scholarly journals Twenty-Five Years After the ADA: Situating Disability in America’s System of Stratification

2020 ◽  
Author(s):  
Michelle Lee Maroto ◽  
David Pettinicchio
Keyword(s):  
Significant Proportion ◽  
The United States ◽  
Capitalist System ◽  
Current Population Survey Data ◽  
Employer Attitudes ◽  
System P ◽  
Disability Status ◽  
Economic Downturns ◽  
Stratification System ◽  
Sociological Studies

Americans with disabilities represent a significant proportion of the population. Despite their numbers and the economic hardships they face, disability is often excluded from general sociological studies of stratification and inequality. To address some of these omissions, this paper focuses on employment and earnings inequality by disability status in the United States since the enactment of the 1990 Americans with Disabilities Act (ADA), a policy that affects many Americans. After using Current Population Survey data from 1988-2014 to describe these continuing disparities, we review research that incorporates multiple theories to explain continuing gaps in employment and earnings by disability status. In addition to theories pointing to the so-called failures of the ADA, explanations also include general criticisms of the capitalist system and economic downturns, dependence on social welfare and disability benefits, the nature of work, and employer attitudes. We conclude with a call for additional research on disability and discrimination that helps to better situate disability within the American stratification system.

scholarly journals Twenty-Five Years After the ADA: Situating Disability in America’s System of Stratification

2015 ◽  
Vol 35 (3) ◽  
Author(s):  
Michelle Maroto ◽  
David Pettinicchio
Keyword(s):  
Population Survey ◽  
Significant Proportion ◽  
The United States ◽  
Capitalist System ◽  
Current Population Survey Data ◽  
Employer Attitudes ◽  
Disability Status ◽  
Economic Downturns ◽  
Stratification System ◽  
Sociological Studies

<p>Americans with disabilities represent a significant proportion of the population. Despite their numbers and the economic hardships they face, disability is often excluded from general sociological studies of stratification and inequality. To address some of these omissions, this paper focuses on employment and earnings inequality by disability status in the United States since the enactment of the 1990 Americans with Disabilities Act (ADA), a policy that affects many Americans. After using Current Population Survey data from 1988-2014 to describe these continuing disparities, we review research that incorporates multiple theories to explain continuing gaps in employment and earnings by disability status. In addition to theories pointing to the so-called failures of the ADA, explanations also include general criticisms of the capitalist system and economic downturns, dependence on social welfare and disability benefits, the nature of work, and employer attitudes. We conclude with a call for additional research on disability and discrimination that helps to better situate disability within the American stratification system.</p><p>&nbsp;</p>

The Postwar Settlement

2014 ◽  
Author(s):  
Daniel Stedman Jones
Keyword(s):  
Great Britain ◽  
Liberal Democracy ◽  
The United States ◽  
The Political ◽  
Top Down ◽  
Capitalist System ◽  
System P ◽  
Policy Elite ◽  
Franklin Roosevelt ◽  
Political Settlement

This chapter describes the contours and limits of the political settlement in Great Britain and the United States in the middle of the twentieth century. It shows how at the heart of both New Deal liberalism and the British Liberal and Labour reforms was a happy conception of the state so long as its power was in the hands of an enlightened and expert policy elite. The famous Brain Trust around Franklin Roosevelt and the progressive liberal civil service personified by Beveridge and Keynes fit exactly this notion of top-down reform for the benefit of society as a whole. The progressive liberal project was not revolutionary; it was born of a desire to preserve and defend liberal democracy and the capitalist system.

The Child Protection System

2019 ◽  
pp. 391-414
Author(s):  
Richard J. Gelles
Keyword(s):  
Child Protection ◽  
The United States ◽  
Family Preservation ◽  
Child Protective Service ◽  
Protective Service ◽  
System P ◽  
Abuse And Neglect ◽  
Protective System ◽  
The Common ◽  
Home Placement

This chapter examines the child protective system in the United States by first examining the scaffolding created by federal legislation and federal funding. Next, it reviews three significant Supreme Court decisions that bear on the operation of child protective service systems. Lastly, it examines the common process and flow of individual cases of child abuse and neglect from initial reporting, through investigation, service response, possible out-of-home placement, and finally decisions regarding when and why to close the case. The conclusion discusses the three core goals of the child protective service system: safety and wellbeing of children; permanency of caregiving; and family preservation.

Weatherwise: Evaluation of a Cue-Based Training Approach for the Recognition of Deteriorating Weather Conditions during Flight

2003 ◽  
Vol 45 (2) ◽  
pp. 337-345 ◽  
Author(s):  
Mark Wiggins ◽  
David O'Hare
Keyword(s):  
Decision Making ◽  
Significant Proportion ◽  
Evaluation Process ◽  
Weather Conditions ◽  
The United States ◽  
Training System ◽  
General Aviation ◽  
Self Report ◽  
Computer Based Training ◽  
Computer Based

Inappropriate and ineffective weather-related decision making continues to account for a significant proportion of general aviation fatalities in the United States and elsewhere. This study details the evaluation of a computer-based training system that was developed to provide visual pilots with the skills necessary to recognize and respond to the cues associated with deteriorating weather conditions during flight. A total of 66 pilots were assigned to one of two groups, and the evaluation process was undertaken at both a self-report and performance level. At the self-report level, the results suggested that pilots were more likely to use the cues following exposure to the training program. From a performance perspective, there is evidence to suggest that cue-based training can improve the timeliness of weather-related decision making during visual flight rules flight. Actual or potential applications of this research include the development of computer-based training systems for fault diagnosis in complex industrial environments.

Asthma

2020 ◽  
Author(s):  
Haitham Nsour ◽  
Anne E. Dixon
Keyword(s):  
Emergency Department ◽  
Inhaled Corticosteroids ◽  
Early Recognition ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Significant Proportion ◽  
The United States ◽  
Asthma Prevalence ◽  
Public Health Burden ◽  
Asthma Exacerbations ◽  
Oral Corticosteroids

Asthma is one of the most common diseases in developed nations. A pathognomonic feature of asthma is episodic aggravations of the disease; these exacerbations can be life-threatening and contribute to a significant proportion of the public health burden of asthma. In the emergency department, successful management of asthma exacerbations requires early recognition and intervention before they become severe and potentially fatal. This review summarizes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for asthma. Figures show the management of asthma exacerbations in the emergency department and hospital, pooled odds ratio comparing inhaled corticosteroids and oral corticosteroids with oral corticosteroids alone following emergency department discharge, and an asthma discharge plan at the emergency department. Tables list current asthma prevalence among selected demographic groups in the United States, risk factors for fatal asthma exacerbations, differential diagnosis of asthma exacerbations, and dosages of drugs for asthma exacerbations. This review contains 3 figures, 16 tables, and 88 references. Key Words: Asthma, allergic bronchopulmonary aspergillosis, gastroesophageal reflux disease, sinus disease, breathlessness, shortness of breath  

Investigation and Review of Unexpected Infant and Child Deaths

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 734-735
Author(s):  
Keyword(s):  
Public Health ◽  
United States ◽  
Child Abuse ◽  
Child Death ◽  
Significant Proportion ◽  
The United States ◽  
Medical Examiner ◽  
Sudden Infant ◽  
Child Deaths ◽  
Death Investigation

A significant proportion of infant and child deaths are preventable. Of the 55 861 deaths of children aged 14 and younger in the United States in 1989, more than three fourths occurred in children under the age of 2 years.1 Approximately one third of the latter were unexpected, including those due to sudden infant death syndrome (SIDS) or trauma, or deaths that were otherwise unexplained. Child abuse deaths occur in greatest numbers among infants, followed by those in toddlers and preschool children.2 Children younger than 6 years of age are most vulnerable to abuse because of their small size, incomplete verbal skills, and often limited contact with adults other than their primary caretakers.3 With few exceptions, throughout the United States there is no uniform system for the investigation of infant and child deaths. Many jurisdictions lack appropriately trained pathologists, interagency collaboration hat would facilitate sharing of information about the family, and a surveillance system to evaluate data regarding infant deaths. As a result, progress in the understanding of SIDS is inhibited, cases of child abuse and neglect may be missed, familial genetic diseases go undiagnosed, public health threats may be unrecognized, and inadequate medical care may be undetected. Lack of adequate infant and child death investigation is an impediment to preventing illness, injury and death of other children at risk. Adequate death investigation requires the participation of numerous individuals including medical examiner/coroner, public health officials, the patient's physician, the pathologist, and personnel from agencies involved with child welfare and social services and law enforcement.

The Economics of Long-Term Care

2013 ◽  
Vol 14 (2) ◽  
pp. 343-375 ◽  
Author(s):  
Luigi Siciliani
Keyword(s):  
Long Term Care ◽  
Private Insurance ◽  
Care Home ◽  
Significant Proportion ◽  
Empirical Work ◽  
The United States ◽  
Ageing Population ◽  
Public Insurance ◽  
Term Care

Abstract Long-term care expenditure is expected to rise, driven by an ageing population. Given that public long-term care expenditure is high in many OECD countries, governments are increasingly concerned about its future growth. This study focuses on three relevant issues. First, we discuss factors that affect the growth of long-term expenditure and its projections. These include demographics, the balance in provision between informal and formal care, whether higher life expectancy translates into higher disability, the interrelation between health and long-term care, and whether long-term care suffers from Baumol’s disease. Second, given that a significant proportion of long-term care expenditure is nursing- and care-home expenditure, we discuss the role of government regulation aimed at ensuring that individuals receive appropriate quality of care in such institutions. We focus in particular on price regulation, competition, and the non-profit sector; these have been the subject of considerable empirical work (mainly in the United States). Third, we discuss the relative merits of public and private insurance. Countries differ greatly in their approach. Some countries have nearly exclusively public insurance but in others this is small. We consider the conditions under which public insurance can overcome the limitations of a private insurance market.

scholarly journals SURG-26. READMISSION FOLLOWING RESECTION FOR PATIENTS WITH BRAIN METASTASES IN THE UNITED STATES

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi245-vi245
Author(s):  
Rupesh Kotecha ◽  
Muni Rubens ◽  
Sergio Gonzalez-Arias ◽  
Vitaly Siomin ◽  
Matthew Hall ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Systemic Disease ◽  
Significant Proportion ◽  
The United States ◽  
Patient Specific ◽  
Unplanned Readmission ◽  
Readmission Rates ◽  
Operative Care ◽  
Nationally Representative

Abstract OBJECTIVE Up to 30% of cancer patients will develop brain metastasis during the course of their systemic disease with a significant proportion undergoing resection of at least one lesion. The objective of the present study was to characterize the rates, predictors, and costs of 30-day readmissions following craniotomy for brain metastases using a nationally representative database. METHODS This study was a retrospective analysis of data from the Nationwide Readmissions Database (NRD) from 2010–2014. We included patients who underwent craniotomy for brain metastasis, identified using ICD-9-CM diagnosis (198.3) and procedure (01.59) codes. The primary outcome of the study was unplanned 30-day all-cause readmission rates. Secondary outcomes included predictors and costs of readmissions. RESULTS During the study period, there were 44,846 index hospitalizations for patients who underwent resection of brain metastasis. Among this cohort, 17.8% (n=7,965) had unplanned readmissions within the first 30 days after discharge from the index hospitalization. The readmission rate did not change significantly during the study period (P=0.286). The odds of unplanned readmission were significantly greater in patients with thromboembolic complications (aOR, 1.53; 95% CI: 1.18–2.01), patients with Elixhauser comorbidities >3 (aOR, 1.35; 95% CI: 1.22–1.50), male patients (adjusted odds ratio [aOR], 1.29; 95% CI: 1.17–1.42), patients with an initial length of stay ≥5 days (aOR, 1.02; 95% CI: 1.01–1.03). The median per-patient cost for 30-day unplanned readmission was $11,109 and this accounted for a total cost of $132.1 million during the study period. CONCLUSIONS Unplanned readmissions after resection for brain metastases involve substantial healthcare expenditures. Though there have been many interventions for improving surgical quality, post-operative care, and cost metrics, unplanned readmission rates have not changed. Key patient-specific variables and high rates of comorbidities should be considered to focus our efforts on patient selection for resection, and for strengthening existing interventions for high-risk patients.

scholarly journals Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory

10.2196/23660 ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. e23660
Author(s):  
Markus W Haun ◽  
Isabella Stephan ◽  
Michel Wensing ◽  
Mechthild Hartmann ◽  
Mariell Hoffmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Diffusion Of Innovations ◽  
Significant Proportion ◽  
The United States ◽  
Diffusion Of Innovations Theory ◽  
Early Adopters ◽  
Adopter Categories

Background Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. Objective This mixed method preimplementation study aims to assess GPs’ intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). Methods Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. Results This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, P<.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. Conclusions A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.

scholarly journals Case series and review of Ayurvedic medication induced liver injury

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher M. Karousatos ◽  
Justin K. Lee ◽  
David R. Braxton ◽  
Tse-Ling Fong
Keyword(s):  
Liver Injury ◽  
Plant Extracts ◽  
Significant Proportion ◽  
Case Series ◽  
The United States ◽  
Tinospora Cordifolia ◽  
Individual Plant ◽  
Medicine Use ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Abstract Background Complementary and alternative medicine use among Americans is prevalent. Originating in India, Ayurvedic medicine use in the United States has grown 57% since 2002. CAM accounts for a significant proportion of drug induced liver injury in India and China, but there have been only three reports of drug induced liver injury from Ayurvedic medications in the U.S. We report three cases of suspected Ayurvedic medication associated liver injury seen at a Southern California community hospital and review literature of Ayurvedic medication induced liver injury. Case presentations Three patients presented with acute hepatocellular injury and jaundice after taking Ayurvedic supplements for 90–120 days. First patient took Giloy Kwath consisting solely of Tinospora cordifolia. Second patient took Manjishthadi Kwatham and Aragwadhi Kwatham, which contained 52 and 10 individual plant extracts, respectively. Third patient took Kanchnar Guggulu, containing 10 individual plant extracts. Aminotransferase activities decreased 50% in < 30 days and all 3 patients made a full recovery. Roussel Uclaf Causality Assessment Method (RUCAM) scores were 7–8, indicating probable causality. These products all contained ingredients in other Ayurvedic and traditional Chinese medicines with previously reported associations with drug induced liver injury. Conclusions These patients highlight the risk of drug induced liver injury from Ayurvedic medications and the complexity of determining causality. There is a need for a platform like LiverTox.gov to catalog Ayurvedic ingredients causing liver damage.

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