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Hearing access 2000. Increasing awareness of the hearing impaired.

Because 90% of all institutionalized elderly have a hearing impairment, nurses in long-term care facilities need to improve the care of the hearing impaired patient and contribute to increasing communication access. The purpose of the Hearing Access 2000 program is to make public facilities more accessible by increasing awareness of the needs of the hearing impaired. Implementation of the program includes an inventory of hearing aids, staff in-service programs, use of assistive devices, otoscopic examinations, cerumen removal protocol, and the use of tent cards, buttons, and posters.

Aged↗

[Effectiveness (accessibility and compliance) of a program of early diagnosis of pulmonary tuberculosis in a penitentiary population].

The aim of the study was to determine the effectiveness of a pulmonary tuberculosis detection Program in a Spanish prison (280-320 inmates) with a high turn-over rate (500 entries annually). 754 prisoners without antituberculous chemotherapic or chemoprophylaxis were included. 642 (85.1%) had access to the Program; the highest percentage of access was obtained when tuberculin test was performed at the entrance (96.4%) versus 80.5% when it was differed (P < 0.000001). The compliance observed was 82.2%, with no evidence that a greater accessibility was influential al all. The effectiveness was 70%, greater when tuberculin test was performed at the entrance in prison (76.7%) versus 66.8% when it was differed (P < 0.000001). We conclude that since pulmonary tuberculosis rates in prisons are so high and since it is possible to obtain a high effectiveness in detection programs, if were generalize these programs in concurrence with an adequate treatment of tuberculosis cases we shall obtain high efficiency rates.

Adolescent↗

[The fertility transition in Latin America].

"In this article fertility behaviour is analyzed between 1950 and 1990, and Latin American countries are classified according to the stages of the transition process. The analysis of fertility decline by age of women indicates that the decrease was more pronounced in women 30 years and over, due principally to a broader access to family planning services. Differences in fertility behaviour by level of urbanization, education and occupation were also analyzed." (SUMMARY IN ENG)

Age Factors↗

UN conference reaffirms reproductive rights.

The United Nations Conference on Human Settlements, also known as the Habitat II conference, met in Istanbul from June 3 to 14. It was the last major UN gathering of this millennium and the first major UN meeting since 1995's Fourth World Conference on Women (the "Beijing Conference")--and thus an important opportunity for a wider international community to weigh in on agreements reached in Beijing and at the International Conference on Population and Development, held in Cairo in 1994. The final document that emerged from Habitat II, the "Global Plan of Action," affirmed crucial elements of those earlier accords. The Habitat documents calls for action to "[d]evelop and implement programmes to ensure universal access for women throughout their life-span to a full range of affordable health care services, including those related to reproductive health care, which includes family planning and sexual health, consistent with the Report of the International Conference on Population and Development." Language adopted at the Cairo meeting is also affirmed in Habitat's call for "universal access to the widest range of primary health care services." Perhaps most significantly, the Istanbul document reiterated an important declaration from the Beijing conference: "While the significance of national and regional particularities and various historical, cultural, and religious backgrounds must be borne in mind, it is the duty of all States to promote and protect all human rights and fundamental freedoms." Most of the 189 UN members and observer states that attended the conference upheld all three of these provisions. Only a small group of states--Argentina, Guatemala, Iran, Jordan, Lebanon, Malta, Qatar, Saudi Arabia, Sudan, Syria, United Arab Emirates, Yemen, and the Holy See--filed reservations on the health care sections.

Delivery of Health Care↗

Lay patient navigator program implementation for equal access to cancer care and clinical trials: essential steps and initial challenges.

BACKGROUND: Disparities in cancer detection, treatment, and outcomes among racial/ethnic minorities and low-income patients are well documented. One way to reduce these disparities is to use patient navigators to address barriers to care. However, little information about optimal characteristics of navigator programs or considerations for those interested in setting up such programs is available. METHODS: The design and implementation of a patient navigator program for underserved cancer patients in an urban, nonacademic community hospital setting is described. The program, which used lay navigators, was conceived as a component of the Urban Latino African American Cancer (ULAAC) Disparities Project in South Los Angeles, a National Cancer Institute (NCI)-sponsored project to improve cancer care and clinical trial access for minority and low-income patients. RESULTS: Careful initial planning, including input from a community advisory committee, was essential to smooth program implementation. Thirty-one volunteers completed navigator training in the program's first year of operation. Of 135 patients offered navigation services, 75 (56%) accepted, and preliminary feedback from patients, navigators, and providers suggests high levels of satisfaction with navigation. Standardized templates used by navigators and staff to record key information are proving helpful for monitoring quality and outcomes (such as effectiveness in addressing specific barriers to care) and continually improving the program. CONCLUSIONS: The ULAAC program represents a viable model for developing lay navigator programs in community hospitals. Preliminary assessments suggest that the program has a positive effect on minority and low-income cancer patients' experience with care and reduces barriers to care. Additional time and research are needed, however, to fully assess the impact on care and outcomes.

Clinical Trials as Topic↗

HRSA's Models That Work Program: implications for improving access to primary health care.

The main objective of the Models That Work Campaign (MTW) is improving access to health care for vulnerable and underserved populations. A collaboration between the Bureau of Primary Health Care (BPHC) at the Health Resources and Services Administration (HRSA) and 39 cosponsors--among them national associations, state and federal agencies, community-based organizations, foundations, and businesses--this initiative gives recognition and visibility to innovative and effective service delivery models. Models are selected based on a set of criteria that includes delivery of high quality primary care services, community participation, integration of health and social services, quantifiable outcomes, and replicability. Winners of the competition are showcased nationally and hired to provide training to other communities, to document and publish their strategies, and to provide onsite technical assistance on request.

Adult↗

A focus group study of accessibility and related psychosocial issues in diabetes education for people with visual impairment.

PURPOSE: This study was conducted to identify accessibility and related psychosocial issues in diabetes care and education for visually impaired adults who have diabetes. METHODS: Two focus groups of adults with visual impairment and diabetes were conducted; data were recorded and analyzed. RESULTS: The 3 main issues identified were lack of access to up-to-date diabetes information in an accessible format, lack of understanding by healthcare providers of the needs and competencies of people with both visual impairment and diabetes, and lack of access to nonvisual diabetes self-management equipment. CONCLUSIONS: This study provides qualitative support for the view that visually impaired people in the United States may, as a group, be systematically excluded from receiving high quality diabetes care and education. Equal access to diabetes care and education for visually impaired people requires increased accessibility of diabetes care and education programs, and increased professional and public awareness that the diabetes programs are accessible. Some specific recommendations are to make all patient education materials available in low-vision/nonvisual formats and to teach all diabetes education professionals how to work effectively with visually impaired people.

Adult↗

[The demographic structure and fertility levels of the population in the new and old slum areas of a "gecekondu" settlement in Antalya Province center].

"The demographic structure and fertility level of the population in two slum areas [in Turkey's Antalya Province]...were investigated with a cross-sectional study in 1989. It was found that the distribution of population by age groups differed and especially the fertility measurements were high in the new area in relation to various social and demographic characteristics. In order to facilitate and accelerate the transition period of slum communities, it is necessary to provide health education, mother and child health and family planning services." (SUMMARY IN ENG)

Age Distribution↗