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Articles 35131 - 35160 of 38783

Full-Text Articles in Social and Behavioral Sciences

"Are You Beginning To See A Pattern Here?" Family And Medical Discourses Shape The Story Of Black Infant Mortality, Elaine R. Cleeton Mar 2003

"Are You Beginning To See A Pattern Here?" Family And Medical Discourses Shape The Story Of Black Infant Mortality, Elaine R. Cleeton

The Journal of Sociology & Social Welfare

Postmodern and poststructuralist theorizations of the interrelations of the particular and the universal have identified women's bodies to be the last frontier for scientific discovery leading to and satisfying the modern compulsion to stabilize and control life from birth to death. This institutional ethnography of one city's response to an elevated infant mortality rate among the babies of African American urban, impoverished women explores their discursive transformation from single mothers who cannot begin prenatal care before the second trimester because too few physicians will treat Medicaid patients, into sexually-immoral, illegaldrug- using women who deliberately harm their babies. The study locates …


A Case Study Of Sodium Reduction In Breakfast Cereals And The Impact Of The Pick The Tick Food Information Program In Australia, P. G. Williams, A. Mcmahon, R. Boustead Mar 2003

A Case Study Of Sodium Reduction In Breakfast Cereals And The Impact Of The Pick The Tick Food Information Program In Australia, P. G. Williams, A. Mcmahon, R. Boustead

Faculty of Health and Behavioural Sciences - Papers (Archive)

In 1997 one of Australia’s largest food companies undertook a program of salt reduction in 12 breakfast cereals. The National Heart Foundation’s Pick the Tick program criterion (<400mg>sodium/100g) was used as a target value where possible. Twelve products were reformulated, with reductions ranging from 85-469mg sodium per 100g and an average reduction of 40% (12-88%). As a result, 235 tonnes of salt were removed annually from the Australian food supply and five more products were able to carry the Tick logo. The impact of the Pick the Tick program in changing the food supply extends beyond those products that …


Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman Mar 2003

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Sociology & Criminology Faculty Publications

OBJECTIVE:

To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).

METHODS:

Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

RESULTS:

Hand hygiene practices, knowledge, and opinions did not change after …


A Child's Death: Lessons From Health Care Providers' Texts, Nancy M. Bell, Marie L. Campbell Mar 2003

A Child's Death: Lessons From Health Care Providers' Texts, Nancy M. Bell, Marie L. Campbell

The Journal of Sociology & Social Welfare

This article originates from a research study that explores 'what happened' to a 10-year-old child with Rett syndrome, who died from "severe malnutrition" according to a Coroners Service inquest jury. The inquest evidence analyzed, using institutional ethnography, shows that approximately one week prior to this child's death three health care providers (an emergency physician, a hospice volunteer and a home care nurse) conducted individual assessments of the child. Child protection workers were also involved. Textual analysis of the health care providers' records shows how the child was officially and textually constructed as 'dying from a terminal illness' in contrast to …


A Comparative History Of Aids In Latin America: Brazil And Cuba, Shawn Smallman Mar 2003

A Comparative History Of Aids In Latin America: Brazil And Cuba, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

According to a joint report of the World Health Organization and the Pan American Health Organization in September 2002 there were approximately 1.4 million HIV+ people in Latin America, and a further 420,000 HIV+ people in the Caribbean. The number of infections had increased by nearly 10% from the previous year in Latin America, and 16% in the Caribbean. While striking, these figures may obscure the diversity of the HIV epidemic in the region. Latin America has a varied pattern of infections, which means that the experience of Bolivia, Ecuador and Mexico is quite different from that of Honduras, Haiti …


Do Eating Disorders Co-Occur With Personality Disorders? Comparison Groups Matter., Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Robert L. Stout, M. Tracie Shea, Mary C. Zanarini, Donna S. Bender, Leslie C. Morey, Ingrid R. Dyck, Thomas H. Mcglashan Feb 2003

Do Eating Disorders Co-Occur With Personality Disorders? Comparison Groups Matter., Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Robert L. Stout, M. Tracie Shea, Mary C. Zanarini, Donna S. Bender, Leslie C. Morey, Ingrid R. Dyck, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To assess and compare lifetime rates of occurrence of eating disorders (ED) with four Axis II personality disorders (PD) and with major depressive disorder (MDD) without PD. The eating disorders met criteria outlined in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

METHOD: Six hundred sixty-eight patients recruited for the Collaborative Longitudinal Personality Disorders Study (CLPS) were reliably assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders and the Diagnostic Interview for DSM-IV Personality Disorders. The distribution of ED diagnoses was compared among four PD study groups (schizotypal, borderline, avoidant, obsessive-compulsive) and …


Reasonable Modification Or Fundamental Alteration? Recent Developments In Ada Caselaw And Implications For Behavioral Health Policy, Sara J. Rosenbaum, Joel B. Teitelbaum, D. Richard Mauery, Alexandra M. Stewart Feb 2003

Reasonable Modification Or Fundamental Alteration? Recent Developments In Ada Caselaw And Implications For Behavioral Health Policy, Sara J. Rosenbaum, Joel B. Teitelbaum, D. Richard Mauery, Alexandra M. Stewart

Center for Integrated Behavioral Health Policy

No abstract provided.


Enterobius Vermicularis: Ancient Dna From North And South American Human Coprolites, Alena M. Iñiguez, Karl J. Reinhard, Adauto Araújo, Luiz F. Ferreira, Ana Carolina P. Vicente Feb 2003

Enterobius Vermicularis: Ancient Dna From North And South American Human Coprolites, Alena M. Iñiguez, Karl J. Reinhard, Adauto Araújo, Luiz F. Ferreira, Ana Carolina P. Vicente

School of Natural Resources: Faculty Publications

A molecular paleoparasitological diagnostic approach was developed for Enterobius vermicularis. Ancient DNA was extracted from 27 coprolites from archaeological sites in Chile and USA. Enzymatic amplification of human mtDNA sequences confirmed the human origin. We designed primers specific to the E. vermicularis 5S ribosomal RNA spacer region and they allowed reproducible polymerase chain reaction identification of ancient material. We suggested that the paleoparasitological microscopic identification could accompany molecular diagnosis, which also opens the possibility of sequence analysis to understand parasite-host evolution.


Antifibrinolytic Therapy And Perioperative Blood Loss In Cancer Patients Undergoing Major Orthopedic Surgery, David Amar, Florence M. Grant, Hao Zhang, Patrick J. Boland, Denis H. Y. Leung, John A. Healey Feb 2003

Antifibrinolytic Therapy And Perioperative Blood Loss In Cancer Patients Undergoing Major Orthopedic Surgery, David Amar, Florence M. Grant, Hao Zhang, Patrick J. Boland, Denis H. Y. Leung, John A. Healey

Research Collection School Of Economics

Background: Aprotinin has been reported to reduce blood loss and transfusion requirements in patients having major orthopedic operations. Data on whether epsilon amino-caproic acid (EACA) is effective in this population are sparse.

Methods: Sixty-nine adults with malignancy scheduled for either pelvic, extremity or spine surgery during general anesthesia entered this randomized, double-blind, placebo-controlled trial, and received either intravenous aprotinin (n = 23), bolus of 2 x 10(6) kallikrein inactivator units (KIU), followed by an infusion of 5 x 10(5) KIU/h, or EACA (n = 22), bolus of 150 mg/kg, followed by a 15 mg/kg/h infusion or saline placebo (n = …


Representations Of Therapists By Patients With Personality Disorders, Donna S. Bender, Barry A. Farber, Charles A. Sanislow, Ingrid R. Dyck, Jesse D. Geller, Andrew E. Skodol Jan 2003

Representations Of Therapists By Patients With Personality Disorders, Donna S. Bender, Barry A. Farber, Charles A. Sanislow, Ingrid R. Dyck, Jesse D. Geller, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

The purpose of this study was to investigate attributes of mental representations of therapists by patients with specific personality disorders (PDs), schizotypal (STPD), borderline (BPD), avoidant (AVPD), and obsessive-compulsive (OCPD), and a comparison group with Major Depressive Disorder and no PD (MDD). The Therapist Representation Inventory-II (TRI) measured characteristics of participants' extra-session thoughts about their therapists. Results showed that patients with STPD had the highest level of mental involvement with therapy outside the session, missing their therapists and wishing for friendship, while also feeling aggressive or negative. Patients with BPD exhibited the most difficulty in creating a benign image of …


Correlates Of Suicide Risk In Juvenile Detainees And Adolescent Inpatients, Charles A. Sanislow, Carlos M. Grilo, Dwain C. Fehon, Seth R. Axelrod, Thomas H. Mcglashan Jan 2003

Correlates Of Suicide Risk In Juvenile Detainees And Adolescent Inpatients, Charles A. Sanislow, Carlos M. Grilo, Dwain C. Fehon, Seth R. Axelrod, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To compare correlates of risk for suicidal behavior in juvenile detainees with those in another high-risk group, adolescent psychiatric inpatients.

METHOD: Eighty-one adolescents in a short-term juvenile detention center were contrasted with a matched group of 81 adolescent psychiatric inpatients on a clinical assessment battery of established instruments including a measure for risk of suicidal behavior.

RESULTS: Juvenile detainees and adolescent psychiatric inpatients reported similar levels of distress on measures of suicide risk, depression, impulsivity, and drug abuse. After controlling for depression, impulsivity and drug abuse remained significantly associated with suicide risk scores in the juvenile detention group, but …


The Effects Of State Dental Practice Laws Allowing Alternative Models Of Preventive Oral Health Care Delivery To Low-Income Children, Lea Nolan, Brian Kamoie, Jennel Harvey, Lissette Vaquerano, Sarah Blake, Satvinder Chawla, Jeffrey Levi, Sara J. Rosenbaum Jan 2003

The Effects Of State Dental Practice Laws Allowing Alternative Models Of Preventive Oral Health Care Delivery To Low-Income Children, Lea Nolan, Brian Kamoie, Jennel Harvey, Lissette Vaquerano, Sarah Blake, Satvinder Chawla, Jeffrey Levi, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

The purpose of this project was to examine state dental practice laws and the extent to which they encourage alternative models of delivering preventive oral health care. This project encompassed two distinct study components: 1) an analysis of existing state dental statutes and regulations; and 2) case studies to examine the enactment of public health-oriented provisions encouraging alternative models of delivering preventive oral health care to low-income children; and the development and implementation of such alternative models.


An International Comparison Of Breast Cancer Survival: Winnipeg, Manitoba And Des Moines, Iowa, Metropolitan Areas, Kevin M. Gorey Jan 2003

An International Comparison Of Breast Cancer Survival: Winnipeg, Manitoba And Des Moines, Iowa, Metropolitan Areas, Kevin M. Gorey

Social Work Publications

PURPOSE: Extending previous Canadian-United States cancer survival comparisons in large metropolitan areas, this study compares breast cancer survival in smaller metropolitan areas: Winnipeg, Manitoba and Des Moines, Iowa.

METHODS: Manitoba and Iowa cancer registries, respectively, provided a total of 2,383 and 1,545 women with breast cancer (1984 to 1992, followed until December 31, 1997). Socioeconomic data for each person's residence at the time of diagnosis was taken from population censuses.

RESULTS: Socioeconomic status and breast cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Des Moines, residents of the …


Parenting Adolescents, Sandra L. D'Angelo, Hatim A. Omar Jan 2003

Parenting Adolescents, Sandra L. D'Angelo, Hatim A. Omar

Pediatrics Faculty Publications

The period of adolescence is often thought to be one of intense stress and turmoil. Yet many parents and teens negotiate this developmental stage without extreme family conflict and without sacrificing close relationships. This review summarizes a portion of the literature on parent-adolescent relationships, focusing on monitoring and control of adolescent behavior and parenting style. Basic principles to emphasize when working with adolescents and parents are also included.


Personality Profiles Of Iditasport Ultra-Marathon Participants, Kristin J. Stuempfle, Sherri Lind Hughes, H. Samuel Case, Deborah S. Evans Jan 2003

Personality Profiles Of Iditasport Ultra-Marathon Participants, Kristin J. Stuempfle, Sherri Lind Hughes, H. Samuel Case, Deborah S. Evans

Health Sciences Faculty Publications

Each February, competitors convene in Big Lake, Alaska, to participate in the “Iditasport Human Powered Ultra-Marathon”. Who would attempt this challenging race? Personality might be one factor predicting participation. Iditasport represents a unique athletic event with a distinctive social and psychological climate that might be reflected in the personalities of the participants in many ways. This study was designed to identify the personality profile of Iditasport athletes when compared to normative populations and to explore differences between athletes competing in different race divisions.


Legal Movements In Intellectual Property: Trips, Unilateral Action, Bilateral Agreements, And Hiv/Aids, Margo A. Bagley Jan 2003

Legal Movements In Intellectual Property: Trips, Unilateral Action, Bilateral Agreements, And Hiv/Aids, Margo A. Bagley

Faculty Articles

This Article begins with an overview of the relationship between the Agreement on Trade-Related Aspects of Intellectual Property Rights (the "TRIPS Agreement") and the HIV/AIDS pandemic which created the need for the Doha Declaration. It then discusses two trade-related movements, unilateral action and TRIPS-plus bilateral agreements, that call into question the long-term effectiveness of the TRIPS Agreement process, generally, and the benefits of the Doha Declaration, in particular, in addressing multiple facets of the access to essential medicines problem. This Article concludes that a consideration of these issues should be included in the development of any further TRIPS-related solutions to …


Cross-Modal Enhancement Of Perceived Brightness: Sensory Interaction Versus Response Bias, Yoav Arieh, Lawrence E. Marks, Eric C. Odgaard Jan 2003

Cross-Modal Enhancement Of Perceived Brightness: Sensory Interaction Versus Response Bias, Yoav Arieh, Lawrence E. Marks, Eric C. Odgaard

Department of Psychology Faculty Scholarship and Creative Works

Stein, London, Wilkinson, and Price (1996) reported the presence of cross-modal enhancement of perceived visual intensity: Participants tended to rate weak lights as brighter when accompanied by a concurrent pulse of white noise than when presented alone. In the present study, two methods were used to determine whether the enhancement reflects an early-stage sensory process or a later-stage decisional process, such as a response bias. First, the enhancement was eliminated when the noise accompanied the light on only 25% versus 50% of the trials. Second, the enhancement was absent when tested with a paired-comparison method. These findings are consistent with …


Associations Between Perceived Family Meal Environment And Parent Intake Of Fruit,Vegetables, And Fat, Kerri N. Boutelle, Amanda Birnbaum, Leslie Lytle, David M. Murray, Mary T. Story Jan 2003

Associations Between Perceived Family Meal Environment And Parent Intake Of Fruit,Vegetables, And Fat, Kerri N. Boutelle, Amanda Birnbaum, Leslie Lytle, David M. Murray, Mary T. Story

Department of Public Health Scholarship and Creative Works

Objective

To describe the family mealtime environment and assess associations with adult fruit, vegetable, and fat intake.

Design

Telephone survey.

Participants

A convenience sample of 277 adults in the Minneapolis/St. Paul area were recruited through 4 schools. The sample was 85% female and 70% married. The mean number of children in the household was 2.6 (range 1 to 9).

Variables Measured

Adult fruit and vegetable intake, fat intake, and perceptions of the mealtime environment.

Analysis

Descriptive and mixed-model linear regression.

Results

Participants reported that the television was frequently on during dinner meals and almost one third felt that their family …


Information Interface - Volume 31, Issue 1 - January/February 2003, George Washington University, Himmelfarb Health Sciences Library Jan 2003

Information Interface - Volume 31, Issue 1 - January/February 2003, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on BioMed Central, Web of Science, understanding electronic holdings, and database search tips.


Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching Jan 2003

Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …


Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health Jan 2003

Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health

Reproductive Health

Many public, NGO, and private-sector service-delivery systems are suitably matched to the requirements of providing injectable contraceptives in India, including the ability to ensure choice and service delivery quality. This operations research study was designed to demonstrate the feasibility of providing injectable contraceptives in private medical practices and to contribute to the body of scientific literature on the acceptability of this method in India. DKT India and EngenderHealth formed a partnership with the Population Council’s Frontiers in Reproductive Health program to conduct this study in Gujarat. The ability to generate recommendations is limited, however, by the special characteristics of the …


Toxicology And New Social Ethics For Animals, Bernard E. Rollin Jan 2003

Toxicology And New Social Ethics For Animals, Bernard E. Rollin

Experimentation Collection

The issue of animal treatment has emerged as a major social concern over the past three decades. This ramified in a new ethic for animal treatment that goes beyond concern about cruelty and attempts to eliminate animal pain and suffering, whatever its source. This is evidenced by laws governing animal research in many countries. Insofar as toxicology can entail significant and prolonged animal suffering, it is at loggerheads with this new ethic. Ways are suggested for the toxicological community to put itself in harmony with the ethic and thereby preserve its autonomy.


Peer Rejection And Social Information-Processing Factors In The Development Of Aggressive Behavior Problems In Children, Reid G. Fontaine, Kenneth A. Dodge, Jennifer E. Lansford, Virginia Salzer Burks, John E. Bates, Gregory S. Pettit, Joseph M. Price Jan 2003

Peer Rejection And Social Information-Processing Factors In The Development Of Aggressive Behavior Problems In Children, Reid G. Fontaine, Kenneth A. Dodge, Jennifer E. Lansford, Virginia Salzer Burks, John E. Bates, Gregory S. Pettit, Joseph M. Price

Reid G. Fontaine

The relation between social rejection and growth in antisocial behavior was investigated. In Study 1,259 boys and girls (34% African American) were followed from Grades 1 to 3 (ages 6-8 years) to Grades 5 to 7 (ages 10-12 years). Early peer rejection predicted growth in aggression. In Study 2,585 boys and girls (16% African American) were followed from kindergarten to Grade 3 (ages 5-8 years), and findings were replicated. Furthermore, early aggression moderated the effect of rejection, such that rejection exacerbated antisocial development only among children initially disposed toward aggression. In Study 3, social information-processing patterns measured in Study 1 …


Practical Skills For Family Caregivers, Mary A. Corcoran Jan 2003

Practical Skills For Family Caregivers, Mary A. Corcoran

Mary A Corcoran

No abstract provided.


Controlling Emotions In Sport, Marc Jones Jan 2003

Controlling Emotions In Sport, Marc Jones

Marc Jones

Emotions play a central role in sport performance. Accordingly, it is important that athletes are able to draw on a range of strategies to enhance emotional control. The present paper outlines a number of strategies based on Lazarus’ cognitive-motivational-relational theory of emotion. Strategies are outlined that aim to change cognitions, resulting in either a more appropriate emotional response or a suppression of the expression of emotion and any maladaptive behavioral consequences. These techniques comprise self-statement modification, imagery, socratic dialogue, corrective experiences, self-analysis, didactic approach, storytelling metaphors and poetry, reframing, cognitive paradox, and use of problem-solving skills. Furthermore, given the changes …


The Press For Help Project Concept, Program And Working Paper Of Emmanuel Mario B Santos And His Marc Guerrero Communications Inc., Emmanuel Mario B. Santos Aka Marc Guerrero Jan 2003

The Press For Help Project Concept, Program And Working Paper Of Emmanuel Mario B Santos And His Marc Guerrero Communications Inc., Emmanuel Mario B. Santos Aka Marc Guerrero

Emmanuel Mario B Santos aka Marc Guerrero

FORETHOUGHT. DECLARATION OF IDEAOLOGY AND PRINCIPLES. VISION. MISSION. VALUES. GOALS. BASIC HELP project. EDUCATIONAL HELP project. MEDICAL HELP project. LEGAL HELP project. EMERGENCY HELP project. LIVELIHOOD HELP project. SPIRITUAL and CULTURAL HELP project. ENVIRONMENTAL HELP project. REENGINEERING HELP project. INTERNATIONAL HELP project. QUADRO CREDO Matthew 5.1-12, the Jerusalem Bible. The Universal Filipino Beatitudes. SALIN SA FILIPINO. DESIDERATA. AFTERTHOUGHT.


Inside Unlv, Richard Jensen, Donna Mcaleer, Jennifer Vaughan, Cate Weeks, Carol C. Harter, Jeffrey Koep Jan 2003

Inside Unlv, Richard Jensen, Donna Mcaleer, Jennifer Vaughan, Cate Weeks, Carol C. Harter, Jeffrey Koep

Inside UNLV

No abstract provided.


Update - January 2003, Loma Linda University Center For Christian Bioethics Jan 2003

Update - January 2003, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Editorial
-- Of One Piece of Cloth: A Journey Discovering Personal and Social Ethics
-- Seventh-day Adventist, Social Policy, and Social Ethics
-- A Dream, the Way, and the Self
-- Seventh-day Adventist Call for Peace
-- Photos from the Contributors Convention . . .


Current Trends In Athletic Training Education And Certification In Japan, Yuriko Ohashi Jan 2003

Current Trends In Athletic Training Education And Certification In Japan, Yuriko Ohashi

Theses, Dissertations and Capstones

Athletic trainer is a well-established profession in the U.S., but its definition is unclear in Japan because of no certification until recently. Japan Amateur Sports Association (JASA) has started in curriculum to prepare, educate and certify athletic trainers since 1994. This study researched the current trends in athletic training education and certification in Japan. It defines the historical and present athletic training situation, and clarifies education and certification with questionnaires. Questionnaires were sent to 43 sports medicine professors at JASA athletic trainer accredited and non-accredited program schools, and 26 (61%) responses were returned. The current problems include lack of clinical …


Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess Jan 2003

Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess

Theses, Dissertations and Capstones

Medicaid-funded long-term care services are traditionally delivered in nursing homes. States may apply for waivers which allow them to provide home and community based services with Medicaid funds. Because these services are by definition an alternative to nursing home care, waiver services are generally based upon a medical model which emphasizes medical deficits and tends to restrict consumers’ movements to inside the home. Recent developments such as the Olmstead Decision and federal New Freedom Initiatives have caused states to recognize that consumers desire and have a legal right to be part of a community rather than institutionalized or homebound. These …