Elderly immigrants and the saga of welfare reform

In 1996 Congress enacted legislation which, among other things, substantially cut off Supplemental Security Income payments and food stamps for present and future legal alien residents of the United States, and made it much harder for them to qualify for Medicaid. For low-income elderly immigrants, who constituted more than two-thirds of aliens on SSI, the adverse and potential impacts were substantial in terms of economic hardship and access to health care. In the months that followed, their plight received significant attention from the media and state and local politicians who now had greater economic and social responsibilities thrust upon them. One year later, Congress restored SSI benefits only for aliens who been receiving them before August 22, 1996 and made it easier for them to qualify for Medicaid. Food stamp benefits, however, were not restored. The limited scope of this restoration of benefits means that many of today's older immigrants, as well as those in the future, will be faced with serious problems in meeting their basic income and health care needs.     

Challenges of and strategies for changing prescribing practices of health care providers

Problems related to inappropriate prescribing practices of physicians in general are well recognized. Dietary fluoride supplements have been implicated as one of the contributing factors in an increase in dental fluorosis. Inappropriate prescribing practices of providers have been cited as a major factor in this implication. Numerous studies of physicians and dentists have documented a lack of knowledge and inappropriate prescribing practices regarding fluoride supplements. The purpose of this paper is to identify barriers to changing fluoride-prescribing practices of health care providers and to suggest strategies for implementing change. To increase optimal and appropriate use of fluoride supplements, educational interventions are necessary for all user groups--detail men and women, physicians, dentists, pharmacists, nurse practitioners, dental hygienists, and the public. In addition, environmental supports for the educational activities in the form of policy, regulation, standards of care, and guidelines are recommended for consideration.     

延迟焦化装置综合优化控制策略的开发和应用

综合采用延迟焦化优化系统静态寻优值作为炉出口温度的设定基准值,在线实行急冷油程序控制和炉出口温度程序控制,开发了延迟焦化装置物料平衡的综合优化控制策略。并成功地应用在工业装置上。     

Policy tools for building health education and preventive counseling into managed care

CONTENT: Six policy tools for building health education and preventive counseling into managed care are presented, and the opportunities and barriers to implementing each are described based largely on managed care plans operating in California in 1998. The six policy tools include (1) covering health education and preventive counseling as defined benefits, (2) increasing access to and use of health promotion programs, (3) incorporating health education into disease-management programs, (4) defining quality performance measures for health education and preventive counseling, (5) defining performance targets and guarantees for health education and preventive counseling to hold health plans accountable for providing these services, and (6) building collaboration between public health agencies and managed care on public health education and health promotion. For each of these, the policy option is described, examples of current practice are provided, and the problems and limitations associated with each are discussed.     

More than just a health issue: a review of current issues in the care of enterally-fed children living in the community

There are increasing numbers of children with a disability living in the community who require enteral tube feeds to optimize their nutritional status. Whilst there appears to be evidence of health gains, for some children there may also be serious and unintended social deprivations resulting from the need to be tube fed. This paper reviews the literature on support for children who are tube fed and makes a case for more coordinated and effective support services for families who are tube feeding a child at home. It is argued that national guidance should be developed which clarifies the position of all non-parent carers and staff who are willing to administer enteral tube feeds. Such guidance should also ensure that enterally-fed children have the same rights to educational and social services as other children and that families are given the opportunity to make informed decisions about the implications of enteral feeding prior to it being established.     

Improvements in retention rates and changes in client group with methadone maintenance streaming

This study evaluated changes in client population and in retention rates following the introduction of a system of methadone maintenance streaming. A low intervention and low supervision stream was combined with two abstinence-orientated streams. Privileges of take-home doses and local pharmacy dose collection were contingent on successful participation in the abstinence-orientated streams. The clinic also modified policy to allow clients greater control over dose levels. The case notes of the first 100 clients entering the programme in the year prior to the changes (1991) and in the year following the changes (1993) were compared. The results showed a significant increase in retention rates. The demographic and heroin using histories did not change, but the newer programme attracted a greater proportion of clients with no previous history of methadone maintenance treatment. Mean clinic dose increased from 45 mg to 63 mg when clients were allowed to exert control over dose. These findings reveal improved outcomes in a public methadone maintenance programme as a result of policy changes designed to give clients greater control of their treatment.     

Restrictions on tobacco and alcohol use in Australian work-places

In a telephone survey of 455 of the top 600 companies in Australia, around three-quarters reported the existence of restrictions on both smoking and alcohol in the workplace. Forty-six percent of companies had a total ban on smoking at work, 31% had designated limited areas where employees were permitted to smoke, and 23% had no policy on smoking. Seventy-seven percent of companies encouraged a total alcohol-free work environment. The larger the company, the more likely it was to have restrictions on smoking in the work-place, but there was no relationship between the size of the company and alcohol restrictions. Government organizations were more likely to have restrictions on smoking than nongovernment organizations, but this difference was not apparent for alcohol restrictions. The major reasons given for smoking restrictions were related to health and comfort, while those for alcohol were related to work productivity and safety.     

医疗机构药品管理现状

本文对医疗机构、计划生育技术服务机构使用药品的现状与存在问题进行了分析，提出了管理对策，建议实行使用药品法律许可制度。     

特区经济学的理论前提

实行特殊政策和实施特殊管理体制是世界经济特区共有的基本特征。正是这两个基本特征构成了特区经济学的两个理论前提。对经济特区实行特殊政策和实施特殊管理体制进行理论分析 ,目的在于为构筑特区经济学的理论体系作理论上的准备