in Nursing Home Stays of Whites and Minority Elderly
Authors: Pourat Nadereh , Andersen Ronald , Wallace Steven
Published: July 2012

This study examined the type of nursing home stay of white and minority elderly and investigated whether minority differences in nursing home admissions were extended to the type of stay, and if so, what accounted for those differences. African American/white and Latino/ white elderly were compared with respect to stays of (1) longer than three months, (2) shorter than three months and discharged alive (recovery), and (3) shorter than three months and deceased (terminal). African American elderly in nursing homes were significantly less likely to have recovery stays than were white elderly. Multivariate analysis revealed that this difference was due to Medicaid coverage. Overall, elderly with Medicaid coverage were more likely to make long-term stays in nursing homes. The findings highlight the importance of Medicaid coverage for short-term recovery nursing home stays. Reductions of benefits or restrictions in eligibility would negatively and disproportionately affect the nursing home stays of elderly African Americans.
Impact of a Personal Response System on Hospital Use by Low-Income African American and White Elders
Authors: McGadney-Douglass Brenda F.
Published: July 2012

In 1994, the American Red Cross initiated a subsidized personal response system program for low-income elders in the Detroit area to help these elders maintain their independence at home. Data were collected on 379 low-income, at-risk elderly clients from Detroit and surrounding Wayne County, Michigan. More than 80 percent of the sample were African American ( n = 313), and the remainder were white ( n = 66) elders. Statistically significant changes in number of emergency room visits only occurred among white subscribers, increasing on average by 1.4 annual visits. One year after the installation of the personal response system, white users were twice as likely as the African Americans to make an emergency room visit or to stay overnight in the hospital. Subsidized personal response system may be an appropriate third-party government-supported secondary intervention for home-based low-income and at-risk elders to prevent premature emergency room use, hospitalizations, and institutional placements.
Depressive Symptoms in Rural West Virginia: Labor Market and Health Services Correlates
Authors: Muntaner Carles , Barnett Elisabeth
Published: July 2012

The prevalence and socioeconomic correlates of depressive symptoms in rural West Virginia were assessed. A random-digit-dialed telephone interview was administered to a community-dwelling sample of adults, ages 18 to 64, residing in the 40 rural counties of the Appalachian State of West Virginia. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Overall rates of depressive symptoms were substantially higher than in the nation as a whole. Gender differences were lower than expected due to a high rate of depressive symptoms among men. Depressive symptoms were inversely associated with higher socioeconomic position. One-third of those who described themselves in "good mental health" reported depressive symptoms. About half who reported depressive symptoms had never seen a mental health professional or a physician for mental health problems. Efforts to increase awareness and access to mental health services are needed to promote the mental health of rural West Virginian populations.
Hispanic Versus White, Non-Hispanic Physician Medical Practices in Colorado
Authors: Fryer George E. , Green Larry A. , Vojir Carol P. , Krugman Richard D. , Miyoshi Thomas J. , Stine Curtis , Miller Marie E.
Published: July 2012

The purpose of the study was to extend the scope of earlier research on minority physicians attending to the needs of the poor and their own ethnicity by contrasting practice characteristics of Hispanic doctors in Colorado with those of their white, non-Hispanic counterparts. It was found that Hispanic physicians spent more hours per week in direct patient care, were more likely to have a primary care specialty, and were less often specialty board certified than white, non-Hispanic doctors. Hispanic generalists established practices in areas in which the percentages of the population that were (1) below poverty level, (2) Hispanic, (3) Hispanic and below poverty level, and (4) white, non-Hispanic, and below poverty level were greater than in areas in which white, non-Hispanic primary care physicians practiced. These findings argue for special provision to admit ethnic minorities to undergraduate and graduate medical education programs.
Un-Just War Against Terrorism and the Struggle to Appropriate Human Rights
Authors: Farer Tom
Published: July 2012

Although there are compelling reasons not to define the struggle against mega-terrorism as a "war," for purposes of moral evaluation of defensive measures, Just War standards provide an essential second line of defense for human rights norms as well as a counsel of strategic prudence. Taking the sum of its policies in the wake of 9/11 it is evident that the Bush administration has failed to satisfy those standards even as it continues the effort of the American Right, launched during the administration of Ronald Reagan, to appropriate human rights for their purposes.
The Lord's Resistance Army and Forced Conscription in Northern Uganda
Authors: Pham Phuong N. , Vinck Patrick , Stover Eric
Published: July 2012

On 13 October 2005, the International Criminal Court unsealed warrants of arrest for five senior leaders of the Lord's Resistance Army (LRA) for the forced conscription of children and other war crimes in northern Uganda. We compiled a database of 25,231 children and youth who had been registered by receptions centers in northern Uganda after their return from the LRA. Most of the LRA returnees were thirteen to eighteen years old (37 percent) and nineteen to thirty years old (24 percent). Twenty-four percent of the LRA returnees were female and 76 percent were male. The average length of abduction was 342 days, and the median number of days of abduction was ninety-two days. Among women aged nineteen to thirty years old, the average length of abduction was four and one half years. At the multivariate level, gender, age, and the interaction between them were associated with length of captivity (F-Statistic = 229.8, p-value = 0.0001). Using triangulation methods, we estimate the LRA abducted 54,000 to 75,000 people, including 25,000 to 38,000 children, into their ranks between 1986 and 2006.
ASEAN States, Their Reservations to Human Rights Treaties and the Proposed ASEAN Commission on Women and Children
Authors: Linton Suzannah
Published: July 2012

This article was inspired by claims made by a number of participants at the Fifth Workshop on an ASEAN Regional Mechanism on Human Rights in Kuala Lumpur (2006) that because all ASEAN states were party to the Convention on the Rights of the Child and the Convention on the Elimination of Discrimination against Women, they shared common legal obligations and so the path was clear for moving forward with the Hanoi Action Plan's Commission on Women and Children. At that time, it was not clear that ASEAN would go any further than this commission. This article is therefore an examination of the law on reservations, but one that has at its core an examination of ASEAN states' reservations to the six main human rights treaties in light of Vienna Convention on the Law of Treaties. Analysis is situated in the on-going debate about reservations to human rights treaties, as well as assessment of the significance and impact of the ASEAN reservations in themselves, in relation to other state parties, on the proposed Commission on Women and Children, and on international law generally. Since this article was written, ASEAN adopted a new Charter for the organization, which, in Article 14, allows for the creation of a human rights body, to operate in accordance with terms of reference yet to be decided by the Foreign Ministers of ASEAN. The Commission on Women and Children has yet to be established.
Standard Setting in Human Rights: Critique and Prognosis
Authors: Mutua Makau
Published: July 2012

This article interrogates the processes and politics of standard setting in human rights. It traces the history of the human rights project and critically explores how the norms of the human rights movement have been created. This article looks at how those norms are made, who makes them, and why. It focuses attention on the deficits of the international order, and how that order—which is defined by multiple asymmetries—determines the norms and the purposes they serve. It identifies areas for further norm development and concludes that norm-creating processes must be inclusive and participatory to garner legitimacy across various divides.
Cuba: Ideological Success or Ideological Failure?
Authors: Roberg Jeffrey L. , Kuttruff Alyson
Published: July 2012

Cuba is typically viewed from one of two conflicting perspectives: a deliverer of education, healthcare, and democracy, or a violator of human rights with no regard for its citizens. There is truth in both perspectives. The Castro regime is still largely guided by its socialist ideology, but a visit to Cuba reveals a country that no longer represents the egalitarian society promised. Cuba's use of neo-socialist and neo-capitalist policies is returning Cuba to a class-based society. While the regime has largely shattered the opposition through repression, its failures to meet its own legitimating ideology will eventually lead to regime change.
Unofficial Truth Projects
Authors: Bickford Louis
Published: July 2012

This article analyzes a category of truth-telling initiatives that emerge from civil society and resemble, either self-consciously or coincidentally, official truth commissions such as those in Chile, Peru, South Africa, and Timor-Leste. Like truth commissions, these Unofficial Truth Projects (UTPs) seek to elucidate, clarify, and acknowledge past human rights abuse or mass atrocity in order to contribute to democratic rule and peace for the long-term.
Democracy and Dirty Wars in Spain
Authors: Encarnación Omar Guillermo
Published: July 2012

This essay examines the rise of government-sponsored anti-terrorist death squads in Spain that accompanied the return to power of the Left since the interwar Second Republic. It locates the roots of this disturbing and puzzling development in the institutional culture of the military inherited from the Franco regime as shaped by its history of counter-terrorism policies. This argument challenges widespread assumptions about a clean break in authoritarian practices in Spain following the democratic transition of 1977. It also calls into question the claim that civilian supremacy over the military was established in Spain by the time democracy was deemed to have reached "consolidation" in 1982. The conclusion culls the lessons of the Spanish experience of battling terrorism with terror for the comparative study of democratization. It suggests that dirty wars intended to eradicate terrorist organizations can erode the legitimacy of a nascent democracy and, paradoxically, prolong the fight against terrorism.
Legal Systems and Constitutionalism in Sub-Saharan Africa: An Empirical Examination of Colonial Influences on Human Rights
Authors: Keith Linda Camp , Ogundele Ayo
Published: July 2012

This article examines the extent to which the British and French colonial legacies influence the human rights behavior of post-colonial African states. We have examined three areas where the literature suggests different colonial experiences for former British and French colonies: legal systems, formal provisions for judicial independence, and emergency powers. Our findings show very little support that different colonial legacies in those three areas affect the level of state abuse of personal integrity in sub-Saharan Africa. We find no solid evidence, for example, that common law system countries have better human rights behavior than civil code system countries. Nor is there any support for the propositions that former French colonies would have less constitutional provisions for judicial independence and checks against the executive during times of emergency than English colonies. Indeed, contrary to expectations, it is the French-legacy states that have stronger protections for emergency powers, perhaps suggesting recognition of the broad powers of the president in the bequeathed French political system and the need to curtail some of those powers. Likewise, we find little evidence that these elements affect their human rights behavior.
The Dance of Diversity: White Male Teachers and Arts Based Instruction for Classrooms
Authors: Dowdy Joanne Kilgour , Campbell Deborah
Published: July 2012

Reading and Writing for Adolescence and Adulthood is a course for teacher candidates that introduces them to arts-based literacy instruction. The purpose is to train teachers to enhance reading and writing skills in adolescents. The pre-service teachers were encouraged to study theory and perform practical exercises using the arts so that they could share their experience with their own high schools students. Evidence of their growth as teacher/leaders who understand and value the arts, regardless of the content area that they work in, is evident in their comments about arts-based literacy instruction. This study is a reminder that young teachers from all backgrounds represent a significant opportunity to change the course of literacy instruction so that more youth are successful in and outside of formal learning institutions.
Selecting a Phenomenalism: Leibniz, Berkeley, and the Science of Happiness
Authors: Carlin Laurence
Published: July 2012

While it is well known that Leibniz and Berkeley adopted versions of phenomenalism, it is less well known that both thinkers also believed that knowledge of phenomenal nature, via the mechanical philosophy, is a necessary condition for human happiness. Yet an examination of their respective accounts of happiness reveals weighty differences, and these differences are rooted in their respective phenomenalisms. The upshot is the somewhat surprising conclusion that adhering to a certain type of phenomenalism can place restrictions on one’s account of human happiness, for Berkeley could not, by the very logic of his phenomenalism, embrace Leibniz’s views on human happiness, nor could Leibniz embrace Berkeley’s. This is significant not only for understanding the systems of Leibniz and Berkeley, but it also illuminates any view that grounds the science of happiness in knowledge of a “material” world that is in some sense mind-dependent.
John Venn, James Ward, and the Chair of Mental Philosophy and Logic at the University of Cambridge
Authors: Wall Byron Emerson
Published: July 2012

In 1897, Cambridge University created a professorship in Mental Philosophy and Logic; despite the double name it was filled by a “mental philosopher,” James Ward, who did no work in logic. The chief logician candidate, John Venn, then turned his attention elsewhere, leaving Cambridge without senior leadership in logic. Ward himself turned to other philosophical issues, doing little further original work in mental philosophy. Cambridge became a center for a fresh interpretation of logic in the early 20th century, but with no help from Venn. Psychology split off from mental philosophy, and what remained, the “philosophy of mind,” was developed elsewhere until after Ward’s tenure.