Indicators of need for health care personnel: the concept of need, alternative measures employed to determine need, and a suggested model.
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Biomedical subjects
Publications and source records attributed to T Choi.
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Overhand throwing requires contributions from and interaction between all limb segments. Most previous investigations have concentrated on the throwing arm itself, yet poor mechanics at the arm may originate in the lower extremities. Multicomponent ground-reaction forces of both the push-off and landing limbs were measured in six collegiate and one high school level baseball pitchers. Full body kinematics were simultaneously recorded to correlate phases in the pitching cycle with the force data. Pitchers were found to generate shear forces of 0.35 body weight in the direction of the pitch with the push-off leg and to resist forces of 0.72 body weight with the landing leg. Wrist velocity was found to correlate highly with increased leg drive. This study validates the clinical impression that the lower extremity is an important contributor to the throwing motion. Based on this study, strengthening of the lower extremities could be inferred to be important both to enhance performance and to avoid injury.
Home care programs for severely disabled, usually technology-dependent, children got a boost in 1981 when the Federal Government gave States permission to use Medicaid to fund home care under the Medicaid model home- and community-based waiver (2176). The model waiver program was unique because it eliminated the bias toward hospitalization by waiving parental income and assets when determining eligibility for children cared for at home and by allowing Medicaid to cover needed home care services. In 1985 Minnesota received Federal approval for the model waiver, and the results are detailed in this report. Although the waiver could provide funding for up to 50 children, after 2 years only 24 children had received approval. Stringent and complex eligibility criteria acted as barriers to accessing the model waiver. In addition, the interaction between the waiver and the State's health care system contributed to inconsistencies in eligibility. This interaction demonstrates the difficulty of administering publicly funded programs in the current health care environment. Recommendations are made for adjusting criteria for eligibility in the waiver program. Unresolved problems facing technology-dependent children on home care programs are discussed.