The VA Health Care System: An Unrecognized National Safety Net

The dominance of local health care markets in conjunction with variable public funding results in a national patchwork of "safety nets" and beneficiaries in the United States rather than a uniform system. This DataWatch describes how the recently reorganized Department of Veterans Affairs serves as a coordinated, national safety-net provider and characterizes the veterans who are not supported by the market-based system

Employing and Accommodating Individuals with Spinal Cord Injuries

This brochure on individuals with spinal cord injuries and the Americans with Disabilities Act (ADA) is one of a series on human resources practices and workplace accommodations for persons with disabilities edited by Susanne M. Bruyère, Ph.D., CRC, SPHR, Director, Program on Employment and Disability, School of Industrial and Labor Relations – Extension Division, Cornell University. Cornell University was funded in the early 1990’s by the U.S. Department of Education National Institute on Disability and Rehabilitation Research as a National Materials Development Project on the employment provisions (Title I) of the ADA (Grant #H133D10155). These updates, and the development of new brochures, have been funded by Cornell’s Program on Employment and Disability and the Pacific Disability and Business Technical Assistance Center

Locally-Owned Retail Stores and Downtown Revitalization:Investigating the Role of Place Attachment

Through revitalization, many downtown areas across the US are seeking to become shopping destinations by creating consumption spaces that are distinct from those in the suburbs. It is possible that the role of place and the bonds that people form with places are key factors involved in achieving the success of distinct consumption spaces. The purpose of this study was to understand the role of attachment to place within the dynamic that exists between local retail store ownership and downtown revitalization. An ethnographic approach to research was employed. Findings of this study highlight the importance of place attachment not just among participants as owners of small retail stores, but for the entire downtown as a community of retailers operating within an area that is being revitalized

Locally-Owned Retail Stores and the Revitalized Downtown: An Investigation of the Role of Civic Engagement and Local Capitalism

Downtown areas were once vital areas for commerce and consumption. Suburbanization changed this, vacating downtown for decentralized locations following the population sprawl. Recently the renaissance of many downtowns across the US has occurred, as locally-owned retailers returned to downtown areas and consumers are following by supporting these efforts. Civic engagement is key for downtown revitalization, and may occur more readily when linked with opportunities for consumption via local capitalism, providing a reason for people to return to downtown. Despite trends in downtown revitalization, few studies examine the topic, none link the locally-owned retail store to concepts of civic engagement and local capitalism. The purpose of this study was to explore how locally-owned retail stores offer a mechanism for revitalization that is fueled by civic engagement through both customers and store owners employing an ethnographic research design. Findings indicate that through local capitalism, civic engagement is key to successful downtown revitalization

Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene?

<p>Abstract</p> <p>Background</p> <p>Over the past twenty years, racial/ethnic disparities between late-stage diagnoses and mortality outcomes have widened due to disproportionate medical benefits that different racial/ethnic groups have received. Few studies to date have examined the spatial relationships of racial/ethnic disparities between breast cancer late-stage diagnosis and mortality as well as the impact of socioeconomic status (SES) on these two disparities at finer geographic scales.</p> <p>Methods</p> <p>Three methods were implemented to assess the spatial relationship between racial/ethnic disparities of breast cancer late-stage diagnosis and morality. First, this study used rate difference measure to test for racial/ethnic disparities in both late-stage diagnosis and mortality of female breast cancer in Texas during 1995-2005. Second, we used linear and logistic regression models to determine if there was a correlation between these two racial/ethnic disparities at the census tract level. Third, a geographically-weighted regression analysis was performed to evaluate if this correlation occurred after weighting for local neighbors.</p> <p>Results</p> <p>The spatial association of racial disparities was found to be significant between late-stage diagnosis and breast cancer mortality with odds ratios of 33.76 (CI: 23.96-47.57) for African Americans and 30.39 (CI: 22.09-41.82) for Hispanics. After adjusting for a SES cofounder, logistic regression models revealed a reduced, although still highly significant, odds ratio of 18.39 (CI: 12.79-26.44) for African-American women and 11.64 (CI: 8.29-16.34) for Hispanic women. Results of the logistic regression analysis indicated that census tracts with low and middle SES were more likely to show significant racial disparities of breast cancer late-stage diagnosis and mortality rates. However, values of local correlation coefficients suggested that the association of these two types of racial/ethnic disparities varied across geographic regions.</p> <p>Conclusions</p> <p>This study may have health-policy implications that can help early detection of breast cancer among disadvantaged minority groups through implementing effective intervention programs in targeted regions.</p

Occurrence of a Synchronous Hermaphroditic Striped Mullet, Mugil cephalus, from the Northern Gulf of Mexico

A synchronous hermaphroditic striped mullet, Mugil cephalus, was captured offshore of Southwest Pass, Louisiana on 6 December 1996 during the commercial roe mullet fishery harvest. The fish measured 412 mm FL, weighed 824 g and was determined to be 4 years old by otolith analysis. Gross examination of the gonads revealed four lobes: right and left ovaries and right and left testis which represents a unique occurrence among hermaphroditic fish. All lobes ended in a common sperm duct/oviduct with the exception of the left ovary which had no oviduct. Both ovaries contained vitellogenic oocytes and both testis had freely running spermatozoa. Histological examination showed many oocytes undergoing final oocyte maturation, the presence of some post ovulatory follicles and lobules full of tailed spermatozoa. There was no evidence of the intermingling of sperm and oocytes within the gonad. The capture of this fish on the spawning grounds and the advanced stage of both ovarian and testicular development suggests spawning probably would involve the release of both oocytes and spermatozoa

The Spitzer Warm Mission Science Prospects

After exhaustion of its cryogen, the Spitzer Space telescope will still have a fully functioning two-channel mid-IR camera that will have sensitivities better than any other ground or space-based telescopes until the launch of JWST. This document provides a description of the expected capabilities of Spitzer during its warm mission phase, and provides brief descriptions of several possible very large science programs that could be conducted. This information is intended to serve as input to a wide ranging discussion of the warm mission science, leading up to the Warm Mission Workshop in June 2007

Predictors of financial capacity performance in older adults using the Financial Competence Assessment Inventory

Background

Through An Equity Lens: Illuminating The Relationships Among Social Inequities, Stigma And Discrimination, And Patient Experiences of Emergency Health Care

People who experience the greatest social inequities often have poor experiences in emergency departments (EDs) so that they are deterred from seeking care, leave without care complete, receive inadequate care, and/or return repeatedly for unre- solved problems. However, efforts to measure and monitor experiences of care rarely capture the experiences of people facing the greatest inequities, experiences of discrimination, or relationships among these variables. This analysis examined how patients’ experiences, including self-reported ratings of care, experiences of discrimination, and repeat visits vary with social and economic circumstances. Every consecutive person presenting to three diverse EDs was invited if/when they were able to consent; 2424 provided demographic and contact information; and 1692 (70%) completed the survey. Latent class analysis (LCA) using sociodemographic variables: age, gender, financial strain, employment, housing stability, English as first language, born in Canada, and Indigenous identity, indicated a six-class solution. Classes differed significantly on having regular access to primary care, reasons for the visit, and acuity. Classes also differed on self-reported discrimination every day and during their ED visit, ratings of ED care, and number of ED visits within the past six months. ED care can be improved through attention to how intersecting forms of structural disadvantage and inequities affect patient experiences