Impact of a Case Management Program On Immigrants\u27 Health Status and Access to Care

In the United States (U.S.), immigrants are among the fastest growing populations of all communities. Today, they comprise approximately 11% of the total U.S. population. Forty-three percent of immigrants are without insurance. They are also associated with higher numbers of untreated medical conditions, fewer interactions with the health care system, and receiving health care through emergency departments (ER). The consequences of these practices include increases in health care costs, changes from preventive care to emergency treatment, delays in identifying illnesses until later, and higher disease prevalence. Case managers are frequently faced with immigrants\u27 concerns regarding access to care and prevention of illness in the community. They respond by implementing community programs. The process involves evaluating the effectiveness of the program. At the Immigration Outreach Service Center (IOSC), a study was completed to evaluate the effects of a case management program to a group of immigrants. Findings will help establish a program that improves immigrant\u27s health status, and increases access to health care services. During a three month period, a health clinic provided health education on disease prevention, access to health care services, and evaluated health services provided to meet immigrants\u27 needs. A systematic assessment and literature review of immigrants in the U.S. gathered information and identified the community\u27s health needs. Project sponsors, stakeholders, resources, funding sources, goals, objectives, mission, vision statements, and outcomes were identified. The logic model and The Public Health Nursing Practice Model served as a guide to accomplish the outcomes. To ensure patient\u27s protection, the IRB process was completed and approved. Data from 72 adult immigrants ages 18 and above were collected from visit records, self report scales, health history questionnaires, and surveys. A quantitative, comparison group, post-test design analyzed measure of health care access and health status. Descriptive analyses of averages and percentages characterized the study participants. Clients\u27 well-being was measured through The Ryff and Reyes Scale of Psychological Well-Being (RPWB). Statistical Package for the Social Sciences (SPSS) software organized, searched, and retrieved the collected data. The variables, subjects\u27 self reports of reduced number of visits to the ER, improved functional status, quality of life, knowledge of disease, clients\u27 demographics, age, ethnicity, cultural beliefs, health status, barriers to access to care, number of services, referrals, length of time in the program, use of health care facilities, resources, and the RPWB were measured

Moderating effect of traceability on value chain governance of credence goods: a perspective of the New Institutional Economics framework

This paper reviews the application of New Institutional Economics (NIE) theoretical assumptions and the way they relate to value chain governance and are moderated by traceability and information technology. Through literature review, NIE assumptions are examined by comparing how they are partially mitigated by traceability. The effect of these mitigations is realised in the readjustment of value chain governance typologies to suit lean and more competitive and visible value chains. The findings are based on the fact that information asymmetry, bounded rationality and behavioural uncertainty have given rise to incomplete contracts, especially in the agri-food sectors of most developing economies. Supply chain actors in this sector have the constant burden of assurance in ascertaining that credence goods remain authentically safe. The moderating effect of traceability is therefore proposed to reduce these uncertainties and is as such a form of assurance to promote both a holistic approach in compliance with standards and a seamless mechanism for product and process integration. However, this moderating effect, despite being novel in the value chain governance discourse, needs to be empirically ascertained. The novelty of this paper is based on the agricultural development agenda of developing economies in the light of the discourse on market-oriented reforms, following multilateral trade liberalisation and especially structural adjustment programmes in developing countries. The consequent increase in world market integration has led to the promotion of value chain strategies and reconsideration of how food is governed in these markets

Anorexia nervosa in Kenya

Background: Anorexia nervosa is a rare disorder in Africans, inspite of posing a serious public health hazard in the West. Whereas it is possible that African psychiatrists lack the skills to diagnose the disorder, other possible explanations for its apparent rarity must be sought in view of emerging evidence, which suggests a real lack of occurrence. Objectives: To establish the knowledge of practicing Kenyan psychiatrists about the signs, symptoms and management of anorexia nervosa and to establish the number of cases they had seen during all their years of practice of psychiatry. Design: Telephone survey and data collection: case-finding approach. Setting: Kenya, June 2001 Methods: Forty seven psychiatrists registered to practice in Kenya as of June 2001 qualified for inclusion. The respondents were interviewed on the same day, to reduce the likelihood of cross checking between colleagues. RK called each one, (all knew her) explained the nature of the survey and obtained verbal consent to administer the brief (10 minutes) questionnaire, developed by the authors for the purpose. Results: Twenty seven of all those eligible were reached on the day. All but one gave consent for the interview (55% response rate). The 20 who were not reached were similar to the respondents with regard to experience in psychiatry, (mean duration 11.4 versus 10.9yrs) but differed in their place of residence, the majority of those not reached resided out of Nairobi (60% versus 26%). In a cumulative total of 320 years of practice, they had seen 16 cases of which seven were of African origin. The rest were Caucasian or of Asian origin. The psychiatrists demonstrated adequate skill in recognising anorexia nervosa. Conclusion: Kenyan psychiatrists can recognise cases of anorexia nervosa. The condition is rare in Kenya. The reasons for this remain unclear and traditional explanations for its cause as due to pressure for thinness may not be adequate for the Kenyan case. East African Medical Journal Vol. 81 No. 4 April 2004: 188-19

Service Oriented Grid Computing Model as a means of Cost Sharing in the Institutions of Higher Learning in Kenya

The use of distributed systems by enterprises and academic institutions has increased exponentially in recent years, enabled by factors such as ready access to the Internet and the World-Wide Web, the maturity and ubiquity of the HTTP protocol, and the improvement in secure communication technology. In the early days, distributed applications communicated using proprietary protocols, and system administrators used adhoc (improvised) methods to manage systems that might be across town, on another continent, or anywhere in between. Numerous standards have been developed over the years to ease the costs of deployment and maintenance, with varying degrees of success. Today, the key technologies in distributed systems are service-oriented architecture (SOA), Web services, and grid computing, all of which are seeing significant investment in standardization and increasingly rapid adoption by organizations of all types and sizes. Academic organizations in Kenya have seen increase in the number of students admitted as well reduction in central government funding to these institutions to purchase more computer systems and procure management information systems .In this paper we offer a highlevel description of each of the technologies, and how they can be used to develop a cost effective co-funded dynamic system that can be used by the institutions

Service Oriented Grid Computing Model as a means of Cost Sharing in the Institutions of Higher Learning in Kenya

The use of distributed systems by enterprises and academic institutions has increased exponentially in recent years, enabled by factors such as ready access to the Internet and the World-Wide Web, the maturity and ubiquity of the HTTP protocol, and the improvement in secure communication technology. In the early days, distributed applications communicated using proprietary protocols, and system administrators used adhoc (improvised) methods to manage systems that might be across town, on another continent, or anywhere in between. Numerous standards have been developed over the years to ease the costs of deployment and maintenance, with varying degrees of success. Today, the key technologies in distributed systems are service-oriented architecture (SOA), Web services, and grid computing, all of which are seeing significant investment in standardization and increasingly rapid adoption by organizations of all types and sizes. Academic organizations in Kenya have seen increase in the number of students admitted as well reduction in central government funding to these institutions to purchase more computer systems and procure management information systems .In this paper we offer a high-level description of each of the technologies, and how they can be used to develop a cost effective co-funded dynamic system that can be used by the institutions. Keywords:service-oriented architecture, Web services, grid computing

The strategically located land index support system for human settlements land reform in South Africa

Abstract: Creating sustainable human settlements is fundamental in fostering spatial and socio-economic integration in South Africa. Policy makers are often faced with the problem of identifying strategically located land for human settlements land reform in South Africa. To date there is no tool or standard framework that assists the government to identify land that is strategically located for land reform. This study proposes the use of Geographic Information Systems (GIS), and Multi-Criteria Decision Making (MCDM) to develop a Strategically Located Land Index (SLLI) deployed in a web viewer to identify land that is smart for human settlements land reform. The study demonstrates that GIS,MCDMand the SLLI are invaluable tools in facilitating streamlined, coordinated, standardised and evidence-based decisions for human settlements land reform. However, there is need for capacity building in government departments responsible for land reform and development planning for the SLLI to be fully utilised