Evaluating correctional health care. The lessons of New York City.

New York City's correctional health care system is a complicated one, with many component parts. Correspondingly, the task of developing an evaluation process to assess this system turned out to be complex as well. The major responsibility for developing such a process and for keeping it in motion lies with the Contract Evaluation Unit of the Department of Health. Our experiences in meeting these challenges, as well as the historical and institutional factors that have influenced our efforts, should be of interest to professional groups facing similar tasks in other localities and to readers curious about how particular health service evaluation approaches take form. This article describes our method, how it emerged, and that it entails, with an eye toward identifying what might usefully be applied to the study of other correctional health care services and settings.     

How Manual Object Exploration is Associated with 7‐ to 8‐Month‐Old Infants’ Visual Prediction Abilities in Spatial Object Processing

The present experiment examined whether infants’ visual prediction performance of the appearance of objects moving in space is related to their manual object exploration ability. Fifty‐five 7‐ to 8‐month‐old infants were tested. A visual object prediction paradigm was developed during which a three‐dimensional object was presented in a live eye‐tracking setting. During familiarization, the object rotated back and forth along the vertical axis. While the object was moving, two target parts of it were briefly occluded from view and uncovered again as the object changed its direction of motion. In the test phase, the entire object was rotated around 90° and now rotated along the horizontal axis. We recorded infants’ eye movements directed at the target locations and analyzed the prediction rates. All of the infants also participated in a manual object exploration task, in which they freely explored five toy blocks. Infants with a higher level of object exploration skill had higher prediction rates during test trials as compared to infants with less proficient object exploratory actions. The results support the interpretation that advanced manual object exploration experience is associated with infants’ advanced visual prediction ability of the appearance of objects moving in space.     

Applying RE-AIM to evaluate two community-based programs designed to improve access to eye care for those at high-risk for glaucoma

IntroductionGlaucoma is a leading cause of vision loss and blindness in the U.S. Risk factors include African American race, older age, family history of glaucoma, and diabetes. This paper describes the evaluation of a mobile eye health and a telemedicine program designed to improve access to eye care among people at high-risk for glaucoma.MethodsThe RE-AIM (reach, efficacy, adoption, implementation, and maintenance) evaluation framework was used to harmonize indicators. Both programs provided community-based eye health education and eye services related to glaucoma detection and care. Each program reported data on participants and community partners. An external evaluator conducted site visit interviews with program staff and community partners. Quantitative and qualitative data were integrated and analyzed using the RE-AIM dimensions.DiscussionBy targeting high-risk populations and providing comprehensive eye exams, both programs detected a large proportion of new glaucoma-related cases (17–19%) – a much larger proportion than that found in the general population (<2%). The educational intervention increased glaucoma knowledge; evidence that it led people to seek eye care was inconclusive.ConclusionsEvaluation findings from the mobile eye health program and the telemedicine program may provide useful information for wider implementation in public health clinics and in optometrist clinics located in retail outlets.     

Advances in Relating Eye Movements and Cognition

Measurement of eye movements is a powerful tool for investigating perceptual and cognitive function in both infants and adults. Straightforwardly, eye movements provide a multifaceted measure of performance. For example, the location of fixations, their duration, time of occurrence, and accuracy all are potentially revealing and often allow stronger inferences than measures such as percentage correct or reaction time. Another advantage is that eye movements are an implicit measure of performance and do not necessarily involve conscious processes. Indeed, they are often a more revealing measure than conscious report (Hayhoe, Bensinger, & Ballard, 1998). Although the mere presence of gaze at a particular location in the visual field does not reveal the variety of brain computations that might be operating at that moment, the experimental context within which the fixation occurs often provides critical information that allows powerful inferences. The articles in this thematic collection are excellent examples of this.     

A study of subjective visual disturbances in jewellery manufacturing

Subjective Visual Disturbances are silent adversaries that appear over a period of continued exposure and arise when the visual demands of the tasks exceed the visual abilities of the user. Jewellery manufacturing activity involves precision designs, setting the metal and stones, polishing and filing which requires higher visual demand. Therefore, it is expected that the jewellery manufacturing workers may experience subjective visual disturbances. This study was taken up with the following objectives 1) To study the presence of subjective visual disturbances among jewellery manufacturing workers and compare the same with VDT operators 2) To study the effect of work exposures on subjective visual disturbances and 3) to ascertain whether subjective visual disturbances have any permanent vision related problems. The study was carried out on jewellery manufacturing workers, VDT operators and on graduate students. The symptoms of subjective visual disturbances were identified using a questionnaire developed by Sheedy (2003). Viewing distances were measured and visual angles were calculated. The eye check--ups were also carried out. The subjective visual disturbances were higher in jewellery manufacturing workers. The findings suggest that work exposure has an impact on the causation of subjective visual disturbances. No pathological conditions of the eyes were observed.     

Lives in Motion: A Review of Former Foster Youth in the Context of their Experiences in the Child Welfare System

In light of the poor prospects facing many former foster youths during the transition to adulthood, it is surprising that so little attention has been given to substitute care contexts during child welfare system involvement. A review of child welfare research finds that many former foster youths go through an alarming number of placement changes and report a high rate of placement into congregate care settings and other unplanned events. Future research should take explicit account of substitute care contexts in designing and carrying out studies examining the adult outcomes of aging out foster care populations. Interventions intended to circumvent high rates of movement in foster care should also be broadened to target multiple aspects of substitute care contexts.     

Defining the challenges of providing long-term care: the case of the nursing home industry's response to the AIDS epidemic

Acquired Immune Deficiency Syndrome (AIDS) is now viewed as a chronic disease requiring long-term management. As a result, more persons with AIDS (PWAs) are seeking long-term care in facilities that have primarily served the elderly. In some regions, however, the nursing home market into which PWAs may introduce new demand is a market already characterized by excess demand. In light of this, competition for limited long-term care resources may develop between the frail elderly and PWAs. The nursing home industry has raised many issues regarding the feasibility of admitting AIDS patients as residents, but little is known about how important these issues are in deciding admissions policy. How the industry perceives and resolves the concerns it has regarding delivery of care to PWAs can affect the overall long-term care system and thus affect the traditional users-the frail elderly. Knowing the concerns and preferences of the industry may help guide and anticipate future changes in the system. In this pilot study, a random sample of 250 nursing home administrators in the five highest AIDS-incidence areas in the United States was surveyed to determine (1) the industry's concerns and issues regarding AIDS care, (2) data regarding requests for admission by PWAs to nursing homes, and (3) data concerning the industry's preferred way of delivering AIDS care. Important admissions policy issues cited by the respondents included the ability to meet special care needs, costs of care, and inadequate reimbursement. The majority also believed the most appropriate methods of providing care were special care units for AIDS within nursing homes or dedicated HIV/AIDS nursing facilities.     

Access to health care in urban areas of developing societies

Emphasis on rural health problems has led to a relative neglect of urban health issues in developing societies. Yet the fact that a large proportion of the limited financial and human resources is allocated to urban health care makes it imperative for researchers and health planners to evaluate the effectiveness of the urban health care system. This paper examines data on health care utilization from a sample survey of 1500 households conducted in three areas of Accra, Ghana in 1982. The factors that influence the use of three types of health care services (clinics, drug vendors, and traditional healers) are examined. Suggestions are made for increasing the effectiveness of the health care system in Accra, with the aim of making medical care more accessible to all families.     

Seeing a talking face matters: Infants' segmentation of continuous auditory-visual speech

Visual speech cues from a speaker's talking face aid speech segmentation in adults, but despite the importance of speech segmentation in language acquisition, little is known about the possible influence of visual speech on infants' speech segmentation. Here, to investigate whether there is facilitation of speech segmentation by visual information, two groups of English-learning 7-month-old infants were presented with continuous speech passages, one group with auditory-only (AO) speech and the other with auditory-visual (AV) speech. Additionally, the possible relation between infants' relative attention to the speaker's mouth versus eye regions and their segmentation performance was examined. Both the AO and the AV groups of infants successfully segmented words from the continuous speech stream, but segmentation performance persisted for longer for infants in the AV group. Interestingly, while AV group infants showed no significant relation between the relative amount of time spent fixating the speaker's mouth versus eyes and word segmentation, their attention to the mouth was greater than that of AO group infants, especially early in test trials. The results are discussed in relation to the possible pathways through which visual speech cues aid speech perception.     

Newborns' Memory Processes: A Study on the Effects of Retroactive Interference and Repetition Priming

Newborns' memory abilities have been shown in a number of studies. Yet little is known about whether many of the factors that are known to affect encoding, storage, and retrieval in older children and adults are also integral to memory processes at birth. Here we tested for the presence at birth of the retroactive interference and repetition priming effects using the visual paired comparison paradigm. Newborns' memory performance on a visual recognition task was prevented by the interposition of a distractor stimulus between the habituation and the test phase (retroactive interference, Experiment 1). However, forgetting was offset by further brief exposure to the familiar stimulus (repetition priming, Experiments 2 and 3).     

Psychiatric nursing in the 1990s & beyond.

In the decade of the '90s, psychiatric mental health nursing will need to take stock of itself--its practice, its education, and its research--if it is to successfully prepare for the changes in care of the mentally ill. Like psychiatrists, we will need to rethink our agendas in light of new science and technology and rationalize the mental health delivery system and our role in it through systematic research and advocate for a system that provides quality care for the chronically ill and the poor. In the next century, we will need to rethink the basics of nursing care and the leadership roles of nurses as hospitals and the doctor's role within them changes. Psychiatric mental health nurses will need to be at the forefront in advocating for a delivery system that listens to patients and families, that humanizes the dehumanizing experience of hospitalization. The challenges before us are formidable.     

Analyse visuelle e représentation de la réalité

The author's objective is to establish a relationship between the theoretical structure at the basis of a qualitative sociological analysis and the forms of visual representation of social reality, such as photography and social documentaries. Visual material becomes an object of analysis when it refers to a society that talks about itself and when it reproduces a reality which it records and makes nameable. The theme of observation is characterized by a complex activity in which perception, imagination, and representation are different functions from the sociological point of view, yet strongly connected because they make it possible for the researcher to interact visually with social reality. Observation procedures ask sociologists to have an eye capable of recognizing and perceiving in a representative way the experiences they have lived and the social facts they have observed and described. These must be portrayed not only as suggestive visual metaphors, but also as a consequence of ‘sensitive hearing’ which is essential in all research phases, from anthropology to ethnography and sociology.     

Behavioral and Cortical Measures of Infants' Visual Expectations

Features of the habituation paradigm were combined with the visual expectation paradigm to examine behavioral and cortical indexes of infants' visual expectations. Eight 3‐month‐old infants watched an alternating picture sequence while their eye movements were videotaped and their cortical electrophysiological activity (event‐related potential [ERP]) was recorded. Two ERP epochs were examined: a 3,000‐msec stimulus‐locked epoch included 1,000 msec before stimulus onset through 1,000 msec after stimulus offset; and a 1,200‐msec response‐locked epoch included 700 msec before saccade onset through 500 msec after the saccade. All infants anticipated upcoming pictures, and eye movement latencies for pictures that were not anticipated were comparable to saccade latencies reported in other visual expectation studies of infants at this age. Three components were identified in the stimulus‐locked ERP waveform: a slowly developing negativity prior to picture onset, a postonset negative slow wave, and a late negative deflection that peaked about 750 msec after picture onset. All stimulus‐locked components were larger for familiar than for unfamiliar pictures; prestimulus negativity was also greater before anticipated pictures. The response‐locked waveform contained 2 prominent features: a slowly increasing negative shift (NS) that began about 500 msec before saccade onset and a positive presaccadic potential that occurred about 30 to 90 msec before the saccade. Response‐locked components were larger for anticipatory saccades at the frontal scalp site; for reactive saccades, response‐locked components were larger at the vertex. Results are informative about ERPs in infants, cortical control of eye movements, and the development of visual expectations.     

Expanding transnational care networks: comparing caring for families with caring for homes

Although many factors may motivate a migrant to own a house in their country of origin, significant practical labour is needed to maintain it, as both a material structure intended for shelter and as a symbolic object reflecting attachment to a place of origin. Most research in this area focuses on the significance accorded to transnational houses by their owners and families connoted by the ‘myth of return’, but little attention has been given to how the labour of ownership – constructing, maintaining, overseeing and improving the house – is accomplished. In the light of emerging studies on the care labour that remittance houses require, this article suggests a theoretical framework for studying networks of transnational house maintenance on three dimensions of care – trust, communication, and remittances – observed in networks for transnational family care provisions. A review of literature on transnational home ownership indicates that these dimensions are also present, with some differences in application.     

Looked after children and offending: An exploration of risk,resilience and the role of social cognition

There have been serious concerns in the UK about the number of young people who are looked after in state care but are also young offenders. The relationship between the care system and offending is complex, since there are shared risk factors, in particular histories of poor parenting, abuse and neglect. This article reports on a mixed methods study. It focuses on findings regarding a sample of 100 young people (age 14–19), using data from file searches, psychological measures and narrative interviews. The sample was made up of three sub-samples — looked after young people who had offended, looked after young people who had not offended and young people who had offended but were not looked after. This paper presents the study's findings in relation to the characteristics and pathways of these groups. It illustrates the range and interaction of individual, family and education and activity risk and resilience factors. In particular, it highlights the role of social cognition deficits in increasing the risk of offending for young people in state care. It also identifies the significance of relationships and constructive activity in promoting resilience.     

A further look at equilibrium theory: Visual interaction as a function of interpersonal distance

This paper presents a study that examined the relationship between visual interaction and interpersonal distance as it relates to an equilibrium theory of social interaction. Differential boundaries were found to exist for the effect of distance on five highly related male and female visual behaviors, exemplifying different overall equilibrium levels for the sexes. While males looked more as distance increased, females looked less after an intermediate distance of 6.5 feet. These data support a modified equilibrium model that posits that eye contact functions to regulate the comfort of an interaction and is also a response to the degree of interaction comfort; further, comfortable interaction distances promote eye contact and, more importantly, uncomfortable distances diminish it. Because women tend to be more oriented toward inclusive relationships, they are more comfortable at closer interaction distances and, hence, look more at these distances. At greater distance, however, they are more uncomfortable and, consequently, look less.This research was supported by NIMH Grant MH-10779-04, grants from the Research Council of Rutgers University, and Grant HD-8546-01 from the National Institute of Child Health and Human Development. This article is based in part on the author's doctoral dissertation completed at Michigan State University; some of these data were presented at the meeting of the Eastern Psychological Association, Washington, D.C., 1973. The author is very grateful to the numerous students who assisted in these studies and to Jeanne Gullahorn, Eugene Jacobson, Lawrence Messe, William Crano, Yakov Epstein, and Miles Patterson for their critical reading of early drafts of this research.     

Understanding Nurse Perceptions of a Newly Implemented Electronic Medical Record System

Nurses are the frontline of healthcare; however, there has been little theoretically-driven research on their acceptance of information technology use in care delivery. This research utilized the unified theory of acceptance and use of technology (UTAUT) model to understand how hospital nurses perceived the implementation of a new electronic medical record (EMR) system. This study used mix methods. The survey responses indicated that social influence and performance expectancy were significant factors in system adoption. Effort expectancy did not have a significant influence on the intention to use the EMR. The interviews were utilized to better understand these results. The UTAUT model highlighted factors that are important to nurses during an EMR deployment and can help in future implementations of technology in healthcare.     

Incidence and risk factors for symptoms from the eyes among professional computer users

Personal computers are used by a majority of the working population in their professions. Little is known about risk-factors for incident symptoms from the eyes among professional computer users. The aim was to study the incidence and risk-factors for symptoms from the eyes among professional computer users.This study is a part of a comprehensive prospective follow-up study of factors associated with the incidence of symptoms among professional computer users. 1531 computer users of different professions at 46 companies were invited, whereof 1283 answered a baseline questionnaire (498 men; 785 women) and 1246 at least one of 10 monthly follow-up questionnaires. The computer work-station and equipment were generally of a good standard. The majority used CRT displays.During the follow-up period 329 subjects reported eye symptoms. The overall incidence rate in the whole study group was 0.38 per person-year, 0.23 in the subgroup of subjects who were symptom free at baseline and 1.06 among subjects who reported eye symptoms at baseline. In the bivariate analyses significant associations were found with all explanatory variables, except BMI. The reduced multivariate model showed significant associations with extended computer work, visual discomfort (dose-response), eye symptoms at baseline (higher risk), sex (women=higher risk) and nicotine use.The incidence of eye problems among professional computer users is high and related to both individual and work-related factors.